Breaking Barriers to Visual Care: Ophthalmology Nights at a Free Clinic.

This report from the field provides an overview of Ophthalmology Nights at the Free Clinic at Lubbock Impact, highlighting its challenges and its usefulness in combating disparities in visual care accessibility for our high-risk population.

Patient's Perceptions of Importance of Discontinuing Antithrombotic Medication Before Oculoplastics Surgery.

This study aims to analyze patients' perspectives to ultimately gain insight into the patients understanding in 3 broad categories: their understanding of how their medications, supplements, and over-the-counter drugs work, their understanding of the risks these agents pose in a surgical setting, and their preferences for the continued use of the agents during and after oculoplastic surgery. To obtain these data, the authors prospectively surveyed 129 patients who had an oculoplastic surgery clinical evaluation at our tertiary care academic facility. Because no previously validated questionnaire on this topic existed, the authors utilized a novel questionnaire the authors developed.

Two-muscle surgical treatment of a compensatory head tilt in an adult with acquired downbeat nystagmus.

Kestenbaum-Anderson-like operations have proven beneficial in treatment of compensatory head tilt in patients with infantile nystagmus. However, their use in acquired vertical nystagmus in adults with head tilt has rarely been reported. Presented here is a case of a 52-year-old woman with acquired downbeat nystagmus with a significant head tilt who responded to a simple two-muscle surgery involving the superior recti.

Ectopic craniopharyngioma of the orbit: illustrative case.

Background: Craniopharyngiomas are uncommon malformations of the sellar or parasellar region that are partly cystic and calcified and have low histological grade. The typical age of presentation is bimodal, with peak incidence rates in children at age 5 to 14 years and in adults at age 50 to 74 years. The usual clinical manifestations are related to endocrine deficiencies due to mass effect along with visual impairment and increased intracranial pressure.

Review of 451 Patients Presenting With Orbital Wall Fractures: A Retrospective Analysis.

A retrospective review of the electronic medical records of patients presenting to the University Medical Center in Lubbock, Texas with orbital wall fractures. Clinical data such as associated ocular injuries and different management approaches are analyzed and discussed to help clarify the specific indications for, and timing of, a formal ophthalmologic examination. All patients who presented to the emergency department for an orbital fracture after suffering various types of traumas between 2008 and 2017 were included.

Case report of instantaneous resolution of juvenile macular degeneration blindness after proximal intercessory prayer.

An 18-year-old female lost the majority of her central vision over the course of three months in 1959. Medical records from 1960 indicate visual acuities (VA) of less than 20/400 for both eyes corresponding to legal blindness. On fundus examination of the eye there were dense yellowish-white areas of atrophy in each fovea and the individual was diagnosed with juvenile macular degeneration (JMD).

Reevaluation of Current Prism Standards With Recommendations to Increase Accuracy in the Measurement of Strabismus.

Purpose: To critically evaluate the traditional standards for holding single prisms in measuring strabismus, with the specific goal being to increase the overall accuracy of clinical measurements.

Design: Reliability and validity analysis.

Methods: Using an analysis involving geometric optics, the effective prism power (EPP), measured in prism diopters (PD), was calculated for glass and acrylic prisms and was the main outcome measure.

Basal Encephalocele Presenting with Bitemporal Hemianopsia in an Adult Male.

Basal encephaloceles are uncommon malformations that are usually congenital in nature, although, occasionally, they can be traumatic. When they are congenital, they are associated with skull and facial midline defects, central nervous system abnormalities, and possible ocular and visual problems. The authors present a case of an adult male with a basal encephalocele who presented with a bitemporal hemianopsia.

Mucosa-associated lymphoid tissue lymphoma with intraocular and orbital involvement: case presentation and review of the literature.

Primary ocular lymphomas are typically confined to either the eye or the orbit. Rarely, in immune-competent patients, lymphomas affect both the eye and the orbit simultaneously. Mucosa-associated lymphoid tissue (MALT) lymphomas are the most common ocular lymphomas.

Lacrimal gland enlargement as an early clinical or radiological sign in thyroid orbitopathy.

Purpose: Characteristic ophthalmic signs of Thyroid Orbitopathy (TO) include exophthalmos, eyelid retraction, eyelid edema, restrictive extraocular myopathy, and optic neuropathy. In addition lacrimal gland (LG) enlargement can be observed in these patients. However TO has not usually been considered in the differential diagnosis of cases of isolated LG enlargement.

The effective corneal refractive surface as a function of a point in visual space: a three-dimensional analysis.

Purpose: To develop a three-dimensional optical model of the anterior segment which will provide a basis for understanding the effects of corneal and adnexal problems on vision.

Methods: A three-dimensional optical model of the anterior segment was developed to calculate the effective corneal refractive surface (ECRS), which is a specific area of cornea that refracts incident light rays arising from an object in visual space through the physical pupil (PP); light rays refracted by cornea outside the ECRS do not traverse the PP. This model incorporated the patient variables of central anterior chamber depth (A) and central corneal curvature (K).

Effective corneal refractive diameter as a function of the object tangent angle in visual space.

Purpose: To determine whether the currently accepted method of selecting a minimum optical zone diameter for laser refractive surgery that is equal to or slightly greater than the dark-adapted pupil diameter provides a sufficient diameter of corneal surface to focus light arising from objects in the paracentral and peripheral visual field.

Setting: Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.

Methods: An optical model of the anterior segment was developed to calculate the effective corneal refractive diameter (ECRD), which is the diameter of the area of cornea that refracts all incident light rays arising from an object through the physical pupil (PP).

Microarray and protein analysis of human pterygium.

Purpose: Pterygium is a sunlight-related, ocular-surface lesion that can obscure vision. In order to identify specific genes that may play a role in pterygium pathogenesis, we analyzed the global gene expression profile of pterygium in relation to autologous conjunctiva.

Methods: Oligonucleotide microarray hybridization was used to compare the gene expression profile between human whole pterygium and autologous conjunctiva.

Topical apraclonidine in the diagnosis of suspected Horner syndrome.

Topical cocaine is used to confirm the clinical diagnosis of ocular sympathetic denervation, or Horner Syndrome (HS). Cocaine blocks re-uptake of norepinephrine (NE) by sympathetic nerve terminals in the iris dilator muscle, transiently increasing its concentration in the synaptic junction. Norepinephrine activates alpha1 receptors in the iris dilator to cause pupil dilation.

Transient homonymous hemianopia and positive visual phenomena in nonketotic hyperglycemic patients.

Purpose: To report a case of a transient homonymous hemianopia in a patient with nonketotic hyperglycemia with negative magnetic resonance imaging (MRI) scans.

Design: Case report.

Method: A 72-year-old woman with diabetes mellitus was referred to the neuro-ophthalmology service with hyperglycemia and multiple visual complaints.

Rapid, painless unilateral vision loss in a 37-year-old healthy woman.

A 37-year-old woman experienced painless, progressive vision loss to no light perception in the left eye over the course of 3 days. The right eye was unaffected. On examination, the only other abnormal finding was a +4 left afferent pupillary defect.

Pupil size and the ablation zone in laser refractive surgery: considerations based on geometric optics.

Purpose: To determine whether the currently accepted method of selecting a minimum ablation zone size for refractive surgery based on dark-adapted pupil diameter is substantiated by geometric optical analysis.

Setting: Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.

Methods: An optical model of the anterior segment was developed to calculate the effective corneal refractive diameter (ECRD), which is the diameter of the area of cornea that refracts all incident light rays arising from objects along the line of sight though the physical pupil (PP).

Gorham disease of the orbit.

Purpose: To report a case of Gorham disease, also known as vanishing bone disease, of the orbit.

Design: Interventional case report.

Methods: A 43-year-old Caucasian woman developed a depression in her left temple, pulsation in her left upper eyelid and temple, and bulging of the left upper eyelid and headache.