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Biomedical subjects

R E Wiggins

Publications and source records attributed to R E Wiggins.

9 recordsLinked to original sources
PubMed1999

Diagnosis and management of divergence weakness in adults.

OBJECTIVE: To determine how frequently neurologic disease accompanies divergence weakness, the stability of the eye movement disorder, and the response to treatment. DESIGN: Prospective, interventional, noncomparative case series. PARTICIPANTS AND METHODS: Seventeen consecutive adult patients (28-96 years of age) with divergence weakness were prospectively evaluated from 1991 to 1997. MAIN OUTCOME MEASURES: Ocular alignment was measured at distance and near and in up, down, left, and right gaze. Fusional divergence amplitudes were measured at distance. The presence or absence of associated neurologic disease was noted. The response to treatment (prisms or strabismus surgery or both) was recorded. RESULTS: None of the patients had concurrent neurologic disease. Thirteen patients remained stable, 3 improved, and 1 progressed. Sixteen patients were treated successfully: 12 with prisms and 4 with strabismus surgery; 1 patient was not treated. CONCLUSION: Divergence weakness is usually an isolated condition that tends to remain stable and respond to treatment with either prisms or strabismus surgery.

Adult↗
PubMed1995

Invasive aspergillosis. A complication of treatment of temporal arteritis.

Temporal arteritis is a systemic necrotizing vasculitis for which the only effective treatment is systemic corticosteroids. A review of the literature suggests that there is a significant mortality rate in untreated patients but that those patients who receive adequate corticosteroid treatment rarely experience a reduced life expectancy. I had the opportunity to evaluate a patient with temporal arteritis who eventually died from disseminated aspergillosis 6 weeks after beginning corticosteroid treatment. A high index of suspicion for infections with opportunistic organisms should be maintained in patients with temporal arteritis receiving corticosteroids.

Aged↗
PubMed1992

The results of glaucoma surgery in aniridia.

Aniridia is an uncommon disorder that may be associated with glaucoma that is usually refractory to conventional medical and surgical therapy. In this study, we report our experience with the surgical management of glaucoma in aniridia in 17 eyes of 10 patients. A total of 45 surgical procedures were performed. The mean preoperative intraocular pressure was 38 mm Hg. The intraocular pressure was ultimately controlled successfully in 11 eyes (intraocular pressure range, 8 to 20 mm Hg) with a mean of 2.8 surgical procedures required in successful cases. Trabeculectomy controlled the intraocular pressure in one eye, but it was successful in only 9% of cases in which it was performed. Cyclocryotherapy was successful in five eyes (25% of cases in which it was performed), although complications of phthisis bulbi and progressive cataract occurred. We detail our experience with the Molteno implant, which was successful in five eyes (83% of cases in which it was performed). We have found this type of drainage device to be effective in controlling intraocular pressure in aniridic eyes when previous attempts at control have failed.

Adolescent↗
PubMed1990

Results of penetrating keratoplasty by residents.

There is little information regarding the results of penetrating keratoplasty for the novice transplant surgeon. We reviewed 63 consecutive cases of penetrating keratoplasty performed by senior residents at our institution. Of 59 cases with a 1-year follow-up, 76% remained clear; the mean astigmatism was 4.15 diopters, and the median visual acuity was 20/50. The two major postoperative complications were graft rejection and increased intraocular pressure, which occurred in 22% and 16% of cases, respectively. In a well-supervised setting, residents can be introduced to the basic principles of keratoplasty and achieve results comparable with those reported in the literature.

Adolescent↗
PubMed1990

12(S)-hydroxy-5,8,10,14-eicosatetraenoic acid is a more potent neutrophil chemoattractant than the 12(R) epimer in the rat cornea.

12(R)-hydroxy-5,8,10,14-eicosatetraenoic acid [12(R)-HETE] is reported to be more potent than its epimer 12(S)-HETE as a chemoattractant for human neutrophils in vitro and following topical application to the skin. To assess the in vivo neutrophil chemoattractant potencies of 12(S)-HETE and 12(R)-HETE in the rat, we injected 1 microgram, 5 micrograms, or 10 micrograms of these eicosanoids into the corneal stroma. Rats were killed 12-15 hours after injection, and the number of neutrophils in the stroma was counted in a histological section of the cornea including the injection site. The number of neutrophils was significantly increased in corneas injected with 5 micrograms (+103% of control) or 10 micrograms (+456% of control) of 12(S)-HETE and in those injected with 10 micrograms of 12(R)-HETE (+111% of control). The neutrophilic infiltrate in corneas injected with 1 microgram or 5 micrograms of 12(S)-HETE was not significantly different from that in corneas injected with 1 microgram of leukotriene B4. The data for the 10 micrograms injections indicate that 12(S)-HETE is a more potent neutrophil chemoattractant than 12(R)-HETE in the rat cornea. Our results suggest that species or tissue specificity may determine the relative potencies of 12-HETE epimers as chemoattractants for neutrophils, and that 12(S)-HETE may be an important inflammatory mediator in the rat cornea.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMedDate not supplied

Monocular eye closure in sunlight.

Monocular eye closure in sunlight is often noted in patients with intermittent exotropia. Neither the reason for eye closure nor its frequency of occurrence in other populations is known. We questioned 147 consecutive nonoperated patients (and/or their parents) ages 1-45 years, 93 with strabismus with onset prior to 7 years of age and 54 without strabismus, for a history of closing one eye in sunlight. Monocular eye closure in sunlight was reported most frequently by patients with intermittent exotropia but was also reported by those with other forms of strabismus as well as by nonstrabismic normals. Cooperative subjects were studied further to determine the cause for eye closure. Each subject was exposed to a source of intense illumination while fixating a target. All who closed one eye under these conditions reported photalgia associated with the high light intensity, most noting less discomfort after closing one eye. None reported diplopia prior to eye closure. Monocular and binocular photophobia thresholds were then measured for each subject. The mean monocular photophobia threshold was significantly higher than the binocular threshold. In addition, binocular photophobia thresholds were significantly lower in those reporting eye closure compared with those who did not. Monocular eye closure in sunlight is a mechanism used to reduce photophobia and is not related to avoidance of diplopia.

Adolescent↗
PubMedDate not supplied

Optic nerve coloboma with cyst: a case report and review.

A 7-month-old boy presented with strabismus and proptosis of the left eye. He was found to have bilateral optic nerve colobomas associated with cysts arising from the optic nerve sheath and in communication with the subarachnoid space. The evaluation and management of this entity are discussed.

Coloboma↗