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Biomedical subjects

P E Romano

Publications and source records attributed to P E Romano.

At least 19 recordsLinked to original sources
PubMed1990

Advances in vision and eye screening: screening at six months of age.

Eye and vision screening is a prototype preventative health measure. Increased knowledge of eye diseases in children and their treatment mandates much earlier screening than was recommended in the past. Advances in testing permit both the adoption of simpler and faster routine techniques and the application of more sophisticated and accurate screening methods. A thorough vision/eye screening at 6 months of age has been added to the previous examination schedule which only required screening at birth and again at 3.5-4 years of age. The simple scrutiny of the red fundus reflexes in the pupil with a direct ophthalmoscope (Brückner test) provides superior screening for vision, binocular alignment and pathology in infants. The difficult-to-master cover test and its variants can be abandoned for screening purposes. In screening preverbal children, simple optotype charts (HOTV) are proving more efficient than the traditional 'tumbling E' game. Color vision testing should be added to the preschool examination. Vision screening in infants can be enhanced where resources permit by using new preferential looking tests and by employing sophisticated electrophysiological testing. Photographic screening methods based on the red reflex hold considerable promise for more efficient screening of children.

Child↗
PubMed1990

The effect of age and ethnic background on the natural rebleed rate in untreated traumatic hyphema in children.

Controlling the natural tendency to rebleed in this condition is important because the serious vision threatening complications usually follow rebleeds. In evaluating treatments, it has been difficult to determine the natural rebleed rate. Recent reports on traumatic hyphema suggest that the natural rebleed rate in this condition may be higher in blacks and young children than in Caucasians and older children and adults. The records of 38 patients who were admitted to a children's hospital and who were the untreated control group in a previous study on systemic steroid treatment for traumatic hyphema, were reviewed to determine their ethnic background and age. The data was examined to see if these characteristics were related to the rebleed rate. The overall rebleed rate in this untreated group was 32% (12 out of 38). For specific ethnic groups, the rebleed rate was: Caucasians, including presumed Hispanics--32% (10 out of 31); Caucasians, not including presumed Hispanics--33% (8 out of 24); presumed Hispanics--29% (2 out of 7). There was no statistically significant (P greater than .95) difference in rebleed rates. With regard to age, the rebleeding rate was 54% (6 out of 11) for children under six years of age, and 22% (6 out of 27) for those over six years of age. This was a statistically significant difference (P less than .05). Ethnicity, therefore, in this group of untreated patients did not affect the natural rebleed rate. Younger age, under six years, is associated with a higher natural rebleed rate in traumatic hyphema, and these children should be most carefully treated.

Adolescent↗
PubMed1989

Simple photogrammetric diagnosis of optic nerve hypoplasia.

It is often clinically important, but also often difficult, to make a definitive morphologic diagnosis of optic nerve hypoplasia in a young child. If, however, one can obtain a photograph of the fundus, including the optic disc, one can make a simple measurement of the horizontal diameter of the optic disc and make this diagnosis. To determine if the horizontal diameter of the optic disc on a 35-mm photographic transparency could be used to separate patients with optic nerve hypoplasia from normal individuals, I measured directly on the transparency the horizontal diameter of the optic disc image taken by a standard 30 degrees field fundus camera with X2.5 magnification in a series of 55 normal eyes, and in 16 eyes with clinically confirmed optic nerve hypoplasia. For the normal series of eyes, the mean optic disc horizontal image diameter was 3.88 mm, with a range of 3.44 to 4.70 mm. For the series of eyes with optic nerve hypoplasia, the mean horizontal diameter was 2.64 mm, with a range of 1.80 to 3.27 mm. There was no overlap between the normal control series and the pathologic series. In subjects with no major ametropia (less than 2.5 diopters of spherical or cylindrical refractive error), a 3.4-mm horizontal diameter optic disc image on a 35-mm transparency can be used as a clinical guide or dividing line for the diagnosis of optic nerve hypoplasia, larger nerves being considered normal and smaller nerves being considered hypoplastic.

Adolescent↗
PubMed1989

Optic disc photogrammetry: magnification factors for eye position, centration, and ametropias, refractive and axial; and their application in the diagnosis of optic nerve hypoplasia.

To determine if image magnification from ametropia or other factors required correction in the photogrammetric diagnosis of optic nerve hypoplasia, the following variables were studied using two standard 30 degrees field fundus cameras (Zeiss FF-3 and Kowa RC-2): (1) distance between the camera and the subject--variations in this distance do not change the image size; (2) decentration of the camera (i.e., decentration of the optic disc image within the field)--no effect was found using the Kowa camera, but in the Zeiss, a 2% (0.07 mm) increase in disc image size was found for each mm of optic disc decentration in the field; (3) ametropia, refractive experimental (induced in one subject with soft contact lenses, from +8.00 diopters (D) to -8.00D)--no significant change in image size was found (In addition, in 50 healthy adult eyes with various refractive errors, including ten with uncorrected aphakia, there was no significant difference found for the size of the optic nerve in different refractive ametropias. No correction factor was necessary for aphakia or for other refractive ametropias); and (4) ametropia, axial--axial myopia showed minor but significant magnification: a linear increase in the horizontal diameter of the optic disc image of 2% (0.07 mm) was found for each diopter of axial ametropia exceeding 3D. There was insufficient data for axial hyperopia. These magnification factors should be applied when measuring the optic disc on 35-mm transparencies to make a diagnosis of optic nerve hypoplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Aphakia↗
PubMed1988

Stage I intraoperative adjustment of eye muscle surgery under general anesthesia: consideration of graduated adjustment.

The eyes diverge under general anesthesia. The amount of divergence is predictable; there is a linear relationship between the preoperative and the anesthetized eye position. We have confirmed Apt and Isenberg's regression formula for this relationship (A = 0.8 P + 30). We have previously also reported that adjusting the amount of surgery to be done (stage I adjustment) in cases deviating from this correlation by one standard deviation or more (anomalous) significantly improved our surgical success rate to 85%. Since a fixed arbitrary adjustment of 1 mm more or less surgery had improved our surgical success rate significantly, but still left room for higher success rates, we reviewed our anomalous cases to determine whether a graduated adjustment might be expected to produce even higher success rates. A review of cases including additional ones since our last report failed to support this hypothesis. Satisfactory results in these most recent cases have, however, almost doubled the surgical success rate (in anomalous cases) for our stage I fixed arbitrary 1 mm intraoperative adjustment, from 47% to 90%.

Adolescent↗