Biomedical subjects
Publications and source records attributed to J E Terry.
Since the cornea responds to various toxic stimuli by swelling and ulcerating, these changes may assume a dendriform pattern. A case of herpes simplex dendritic keratitis is presented along with its treatment. In addition, several other etiologic sources of an arborescent keratitis are discussed as to their differentiation and management implication.
Slit lamp biomicroscopy provides invaluable diagnostic information as to the nature of ocular abnormalities and disease processes. As such, the emphasis to be presented in this discourse is biomicroscopic interpretation, as opposed to simple observation, with each major ocular structure discussed in turn.
Using a micro-osmometry technique, 450 nonreflex tear samples were collected hourly from six subjects throughout their waking hours, and on initial opening of the eyes following six to eight hours of sleep. While the waking day mean found for this population agreed closely with current values in the literature, considerable variation did occur among individuals, both in their mean as well as in their hour-to-hour levels. The prolonged lid closure condition resulted in a considerable decrease in tear osmotic pressure and was found to be significantly different from the open-eye condition (P less than .001). No significant differences could be shown however between findings for men and women for either condition, and no consistent impact of food or fluid intake could be demonstrated.
Antepartum fetal evaluation by heart rate monitoring was carried out on a clinical service during a 1-year period utilizing the nonstress test as the primary screening device. Nonreactive nonstress tests were supplemented by the oxytocin contraction stress test. In this study, the use of the nonstress test appropriately led to the identification of all fetuses who were in jeopardy and, in the majority of instances, identified fetuses in good condition who did not require the administration of oxytocin to determine fetal well-being. In our experience, the nonstress test is a reliable, inexpensive, convenient, time-saving screening procedure which can be made available to a greater number of patients than the contraction stress test alone.
Using a precision thermocouple hygrometer, requiring just 5 microliters of sample, the tear osmotic pressures of 6 subjects were monitored throughout their adaptation to rigid contact lenses. Relative to the prefitting baselines established for each previous to this study, these subjects showed a range of hypotonic shifts on initially receiving their lenses, but this imbalance was rectified by the end of the first wearing week and a new relatively hypertonic level of tear osmotic pressure was commonly established. This new baseline was reflected in the pre-insertion samples of several of the subjects as well once adaptation was advanced.
Ocular mydriatics are diagnostic agents that generally facilitate a preferable ophthalmoscopic examination. However, the optometrist should be aware of certain iatrogenic side effects including the precipitation of an acute angle-closure. The purpose of this paper is to summarize the mechanism of mydriatic angle-closure glaucoma. In addition, a shallow anterior chamber is a fundamental ocular variable which should be evaluated before inducing mydriasis and/or cycloplegia. The technical procedures for the oblique illumination shadow test and the van Herick slit lamp test are presented, both of which provide an accurate estimation of the anterior chamber angle. The risk of precipitating an attack after reasonable circumspection by such evaluations approaches zero. However, should an attack occur, the procedures to rapidly lower the intraocular pressure and open the chamber angle are discussed.
Patients were found to differ in their prefitted tear osmotic baselines. Although such differences appeared small, they did represent the "safety margin" (i.e., against osmotic edema) each patient had against a "hypotonic shift" when receiving a hard (PMMA) contact lens.
In a sample of 212 eyes of patients referred to an ocular pathology clinic, measures of intraocular pressure (IOP) using the non-contact tonometer (NCT) and the Mackay-Marg tonometer were highly correlated (+0.91), the NCT MEASURES BEING LOWER BY AN AVERAGE OF 6.5 MM Hg. In a general optometry clinic, the mean IOP as measured with the NCT on 987 eyes of patients, ages 7 to 85 years, was 15.7 mm Hg (S.D.=3.5 mm Hg). Stability of IOP was age, found for this sample, is unexpected if IOP is proportional to systemic blood pressure which rises with age. Several hypotheses propose to explain the apparent inconsistency.
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Morgagnian cataract is a hypermature lens in which the cortex liquifies and the dense nucleus sinks inferiorly. Aside from the total reduction of vision, serious sequelae may result. This report is of a unilateral Morgagnian cataract of unknown etiology for which a dilated pupil facilitated the differential diagnosis between cataract types.
Biomicroscopy is an indispensable part of the ocular health examination performed on every patient. The purpose of this paper is to briefly review the basic illumination technique so that the examiner thoroughly understands their uses and develops for himself a specific investigative procedure. This testing may progress from the lids and lashes to the anterior vitreous in a coordinated manner.
Gonioscopy is the ocular health examination technique which offers to the practitioner the means to directly study the anterior chamber angle. Its uses are numerous and include glaucoma classification, predilation angle evaluation, and the presence of iris tumors, foreign bodies and anterior synechiae. Since a meaningful gonioscopic examination depends upon the examiner's recognition of the chamber landmarks, a detailed analysis of each structural element is presented. In addition, the techniques for performing gonioscopy with the popular lens types are viewed as is the system for interpretation and recording.
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The measurement of systemic blood pressure is a very significant detection test that can provide a great deal of information for the optometrist. The blood pressure readings can be critical in aiding the practitioner's evaluation of both the patient's visual health and related systemic condition and in indicating the possible need for referral. This paper presents a general survey of the benefits blood pressure measurements can provide in the optometric practice.
Systemic blood pressure is a vital sign and fundamental variable and as such the areas of its involvement in all individuals are indeed multifaceted. The purpose of this paper is to discuss the interpretation of systemic blood pressure readings as they specifically relate to a detailed analysis of hypertensive retinopathy.
The measurement of blood pressure, sphygmomanometry, can provide much significant information for the optometrist's evaluation of his patient's ocular and related systemic conditions when the principles involved are understood and skill in its measurement is achieved. This paper will discuss the procedural details of blood pressure measurement.
Using a cul-de-sac sampling method, tear cholesterol concentrations were measured for a population of subjects varying widely in age and relative body weight. Under unregulated conditions tear and plasma cholesterol levels failed to correlate significantly; however, when both diet and sampling times were strictly regulated, a number of well defined correlations did emerge amongst age, relative body weight, tear and plasma cholesterol levels. No significant response differences were found between the sexes in either the unregulated or the regulated formats however.
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