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Biomedical subjects

R F Multack

Publications and source records attributed to R F Multack.

3 recordsLinked to original sources

Health fair glaucoma screening: follow-up evaluation.

Glaucoma screening is a standard procedure at many health fairs. Information on correct screening techniques, instrumentation, and target populations has been available. However, a scarcity of information exists concerning the success of efforts to follow up on abnormal results. This study reports on the findings of a long-term (6-month) follow-up of all individuals with abnormal tonometric results screened at an inner-city osteopathic hospital. Of the 218 subjects screened, 15 were found to have abnormal tonometric results. Seven of the 15 subjects were actually reached at the 6-month follow-up interval. Four of the seven had not sought any further eye care; two had sought nonmedical evaluation; only one had sought medical ocular care, and that subject was later found to have glaucoma. The results presented in this article indicate that compliance by this population is inadequate. Inner-city participants require more education. We encourage physicians to promptly refer such patients for appropriate medical ocular care.

Adolescent↗

Improving diagnostic acumen in pupillary evaluation: a review for the primary care physician.

Many primary care physicians perform only a superficial pupillary evaluation as part of the physical examination. The authors review several maneuvers that require no special equipment and help to improve diagnostic yield. The "swinging flashlight" test aids in detecting a relative afferent pupillary defect. When a patient has anisocoria, the initial diagnostic challenge is to determine which pupil is abnormal. Comparing the extent of pupillary inequality under both dim and bright illumination almost always identifies the dysfunctioning pupil(s) and narrows the differential diagnosis. The authors compare third-nerve palsy and Horner's syndrome as causes of anisocoria and review light-near dissociation, another important category of pupillary dysfunction. This latter phenomenon is seen in the Argyll Robertson pupil, the dorsal midbrain syndrome, and the tonic pupil syndromes. Pupillary size and activity are key diagnostic parameters in the evaluation of patients in coma. Structural and mechanical iris defects are also frequently responsible for pupillary anomalies.

Brain Diseases↗

Spasmus nutans: a pediatric enigma.

Spasmus nutans is an unusual neuro-ophthalmologic syndrome that affects infants. The clinical features of head nodding, nystagmus and head tilt are diagnostic although variability in their presentation is not uncommon. Computerized tomography of the head is recommended to rule out possible accompanying intracranial gliomas.

Brain Neoplasms↗