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PubMed2006

Ophthalmologic findings in Cornelia de Lange syndrome: a genotype-phenotype correlation study.

OBJECTIVE: To evaluate individuals with Cornelia de Lange syndrome previously screened for mutations in the NIPBL gene for genotype-phenotype correlations with regard to severity of ophthalmologic findings. METHODS: Fifty-four patients with Cornelia de Lange syndrome (26 mutation positive and 28 mutation negative) with varying extent and severity of ophthalmologic findings participated in the study. We conducted a retrospective analysis of ophthalmologic data obtained through survey responses and medical records. The severity of nasolacrimal duct obstruction, myopia, ptosis, and strabismus was classified. The severity of eye findings was compared relative to the presence vs the absence of mutations in the coding region of NIPBL and relative to mutations predicted to result in a truncated protein (nonsense and frameshift mutations) vs missense mutations. Fisher exact test was used to determine the significance of these correlations. RESULTS: A trend toward increased ptosis severity was found among individuals with truncating (nonsense and frameshift) mutations compared with individuals with missense mutations (P = .07). CONCLUSION: NIPBL may be directly involved in ptosis pathogenesis. CLINICAL RELEVANCE: Elucidating the pathogenetic mechanisms of ophthalmologic morbidities in patients with de Lange syndrome may lead to more effective treatment.

Adolescent↗

PubMedDate not supplied

Utilization of routine ophthalmologic examinations in pregnant diabetic patients.

OBJECTIVE: To determine the appropriate frequency of ophthalmologic examinations for retinopathy during gestation in diabetics categorized according to White's classification. STUDY DESIGN: Retrospective review was performed over the period of 1989-1994. Inclusion criterion for gestational diabetics was a late second or early third trimester ophthalmologic examination. Inclusion criteria for classes B-R were a first trimester and third trimester or early postpartum examinations. RESULTS: Of 300 charts reviewed, 100 met inclusion criteria. None of the gestational diabetics had retinopathy. Of class B patients (n = 21), 19% had retinopathy, with 11% progression in background retinopathy; none developed severe background or proliferative disease. In class C patients (n = 9), 56% had retinopathy, 33% with progression; none developed severe background or proliferative disease. Thirteen patients were class D; 92% had background retinopathy, in whom 45% showed progression, 31% with severe background retinopathy; none developed proliferative disease. Combined classes F, R, RF represented 13 patients; 100% demonstrated retinopathy; 46% progressed, 77% with proliferative disease; 15% required laser treatment during the pregnancy. CONCLUSIONS: Routine ophthalmologic examinations in gestational (class A) diabetics have little utility. Results suggest that the need for subsequent ophthalmologic examinations can be based upon White's classification and initial examination results. Classes B and C do not require every trimester eye examinations. Rigorous follow-up is warranted in classes D-R.

Diabetes, Gestational↗

PubMed2004

Ophthalmologic and intraocular non-Hodgkin's lymphoma: a large single centre study of initial characteristics, natural history, and prognostic factors.

The aims of this study were to define the initial characteristics, natural history, and prognostic factors of patients with ophthalmologic and intraocular malignant lymphoma. All patients treated at the Institut Curie for lymphoma with ophthalmologic (orbit and/or adnexa) or intraocular involvement were retrospectively reviewed. A pathological review of all cases was performed according to the WHO classification. One hundred and forty-five patients were selected for the study. Pathological review showed 36% MALT type lymphoma, 22% lymphoplasmocytic lymphoma, and 15% diffuse large B-cell lymphoma. Ophthalmologic and ocular sites were intra-orbital in 61 cases (42%) and conjunctival in 51 cases (35%), with bilateral involvement in 10% of cases. Stage IV was found in 32% of cases, with bone marrow involvement in 12%. With a median follow-up of 90 months, the 5-year DFS and OS were 64 and 79% for low-grade NHL, and 43 and 50% for high-grade NHL. On multivariate analysis, age greater than 59 years, elevated LDH level, stage IV, high-grade histological subgroup, and presence of B-symptoms had a negative impact on OS for the overall population. In conclusion, with a median follow-up of 7.5 years, our large cohort of patients represents one of the largest published series on primary ophthalmologic and intraocular malignant lymphoma.

Adult↗

PubMed2004

Ophthalmologic findings in a large pedigree of 11778/Haplogroup J Leber hereditary optic neuropathy.

PURPOSE: To report the ophthalmologic characteristics of a newly identified seven-generation pedigree of 11778/Haplogroup J Leber hereditary optic neuropathy consisting of 328 living individuals, 111 of whom are maternally related. DESIGN: Observational population cohort study. METHODS: This prospective study of a large Brazilian Leber hereditary optic neuropathy pedigree was carried out as a field investigation in Brazil. We describe the ophthalmologic findings of 192 eyes from 96 maternally related individuals of this pedigree. Spouses were used as control subjects. We conducted comprehensive neuro-ophthalmologic examinations with psychophysical tests, Humphrey visual fields, and fundus photographs. We also correlated the ophthalmologic findings with the previously published epidemiologic assessment of risk factors. RESULTS: We examined 76 carriers and 20 affected individuals. The affected individuals showed severe disease with a mean visual acuity of 2.04 logarithm of the minimal angle of resolution and without evidence of recovery. All the affected individuals showed diffuse optic atrophy with a cup-to-disk ratio greater than 0.5 in 55% of cases. Moreover, among Affected individuals, smokers had a poorer visual acuity (P =.002). Among carriers there were several subclinical abnormalities, including microangiopathy, swelling of nerve fibers, and visual field abnormalities that did not correlate with tobacco or alcohol consumption. CONCLUSIONS: Our results demonstrate a significant influence of environmental risk factors, particularly smoking, for developing Leber hereditary optic neuropathy and for the severity of its clinical expression. However, smoking did not correlate with the subclinical abnormalities detected in carriers. Moreover, subclinical abnormalities were equally distributed between gender.

Adolescent↗

PubMed2003

Prevalence of organic neuro-ophthalmologic disease in patients with functional visual loss.

PURPOSE: To determine the concurrence of various patterns of functional visual loss (FVL) and organic disease. DESIGN: A retrospective case series in a university neuro-ophthalmology practice. METHODS: A retrospective case series in which we reviewed the clinical histories and neuro-ophthalmologic examinations of 133 consecutive patients diagnosed with FVL between July 1999 and August 2001. Functional visual loss was defined as an apparent afferent or efferent dysfunction that was unassociated with or far out of proportion with an identifiable lesion of the visual pathways. RESULTS: A total of 133 patients were identified. Nineteen were pediatric, and 76 were female. Fifty-six had concurrent head or eye pain. Nineteen had a recent history of trauma, and 17 had a recent surgical procedure. The most common pattern of FVL was a normal visual field in the presence of reduced visual acuity. Seventy-one patients (53%) with FVL presented with abnormal neuro-ophthalmologic examinations. Thirteen patients had central scotomata, and all had concurrent retinal or optic nerve pathology. Only 18 patients had a known disability claim pending. CONCLUSION: Although FVL was found in patients with no pathology, it was more common to find objective abnormalities on examination. This concurrence rate underscores the clinical necessity for following patients closely despite the diagnosis of FVL. No pattern of visual field constriction was routinely predictive of ophthalmologic or neurologic pathology except the presence of a central scotoma. The presence of a central scotoma in a nonorganic visual field should alert the practitioner to search for organic pathology.

Adolescent↗

PubMed1994

Ophthalmologic abnormalities in the pediatric cochlear implant population.

To determine the nature and prevalence of ophthalmologic abnormalities in children with congenital or prelinguistic sensorineural deafness, we performed complete ophthalmologic examinations on 54 children aged 2 to 14 years from the University of Miami Ear Institute's Cochlear Implant Program. Of 54 children, 33 (61.1%) had some form of ophthalmologic abnormality, with the majority (24 patients; 44.4%) being refractive errors. Of 54 patients, two (3.7%) had strabismus and two (3.7%) had external adnexal anomalies. One child (1.8%) had cataracts. The cause of the deafness, which had previously been unknown, was determined in three of 54 cases (5.6%) as a result of ocular examinations documenting rubella retinopathy, tapetoretinal degeneration (Usher's syndrome), and iris heterochromia (Waardenburg's syndrome). Routine ophthalmologic examination must be mandated for this population, and the ophthalmologist should be encouraged to play a broader role in the care of children with deficiencies of both vision and audition.

Adolescent↗

PubMed1998

Ophthalmologic manifestations of internal carotid artery dissection.

PURPOSE: To report the ophthalmologic symptoms and signs associated with extracranial internal carotid artery dissection. METHODS: One hundred forty-six consecutive patients with extracranial internal carotid artery dissection were evaluted; 29 were studied retrospectively from 1972 to 1984 and 117 prospectively from 1985 to 1997. RESULTS: Sixty-two percent of patients (91/146) with extracranial internal carotid artery dissection had ophthalmologic symptoms or signs that were the presenting symptoms or signs of dissection in 52% (76/146). Forty-four percent (65/146) had painful Horner syndrome, which remained isolated in half the cases (32/65). Twenty-eight percent (41/146) had transient monocular visual loss, which was painful in 31 cases, associated with Horner syndrome in 13 cases, and described as "scintillations" or "flashing lights"-often related to postural changes or exposure to bright lights-suggesting acute choroidal hypoperfusion in 23 cases. Four patients had ischemic optic neuropathy; one had diplopia. Among the 76 patients with ophthalmologic symptoms or signs as the presenting features of carotid dissection, a nonreversible ocular or hemispheric stroke later occurred in 27, within a mean of 6.2 days (range, 1 hour to 31 days). Eighteen patients had a stroke within the first week after the onset of neuro-ophthalmic symptoms and signs, and 24 had a stroke within the first 2 weeks. CONCLUSION: Ophthalmologic symptoms or signs are frequently associated with and are often the presenting features in internal carotid artery dissection. Painful Horner syndrome or transient monocular visual loss should prompt investigations to diagnose carotid artery dissection and begin early treatment to prevent a devastating ocular or hemispheric stroke.

Adult↗

PubMed2005

[Ophthalmologic prevention of chloroquine and hydroxychloroquine induced retinopathy].

INTRODUCTION: Antimalarial drugs induce severe retinal toxicity. The aims of this study were to evaluate the strategy of screening clinical and preclinical intoxication due to antimalarial agents in two centres of reference and to describe the results of ophthalmologic examination. PATIENTS AND METHODS: Patients referred for ophthalmologic evaluation in connection with antimalarial agents therapy in the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts from October 1999 to December 2000 and in the Hôpital Lariboisière from January 1995 to December 1998 were investigated. A retrospective review of results of ophthalmologic examination, electroretinogram, electro-oculogram, colour vision test and central visual field was conducted to assess retinal intoxication. RESULTS: Among 705 patients recruited in the Centre des Quinze-Vingts, 10 out of 133 who were never treated had an electrophysiological contra-indication to the treatment. Among the 572 other patients, 31 presented with preclinical intoxication (5.4 p. 100) and 8 other patients presented with clinical intoxication. Among 925 patients recruited in the Hôpital Lariboisière, 37 presented with preclinical intoxication (4 p. 100) and four patients presented with clinical intoxication. DISCUSSION: The antimalarial drugs clinical intoxication is rare but nevertheless real. Screening for preclinical intoxication can prevent the evolution toward irreversible retinal intoxication. Diagnosis of preclinical intoxication is established through the confrontation of results of different tests and their evolution. The multifocal electroretinogram remains to be evaluated. CONCLUSION: Ophthalmologic monitoring including funduscopy, should be recommended at least once a year. Visual field seems to become interesting in the screening. Electroretinogram and electro-oculogram remain useful quantitative and obvious tests. A prospective study to assess the optimal way to prevent retinal intoxication is mandatory.

Antimalarials↗

PubMed2001

Neuro-ophthalmological manifestations of systemic lupus erythematosus in Asian patients.

PURPOSE: To report eight patients with diagnosed systemic lupus erythematosus (SLE) who presented with a variety of neuro-ophthalmological complications and outcomes. METHODS: A review of the follow up, subsequent management and outcomes of the neuro-ophthalmological complications of eight patients with SLE. RESULTS: The patients presented with a myriad of symptoms of varying severities. The most common manifestations were that of optic neuropathy and eye movement abnormalities. The outcome was variable ranging from complete recovery to optic atrophy with navigational visual acuity. Treatment was often empirical, although early treatment with corticosteroids has been tried with varying success, CONCLUSIONS: The pathophysiology in the neuro-ophthalmological manifestations of SLE is thought be due to vaso-occlusive disease of the small vessels of the nerve and brain, secondary to an autoimmune process. Ophthalmologists may need to consider the diagnosis of SLE in young women who present with a recent onset of neuro-ophthalmological symptoms and signs.

Adult↗

PubMed1988

[Pediatric ophthalmology: reasons for examination and disease pictures].

A representative sample of 800 patients was taken from 15,000 children treated between 1972 and 1984 in the Department of Pediatric Ophthalmology of Frankfurt University Eye Hospital. Their charts were reviewed to answer two questions: what are the most frequent reasons for ophthalmological examination in children under 15 years old and what are the most frequent diagnoses? Ophthalmological examinations were most frequently scheduled because of strabismus, errors of refraction and trauma or inflammation of the anterior segment, though also in a large number of cases because of general diseases, most often neurologic diseases such as epilepsy or elevated intracerebral pressure. The diseases diagnosed ophthalmologically were classified as congenital or acquired eye diseases and congenital or acquired general diseases with ocular symptoms. The most frequent are indicated in the text. Acquired diseases were more frequent than congenital diseases, though this group proved to be much larger in pediatric patients than in adult patients.

Adolescent↗

PubMed2000

Ophthalmologic findings in children with congenital cytomegalovirus infection.

BACKGROUND: Cytomegalovirus (CMV) infection is the most common congenital viral infection in the United States, affecting 0.5% to 2% of live births. Approximately 90% of infected infants are asymptomatic at birth. We undertook this study to determine the incidence and etiology of visual impairment and other ophthalmologic abnormalities in children with congenital CMV infection. METHODS: We prospectively evaluated 42 symptomatic and 83 asymptomatic children with congenital CMV infection, along with 21 control patients. One or more comprehensive ophthalmologic examinations were performed on each patient. The frequency and etiology of visual impairment and other ophthalmologic problems were tabulated for each patient. RESULTS: Nine of 42 (22%) patients in the symptomatic group had moderate to severe visual impairment in 16 eyes. Visual impairment was primarily due to optic atrophy in 6 of 16 (37%) eyes, macular scars in 2 of 16 (13%) eyes, and cortical visual impairment in 8 of 16 (50%) eyes. In comparison, none of 83 asymptomatic patients had severe visual impairment (P <.001). One asymptomatic patient had mild unilateral visual impairment caused by a macular scar. Strabismus developed in 12 of 42 (29%) symptomatic patients compared with 1 of 83 (1.2%) asymptomatic patients (P <.001). CONCLUSIONS: Visual impairment and strabismus are common in patients with symptomatic congenital CMV infection and rare in patients with asymptomatic congenital CMV infection. Visual impairment may be caused by cortical, optic nerve, and/or retinal abnormalities. Infants with symptomatic congenital CMV infection should undergo careful ophthalmologic screening and follow-up examinations.

Adolescent↗

PubMed2004

Neuro-ophthalmology and paraneoplastic syndromes.

PURPOSE OF REVIEW: To describe the neuro-ophthalmological manifestations of paraneoplastic syndromes and their immunological associations. RECENT FINDINGS: Neuro-ophthalmological signs and symptoms are usually present in paraneoplastic syndromes of the central nervous system. Unlike opsoclonus, less characteristic eye movement abnormalities are difficult to recognize as presenting symptoms of paraneoplastic syndromes. In this setting, the detection of several antibodies, including anti-Hu, Yo, Ma2, Ri, Tr, CV2/CRMP5 or voltage-gated calcium channel antibodies may help to establish that the neuro-ophthalmological disorder is paraneoplastic. Among the recently characterized antibodies, those against the Ma proteins often associate with brainstem encephalitis and vertical gaze paralysis. A small subset of patients with opsoclonus and ataxia harbor anti-Ri antibodies. In other patients, there is preliminary evidence that the autoantigens of opsoclonus reside in the postsynaptic density, but no dominant antibody marker has been identified. Uveitis and optic neuritis are rare accompaniments of paraneoplastic encephalomyelitis; some of these patients harbor anti-CV2/CRMP5 in association with other antibodies. Studies on paraneoplastic retinopathy indicate that immunity to retinal proteins other than recoverin can result in a similar syndrome to that associated with recoverin antibodies, and that melanoma-associated retinopathy may associate with several retinal antibodies. SUMMARY: There is increasing recognition of an extensive variety of neuro-ophthalmological abnormalities as manifestations of paraneoplastic syndromes and of several antineuronal antibodies as clinical markers of these disorders. Basic immunological studies support the pathogenic role of some of these antibodies, and are elucidating the pathogenic mechanisms that underlie these and other antibody-associated paraneoplastic syndromes.

Autoantibodies↗

PubMed1982

Do visual evoked potentials give relevant information to the neuro-ophthalmological examination in optic nerve lesions?

The visual evoked potentials (VEPs) and neuro-ophthalmological examinations of 134 patients were compared. The VEPs were abnormal in 95% of the eyes with optic neuritis. Defective color vision was found in 99%, visual field defects in 88%, decreased vision in 66% and an afferent pupillary defect in 55%. 29 patients with optic neuritis were followed up with repeated tests. VEPs and color vision recovered more slowly than visual acuity and visual field. Abnormal VEPs were observed in 68% of 50 MS patients. An analysis of symptomatic and asymptomatic eyes showed that testing of color vision, visual field and red-free ophthalmoscopy were equally as useful diagnostic tools as VEPs. 4 (8%) of the MS patients had abnormal VEPs despite a normal neuro-ophthalmological examination; 94% of MS patients with symptoms and 47% of MS patients without visual symptoms had abnormal VEPs. VEPs were pathological in 59% of 24 patients with traumatic or compressive optic nerve diseases or optic atrophies of unknown etiology. The neuro-ophthalmological examination was more sensitive than VEPs in the diagnosis of these disorders. A neuro-ophthalmological examination is in most cases sufficient to diagnose optic nerve lesions. VEPs are of diagnostic aid especially in mild optic nerve lesions.

Diagnosis, Differential↗

PubMed1993

Pattern of ophthalmological accidents and emergencies presenting to hospitals.

STUDY OBJECTIVE: To investigate the numbers and characteristics of patients with ophthalmological accidents and emergencies presenting to hospitals. DESIGN: Prospective survey over eight weeks. SETTING: Two general and one ophthalmic accident and emergency departments, two general outpatient departments, and an eye hospital ward consulting room (all in two teaching hospitals) in Newcastle upon Tyne. MEASUREMENTS AND MAIN RESULTS: Consultation numbers by age, sex, health district of residence, source of referral, diagnosis, and disposal were determined. An average of 37 ophthalmological emergency patients were seen daily. The all cause consultation rate per 1000 population for Newcastle residents was 2.64 (17.2 per year); for injuries it was 1.10 (7.2 per year) and for inflammations the rate was 0.91 (5.9 per year). Consultation rates per 1000 were 3.5 for males and 1.8 for females, the excess being explained by the higher risk of injury to men. Most patients were self-referred (58%), consulted during office hours (79.6%), were attended by senior house officers working alone (83.9%), and were asked to return for follow up (66.1%). Patients in an accident and emergency department seldom saw a consultant in their initial management. The diagnoses of patients from outside Newcastle were little different from those who lived within the city. The 10 commonest problems accounted for 68% of all cases. Injuries were the commonest problem (40.9% of all diagnoses). CONCLUSION: Ophthalmological accident and emergencies are an important component of an accident and emergency department workload. These patients are usually seen by junior doctors, some untrained in ophthalmology. The wide range of presenting problems poses a challenge for training and the organisation of effective referral chains, while the gender difference in injury rates points to the potential for prevention.

Adolescent↗

PubMed1993

Lacunar infarcts and white matter attenuation. Ophthalmologic and microcirculatory aspects of the pathophysiology.

BACKGROUND AND PURPOSE: By means of neurological and ophthalmologic examinations we considered whether there is a microcirculatory disorder not related to hypertension and diabetes in patients with lacunar infarcts and whether there are microcirculatory differences in patients with lacunar infarcts compared with those with white matter attenuation. METHODS: Eighty neurological patients with a lacunar infarct underwent computed tomography and, based on the results, were prospectively assigned to subgroups as follows: (1) patients without changes; (2) patients with white matter attenuation but without lacunar infarcts; (3) patients with lacunar infarcts alone; and (4) patients with both lacunar infarcts and white matter attenuation. Clinical and ophthalmologic parameters were monitored. The retinal microcirculation was studied by videofluorescence angiography. These neurological patients were compared with control ophthalmologic patients matched for age, sex, hypertensive and diabetic ocular fundus changes, and smoking habits. RESULTS: On average, the 80 patients with lacunar infarcts had a significantly (P = .0001) slower arteriovenous passage time (2.6 +/- 0.7 seconds) than the ophthalmologic control subjects (1.6 +/- 0.6 seconds). Arteriovenous dye passage time through the retinal microcirculation was nearly normal (2.2 +/- 0.8 seconds) in patients with white matter attenuation alone, but was significantly prolonged in patients with lacunar infarcts (2.9 +/- 0.8 seconds, P = .00085) or both white matter attenuation and lacunar infarcts (2.8 +/- 0.4 seconds, P = .008). CONCLUSIONS: Patients with lacunar infarcts are characterized by an additional disorder of retinal microcirculation independent of arterial hypertension and diabetes. Our data suggested that white matter attenuation and lacunar infarcts may be phenomena with only weak interdependence.

Aged↗

PubMedDate not supplied

Chemoprevention of breast cancer with fenretinide (4-HPR): study of long-term visual and ophthalmologic tolerability.

BACKGROUND: Fenretinide (4-HPR) is a synthetic retinoid being clinically tested in the chemoprevention of different tumors and precancerous lesions. Though safer than many other retinoids in experimental models, in humans 4-HPR may induce adverse effects that mainly affect the eye and visual function. Such effects are thought to be caused by the reduction of plasma retinol levels, which occurs after administration of the retinoid. METHODS: A series of 826 women treated with 4-HPR was studied to quantify the incidence and temporal pattern of occurrence of visual (dark adaptation) and ophthalmologic complaints (ocular dryness, lacrimation, conjunctivitis or photophobia) and to investigate the possible association between their occurrence and plasma retinol levels. RESULTS: The cumulative incidence of visual complaints reached nearly 20% at 5 years. The occurrence of these symptoms was more frequent at the start of treatment. The probability of developing visual complaints was significantly higher in patients with lower plasma retinol concentrations following 4-HPR treatment. The cumulative incidence of ophthalmologic complaints was 8% at 5 years. The occurrence of these complaints was evenly distributed during treatment. Ophthalmologic complaints were not associated with a greater degree of reduction of plasma retinol concentrations, but rather with the patient's age, since symptomatic patients were generally older than asymptomatic patients. CONCLUSIONS: Visual and ophthalmologic complaints are common during 4-HPR treatment; their estimated 5-year cumulative incidence is close to 20% and 8%, respectively. However, the pattern of occurrence over time and the underlying mechanisms of these two types of complaints seem different.

Adult↗

PubMed2006

[Ophthalmological alterations in outpatients with systemic lupus erythematosus].

PURPOSE: To evaluate the ophthalmological alterations in patients with systemic lupus erythematosus (SLE). METHODS: A descriptive cross-sectional study was conducted to analyze 70 patients with diagnosis of SLE based on the American College of Rheumatology criteria. Data regarding sex, age, ethnicity, duration of disease, disease activity, use of corticosteroids and antimalarial drugs, and presence of ophthalmological symptoms were recorded and a full ophthalmic examination was carried out. RESULTS: Sixty-two patients (88.6%) were females, 43 patients (61.4%) were white. Mean age was 43.9 years, 57 patients (81.4%) presented no sign of active disease and 46 patients (65.7%) had no ophthalmological complaints. Dry eye syndrome was diagnosed in 22 patients (31.4%), bilateral subcapsular cataract in 15 patients (21.1%) and glaucoma in 2 patients (2.9%). Fundoscopic evaluation disclosed 8 patients (11.4%) with drusen, 7 (10.0%) with RPE atrophy, 2 patients (2.9%) presented pathological disc excavation, 2 (2.9%) vascular tortuosity and arteriovenous crossing changes, 1 patient (1.4%) had macular chorioretinitis scar and 1 patient (1.4%) had branch retinal vein occlusion. CONCLUSION: SLE is a disease that can present with ophthalmic involvement, usually benign in outpatients. Dry eye and cataract are the commonest ocular findings. The former seems to be more related to SLE itself while the latter probably relates to the chronic use of corticosteroids for the disease treatment. Antimalarial drugs do not frequently cause ophthalmic lesions, although further studies must be conducted in order to assess their impact on patients' long-term visual quality. In the patients with the disease under control, ocular damage is more related to systemic treatment what enhances the need for ophthalmological examination as a routine even in these patients.

Adolescent↗

PubMedDate not supplied

The range and variability of ophthalmological parameters in normal children aged 4 1/2 to 5 1/2 years.

BACKGROUND: Some standards for childhood ophthalmological variables exist. However, for most parameters, the range of variation found in normal children remains poorly defined. METHODS: We have determined the range of normal function for a number of commonly measured ophthalmological variables in 162 children, classified normal by Gold Standard ophthalmological examination. This group is representative of almost 12,000 normal children aged 4 1/2 to 5 1/2 in Nova Scotia. RESULTS: In 56.8% of eyes the visual acuity was 6/4.5. The use of a chart with crowding bars was more discriminating between differences in higher levels of acuity and highlighted differences in acuity between the two eyes. Randot stereoacuity showed a uniform, non-Gaussian distribution of scores. Cycloplegic refractive errors were distributed about a modal value of between +0.5 and +1.0 diopter. Forty percent of eyes had no detectable astigmatism. Ninety-seven percent of subjects had no heterophoria. Fusional vergence data are presented. CONCLUSION: Our results document the complete normal range for selected ophthalmological parameters in normal preschoolers. The values obtained were in general better than expected.

Astigmatism↗