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Biomedical subjects

R M Feist

Publications and source records attributed to R M Feist.

At least 19 recordsLinked to original sources
PubMed1992

Branch retinal vein occlusion and quadratic variation in arteriovenous crossings.

To explore further the origin and clinically observed regional variation of branch retinal vein occlusion, we studied fluorescein angiograms of 42 patients (42 eyes) with branch retinal vein occlusion and a control population of 126 consecutive patients. In a statistically significant percentage of crossings, the artery was anterior to the vein in those areas of the retina clinically predisposed to branch retinal vein occlusion. Thirty-nine of the 42 patients with branch retinal vein occlusion sites had artery-anterior-to-vein crossings (P = .002), whereas 183 of all 266 arteriovenous crossings in these same eyes were similarly positioned. The artery lay anterior to the vein in significantly more temporal retinal crossings (337 of 457) than nasal retinal crossings (89 of 149; P = .002). Similarly, significantly more superotemporal quadrant crossings (164 of 209) than inferotemporal quadrant crossings (173 of 248) had the artery anterior to the vein (P = .0045). These results suggested that variation in the pattern of arteriovenous crossings may have a role in the clinical distribution of branch retinal vein occlusion.

Aging↗
PubMed1991

Penetrating ocular injury from contaminated eating utensils.

Although the rate of infectious endophthalmitis following penetrating ocular injury is generally less than 10%, certain settings may carry a greater risk of infection. One such setting is penetrating injury resulting from eating utensils contaminated with oral flora. We reviewed six of these injuries. Culture-positive bacterial endophthalmitis developed in four of the six eyes; only one of the eyes retained reading visual acuity (greater than 20/50) and two eyes lost light perception. The potential for infection and limited visual outcome in this series warrants aggressive prophylaxis and treatment. The unexpected isolation of Haemophilus influenzae in two of the four infections suggests that broad-spectrum antibiotic treatment should be considered in all such injuries since less common organisms may be encountered.

Adult↗
PubMed1991

Orbital and sinus inflammation with secondary optic neuropathy.

Optic neuropathy with simultaneous orbital and sinus inflammation is a diagnostic dilemma. Although sinus inflammation was described previously as causative in some cases of optic neuritis, the relatively high rate of asymptomatic sinus opacification in radiologic studies of the general population (as high as 13%) makes this a diagnosis of exclusion. We describe a patient who had optic neuropathy associated with simultaneous orbital and sinus inflammation. Although definitive determination of etiology may not be made without tissue biopsy, cases suspected of having a bacterial etiology may benefit from an initial 48-hour trial of intravenous antibiotics before initiation of systemic corticosteroids.

Adrenal Cortex Hormones↗
PubMed1990

Haptic externalization in a backwardly placed anterior chamber intraocular lens.

A patient who had been asymptomatic following extracapsular cataract extraction with posterior capsule rupture and anterior chamber lens implantation presented 18 months postoperatively with iritis and erosion of the superior haptic through the site of the cataract wound. At the time of explantation, it was seen that the anterior chamber lens had been inserted in a backward manner with the anterior face of the lens placed posteriorly. The resultant lens vaulting placed the superior haptic in the same plane as the cataract wound. Whether the superior haptic had initially been incorporated in the surgical wound or had eroded through the eye wall from the anterior chamber, the backward placement of the anterior chamber lens likely played a role in the development of haptic externalization.

Aged↗
PubMed1990

Vitrectomy in asteroid hyalosis.

Asteroid hyalosis (AH), a condition in which calcium-lipid complexes form in the collagen meshwork of the vitreous, affects from 0.5% to 0.9% of the general population. In patients with dense AH and visual loss, obscuration of fundus detail on ophthalmoscopy and even on fluorescein angiography may complicate the diagnosis and treatment of underlying posterior segment disease. To evaluate the usefulness of vitrectomy in AH, we reviewed 7 cases of dense AH in 6 patients who underwent vitrectomy in the setting of decreased visual acuity of uncertain cause. Additional diagnoses made following surgery included age-related macular degeneration (ARMD) in 2 eyes, ARMD with associated epiretinal membrane in one eye, and the staging of diabetic retinopathy as proliferative in one eye. Although no major surgical complications occurred in this series, the potential for serious complications exists, and pars plana vitrectomy (PPV) should be considered only after less invasive diagnostic evaluations and therapeutic approaches have been exhausted.

Adult↗
PubMed1989

Ocular self-mutilation.

A 32-year-old paranoid schizophrenic man repeatedly stabbed both his eyes with a sharpened wire coat hanger. The patient underwent vitrectomy on each eye approximately 2 1/2 weeks after injury, with multiple retinal defects noted OU. None of the posterior wounds involved the macula or optic disc, and final vision was 20/70 OD and 20/50 OS. Ocular self-mutilation, deliberate and severe self-injury which threatens visual function, is a rare occurrence most often described in acutely psychotic patients. Psychosis may be due to schizophrenia, drug abuse, manic phases of bipolar mood disorders, and depression. A striking number of these patients have delusions with religious and sexual content. They are prone to repeated attempts during the acute psychotic phase and must be monitored closely at this time.

Adult↗
PubMed1989

Eye injury: prevalence and prognosis by setting.

Although an estimated 1 million Americans suffer ocular injuries each year, the setting of injury and its prognostic implications have not been closely examined. Using data compiled by the Eye Injury Registry of Alabama (EIRA) from 514 cases of serious eye injury, we examined the demographics and prognosis of ocular injury by setting of injury. Work-related injuries accounted for only 28% of total injuries, and injuries occurring at home accounted for 27%, followed by situations related to recreation (25%), assault (11%), travel (5%), and "other" (school, unknown, etc) (4%). The poorest initial vision, poorest final vision, and highest rate of enucleation occurred in patients injured by assault, whereas the lowest rate of enucleation and loss of light perception was found in patients who had work-related injuries. Patients in the "other" category had the highest rate of return to 20/100 or better vision.

Accidents, Home↗
PubMed1988

Ocular lawnmower injuries.

In the 10-year period from 1977 to 1987, lawnmowers have been responsible for approximately 70,000 injuries annually with an estimated 5% (3300) involving the eyes. Hyphema, angle recession, and traumatic retinopathy are especially common forms of lawnmower ocular trauma. A series of 14 cases of lawnmower-induced eye injuries is presented along with demographics of the patient population involved. An analysis of various types of lawnmowers currently in use are also included, and preventive measures are suggested.

Accidents, Home↗
PubMed1988

Field evaluation of polycarbonate versus conventional safety glasses.

Of all the causes of eye injury, gunshot has recently been cited as resulting in the highest rate of blindness and the lowest rate of visual recovery. Many of these cases are hunting accidents in which safety glasses could have prevented or lessened ocular damage. To evaluate the effectiveness of various types of safety glasses, we fired a Remington automatic shotgun at mannequin heads fitted with one of four types of safety lenses. From a distance of 10 yards, only polycarbonate lenses provided even partial protection. At 30 yards, polycarbonate and heat-treated lenses provided the best protection, whereas chemically treated and CR39 lenses provided significantly less protection. We recommend that hunters using shotguns in areas of poor visibility wear widely available polycarbonate safety glasses as well as "hunter's orange" to minimize their risk of devastating ocular gunshot injury.

Accidents↗
PubMed1987

Bilateral ocular shotgun injury.

We retrospectively studied 14 patients with bilateral ocular shotgun injury in order to determine overall visual prognosis and factors affecting individual prognosis. Although only eight of 28 eyes (29%) in this series recovered visual acuity of 20/100 or better, six of 14 patients (43%) recovered at least 20/100 and eight of 14 patients (57%) recovered visual acuity of at least 20/400. Tissue destruction in the form of severe ocular disorganization or direct injury of optic nerve or macula was the primary limiting factor to visual recovery in 16 of 20 eyes (80%) not recovering to 20/100, while retinal detachment was the limiting factor in only four of these 20 eyes (20%). While extensive ocular disorganization, direct optic nerve or macular injury, no light perception on initial examination, and multiple pellet injuries were predictive of poor outcome, retinal detachment and double perforating injury were not.

Adolescent↗