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Biomedical subjects

W Rüssmann

Publications and source records attributed to W Rüssmann.

At least 37 records · Page 2Linked to original sources
PubMed1996

The influence of strabismus surgery on the blood-aqueous barrier: tyndallometry case studies in patients with risk factors.

We present tyndallometry as a method for investigation of subclinical changes in anterior-chamber flare in patients with risk factors regarding anterior-segment ischemia after squint surgery. The cases of six adult patients who underwent surgery on the vertical recti and who had additional risk either because of dysthyroid orbitopathy or because of transpositions carried out on the recti are presented. In one case a transient subclinical increase in the flare value was observed. This noninvasive method seems suitable for the provision of further information on the pathophysiology of anterior-segment ischemia and for monitoring of patients at special risk postoperatively such that early treatment can be started if necessary. Additionally, early detection of nonischemic intraocular inflammation in the postoperative course is rendered possible by this examination.

Adult↗
PubMed1993

[The 4-prism diopter base-in test in diagnosis of exophoria with asthenopia and compensation by accommodative convergence].

About 30% of our patients suffering from purely binocular asthenopia showed lower binocular than monocular visual acuity. Cover test examination revealed exophoria at near fixation, which could be regarded to be physiological. Furthermore, the Pola test as well as Graefe's prism diplopia test showed no pathological findings. When given 4 prism base-in, a better binocular acuity was achieved and exophoria at for distance fixation was revealed. Often the prisms base-in had to be increased slowly and an operative treatment was indicated in 80%. The test is described in detail and examples from typical case studies are demonstrated. The importance of the test for understanding asthenopia in cases with heterophoria is discussed.

Accommodation, Ocular↗
PubMed1992

Asthenopia: frequency and objective findings.

Fifty young adults were interviewed about the asthenopic symptoms experienced in the preceding 6 months by means of a questionnaire; they then underwent ophthalmic investigation. We established the frequency of occurrence of single asthenopic symptoms and looked for their prevalence in subgroups determined by objective findings such as phorias, different accommodation widths, different fusional vergence widths, and others. The frequencies of single complaints were: headache 42/50 (84%), ocular pain 17/50 (34%), foreign body sensation 25/50 (50%), red eyes 22/50 (44%), photophobia 24/50 (48%), double vision 5/50 (10%), difficulties when changing fixation distance 21/50 (42%). We did not find any obvious preference for one of the symptoms in any of the subgroups mentioned above.

Adult↗
PubMed1991

[Endoscopically-controlled endonasal orbital decompression in malignant exophthalmos].

In 6 patients with endocrine ophthalmopathy, indications, surgical technique and results of the endoscopic controlled endonasal orbital decompression are described in comparison to the common surgical procedures. When medical and radiation therapy fail, indications for decompression are a) loss of visual acuity or visual field defects, b) increasing strabismus, c) severe keratopathy due to eyelid retraction. The endoscopic-controlled endonasal surgical decompression technique is proceeded in three steps. First, an endonasal ethmoidectomy with resection of the middle turbinate is performed and the medial wall of the maxillary sinus is widely opened. Second, the medial and inferior wall of the orbital walls are removed, preserving the infraorbital nerve. In the last step, the periorbital area is incised and the orbital fat herniates. The advantages of this procedure consist in the absence of exterior scars and the known morbidity of a Caldwell-Luc antrotomy. The results were documented by computed tomographic scans (CT), magnetic resonance imaging (MRI), Hertel measurements, evaluation of ocular motility and ophthalmoscopy. An average of 3-4 mm improvement in Hertel-measurements could be reached. All patients had a postoperative improvement of visual acuity. 2 patients developed more significant diplopia postoperatively, whereas in all other patients ocular motility either improved or rested unaffected. Therefore, the endoscopic controlled endonasal procedure allows to obtain comparable results to the common extranasal and transantral procedures without the disadvantages of the latter.

Aged↗
PubMed1990

[Surgical treatment of squint today. A status determination].

The treatment of choice for eso- and exodeviations with variable angle and/or convergence excess or eye muscle palsy with diplopia in the gaze field of the paretic muscle is--at least in Central Europe--posterior fixation sutures (Cüpper's suture operation). The scleral sutures are critical in this procedure. More reliable results can be obtained if the sclera is scarified meridionally at the suture site. Sufficient experience with guarantee stable results, even though the procedure is difficult. Tucking of the rectus muscles is gaining increasing acceptance as a less traumatic alternative to resection since with this procedure the vasculature of the insertion is conserved to some extent. Significant sursumduction or deorsumduction of 15 degrees or more and corresponding trochlear palsies can be treated by combined recess-tuck procedures on the oblique muscles (e.g., tucking of the superior oblique and recession of the inferior oblique in the same eye). A combined procedure is more effective than successive operations and side effects are minimized (e.g., consecutive Brown's syndrome). Differing amounts of vertical and torsional deviation can be treated with differential surgery on the margin of the oblique muscles. Dissociated vertical deviation should not be taken for sursumduction caused by inferior oblique overaction (reversed fixation test), as straightforward weakening of the inferior oblique muscles may have serious consequences in the former condition. Surgical treatment of Duane's syndrome should be based on the amant of head posture and on the angle of deviation and retraction in the primary position.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1990

[Refractive errors, strabismus and amblyopia in pre-school screening--experiences using a vision test in kindergarten].

UNLABELLED: Within the framework of mass screenings conducted by the Public Health service section for juveniles, 254 children were examined jointly on a voluntary basis in 5 different kindergartens. The examined children represented in each case 88% of the respective kindergarten groups. The examination programme included, among others, the R5 apparatus (visual acuity in respect of remote objects with and without + 1.5 D), Lang- and DeKa Stereo Test, Cover-and-Uncover Test with remote and near fixation, heterostatic retinoscopy (in 205 children only), ophthalmoscopic fixation test. In addition, the acceptance for U8 and the degree of care in respect of ophthalmological control and treatment were investigated. RESULTS: Strabismus or significant uncorrected errors of refraction were discovered by the on-target tests of covering and uncovering, fixation and retinoscopy in 26 of 205 completely examined children (12.7%). This had not been satisfactorily covered by single tests such as R5-Visus test with the criteria much less than 1.0 (grade 5) or much less than 0.7 (grade 4), respectively stereo tests. The combination of "R5-Test Visus much less than 1.0" and "DeKa Stereo Test not fully identified" attained a sensitivity of 81% with a positive predictive value of only 28%. This combination, therefore, results in too many healthy children being referred to the ophthalmologist. "R5-Test Visus much less than 0.7" and "DeKa Stereo Test not fully identified" attained a sensitivity of 75% with a positive predictive value of 44%. This combination is recommended as long as the R5 or R11 apparatuses are used. The phoria and stereo tests contained in the R5 apparatus are unsuitable for kindergarten screening.(ABSTRACT TRUNCATED AT 250 WORDS)

Amblyopia↗
PubMed1986

[Attention shifting and dissociated vertical squint].

Some patients with dissociated vertical deviation show an increasing upward drift of their squinting eye when reading small numbers at a distance of 5 m, making a special effort to shift attention to the non-squinting eye. This finding is at variance with the view that the manifestation of dissociated vertical deviation may be induced by visual inattention. The phenomenon could be explained by analogy to the occlusion test, by a binocular imbalance in visual information processing. The phenomenon may be found frequently in patients who require surgery for an especially disfiguring intermittent vertical squint. Looking for the phenomenon may be useful when deciding whether to operate for a dissociated vertical deviation: If increasing vertical deviation is observed during binocular acuity testing, surgical treatment should be considered.

Adolescent↗
PubMed1981

[Effectiveness of oblique recession with and without resection of horizontal recti in A and V patterns (author's transl)].

Report on 50 patients (17 V-esotropia, 6 V-exotropia, 17 A-esotropia, 10 A-exotropia) who were re-examined between six weeks and six months after oblique recession without/with resection of horizontal recti (procedure of Bietti, Boyd, Lavat et al.). The reduction in A and V patterns achieved varied considerably and nd was unpredictable. In 45% of the patients there was no change at all, or at most a slight change of less than 3%. Thus, the procedure appears to be less effective than oblique muscle surgery or vertical transposition of horizontal recti. Nevertheless, the oblique recession-resection procedure might be of limited use of torsional effects induced by transposition of horizontal recti are undesirable for functional reasons. A curious finding was the reduction in A and V patterns in three out of five patients who were treated with oblique recessions without/with resection in the opposite direction.

Esotropia↗