Ophthalmology
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To determine whether early age-related maculopathy (ARM) is associated with visual difficulty in daily activities beyond the difficulty that would be expected based on normal retinal aging; to determine whether scotopic sensitivity and visual acuity are associated with visual difficulties in these older adults. ⋯ Persons in the early phases of ARM, even when their fellow eye has relatively good acuity, are more likely to experience difficulty in night driving, near vision tasks, and glare disability compared with those in good retinal health. Scotopic dysfunction, a functional marker of early ARM, is linked to reported night driving problems. Even when acuity impairment occurs in one eye only, patients report difficulties with day driving and near and far vision tasks.
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To detect and determine the magnitude of vertical deviation in patients with unilateral sixth nerve palsy. ⋯ Small vertical deviations in sixth nerve palsy are consistent with normal hyperphorias that become manifest in the presence of esotropia. In peripheral sixth nerve palsy, static head roll to either side induces hyperdeviation in the eye on the side of the head tilt. Hyperdeviation of the same eye induced by head tilt to either direction implicates a brainstem lesion as the cause of paretic abduction. Quantitative study of sixth nerve palsy demonstrates that if a vertical deviation falls within the normal range of hyperphoria, multiple cranial nerve palsy or skew deviation may not be responsible. Conversely, vertical deviation > 5 PD indicates skew deviation or peripheral nerve palsy in addition to abduction palsy.
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Randomized Controlled Trial Clinical Trial
Intraobserver and interobserver reproducibility in the evaluation of optic disc stereometric parameters by Heidelberg Retina Tomograph.
To assess intraobserver and interobserver reproducibility of the measurement of stereometric parameters of the optic disc by means of the Heidelberg Retina Tomograph I (HRT). ⋯ Measurement of optic disc stereometric parameters by HRT is highly reproducible. However, the use of retinal nerve fiber layer-related parameters should be taken cautiously. The image acquisition-induced variability seems larger than the operator-induced variability.
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To study the clinical and histopathologic features of cutaneous eyelid melanomas and identify prognostic factors in the behavior of such tumors. ⋯ Eyelid skin melanomas have a relatively good clinical prognosis. The histologic type and thickness of the primary melanoma were not clearly related to the clinical behavior once they were completely excised. The use of very narrow excisions of 5 mm or less was associated with greater frequency of local recurrence. Lentigo maligna melanomas were the largest tumors at presentation and, despite being thinner, were a greater surgical challenge. This type of melanoma is almost certainly underdiagnosed by ophthalmologists.