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Biomedical subjects

Mark J Walland

Publications and source records attributed to Mark J Walland.

6 recordsLinked to original sources
PubMed2006

Failure of medical therapy despite normal intraocular pressure.

The disease glaucoma is now defined by characteristic optic disc and visual field change, without specific reference to the intraocular pressure (IOP). Success of treatment is no longer judged by the mere attainment of IOP less than 21 mmHg. Controversy remains, however, in deciding appropriate management where optic disc and/or visual field damage continues to progress despite a 'normal' IOP having been achieved with medical treatment. A panel of international glaucoma experts has provided management recommendations in four clinical scenarios--open-angle glaucoma, open-angle glaucoma in a myopic contact lens wearer, uveitic glaucoma and open-angle glaucoma in combination with visually significant cataract--where optic nerve and visual field progression has continued despite an IOP less than 21 mmHg on full medical treatment. Surgical intervention with mitomycin trabeculectomy is the most favoured further therapy.

Adult↗
PubMed2004

Whither the blade?

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Anti-Inflammatory Agents↗
PubMed2004

Glaucoma from topical corticosteroids to the eyelids.

Raised intraocular pressure and glaucoma have rarely been associated with use of periorbital corticosteroids for dermatological conditions such as blepharitis and eczema. Three cases are described in which periorbital topical corticosteroids appear to have resulted in raised intraocular pressure or glaucoma. Topical corticosteroids used for dermatological conditions around the face and eyes are often regarded as being fairly innocuous with regard to ocular side-effects. This case series demonstrates that secondary open-angle glaucoma can be a sight-threatening consequence, and periorbital steroids should therefore be used cautiously and sparingly, particularly in those with a family history of glaucoma. Intraocular pressure may not always return to normal upon cessation of the drug.

Adult↗
PubMed2004

Glaucoma treatment in Australia: changing patterns of therapy 1994-2003.

AIM: To document the change in pattern of glaucoma treatment in Australia over the decade 1994-2003. METHODS: Observational study: retrospective data audit. RESULTS: The total number of prescriptions for glaucoma items has increased in this time period from 1.9 million to 3.3 million, with a cost increase to the Pharmaceutical Benefits Scheme (PBS) of in excess of 50m dollars. The largest increase has been in the class of prostaglandin analogues, which now comprise 49% of all glaucoma topical therapy prescriptions. Rates of laser trabeculoplasty and trabeculectomy surgery have fallen by 60% and 58%, respectively. Rates for secondary procedures such as repeat trabeculectomy, drainage implant devices and cycloablation have remained stable, although with some variation between Australian states. CONCLUSIONS: The introduction of multiple new medications has resulted in a decline in the amount of glaucoma surgery and laser trabeculoplasty performed. There has been an associated increase in the total number of glaucoma prescription items dispensed, and a large increase in the cost to the PBS of this change. Outcome measures of the benefit of these changes are lacking.

Antihypertensive Agents↗
PubMed2004

Recurrent posterior capsular opacification and capsulorhexis contracture after cataract surgery in myotonic dystrophy.

Cataracts are well known to be associated with myotonic dystrophy. Less well known are the phenomena of recurrent posterior capsule opacification and capsulorhexis contracture post cataract surgery. Two cases are described herein of postoperative capsular complications requiring multiple capsulotomies in patients with myotonic dystrophy. It is proposed that a common aetiology may underlie both posterior capsule opacification and capsulorhexis contracture in myotonic dystrophy cases.

Adult↗