Purpose: To report a carefully studied case of high voltage electrical injury of the retina and optic nerve with anatomically reversible retinoschisis.
Methods: Observational case report.
Results: A 22 year old power company worker was electrocuted with 12,000 V, with his left forehead being the exit point of the current.
Background: The continued increase in idiopathic intracranial hypertension (IIH) prevalence has many implications for societal health care. Its potential vision-threatening consequences make ophthalmologists key players in its diagnosis and management. Newer technology such as optical coherence tomography angiography (OCT-A) enables evaluation of the branching complexity of the peripapillary capillary plexus, a region where accurate imaging via fluorescein angiography was previously limited.
View Article and Find Full Text PDFNeuroophthalmology
June 2016
Horner syndrome can be caused by a wide range of pathologies along the sympathetic nerve chain, from the hypothalamus to the orbit. Imaging workup of Horner syndrome is necessary given the potential for deadly lesions, especially in a patient with a previous cancer history. The authors report a case of a woman who presented with a preganglionic Horner syndrome secondary to vertebral metastasis from previously diagnosed breast cancer that involved the neural foramina at T1 and T2.
View Article and Find Full Text PDFBackground: Idiopathic intracranial hypertension is a disorder characterized by elevated intracranial pressure without an identifiable etiology. Detection of papilledema may be challenging and leads to diagnostic uncertainty in evaluating a child for possible idiopathic intracranial hypertension. Ocular coherence tomography has the potential to add accuracy to the diagnosis of idiopathic intracranial hypertension.
View Article and Find Full Text PDFPurpose: To investigate the relationships between ophthalmology resident performance on the United States Medical Licensing Examination (USMLE), the Ophthalmic Knowledge Assessment Program (OKAP) exam and the American Board of Ophthalmology written qualifying examination (ABO-WQE).
Design: Cohort study.
Participants: We included 76 residents from 15 consecutive training classes (1991-2006) at 1 ophthalmologic residency training program.
We conducted a masked, crossover, therapeutic trial of gabapentin (1,200mg/day) versus memantine (40 mg/day) for acquired nystagmus in 10 patients (aged 28-61 years; 7 female; 3 multiple sclerosis [MS]; 6 post-stroke; 1 post-traumatic). Nystagmus was pendular in 6 patients (4 oculopalatal tremor; 2 MS) and jerk upbeat, hemi-seesaw, torsional, or upbeat-diagonal in each of the others. For the group, both drugs reduced median eye speed (p < 0.
View Article and Find Full Text PDFJ Pediatr Ophthalmol Strabismus
January 2010
Purpose: To review the hypothetical mechanism and therapeutic benefits of the four-muscle tenotomy and reattachment (T&R) procedure using knowledge accrued over the 10 years since its proposal; to describe an augmented tendon suture (ATS) technique to improve the procedure based on one of the originally suggested alternative methods (mechanical); and to hypothesize a new ATS procedure to achieve the same therapeutic benefits without extraocular muscle tenotomy or reattachment to the globe.
Methods: Standard surgical methods were used.
Results: The T&R procedure damps and improves infantile nystagmus syndrome (INS) waveforms, improves eXtended Nystagmus Acuity Function (NAFX) values, broadens the NAFX peak versus gaze angle, and damps slow eye movements but not saccades.
Two patients with genetically confirmed spinocerebellar ataxia type 7 (SCA7) presented with progressive visual loss. Examination disclosed substantial visual acuity loss, central scotomas, and marked dyschromatopsia. Ophthalmoscopic abnormalities were subtle, with only mild retinal artery attenuation and minimal foveal region pigmentary abnormalities.
View Article and Find Full Text PDFPurpose: To delineate the disease course and prognosis of patients with mass lesions of the fourth nerve presumed to be schwannomas.
Design: Nonrandomized retrospective case series.
Participants: Thirty-seven consecutive cases of presumed trochlear nerve schwannoma from 9 tertiary university neuro-ophthalmology centers.
The central projections of the anterior semicircular canals are thought to be conveyed from the vestibular nuclei to the oculomotor nuclei in the midbrain by three distinct brainstem pathways: the medial longitudinal fasciculus, crossing ventral tegmental tract, and brachium conjunctivum. There is controversy as to whether upbeat nystagmus could result from lesions involving each of these pathways. We report a 52-year-old man who presented with a contralesional fourth-nerve palsy and primary-position upbeat-torsional nystagmus due to a small unilateral dorsal pontomesencephalic lymphomatous deposit.
View Article and Find Full Text PDFSaccades are rapid eye movements that assist vision by pointing the fovea of the retina, which contains the highest density of photoreceptors, at features of interest in the visual environment. A great deal is now known about the properties and neurobiology of saccades in both health and disease states. They have consequently become a valuable diagnostic and research tool.
View Article and Find Full Text PDFOcular myasthenia can mimic central disorders of eye movements. We compared horizontal saccades in two patients with myasthenia gravis who presented as pseudo-internuclear ophthalmoplegia (pseudo-INO), two patients with true INO due to multiple sclerosis (MS), and five healthy subjects. In myasthenics, peak velocity of horizontal saccades was similar to, or greater than, controls; in MS patients, adducting saccades were slower than controls.
View Article and Find Full Text PDFObjective: To characterize the syndrome of saccadic palsy that may follow cardiac surgery, and to interpret the findings using current concepts of the neurobiology of fast eye movements.
Methods: Using the magnetic search coil technique, we measured eye, eyelid, and head movements of 10 patients who developed selective palsy of saccades after cardiac surgery.
Results: Patients showed varying degrees of slowing and hypometria of saccades in the vertical plane or both horizontal and vertical planes, with complete loss of all saccades in one patient.
Purpose: To investigate the effects of combined tenotomy and recession procedures on both acquired downbeat nystagmus and horizontal infantile nystagmus.
Methods: Patient 1 had downbeat nystagmus with a chin-down (upgaze) position, oscillopsia, strabismus, and diplopia. Asymmetric superior rectus recessions and inferior rectus tenotomies reduced right hypertropia and rotated both eyes downward.
Purpose: To investigate the effects of four-muscle tenotomy on visual function and gaze angle in patients with infantile nystagmus syndrome (INS).
Methods: Eye movements of nine patients with infantile nystagmus were recorded using infrared reflection or high-speed digital video techniques. Experimental protocols were designed to record the patients' eye-movement waveforms, pre- and post-tenotomy, at different gaze angles.
Background: Diplopia is a common complaint in both inpatient and outpatient neurologic practice. Its causes are many, and special historical and examination features are important to localization and accurate diagnosis.
Review Summary: This review is divided into 2 sections: the first related to diagnosis and the second to treatment of binocular diplopia.
Purpose: To investigate therapeutic effects of oral gabapentin therapy on superior oblique myokymia.
Design: Observational case series with measurement of visual acuity and eye movements before, during, and after therapy.
Methods: Two adult patients with superior oblique myokymia, refractory to other therapies, were treated with gabapentin orally after informed consent was obtained.
© LitMetric 2025. All rights reserved.