Amblyopia: Etiology, Detection, and Treatment

1992 ◽  
Vol 13 (1) ◽  
pp. 7-14
Author(s):  
Irene Magramm
Keyword(s):  
Visual Acuity ◽  
Early Detection ◽  
Visual Loss ◽  
Early Recognition ◽  
Visual Outcome ◽  
Visual Development ◽  
Refractive Errors ◽  
Prompt Treatment ◽  
Adhesive Patch ◽  
Cover Test

Amblyopia is a preventable cause of visual loss in children that may be permanent unless it is detected and treated early. It may be caused by strabismus, refractive errors, or cataracts. Primary strabismus may lead to loss of vision from amblyopia and the loss of binocularity. Secondary strabismus may be a sign of primary visual loss in one or both eyes. The most serious disorder that may present as secondary strabismus is retinoblastoma. It is imperative to detect retinoblastoma early because of its morbidity and mortality. Amblyopia is detected by assessing the visual acuity of each eye. Strabismus is detected by using the corneal light reflex test and the cover test. Focusing problems are detected by assessing the visual acuity and the red reflex. Cataracts and retinoblastoma may be detected by examining the red reflex of the eye. Treatment of amblyopia consists of correcting the amblyogenic factor with appropriate glasses and surgery. The preferred eye is patched with an adhesive patch to stimulate visual development in the amblyopie eye. The pediatrician plays a crucial role in the early detection of amblyopia, strabismus, and cataracts. The key to successful visual outcome is early recognition by the pediatrician, referral to the pediatric opthalmologist, and prompt treatment.

scholarly journals Bilateral Syphilitic Optic Neuropathy with Secondary Autoimmune Optic Neuropathy and Poor Visual Outcome

2019 ◽  
Vol 10 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Tanya Kowalski ◽  
Dujon  Fuzzard ◽  
Isla Williams ◽  
Jonathan Darby ◽  
Heather Gwen Mack
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Optic Neuropathy ◽  
Nerve Palsy ◽  
Visual Loss ◽  
Visual Outcome ◽  
High Dose ◽  
Optic Nerve Atrophy ◽  
Poor Visual Outcome ◽  
Appropriate Treatment

We describe the case of a 65-year-old man who suffered progressive visual loss despite appropriate treatment of ocular syphilis. Our patient initially presented with a unilateral 6th nerve palsy and associated double vision, which self-resolved over 6 months. His ophthalmic examination was otherwise normal. 12 months after the initial complaint, he represented with dyschromatopsia, reduced visual acuity, tonic pupils, and optic nerve atrophy. He tested positive for syphilis and was admitted for treatment of neurosyphilis with high-dose benzylpenicillin. Despite treatment, at a 4-month review his visual acuity remained poor and progression of optic nerve atrophy was noted alongside the development of bilateral central scotomas. Further testing was congruent with a diagnosis of autoimmune optic retinopathy. We propose this to be secondary to his syphilitic infection. Syphilis is known as the “great mimicker,” and despite being quite treatable, this case highlights ongoing complexity in the diagnosis and management of syphilis, unfortunately with a poor visual outcome.

scholarly journals VISUAL SCREENING OF SCHOOL CHILDREN IN THE MUNICIPALITY OF SAPAREVA BANYA IN SOUTHWESTERN BULGARIA

2019 ◽  
Vol 31 (4) ◽  
pp. 995-999
Author(s):  
Slavena Stoykova ◽  
Ekaterina Petrova
Keyword(s):  
Visual Acuity ◽  
School Children ◽  
Refractive Errors ◽  
Color Vision Deficiency ◽  
Pupillary Reaction ◽  
Doctor Visits ◽  
High Incidence ◽  
Visual Screening ◽  
Visual Health ◽  
Cover Test

Within 3-days-program almost 200 children and 50 adults had their vision checked by an international qualified team of eye specialists in the local school in Sapareva Banya. Visual acuity, objective and subjective refraction, color perception, binocular vision, cover test, pupillary reaction and other tests were performed. Apart from the ophthalmic examination, all the patients’ parents also filled in questionnaire regarding visual strain regimen, previous eye doctor visits and other details. The aim was to promote visual health, establish and possibly treat refractive errors and amblyopia, to facilitate access to specialized medical care, optical and optometrist’s service for children’s population of remote municipalities with population under 10 000 people. The visual screening of Sapareva Banya school children was of great value because only 38% of children had been examined before. There were no major deviations, severe anisometropia and ametropia values or very low visual acuity patients not wearing optical correction. A surprisingly high incidence of color vision deficiency was found 9, 2% males and 4, 3 % females.

scholarly journals Causes of sub-optimal cataract surgical outcomes in patients presenting to a teaching hospital

1970 ◽  
Vol 4 (1) ◽  
pp. 73-79
Author(s):  
Kshitiz Kumar ◽  
VP Gupta ◽  
U Dhaliwal
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Categorical Variables ◽  
Refractive Errors ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Good Outcome

Introduction: Surgical treatment for cataract blindness in India is increasing apace; however, sight restoration after surgery is not always satisfactory. Objective: To evaluate visual outcome after cataract surgery and causes of sub-optimal outcome, if any. Materials and methods: A cross-sectional study including the patients who had undergone cataract surgery six months to ten years ago was carried out. The variables studied were visual acuity, demographic and surgical factors and ocular findings. The causes of subnormal outcome was categorized into cataract surgery-related or unrelated. Statistical analysis: SPSS-17 was used; the Chi-square test was used to determine the association between good outcome and categorical variables; the t-test was used for continuous variables. Multivariate analysis using step-wise logistic regression was done. Results: Among 644 patients (644 eyes), good outcome (presenting visual acuity 6/18 or better) after surgery was seen in 266 (41.3 %) eyes. Good outcome was significantly related to urban residence, presence of an intraocular lens and absence of ocular co-morbidities or posterior capsule opacification. Borderline and poor outcomes were mainly due to surgeryrelated causes; treatable causes included uncorrected refractive errors, and posterior capsule opacification. Intra-operative complications resulting in a pulled-up pupil were frequent. Conclusions: Surgical factors are responsible most often for sub-optimal visual outcome; some, like induced astigmatism and vitreous loss, can be modified with training; actively encouraging follow-up visits can allow treatment of residual refractive errors and capsular opacification. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5855 NEPJOPH 2012; 4(1): 73-79

An unusual cause of visual loss: Subfoveal, motile angiostrongyliasis

2021 ◽  
pp. 004947552098639
Author(s):  
Roshni Sawh ◽  
Lizette Mowatt
Keyword(s):  
West Indies ◽  
Visual Loss ◽  
Clinical Presentation ◽  
Early Recognition ◽  
University Hospital ◽  
Short Report ◽  
Eosinophilic Meningitis ◽  
The West ◽  
Prompt Treatment ◽  
The University

This is a short report describing the clinical presentation, investigations, treatment and outcome of a patient living in the Jamaican countryside who was diagnosed with a live, motile subfoveal helminth identified as Angiostrongylus cantonensis on optical coherence tomography at the University Hospital of the West Indies Eye Clinic. This is the second documented case in Jamaica. Early recognition of angiostrongyliasis is important as it may manifest as eosinophilic meningitis which can be fatal without prompt treatment.

Ophthalmological follow-up of prematurely born children in preschool age: prospective study of visual acuity, refractive errors and strabismus

2016 ◽  
Vol 22 (4) ◽  
pp. 205-215
Author(s):  
Donata Montvilaitė ◽  
Agnė Grizickaitė ◽  
Aistė Augytė ◽  
Inesa Skvarciany ◽  
Arūnas Barkus ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Prospective Study ◽  
Visual Outcome ◽  
Treated Group ◽  
Full Term ◽  
Preschool Age ◽  
Control Group ◽  
Refractive Errors ◽  
Healthy Children ◽  
A Prospective Study

Background. Preterm birth is a very relevant problem. Retinopathy of prematurity in its severe forms causes visual impairment or can lead to blindness. The aim of the present study was to describe the visual outcome in prematurely born and full-term children at the preschool age and to evaluate the effects of prematurity per se, ROP, and treatment on visual acuity and refractive errors. Materials and methods. A prospective study on the incidence of ROP during 2006–2008 included 103 preterm infants. 81 had ROP and 22 had no history of ROP; 40 were age-matched healthy children. All underwent a complete ophthalmic examination. Results. Significant myopia (≤  –0.50D) in prematurely born children differed from full-term ones. The  ROP treated group had the  highest prevalence of myopia (P  2D) was dominant in the premature group (39%) as compared with the  control group (0%) (P 

scholarly journals Herpes zoster ophthalmicus with retrobulbar neuritis

2016 ◽  
Vol 8 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Pranisha Singh ◽  
Srijana Karmacharya ◽  
Aparna Rizyal ◽  
A P Rijal
Keyword(s):  
Visual Acuity ◽  
Herpes Zoster ◽  
Visual Field ◽  
Rare Case ◽  
Visual Outcome ◽  
Central Scotoma ◽  
Herpes Zoster Ophthalmicus ◽  
Retrobulbar Neuritis ◽  
Prompt Treatment ◽  
Treatment Responses

Background: Retrobulbar neuritis in Herpes Zoster Ophthalmicus (HZO) has been reported very rarely. Objective: To report a very rare case of HZO with retrobulbar neuritis with detailed clinical features and treatment responses. Case: A fifty-eight- year old male presented with Herpes zoster-retrobulbarneuritis in the left eye. It was characterized by decreased visual acuity, mid dilated pupil with sluggish reaction, normal optic disc and central scotoma in Humphrey visual field. Visual acuity improved with systemic Acyclovir and steroids. Conclusion: This is a rare case of HZO associated with retrobulbar neuritis. Prompt treatment with systemic antiviral and steroid improve the visual outcome. Nepal J Ophthalmol 2016; 8(15): 78-81

Internal limiting membrane graft as a treatment for the retinal detachment secondary to an optic disc coloboma

2021 ◽  
pp. 112067212199268
Author(s):  
Jorge Fernández-Engroba ◽  
Muhsen Saman ◽  
Jeroni Nadal
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Optic Disc ◽  
Subretinal Fluid ◽  
Visual Outcome ◽  
Internal Limiting Membrane ◽  
Subretinal Space ◽  
Direct Closure ◽  
Retinal Tears ◽  
Optic Disc Coloboma

Purpose: To report our anatomical outcome with the internal limiting membrane (ILM) graft procedure in the management of rhegmatogenous retinal detachment (RRD) secondary to optic disc coloboma (ODC). Methods: Description of a new surgical procedure in one eye of one patient who underwent pars plana vitrectomy (PPV) combined with ILM graft technique. Subsequent follow-up included optical coherence tomography (OCT) and visual acuity. Results: After only 1 week, the OCT revealed the ILM graft plugging the retinal tear with complete resorption of subretinal fluid. The sealing effect of this graft persisted after 6 months. However, visual outcome was poor and corrected distance visual acuity was 20/200 as a result of the previous long-standing retinal detachment with loss of photoreceptors. Conclusion: We suggest that ILM graft could be performed as a first line treatment in the management of RRD secondary to ODC. This direct closure of the retinal tears, allows a quick and effective interruption of the communication between the subretinal space and the vitreous cavity. Detecting these retinal tears and applying this technique as soon as possible could achieve not only an earlier anatomical success but obtain good visual results in retinal tears with RRD secondary to ODC. Further studies will be necessary to provide more evidences

scholarly journals Epidemiological Findings of Refractive Errors and Amblyopia among the Schoolchildren in Hatta Region of the United Arab Emirates

2021 ◽  
pp. 1-7
Author(s):  
Salam Chettian Kandi ◽  
Hayat Ahmad Khan
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
United Arab Emirates ◽  
Refractive Error ◽  
Screening Program ◽  
Low Vision ◽  
Refractive Errors ◽  
Vision Screening ◽  
Screening Programs ◽  
School Based

<b><i>Introduction:</i></b> Uncorrected refractive errors and amblyopia pose a major problem affecting schoolchildren. We had previously observed that many schoolchildren in the Hatta region presented to the ophthalmology clinic with uncorrected refractive errors and amblyopia, which led us to undertake this research. As per the WHO, the term “visual impairment” can be “low vision” or “blindness.” Based on the presenting vision, “low vision” is defined for children who have vision of &#x3c;6/18 to 3/60 or having visual field loss to &#x3c;20° in the better-seeing eye. Children defined to have “blindness” have presenting vision of &#x3c;3/60 or corresponding visual field of &#x3c;10°. <b><i>Purpose:</i></b> To estimate the magnitude of uncorrected refractive errors and amblyopia among the schoolchildren aged 6–19 years and to assess the efficacy of school-based refractive error screening programs in the Hatta region of the United Arab Emirates. <b><i>Methods:</i></b> An epidemiological, cross-sectional, descriptive study was conducted on the entire student population studying in the government schools of the region. Those who failed the Snellen visual acuity chart test and those who were wearing spectacles were evaluated comprehensively by the researcher in the Department of Ophthalmology of the Hatta Hospital. Data were entered in the Refractive Error Study in School Children (RESC) eye examination form recommended by the WHO, and were later transferred to Excel sheets and analyzed by SPSS. <b><i>Results:</i></b> 1,591 students were screened and evaluated from the end of 2016 to mid-2017. About 21.37% (<i>n</i> = 340) had impaired vision with 20.9% (<i>n</i> = 333) refractive errors, of which 58% were uncorrected. Among the refractive error group, 19% (64 subjects) had amblyopia (4% of total students). The incidence of low vision was 9.5% and blindness was 0.38%. Low vision was found to be 9.5% and blindness 0.38%, taking in to account presenting visual acuity rather than best-corrected visual acuity for defining low vision and blindness. <b><i>Conclusion:</i></b> A significant number of students were detected to have uncorrected refractive errors among the vision impaired group (59%, <i>n</i> = 197) despite a school-based vision screening program in place. Seventy-eight percent of the amblyopia cases (<i>n</i> = 50) were found to be in the 11–19 years age group. Noncompliance with optical corrections was the reason for the high number of cases. A rigorous vision screening program and refractive services, complimented with awareness among parents and teachers, are recommended.

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

2021 ◽  
pp. 112067212110006
Author(s):  
Xin Liu ◽  
Lufei Wang ◽  
Fengjuan Yang ◽  
Jia’nan Xie ◽  
Jinsong Zhao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Management ◽  
Pediatric Patients ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Poor Visual Outcome ◽  
Early Vitrectomy ◽  
Open Globe ◽  
Time From Injury ◽  
Ocular Sign

Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

Recognition and management of neonatal sepsis

2021 ◽  
Vol 30 (7) ◽  
pp. 410-415
Author(s):  
Luke William Crocker ◽  
Ayesha White ◽  
Paul Anthony Heaton ◽  
Débora Pascoal Horta ◽  
Siba Prosad Paul
Keyword(s):  
Neonatal Sepsis ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Evidence Based ◽  
Suspected Sepsis ◽  
Serious Illness ◽  
Prompt Treatment ◽  
Serious Infection ◽  
Common Causes ◽  
Red Flag

Neonatal sepsis results from acute bacterial or viral infection occurring in the first 28 days of life. It causes significant morbidity and mortality, although the outcome can be improved by early recognition and prompt treatment by health professionals. This article describes the most common causes of sepsis, and explains why neonates are particularly vulnerable to infection. It highlights the non-specific way in which an infant with a serious infection may present, indicating the crucial features to elicit during history taking and examination, and emphasising the ‘red-flag’ signs and symptoms that should increase suspicion of a serious illness. The authors have adapted National Institute for Health and Care Excellence guidelines to produce an evidence-based approach to the management of an infant with suspected sepsis, and describe the roles of nurses in ensuring effective treatment and best outcomes for these babies.

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