Intraoperative succinylcholine and the postoperative eye alignment.

In 99 patients undergoing strabismus surgery, an intravenous bolus of succinylcholine (Sch) was given after completion of the strabismus procedure. Reliable data were obtained in 53 patients. The interlimbal distance measured at 60 seconds after injection (VR60) was compared to the interlimbal distance at 1 and 6 weeks postoperatively, to evaluate the correlation between the drug-induced eye position under anesthesia and the awake-eye alignment postoperatively.

A cohort study of transcutaneous oxygen tension and the incidence and severity of retinopathy of prematurity.

Background: Retinopathy of prematurity is a disease affecting the blood vessels of the retina in premature infants that may result in scarring, retinal detachment, and loss of vision. An association between this condition and the exposure of premature infants to supplemental oxygen has been postulated, but the relation between retinopathy of prematurity and blood oxygen levels has not been defined. The purpose of this study of a cohort of preterm infants was to correlate the incidence and severity of retinopathy of prematurity with the duration of exposure to different ranges of oxygen tension as measured by transcutaneous monitoring (tcPO2).

Effectiveness of a gentamicin dosing protocol based on postconceptional age: comparison to published neonatal guidelines.

Objective: To evaluate the effectiveness of a gentamicin dosing protocol based on postconceptional age in producing therapeutic serum concentrations and to compare the protocol with commonly used gentamicin dosing guidelines.

Design: During the initial three months of this study infants were dosed according to physician discretion (group I). In the subsequent three-month period patients were dosed according to a postconceptional age dosing schedule (group II).

Results and complications in treated retinal breaks.

One hundred sixty-four patients (171 eyes) were treated for retinal breaks and the treatment outcomes were studied. One hundred two eyes were acutely symptomatic, 22 eyes were chronically symptomatic, and 47 eyes were asymptomatic. The reasons for further treatment in 38 of the 171 eyes (22%) included the following: (1) inadequate closure of the original break without detachment in eight eyes (5%), (2) new breaks without detachment in 15 eyes (9%), (3) an operation for retinal detachment caused by the original break in seven eyes (4%), or (4) retinal detachment caused by a new break in eight eyes (5%).

Diameter of normal extraocular recti muscles with echography.

To establish the range of diameters of normal extraocular muscles, we used standardized A-scan echography to measure the superior recti/levator complex, medial, lateral, and inferior recti muscles in 38 subjects with healthy orbital tissues. The relationships of age, gender, height, and weight to axial length of the globe were considered. These factors and extraocular muscle diameters were not consistently associated.

Statpac 2 glaucoma change probability.

We compared the traditional intuitive criterion (fixed at 5 dB) with the variable Statpac 2 criterion of the Humphrey Field Analyzer for identifying visual deterioration at individual points within a visual field. The separation of depressed from stable points in 123 follow-up fields of 17 patients, when all points within a field were considered, was reasonably equivalent between the two methods (kappa = 0.55 +/- 0.

Beta-adrenergic responsiveness of choroidal vasculature.

Using in vitro binding methods and autoradiographs, the authors showed that choroidal vessels specifically bind iodine 125 cyanopindolol, a nonselective blocker of beta-adrenergic receptors, in albino rabbits. In humans, the presence of beta-adrenergic receptors in choroidal vessels was confirmed by showing an increased choroidal vascular tone after systemic administration of timolol maleate, a nonselective beta-adrenergic blocker. Topically administered timolol maleate lowered the intraocular pressure but did not reach the choroidal receptors in sufficient quantity to produce a measurable effect on vascular tone.

Nd:YAG cyclophotocoagulation: outcome of treatment for uncontrolled glaucoma.

We reviewed the records of 35 patients (35 eyes) treated with Nd:YAG cyclophotocoagulation for uncontrolled glaucoma and followed for 6 to 36 months or until treatment was declared a failure (loss of light perception, or intraocular pressure (IOP) greater than 21 mm Hg). The mean pretreatment intraocular pressure was 37.9 mm Hg (range, 20 to 61 mm Hg).

Succinylcholine-stimulated muscle tensions following botulinum injection in the domestic cat.

Succinylcholine (SCh) selectively stimulates, and can therefore selectively assay, the multiple innervated (MI) fiber system of the extraocular muscles. Since botulinum-A toxin has been observed to induce changes in eye position in humans, SCh was used to assess the effect of botulinum-A on the SCh-sensitive MI fibers of extraocular muscles. Intravenous SCh infusion (40 micrograms-1 kg-1 min-1 was performed in the anesthetized domestic cat.

Pseudo-loss of fixation in automated perimetry.

During automated perimetry with the Humphrey Visual Field Analyzer, field examinations are labeled unreliable whenever the reported rate of fixation loss is 20% or more. The reported rate of fixation loss results in part from times when the patient's gaze drifts from the fixation point during the examination, but also in part from technical artifacts such as faulty initial localization of the blind spot or false-positive responses by the patient. It was found that technical artifacts caused nearly half of the instances in which a field examination had a reported fixation loss rate of greater than 20%.

Conjunctival cytologic features of primary Sjögren's syndrome.

To determine whether there are specific cytologic features associated with primary Sjögren's syndrome (SS), the authors evaluated impression cytology specimens from three conjunctival sites (temporal bulbar [TB], inferior bulbar [IB], and inferior tarsal [IT]) from 38 SS eyes, 34 eyes of aqueous tear-deficient patients without SS, 35 eyes of seborrheic blepharitis patients, and 17 eyes of normal controls in a masked fashion. The following features were observed more frequently in SS eyes than in the eyes of the other groups: squamous metaplasia of the TB and IB (P less than 0.05), extensive (greater than 75%) goblet cell loss of the TB (P less than 0.

Epstein-Barr virus infection and immunologic dysfunction in patients with aqueous tear deficiency.

The authors tested their hypothesis that Epstein-Barr virus (EBV) infection is a risk factor for aqueous tear deficiency (ATD) by evaluating 38 ATD patients and 17 controls for serologic evidence of EBV infection. Aqueous tear deficiency was graded clinically as mild or severe. A linear trend toward elevated EBV capsid (P less than 0.

Contact B-scan echography in the assessment of optic nerve cupping.

We determined the reliability of high-resolution contact B-scan echography for estimating the optic cup size in 56 eyes of 28 patients with glaucoma or ocular hypertension. Two trained observers independently evaluated horizontal and vertical cup/disk ratios in stereophotographs, and two skilled echographers independently estimated optic cup size in photoechograms in a masked fashion. The reliability of echographic interpretation varied (kappa 0.

The influence of decreased retinal illumination on automated perimetric threshold measurements.

Decreased retinal illumination (such as can be caused by pupillary constriction or light absorption by ocular media opacities) was simulated with a randomly ordered series of neutral density filters in front of the right eyes of five subjects with dilated pupils. Threshold measurements were performed on Humphrey and Octopus perimeters at 0, 5, 10, 15, 20, and 25 degrees nasally along the 180-degree meridian. A 0.

Static threshold asymmetry in early glaucomatous visual field loss.

Ten normal subjects underwent static threshold visual field testing of both eyes with the Humphrey perimeter, with one eye tested twice. The mean sensitivity of the field seemed virtually identical in the two eyes, with the average difference between the right and left eyes (0.65 decibels [dB]) being no greater than the testing error as reflected in the difference between the same eye tested twice (0.

Possibly reduced prevalence of peripapillary crescents in ocular hypertension.

We studied optic disc photographs from 137 healthy subjects and 195 subjects with ocular hypertension. The prevalence of peripapillary crescents was lower among hyperopes than among myopes (p less than 0.05).

Threshold equivalence between perimeters.

To determine equivalence between perimeters, 49 eyes of 35 subjects underwent static threshold testing of the central 30 degrees twice on each of three automated perimeters and twice by manual kinetic threshold testing with the Goldmann perimeter. The Octopus-Humphrey difference was 3.3 dB (2.

Interocular asymmetry of visual function in heterozygotes of X-linked retinitis pigmentosa.

Heterozygotes of X-linked retinitis pigmentosa were studied with full field rod and cone electroretinography and light adapted kinetic perimetry. Twelve parameters from the electroretinograms (ERGs) and two parameters from the kinetic visual fields of both eyes of 22 heterozygotes were measured and statistical comparisons made with results from female control subjects. Rod and cone ERG amplitude parameters were significantly lower and cone timing delayed in the heterozygotes.

Evaluation of phototoxic retinal damage after argon laser iridotomy.

We performed several visual function tests in 17 eyes (ten patients) before and after argon laser iridotomy in an effort to detect diffuse photochemical damage to photoreceptors caused by exposure to the intense, blue-green light that is transmitted into the posterior segment as the iridotomy is created and enlarged. No change was detected in static threshold sensitivity in the central 30 degrees of the field (Octopus perimeter), color sensitivity (Farnsworth-Munsell 100-Hue test), or visual acuity. Contrast sensitivity showed a small increase at low spatial frequencies and a small decrease at high spatial frequencies.

The influence of simulated light scattering on automated perimetric threshold measurements.

The effect of light scattering by ocular media opacities on OCTOPUS and Humphrey perimeter threshold measurements was simulated with randomly ordered sequences of six ground-glass diffusers in the right eyes of five subjects. Threshold measurements were performed at 0 degrees, 5 degrees, 10 degrees, 15 degrees, 20 degrees, and 25 degrees nasally along the 180 degrees meridian with the F4 program on an OCTOPUS perimeter, and with twice-repeated profiles on a Humphrey perimeter. The reduction in differential light sensitivity correlated well with the 2.

The influence of refraction accuracy on automated perimetric threshold measurements.

The effect of refraction accuracy on the differential light threshold of a Goldmann size III (0.43 degrees diameter) stimulus was evaluated in the right eyes of five normal subjects with randomly ordered sequence of plano, +1.00-, +2.

Glaucoma filtering surgery with 5-fluorouracil.

A life-table analysis of surgical outcomes was performed on the first eye of 155 patients who were enrolled in a pilot study of glaucoma filtering surgery with postoperative subconjunctival 5-fluorouracil (5-FU) injections. The success rates at 1-, 2-, and 3-year intervals were 68, 63, and 63%, respectively, for 88 patients with non-neovascular glaucoma in aphakia; 82, 75, and 75% for 39 patients with non-neovascular glaucoma after unsuccessful filtering surgery; and 68% at each yearly interval for 28 patients with neovascular glaucoma. Complications which resulted from filtering surgery and the 5-FU injections included corneal epithelial defects (55.

Retinopathy of prematurity. A randomized, prospective trial of transcutaneous oxygen monitoring.

To determine whether the use of continuous transcutaneous oxygen monitoring (tcPO2) could reduce the incidence of retinopathy of prematurity (ROP) in pre-term infants receiving oxygen therapy, a randomized, prospective trial of constant monitoring using the transcutaneous oxygen monitor versus intermittent monitoring of oxygen was performed on a population of premature infants at very high risk for the development of ROP. Two hundred ninety-six infants were randomly assigned to either a constantly monitored (CM) or standard care (SC) group. CM infants had tcPO2 monitored continuously as long as they required supplemental oxygen, whereas SC infants had tcPO2 monitored only during the more acute state of their illness.

Retinopathy of prematurity. Diagnosis, severity, and natural history.

This article presents data gathered in a prospective clinical trial of constant monitoring of oxygen therapy on the diagnosis, severity (as coded by a severity index [SI]) and natural history of retinopathy of prematurity (ROP) in 214 surviving infants with birthweights less than or equal to 1300 g. ROP developed in 119 (55.6%) infants and, of these, cicatricial ROP developed in nine (7.