Successful argon laser sclerostomy for glaucoma.
A sclerostomy was produced in a case of chronic angle-closure glaucoma using the Argon laser. A filtering bleb was present two years postoperatively and pressure was normalized.
Aged↗
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Results for “Glaucoma, Angle-Closure”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Recurrent orbital and metastatic melanoma in a patient undergoing previous glaucoma surgery.
A 61-year-old woman had unilateral acute angle-closure glaucoma and subsequently underwent a Scheie filtering operation. After a two-week interval, a large choroidal and ciliary body melanoma in the glaucomatous eye was found. No evidence of metastatic disease was found and the eye was enucleated. Histopathologic sections did not show extrascleral extension. Two and one-half years later the patient developed local orbital recurrence of the melanoma and fatal metastatic disease. We hypothesized a possible causal relationship between the filtering surgery and the local and systemic recurrence of the tumor.
Choroid Neoplasms↗
A decision-making schema for the detection of glaucoma.
A schema is proposed for management of optometrical patients who may have glaucoma or any of 22 risk factors of glaucoma. The assessment system has established decision points and management pathways based on risk factors in glaucoma which employ only clinical procedures appropriate to current optometrical practice. This schema is particularly designed to permit diagnosis of early angle-closure glaucoma while the disease is in the symptomless phase, prior to chronic elevation of intraocular pressure and the development of damage to the optic disc and visual fields. A recommendation is made for inclusion of the Van Herick test as routine and in the assessment of patients entering the schema. Gonioscopy should form part of the diagnostic workup, but an alternative pathway is established for use when this technique is omitted.
Adult↗
Management of patients with glaucoma and cataract.
The recent rise in the number of patients with both glaucoma and cataracts has increased the controversy over the management of these concurrent problems. Visual acuity, strength of medication, and previous surgery must be considered when determining whether to do cataract extraction alone, glaucoma surgery alone, or a combined procedure. We have found that the type of glaucoma the patient has influences our choice of surgery. The combined procedure is reserved for patients who have had repeated attacks of angle-closure glaucoma and those whose open-angle glaucoma is difficult to control. Thermal sclerostomy with cataract extraction was successful in maintaining intraocular pressures of 18 mm Hg or lower without medication in 48 of 58 patients.
Cataract↗
Thymoxamine hydrochloride: effects on the facility of outflow and intraocular pressure.
Eleven subjects with normal eyes and sixteen subjects with open-angle glaucoma had a selective alpha-adrenergic blocking agent, thymoxamine hydrochloride 0.5 per cent eyedrop, applied to one of their eyes. This consistently produced miosis, but did not significantly alter the intraocular pressure or the tonographically determined facility of aqueous outflow. Because we find that thymoxamine can selectively induce miosis without significant accompanying effect on the ciliary muscle or facility of outflow, we expect that this drug may prove to be a useful diagnostic adjunct to gonioscopy in distinguishing between angle-closure glaucoma and open-angle glaucoma with narrow angle. It seems worthwhile proceeding with clinical evaluation of this possibility.
Adult↗
[Clinical experiences with timolol eye drops].
Three groups of chronic simple glaucoma (group I: newly adjusted patients; group II: previously satisfactorily pressure-regulated patients; group III: previously notsatisfactorily pressure-regulated patients) received treatment with Timolol eye drops for 4 months. In 34 eyes the intra-ocular pressure could be lowered below 22 mm Hg by Timolol alone, whereas 10 eyes additionally had to be treated with 1% epinephrine. The higher the initial pressure effect, the more pronounced the pressure-lowering properties of Timolol became. Especially in the first 2 weeks, less in the following 14 weeks, Timolol showed a loss in effectiveness. The application of Timolol instead of carbonic anhydrase inhibitors with acute angle-closure glaucoma and secondary glaucoma was successful. Timolol eye drops were tolerated very well. There were no local or systemic side effects.
Adult↗
The Use of ChatGPT to Assist in Diagnosing Glaucoma Based on Clinical Case Reports.
INTRODUCTION: The purpose of this study was to evaluate the capabilities of large language models such as Chat Generative Pretrained Transformer (ChatGPT) to diagnose glaucoma based on specific clinical case descriptions with comparison to the performance of senior ophthalmology resident trainees. METHODS: We selected 11 cases with primary and secondary glaucoma from a publicly accessible online database of case reports. A total of four cases had primary glaucoma including open-angle, juvenile, normal-tension, and angle-closure glaucoma, while seven cases had secondary glaucoma including pseudo-exfoliation, pigment dispersion glaucoma, glaucomatocyclitic crisis, aphakic, neovascular, aqueous misdirection, and inflammatory glaucoma. We input the text of each case detail into ChatGPT and asked for provisional and differential diagnoses. We then presented the details of 11 cases to three senior ophthalmology residents and recorded their provisional and differential diagnoses. We finally evaluated the responses based on the correct diagnoses and evaluated agreements. RESULTS: The provisional diagnosis based on ChatGPT was correct in eight out of 11 (72.7%) cases and three ophthalmology residents were correct in six (54.5%), eight (72.7%), and eight (72.7%) cases, respectively. The agreement between ChatGPT and the first, second, and third ophthalmology residents were 9, 7, and 7, respectively. CONCLUSIONS: The accuracy of ChatGPT in diagnosing patients with primary and secondary glaucoma, using specific case examples, was similar or better than senior ophthalmology residents. With further development, ChatGPT may have the potential to be used in clinical care settings, such as primary care offices, for triaging and in eye care clinical practices to provide objective and quick diagnoses of patients with glaucoma.
Artificial intelligence (AI)↗
Mydriatic effect of anticholinergic drugs used during reversal of nondepolarizing muscle relaxants.
Large doses of anticholinergic drugs (atropine, glycopyrrolate) produced mydriasis in a group of adults with no eye abnormalities except strabismus, though the usual intramuscular and intravenous doses of these drugs do not have this tendency. Such large doses are often given intravenously during general anesthesia to prevent the side effects of neostigmine methylsulfate, which is used to reverse the effect of nondepolarizing muscle relaxants. Neostigmine methylsulfate (Prostigmin) reduced the mydriatic effect when given intravenously in conjunction with atropine or glycopyrrolate. Mydriasis was more likely to occur in lightly pigmented eyes than in eyes with dark irides. Pilocarpine eyedrops instilled at the beginning of anesthesia caused miosis that persisted after the large intravenous doses of atropine or glycopyrrolate were given. To prevent an attack of acute angle-closure glaucoma in any patient who is to receive large doses of anticholinergic drugs during general anesthesia, miotic drug therapy should be continued before, during, and after anesthesia at the same frequency as when awake.
Adolescent↗
Clinical experiences with the use of an automated perimeter (Octopus) in the diagnosis and management of patients with glaucoma and neurologic diseases.
This is a study of 59 patients, 42 with glaucoma and 17 with neurological disease, to compare the Octopus automated perimeter with the conventional Goldmann and Tubinger perimeters for detection and assessment of visual field defects. We believe the Octopus automated perimeter is an excellent method for screening patients suspected of glaucoma and can be expected to identify over 90% of the patients actually having visual field loss due to glaucoma. In patients with neurological disease, the Goldmann perimeter was superior to either the Octopus or Tubinger perimeters in providing clinically useful information.
Adolescent↗
Anterior segment abnormalities in cicatricial retinopathy of prematurity.
Abnormalities that occur in the anterior segments of patients with retinopathy of prematurity have been studied in 72 eyes of 36 patients. The anterior chamber depth, the placido disc image on the cornea, the distortion of polarized light by corneal stress, and keratometry readings were recorded. There was a highly significant correlation between anterior chamber depth, retinopathy of prematurity, and keratometry readings (p less than .001). These findings emphasize the importance of careful follow-up examinations of the anterior segment in retinopathy of prematurity because cataracts, band keratopathy, acute hydrops, and angle-closure glaucoma can progressively occur as complications.
Adolescent↗
Variation and heritability of ocular dimensions. A population study among adult Greenland Eskimos.
Adult Greenland Eskimos from Umanaq town (age 15+) and villages (age 40+) were examined. Optical pachymetry, ultrasonic oculometry, corneal diameter and curvature measurements, and subjective refraction were performed in 5-600 persons. Frequent occurrence of primary angle-closure glaucoma motivated the survey. Age-, sex- and family-variations were studied by linear regression analyses. Conspicuous age effect was found with respect to increase of lens thickness and forward displacement of the lens with age. Almost no age influence was found with respect to increase of lens thickness and forward displacement of the lens with age. Almost no age influence was found with respect to corneoscleral size, i. e. axial length, corneal size and corneal radius of curvature. Conspicuous heritability (h2=0.6-0.8) was found in corneoscleral size parameters as well as lens position, while refractive error showed a much smaller genetic influence.
Adolescent↗
Ultrasonographic study of the effect of different miotics on the eye components.
The effect of topical instillations of carbachol 3%, pilocarpine 2%, aceclidine 2%, aceclidine 2%-adrenaline 1%, and of the Ocusert delivery system was determined and compared in 151 eyes. The depth of the anterior chamber, the thickness and the position of the lens, the length of the vitreous and the refraction were studied. Aceclidine has negligible side effects on the ocular components (maximal change of the anterior chamber 0.20 mm; maximal change of the lens thickness 0.14 mm; maximal myopisation: -1.5 delta. Carbachol has the strongest side effects (maximal change of the anterior chamber 0.80 mm; maximal change of the lens thickness 0.80 mm; maximal myopisation -11.50 delta). Carbachol and pilocarpine may cause an important forward displacement of the lens with the risk of an angle-closure glaucoma in an eye with shallow anterior chamber.
Administration, Topical↗
[Irisangiography of rubeosis iridis].
In 66 patients with a rubeosis iridis due to diabetes mellitus (25), old central retinal vein occlusion (22), long-standing secondary angle-closure glaucoma (6), total old retinal detachment (3) and chronic uveitis (10), iris angiography was performed. Typical angiographical findings were found in some of the cases. One can differentiate the different modes of formation of the new vessels; angiographically, rubeosis iridis is never a congestion of preexisting vessels but rather an active vascular proliferation which is always permeable to fluorescein.
Aged↗
[Contusion and permeability of the hemato-aqueous barrier to fluorescein. Effect of a pretreatment by local indometacine (author's transl].
An experimental study, by angiography of the anterior segment of rabbit's eye, estimates the permeability of the hemato-aqueous barrier, using fluorescein. A trauma of the eye (contusion) leads to a rapid and significant increase in this permeability. However, local pretreatment, using an ophthalmic solution of 0,33% indometacine, almost completely stabilizes the hemato-aqueous barrier, even for elements as diffusible as fluorescein. These results suggest that application of a similar preparation to the human eye could be useful in the treatment of ocular contusions, chemical burns and angle-closure glaucoma. But the best perspective could be the application of the indometacine solution to the eye, before an operation, to reduce the sideeffects of surgery relative to the surgical break of the hemato-aqueous barrier.
Animals↗
Blindness due to illicit use of topical cocaine.
A drug abuser developed simultaneous bilateral corneal ulcerations after the use of topical cocaine. One eye was enucleated because of secondary angle-closure glaucoma and the other developed a dense central corneal scar.
Administration, Topical↗
[Trabeculectomy-iridencleisis combined with cataract extraction].
On 31 eyes (23 patients, average age 74 years) with cataract and primary open-angle or chronic angle-closure glaucoma modified trabeculectomy with lobelike iridencleisis was performed combined with cataract-extraction. They were followed up for periods between 6 months and 3 years. In 84% of cases the i.o. pressure continued to be normalized without further antiglaucomatous therapy, in 16% additional treatment with drugs achieved sufficient lowering of i.o. pressure. In nearly all of the cases I observed a diffuse, very flat filtering bleb. Gonioscopy shows, that filtering channels stay open along the margin of the imbedded iris flap. Complications were rare and demanded no further surgery.
Aged↗
Argon laser iridotomy in the treatment of patients with primary angle-closure or pupillary block glaucoma: a clinicopathologic study.
A "pulsed" argon laser was successful in 48 of 64 (75%) attempted laser iridotomies. Scanning and transmission electron microscopy performed on specimens taken at varying intervals following laser treatment revealed progressive scarring of iris tissue. The complications appear minimal at this time, but longer follow-up is required before it can be stated that laser and surgical peripheral iridectomies are comparable. However, the laser's simplicity and ease of administration appear to warrant its continued use at this time.
Argon↗
Argon laser iridotomy in primary angle-closure or pupillary block glaucoma.
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Argon↗