PubMed Health⌕ Search

Biomedical subjects

Vimla Menon

Publications and source records attributed to Vimla Menon.

12 recordsLinked to original sources
PubMed2006

Precaruncular periosteal anchor of medial rectus, a new technique in the management of complete external third nerve palsy.

Management of complete external third nerve palsy is a challenge to a strabismologist; as four of six extra-ocular muscles are affected, it leaves eye in fixed hypotropic and exotropic position (Srivastava et al., 2004). Although numerous surgical procedures have been described, none has been found to be ideal for all cases. Horizontal supramaximal recession-resection procedure may work in cases having some function of medial rectus (Harley, 1980). In cases of complete external palsy, anchoring of globe to periosteum of medial orbital wall using different structures has been described (Villasenor Solares et al., 2000; Bicas, 1991; Salazar-Leon et al., 1998), as recession-resection may result in large residual deviation and/or eye drifts back to abducted position due to unopposed lateral rectus action (Von Noorder, 1996). These anchoring procedures are with associated problems of skin incision, thigh surgery or loss of superior oblique function (Villasenor Solares et al., 2000; Bicas, 1991; Salazar-Leon et al., 1998). We describe a new and safe technique for management of complete external third nerve palsy by anchoring insertion of medial rectus to medial wall periosteum, posterior to posterior lacrimal crest, along with supra maximal recession of lateral rectus.

Adult↗
PubMed2006

Pontine tuberculoma presenting with horizontal gaze palsy.

A 38-year-old immunocompetent man presented with a horizontal supranuclear gaze palsy as the only neurologic manifestation of a pontine tuberculoma. Although a biopsy of the brain lesion was not performed, it was attributed to tuberculosis because of chest x-ray evidence. The patient was given empirical anti-tuberculous therapy. After one month, the gaze palsy had fully recovered and repeat MRI showed a decrease in the size of the lesion. This is the first reported case of supranuclear gaze palsy without diplopia as a manifestation of a tuberculous brain stem lesion.

Abducens Nerve↗
PubMed2006

Visual outcome after intravenous dexamethasone therapy for idiopathic optic neuritis in an Indian population: a clinical case series.

PURPOSE: To evaluate the clinical profile, response to dexamethasone treatment and visual function outcome in Indian patients with acute optic neuritis. MATERIALS AND METHODS: We conducted an observational study of patients with acute optic neuritis who were treated with intravenous dexamethasone (100 mg in 250 ml of 5% dextrose over 1-2 hours daily, for three consecutive days) and had completed at least two years of follow-up. Parameters assessed included visual acuity, contrast sensitivity, color vision, visual fields, relative afferent pupillary defect (RAPD) and visually evoked potentials. Out of 40 patients studied, 26 patients (33 eyes) had all visual function parameters assessed. Twenty three patients (28 eyes) had completed two years of follow-up and were included for statistical analysis. RESULTS: Improvement in visual acuity was statistically significant for distance after 24 hours of the first dose (P = < 0.001) and for near vision after 24 hours of the second dose (P = 0.006); improvement in color and contrast sensitivity was statistically significant 24 hours after the third dose (P = < 0.001 for color vision and P = 0.013 for contrast sensitivity). Significant improvement in RAPD and visual fields were seen by 1 month (P = 0.005). Recurrence was seen in 4 eyes of 4 patients. No serious side effects were observed. At two years, 82.14% (23 out of 28) eyes had visual acuity > 20/40. CONCLUSION: Treatment with intravenous pulsed dexamethasone led to rapid recovery of vision in acute optic neuritis, without any serious side effects.

Adolescent↗
PubMed2005

Bilateral neuro-retinitis following chick embryo cell anti-rabies vaccination--a case report.

BACKGROUND: The Optic nerve is rarely involved after sheep brain anti-rabies vaccination in the form of retrobulbar neuritis or papillitis. Bilateral neuroretinitis after chick embryo cell antirabies vaccination has not been reported. CASE PRESENTATION: We report the case of a 56 year old male who developed bilateral neuro-retinitis following three injections of antirabies vaccine prepared from the chick embryo. CONCLUSION: The chick embryo cell antirabies vaccine can cause bilateral neuroretinits which has not been reported previously.

Animals↗
PubMed2005

Profile of amblyopia in a hospital referral practice.

OBJECTIVE: Evaluation of the clinical profile and distribution of different sub-types of amblyopia in a referral eye hospital in India. METHODS: This was a prospective hospital-based observational study, evaluating the clinical profile of patients with amblyopia presenting to a referral strabismology practice. The examination included assessment of the visual acuity, the refractive status, the fixation pattern, the grade of binocularity, and evaluation of the associated strabismus, if any before treatment was started. RESULTS: The average age of the patients at presentation was 7.97?6.18 years with 81 out of 683 patients (11.8%) presenting above the age of 20 years. The best-corrected visual acuity (BCVA) was less than 6/60 in the amblyopic eye in 121 out of 733 eyes (16.5%). Strabismic amblyopia was the most common sub-type of amblyopia seen (274/733 eyes, 37.38%). Though patients with anisometropic amblyopia presented at a later age (average of 10.03+/-6.92 years), they had better visual acuity, binocular functions, and centricity of fixation at all ages, relative to other sub-types of amblyopia. The BCVA did not show any co-relation with the age of presentation [co-relation co-efficient (CF) of 0.074], refractive status of the amblyopic eye (CF of 0.078), the type of amblyopia (CF of 0.196), or the type of strabismus present (CF of 0.079). However, a very significant co-relation was seen between the BCVA and the fixation pattern of the amblyopic eye (CF of 0.817). CONCLUSIONS: Lack of knowledge and awareness about amblyopia and its appropriate timely management has been the main cause for the late presentations and significant visual impairment associated with the condition.

Adolescent↗
PubMed2005

Pontine cavernous hemangioma presenting with horizontal gaze palsy.

Pontine cavernous hemangioma presenting as horizontal gaze palsy is extremely rare. A 32-years-old patient presented with left horizontal gaze palsy with left esotropia. A large pontine mass was present which was removed in-toto using a sub-occipital craniotomy. Post- operatively, the gaze palsy showed recovery and the diplopia decreased. Follow-up MRI showed no residual mass.

Adult↗
PubMed2005

Ocular and cardiovascular autonomic function in diabetic patients with varying severity of retinopathy.

The study was conducted to assess the ocular and cardiovascular autonomic function in diabetic patients with varying severity of diabetic retinopathy. Ocular and cardiovascular autonomic function tests were performed in 30 patients with type 2 Diabetes Mellitus (10 in each group of proliferative retinopathy, non-proliferative retinopathy and no retinopathy) of more than 5 years duration and 10 normal controls. Ocular autonomic function tests were done by measuring pupil cycle time and denervation hypersensitivity with 0.125% pilocarpine and 0.5% phenylephrine. Cardiovascular autonomic function was measured by a battery of standard tests. Denervation hypersensitivity to 0.125% pilocarpine and to 0.5% phenylephrine and pupil cycle time showed statistically significant differences (P value < 0.001) between controls and patients with proliferative retinopathy (PDR) and also between no retinopathy and PDR (P < 0.001). Systemic autonomic function tests namely expiration--inspiration ratio, difference in heart rate, 30th beat and 15th beat ratio in head up tilt and difference in diastolic blood pressure in head up tilt test also showed significant difference (P < 0.01) between controls and all 3 groups of diabetics. There was statistically significant difference found in para-sympathetic ocular autonomic dysfunction between NPDR and controls. Ocular and systemic autonomic dysfunctions are related to the severity of diabetic retinopathy.

Adult↗
PubMed2005

Factors influencing visual rehabilitation after occlusion therapy in unilateral amblyopia in children.

BACKGROUND & OBJECTIVE: Amblyopia is one of the most common causes of visual impairment in adults and children, and visual loss may be permanent if not treated in time. Though many studies have been done on occlusion therapy which is the mainstay in the treatment of unilateral amblyopia, discrepancies exist in literature about quantification of treatment and follow up measures. The present study was undertaken to evaluate the factors responsible for the successful outcome of treatment and the optimum time required for the same in children with unilateral amblyopia. METHODS: Baseline characteristics of 63 verbal patients with unilateral amblyopia (strabismic, anisometropic, mixed) referred to the Strabismus and Amblyopia Clinic at the Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi between September 2001 to December 2002 who improved to the desired level of visual acuity after treatment for amblyopia in the mentioned time period, were analyzed to assess for factors that directly or indirectly influenced the optimum visual rehabilitation and the average duration of therapy required for the same. The evaluation included assessment of the baseline best-corrected visual acuity (BCVA) and refractive status in both eyes, the age at presentation, the type of amblyopia present, fixation pattern in the amblyopic eye, inter-eye visual acuity difference, and evaluation of compliance through a parental diary system. RESULTS: Baseline BCVA in the amblyopic eye was similar in all the three groups. Patients with anisometropic amblyopia showed a quicker response to therapy. Compliance to treatment was the major factor affecting the overall time required for a successful outcome in most cases. The overall time required for the treatment to be successful (including the period of maintenance) was about 1,089 h. INTERPRETATION & CONCLUSION: This hospital-based study showed that the average duration of occlusion therapy to achieve stable isoacuity was 7.2 months with an average occlusion of 6-7 h/day. Compliance to therapy was the most important factor affecting the duration of therapy. With increasing emphasis on paediatric eye diseases, amblyopia is at last getting its due importance as a cause of treatable correctable paediatric visual impairment which can have lifelong repercussions, both in terms of individual disability and financial burden to the society if not treated in time. As the therapy is simple and effective if started early, mass awareness, visual screening, and counselling would go a long way in treating the patients, thus decreasing the prevalence of amblyopia in the country.

Amblyopia↗
PubMed2004

Isolated "one and a half syndrome" with brainstem tuberculoma.

A seldom reported causal association of two rare entities, an isolated brainstem tuberculoma and an isolated One and a half syndrome in a 12 year old girl is presented. MRI showed an isolated inflammatory granuloma in the brainstem which on empirical treatment with anti tubercular drugs resulted in complete restoration of ocular motility, along with resolution of the lesion on follow up MRI at 6 months. The diagnosis and management are discussed.

Antitubercular Agents↗
PubMedDate not supplied

Study of the psychosocial aspects of strabismus.

PURPOSE: To systematically evaluate the perception of psychosocial difficulties due to strabismus and the impact of corrective surgery in adolescents and young adults in India. METHODS: Patients 15 to 25 years of age with childhood onset (< or = 5 years of age) of constant concomitant squint (> or = 30 prism diopters of deviation for distance) were included in the study. After a detailed orthoptic evaluation, demographic data of the patients and their parents were recorded. Postgraduate Institute Health Questionnaire N-2 (standardized in India) was administered to rule out neuroticism in the patients. Psychosocial problems faced by the patients were evaluated with a semistructured interview schedule. Patients were evaluated 3 months after surgery using a similar interview schedule to assess the psychological impact of surgery. RESULTS: Eighty percent of both male and female patients had problems in their social life; 85% of the males and 75% of the females had personal problems due to squint. After surgery, a positive change in appearance was noticed by 97.5% and 95% noticed a change in self-esteem and self-confidence. CONCLUSION: These patients had difficulties with self-image and interpersonal relationships, faced ridicule at school and work, and generally avoided activities that brought attention to their defect. Substantial changes were noticed in them after corrective surgery, and the differences in their scores before and after surgery were statistically significant.

Adolescent↗