Effect of drysuit seals on intraocular pressure in non-immersed scuba divers.

Objective: This study quantifies the change in intraocular pressure (IOP) secondary to wearing neck seals in scuba diving drysuits. Previous work demonstrates significant pressures exerted by these seals; we hypothesize that they would.

Methods: IOP was measured in 33 divers before and while wearing a drysuit using rebound tonometry.

Quantifying drysuit seal pressures in non-immersed scuba divers.

Introduction: Drysuits use flexible neck and wrist seals to maintain water-tight seals. However, if the seals exert too much pressure adverse physiological effects are possible, including dizziness, lightheadedness, syncope, and paresthesias in the hands. We aimed to quantify the seal pressures of neck and wrist seals in non-immersed divers.

Delayed recognition of Type II decompression sickness in a diver with chronic atrial fibrillation.

Introduction: This case report describes an initially overlooked Type II decompression sickness (DCS) occurrence that was confused with a cerebral vascular accident in a patient with chronic atrial fibrillation (AF). The purpose of this case report is to reinforce the maxim that DCS needs to be suspected anytime a scuba diver experiences signs or symptoms compatible with DCS after completing a scuba dive.

Methods: A 71-year-old scuba diver with a history of AF and who was taking warfarin made four dives, all with maximum depths less than 60 fsw (20 msw) over a 10-hour interval.

Is more complex safer in the case of bail-out rebreathers for extended range cave diving?

Nowhere is redundancy more indispensable than extended range cave diving. Training and practice in this discipline ensure divers are equipped with backup regulators, gauges, lights, and adequate breathing gas for a safe exit, emergencies, and decompression. Depending on penetration distances and depth, open circuit cave diving may require carrying more gas cylinders than can be logistically managed by the diver themselves while maintaining safe gas supply margins.

Prevention of middle ear barotrauma with oxymetazoline/fluticasone treatment.

Middle ear barotrauma (MEB) is a common complication of hyperbaric oxygen (HBO2) therapy. It has been reported in more than 40% of HBO2 treatments and can interrupt the sequence of HBO2. MEB may lead to pain, tympanic membrane rupture, and even hearing loss.

The effectiveness of risk mitigation interventions in divers with persistent (patent) foramen ovale.

Introduction: Persistent (patent) foramen ovale (PFO) is a recognized risk for decompression sickness (DCS) in divers, which may be mitigated by conservative diving or by PFO closure. Our study aimed to compare the effectiveness of these two risk mitigation interventions.

Methods: This was a prospective study on divers who tested positive for PFO or an atrial septal defect (ASD) and either decided to continue diving without closure ('conservative group'), or to close their PFO/ASD and continue diving ('closure group').

Underwater nasal decongestant use: a novel approach to middle ear equalization.

Middle ear barotrauma is the most common diving-related injury. It is estimated to occur in more than 50% of experienced divers. Although divers learn how to effectively equalize their ears with various maneuvers, airway congestion may impede the ability to equalize the middle ear space via the Eustachian tube.

Efficacy of the U.S. Navy Treatment Tables in treating DCS in 103 recreational scuba divers.

Despite the fact that current decompression schedules reduce the risk of decompression sickness (DCS), recreational scuba divers continue to experience DCS. Therapy outcomes in these divers are difficult to track. Our study aims to understand the efficacy of the United States Navy (USN) Treatment Tables (5, 6, 6A, 9) in providing symptomatic relief among recreational scuba divers.

A favorable outcome despite a 39-hour treatment delay for arterial gas embolism: case report.

Cerebral arterial gas embolism (CAGE) occurs when gas enters the cerebral arterial vasculature. CAGE can occur during sitting craniotomies, cranial trauma or secondary to gas embolism from the heart. A far less common cause of CAGE is vascular entrainment of gas during endoscopic procedures.

Assessment of Somatosensory Function in Patients With Idiopathic Dry Eye Symptoms.

Importance: Somatosensory dysfunction likely underlies dry eye (DE) symptoms in many individuals yet remains an understudied component of the disease. Its presence has important diagnostic and therapeutic implications.

Objective: To assess the integrity of nociceptive system processes in persons with DE and ocular pain using quantitative sensory testing (QST) techniques applied at a site remote from the eye.

Characteristics of Ocular Pain Complaints in Patients With Idiopathic Dry Eye Symptoms.

Objective: The purpose of this study was to examine the severity and quality of ocular pain complaints in patients with dry eye symptoms.

Methods: Subjects with clinically relevant dry eye symptoms (dryness, discomfort, tearing) of unknown origin seen in the Miami Veterans Affairs eye clinic were administered questionnaires for dry eye symptoms and ocular pain and underwent a standardized ocular examination. Qualities and severity ratings of ocular pain in subjects with idiopathic dry eye were compared with similar measures from published data in other chronic pain populations.

Neuropathic Ocular Pain due to Dry Eye is Associated with Multiple Comorbid Chronic Pain Syndromes.

Unlabelled: Recent data show that dry eye (DE) susceptibility and other chronic pain syndromes (CPS) such as chronic widespread pain, irritable bowel syndrome, and pelvic pain, might share common heritable factors. Previously, we showed that DE patients described more severe symptoms and tended to report features of neuropathic ocular pain (NOP). We hypothesized that patients with a greater number of CPS would have a different DE phenotype compared with those with fewer CPS.

Outcomes in pediatric patients with Chiari malformation Type I followed up without surgery.

Object: The natural history of untreated Chiari malformation Type I (CM-I) is poorly defined. The object of this study was to investigate outcomes in pediatric patients with CM-I who were followed up without surgical intervention.

Methods: The authors retrospectively reviewed 124 cases involving patients with CM-I who presented between July 1999 and July 2008 and were followed up without surgery.

Angiocentric glioma-like tumor of the midbrain.

Angiocentric glioma, a rare brain neoplasm with features of ependymal differentiation, has only recently been recognized as a distinct clinicopathological entity. To date, all reported cases have involved tumors in the cerebral hemispheres, and the majority have presented with seizures. The authors report the case of a 5-year-old girl who presented with several cranial neuropathies and mild gait disturbance.