Biomedical subjects

Joseph Sowka

Publications and source records attributed to Joseph Sowka.

6 recordsLinked to original sources

PubMed2006

Ocular vascular hamartomas: the relationship with phakomatoses and possible commonalities in pathogenesis.

BACKGROUND: Ocular vascular hamartomas may present as isolated lesions or as part of a multisystemic congenital syndrome known as vascular phakomatoses. These syndromes are characterized by ocular, cerebral, and cutaneous lesions. Although each of these lesions manifests distinct characteristics, there may be overlapping characteristics and manifestations attributable to a common pathogenesis. METHODS: A case series and a literature review are presented illustrating ocular and systemic manifestations associated with vascular hamartomas, with each case representing varying degrees of ocular and systemic expression. CONCLUSION: Because of the potential ocular morbidity and systemic mortality associated with vascular hamartomas and associated syndromes, the optometrist plays an important role in the management of these patients. In general, understanding the pathogenesis of these diseases may contribute to future treatment and prevention opportunities.

Adult↗

PubMed2006

Phacomorphic glaucoma: case and review.

Phacomorphic glaucoma is a lens-induced secondary angle closure glaucoma that may occur as a result of mature cataract formation. A patient with markedly asymmetric cataract and anterior chamber depth was referred after the development of significant eye pain and elevated intraocular pressure that did not respond to topical antiglaucoma medications. The presence of an asymmetric mature lens, angle closure, and intraocular pressure elevation in the affected eye led to the diagnosis of phacomorphic glaucoma. Because the patient was systemically ill, physically frail, and had poor vision in the affected eye since birth, secondary to strabismic amblyopia, initial therapy was medically directed toward pain management. Cycloplegia, corticosteroids, and aqueous suppressants successfully ameliorated the patient's intraocular pressure and adequately controlled pain. However, progression to phacolysis and subsequent failure of pain management necessitated referral for lens extraction. The diagnosis and mechanism of phacomorphic glaucoma is discussed along with a review of current treatment modalities.

Cataract↗

PubMed2005

New thoughts on normal tension glaucoma.

Normal tension glaucoma (NTG) is considered a primary optic neuropathy within the glaucoma family. Whereas NTG shares many of the same pathologic characteristics as primary open angle glaucoma (POAG), there are several differences such as pattern of visual field defect and incidence of disc hemorrhaging. The most notable difference is that NTG does not manifest a recordable intraocular pressure (IOP) greater than 21 mmHg. Debate has existed as to whether NTG is a pressure-sensitive neuropathy and if pressure reduction affects the course of the disease. Likely, there are aspects in the pathophysiology of NTG that are both pressure sensitive and insensitive, and the etiology of NTG has never been adequately explained.

Glaucoma, Open-Angle↗

PubMed2004

Pigment dispersion syndrome and pigmentary glaucoma.

BACKGROUND: Pigmentary glaucoma is a common secondary glaucoma that results from pigment being liberated from the posterior iris with subsequent buildup in the trabecular mesh-work. Following this, there is a decrease in aqueous outflow and resultant rise in intraocular pressure. PURPOSE: While this presentation typically occurs in white myopic males, there is a distinct subtype that occurs in patients of African descent. While there are similarities between the races, there are also significant differences in the clinical presentation of pigmentary glaucoma in white patients and patients of African descent. Iris transillumination defects, corneal endothelial pigment accumulation, and a concave iris-common in whites-are typically absent in patients of African descent. METHOD: The literature is reviewed in order to summarize pigment dispersion syndrome and pigmentary glaucoma.

Black People↗

PubMed2004

Pseudoexfoliation syndrome and pseudoexfoliative glaucoma.

BACKGROUND: Pseudoexfoliative glaucoma (PXG) is a common secondary glaucoma that occurs when pigment and abnormal basement membrane material from anterior segment anatomical structures deposit in the trabecular meshwork. This anomaly arises from the predisposing condition, pseudoexfoliation syndrome (PXE). Complications are common, making this one of the most difficult glaucomas to manage. PURPOSE: The literature is reviewed in order to facilitate understanding of this condition.

Antihypertensive Agents↗

PubMed2004

Rapid onset phacolysis.

BACKGROUND: Phacolysis involves the breakdown of a hypermature cataract, causing an antigenic reaction to the lens proteins released into the anterior chamber with subsequent inflammation. To date, the time it takes for a crystalline lens to reach hypermaturity and induce a phacolytic response has never been clearly detailed. It is believed that cataract maturation is a slow process. The process by which the lens proteins begin to leak is thought by many to be similarly slow. However, the immune-related inflammatory process that develops when the lens proteins begin to leak may be quite rapid. It may be an error to consider this aspect of the phacolytic process to be slow. METHODS: We present a case with a clear, timed delineation of the phacolytic process. A mature cataract became hypermature with subsequent phacolysis and inflammatory pressure rise over the course of 17 days. It appears that this is the first published account of the time involved in the development of phacolysis and, we believe, the fastest onset of the process. CONCLUSION: While cataract maturation is generally considered to be a slow, insidious process, it should be recognized that the phacolytic process might not be slow. Once a lens reaches hypermaturity, phacolysis could occur quite rapidly over the course of several days. This case could be an important consideration in management of the removal of advanced cataracts. This case may be the shortest reported time from diagnosis of a mature cataract to the development of inflammatory phacolysis and secondary glaucoma, occurring over a period of only 17 days.

Autoantibodies↗