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Biomedical subjects

R M Manners

Publications and source records attributed to R M Manners.

At least 19 recordsLinked to original sources
PubMed2002

Doppler ultrasonography to aid diagnosis of orbital capillary haemangioma in neonates.

PURPOSE: To illustrate the use of Colour Doppler Ultrasonography to aid the differential diagnosis of orbital masses in neonates. METHODS: Three cases are reported of neonates presenting with undiagnosed orbital masses as isolated findings, causing lid swelling and proptosis and prompting a differential diagnosis of an orbital vascular lesion, rhabdomyosarcoma or other tumour. Colour Doppler Ultrasonography in expert hands using a small footprint linear 10-5 transducer proved an atraumatic, rapid and accurate way of confirming a vascular lesion at the first clinic visit. This reassured the family and ophthalmologist alike, and obviated the need for biopsy or cross sectional imaging requiring anaesthetic. All three lesions were orbital capillary haemangiomas with characteristic ultrasonographic findings. RESULTS: Illustrations are provided to illustrate the features of the capillary haemangiomas when visualised with Colour Doppler Ultrasonography. CONCLUSIONS: The use of ultrasonography in very young infants can help exclude malignancy, without the need for cross sectional imaging or biopsy under anaesthetic. However, close observation remains mandatory. Repeat scanning is easily performed with no adverse effects, in potential contrast to other imaging modalities.

Diagnosis, Differential↗
PubMed2000

Painful blind eye: efficacy of enucleation and evisceration in resolving ocular pain.

AIMS: To assess the effectiveness of enucleation or evisceration in relieving pain from painful blind eyes. METHODS: 24 patients with intractable ocular pain underwent enucleation or evisceration with or without an orbital implant. RESULTS: Complete pain relief was achieved in all patients at an average time of 3 months (range 1-15 months). Seven patients required further medical or surgical treatment in addition to removal of the globe. CONCLUSION: Enucleation and evisceration were effective in relieving ocular pain in all patients with a painful blind eye in our study. However, complications of surgery and orbital implants can cause recurrent pain.

Adolescent↗
PubMed1998

Levator palpebrae superioris fibre size in normals and patients with congenital ptosis.

A study of the histochemical staining of levator palpebrae superioris (LPS) was undertaken to measure the muscle fibre size in normal individuals and in patients with congenital dystrophic ptosis in order to see whether there is an alteration in muscle fibre size in congenital ptosis. Eight LPS specimens were obtained: 4 from normal patients (3 from normal levator divided in a bilateral brow suspension procedure and 1 from an exenteration specimen) and 4 from levator resection procedures for treatment of unilateral congenital ptosis. Cryostat sections from these specimens were stained histochemically to reveal muscle fibre types. The orthogonal diameters were measuring using a computer-generated program and the two groups compared using the Mann-Whitney mu-test. No statistically significant difference in muscle fibre diameter was found between normals and patients with congenital ptosis. There was also no change in the distribution or range of muscle fibre diameter in patients with congenital ptosis. Our findings do not support the classification of congenital ptosis as a dystrophy.

Aged↗
PubMed1996

Levator transposition procedure: a review of 35 cases.

BACKGROUND: Levator transposition is used as a unilateral procedure for patients with both ptosis and aberrant movements of the eyelid. Muscular neurotisation occurs in the transposed levator muscle and thus some levator function is restored. METHOD: We reviewed 35 patients who had undergone a levator transposition procedure. RESULTS: Twenty-eight patients had jaw-winking ptosis, three had cyclic oculomotor palsy and four had a third nerve palsy with aberrant regeneration. The follow-up period was between 1 and 39 months (mean 12 months). Eighteen patients were followed up for at least 12 months and their results were analysed as a separate group. CONCLUSIONS: The levator function attained following transposition is related to the pre-operative voluntary function and this relationship is statistically significant (Wilcoxon test p < 0.001). Maximal levator function may not be achieved until 12 months post-operatively. The procedure is successful in abolishing aberrant eyelid movements and treating ptosis but the majority of patients require an additional levator resection to achieve a satisfactory lid height.

Adolescent↗
PubMed1994

Histochemical staining of orbicularis oculi muscle in ectropion and entropion.

A histochemical study of orbicularis oculi was undertaken to test the hypothesis that there is a difference in the percentage and size of muscle fibre types which accounts for the development of involutional ectropion or entropion. Wedge excisions from lower lids of patients undergoing repair of these conditions were frozen-sectioned and stained histochemically to reveal muscle fibre types. Five ectropion and five entropion specimens were obtained, and the percentage of type 1 and type 2 fibres, fibre perimeters and fibre diameters were measured. An abundance of type 2 fibres was found in both ectropion (mean 89.6%) and entropion (mean 82.6%). No significant difference was found with respect to fibre type, perimeter or diameter when ectropion was compared with entropion or when either was compared with normals. Type 2 fibres were larger than type 1 in both ectropion and entropion. We conclude that no significant difference could be identified between orbicularis muscle fibres in ectropion, entropion and normals to account for the development of the eyelid malpositions.

Aged↗
PubMed1994

The use of Prolene as a temporary suspensory material for brow suspension in young children.

Children with severe, unilateral congenital ptosis are at risk of developing amblyopia if the lid obscures the visual axis. In this situation, urgent repair of the ptosis is indicated. These patients generally have very poor function of the levator palpebrae superioris muscle and a brow suspension is required. The suspensory material which gives the best long-term results is autogenous fascia lata. In young children, however, there is insufficient autogenous fascia available. We reviewed 9 patients aged 4 years or less who had undergone surgery for congenital ptosis. In each case a brow suspension was performed using 4/0 Prolene (monofilament polypropylene) suture as a temporary suspensory material. All patients achieved a satisfactory result with the upper lid remaining clear of the visual axis during a mean follow-up period of 18.7 months (range 8-29 months). We suggest that Prolene suture is a readily available material which is suitable as a temporary suspensory material for brow suspension in very young children.

Amblyopia↗
PubMed1994

Superior oblique tendon lengthening for acquired superior oblique overactions.

Two patients who presented with compensatory head postures and diplopia are described. They both had marked unilateral superior oblique overaction, in one patient due to a large, incomitant skew deviation. Each underwent a superior oblique tendon lengthening procedure using a segment of silicone 240 retinal band as an expander, in combination with a contralateral superior rectus recession. Both achieved an excellent result with an improvement of the compensatory head posture and an increase in the field of binocular single vision. This surgical procedure is proposed as an option in the management of superior oblique overaction, including certain cases of skew deviation.

Accidental Falls↗
PubMed1991

Posterior lens capsule abscess due to Propionibacterium acnes and Staphylococcus epidermidis following extracapsular cataract extraction.

A case of posterior lens capsular abscess occurring many months after an extracapsular cataract extraction is presented. This was caused by a mixed infection involving Propionibacterium acnes and Staphylococcus epidermidis. The significance of Staph epidermidis after such a long postoperative period is uncertain, but the case shows features typical of secondary endophthalmitis due to P acnes, including a long delay in onset and a grumbling course not brought under control by medical treatment. It supports the theory that the nidus of infection is localised in the posterior lens capsule by showing development of a visible capsular abscess with associated vitreous involvement. The subsequent removal of the capsule and vitreous, despite leaving the intraocular lens in place, led to complete resolution of the inflammation. Both organisms have previously been found to be sequestered in the posterior lens capsule by histological and microbiological examination of excised capsular specimens. It is important to consider them as possible causative agents in the formation of a postoperative capsular abscess.

Abscess↗
PubMedDate not supplied

Expulsion of a lacrimal dacryolith by sneezing: a rare event.

PURPOSE: To describe the case of a man presenting with intermittent epiphora of the right eye and a low grade dacryocystitis due to a dacryolith. METHODS/RESULTS: He was treated conservatively and was offered a Dacryocystorhinostomy. A few weeks before surgery, he developed swelling and pain over the right medial canthus followed by violent sneezing with spontaneous extrusion of the dacryolith. DISCUSSION: The authors propose that the dacryolith fragmented spontaneously and once it reached the nasal cavity, was expelled by violent sneezing to the nostril, a mechanism not previously reported. CONCLUSIONS: Reformation of dacryolith is a likely possibility, and recurrence of symptoms in such cases may ultimately require a Dacryocystorhinostomy.

Calculi↗