Biomedical subjects

William E Scott

Publications and source records attributed to William E Scott.

4 recordsLinked to original sources

PubMed2004

Prism adaptation in visually mature patients with esotropia of childhood onset.

OBJECTIVE: To investigate the role of prism adaptation in the visually mature population with esotropia onset before visual maturation. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Eighty-five patients, 26 prism adapted for near (PAN) and 59 prism adapted for distance (PAD), were included in the study. METHODS: Patients included in this study were older than 9 years and had esotropia with an onset before age 9. Mean follow-up was 30 months (range = 6 weeks-164 months). All patients had prism adaptation and subsequent surgical correction. Surgical success was defined as peripheral fusion on the Worth 4-dot test and < or = 8(Delta) deviation at near and distance on the simultaneous prism and cover test. MAIN OUTCOME MEASURES: Response to preoperative prism adaptation and postoperative alignment and sensory results were examined. RESULTS: Twenty-six of the 85 patients had previous surgical esotropia correction. In the PAD group, 41 were responders. Seventeen of these had built their deviation > or = "0" > 10(Delta) with prism adaptation. All responders had surgery for their prism-adapted angle. Postoperatively, 34 of 41 (83%) responders and 6 of 18 (33%) nonresponders had fusion. In the PAN group, 17 were responders. Nine of these built their deviation with prisms. Postoperatively, 16 of 17 (94%) responders and builders and 1 of 9 (11%) nonresponders had successful surgery with sensory and motor fusion. CONCLUSIONS: Adults with esotropia onset before visual maturation can be prism adapted and surgically treated with a predictable outcome of sensory and motor fusion. Those prism adapted for near with response can be successfully treated with surgery for the near deviation. Prism adaptation also aids in determining those who would benefit from larger amounts of surgery.

Adaptation, Ocular↗

PubMed2002

Sensitivity of photoscreening to detect high-magnitude amblyogenic factors.

PURPOSE: To determine the sensitivity of a unique pupil-size based set of referral criteria of the MTI PhotoScreener(Medical Technology and Innovations, Inc, Cedar Falls, Iowa) to detect high magnitude refractive error. METHODS: The photoscreening photographs of 949 preschool children previously analyzed were reevaluated with the new referral criteria. The original photographs had been obtained from pediatricians' offices and public health and Women, Infants, and Children's (WIC) clinics. The results of this analysis were compared with the gold standard clinical examination and cycloplegic refraction. Sensitivities were calculated for amblyogenic factors based on the magnitude of the refractive error. RESULTS: For 26 patients with anisometropia, the sensitivity to detect anisometropia increased from 46% for +1.25 or greater spherical interocular difference to 100% for +2.50 spherical intraocular difference. For 36 patients with hypermetropia in at least 1 meridian ranging from +3.75 to +7.50 D, sensitivity increased from 53% to detect +3.75 D or greater to 70% for +5.00 D or greater. The sensitivity to detect hypermetropia of +5.75 D or greater was 100%. These criteria detected 82% of patients with astigmatism greater than or equal to +3.00 D, and 100% of patients with astigmatism greater than +3.50 D. CONCLUSION: It is crucial that screening programs avoid over-referrals caused by high false-positive screening rates. The sensitivity of our new criteria increases with higher magnitude refractive error; patients with moderate and severe amblyogenic factors are almost never missed. While the sensitivity to detect lower magnitude refractive error is poor, the amblyogenic impact of such errors remains to be determined.

Amblyopia↗

PubMed2002

Marginal myotomy of the minimally overacting inferior oblique muscle in asymmetric bilateral superior oblique palsies.

PURPOSE: We report the surgical results of marginal myotomy of a minimally overacting inferior oblique muscle in conjunction with traditional recession or myectomy of the greater overacting inferior oblique muscle in 10 patients with asymmetric bilateral superior oblique palsies and asymmetric inferior oblique overaction. METHODS: Ten consecutive patients with bilateral superior oblique palsies had a hypertropia in primary position (5-28 PD) and unequal inferior oblique overaction (0 to +2 in the lesser overacting inferior oblique muscle, +2 to +4 in the greater overacting inferior oblique muscle). Reversal of the hypertropia was noted in ipsilateral oblique upgaze. All patients underwent a recession or myectomy of the greater overacting inferior oblique muscle and a marginal myotomy of the lesser overacting inferior oblique muscle. RESULTS: Seven patients had no vertical deviation in primary position, 2 patients had a residual hypertropia of 2 to 3 PD, and 1 patient had a residual hypertropia of 8 PD. The abnormal head position present preoperatively in 8 patients was eliminated or greatly improved after surgery. Postoperatively all but 1 inferior oblique overaction was graded as 0 to trace. Mean follow-up time was 19 months (range, 1.5-68 months). CONCLUSIONS: In bilateral superior oblique palsies with asymmetric inferior oblique overaction, a mildly overacting inferior oblique muscle can be corrected by marginal myotomy, combined with a recession or myectomy of the greater overacting inferior oblique muscle. This procedure can reduce or eliminate the hypertropia in primary position while minimizing the possibility of residual inferior oblique overaction.

Adult↗

PubMedDate not supplied

Strabismus surgery.

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Humans↗