A search was performed of the literature published in peer-reviewed journals from disciplines related to eye care and rehabilitation between 2000 and 2022. The purpose was to discover new thinking on the topic of the evaluation and management of convergence insufficiency in adults. Ninety-one papers were reviewed and summarized. The etiology, identification, evaluation, and management of convergence insufficiency in this population, as reported in the literature, is presented in this paper. Many publications addressing rehabilitation after traumatic head injury addressed the management of convergence insufficiency. There was consensus in the importance of complete patient examination, to include a complete sensorimotor examination and careful refraction, prior to initiating any therapy. A chronic issue continues in the paucity of large, placebo-controlled studies to provide clear best practice for providers. Additionally, healthcare professionals from eye care and other professions are working with patients who have convergence insufficiency without significant interprofessional collaboration.
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BMC Ophthalmol
January 2025
Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Purpose: Reoperations in strabismus are reportedly needed in 20-40% of cases undergoing surgery. The present study investigated the outcomes of reoperations based on preoperative imaging of extraocular muscle insertions, and whether the Anterior Segment Optical Coherence Tomography (ASOCT) was of value.
Methods: Patients with strabismus requiring reoperation with/without previous surgical records at the Advanced Eye Centre, PGIMER, Chandigarh were recruited.
Gac Med Mex
January 2025
Laboratorio de Reprogramación Celular y Enfermedades Crónico-Degenerativas, Department of Physiology, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Progressive supranuclear palsy (PSP) is a rare, atypical parkinsonism, characterized by the presence of intracerebral tau protein aggregates and determined by a wide spectrum of clinical features. The definitive diagnosis is postmortem and is identified through the presence of neuronal death, gliosis, and aggregates of the tau protein presented in the form of neurofibrillary tangles (MNF) with a globose appearance in regions such as the subthalamic nucleus, the substantia nigra, and the globus pallidus The findings in ancillary imaging studies, as well as fluids biomarkers, are not sufficient to support diagnosis of PSP but are used to rule out similar pathologies because there are still no specific or validated biomarkers for this disease. The current treatment of PSP is focused on reducing symptoms, although emerging therapies seek to counteract its pathophysiological mechanisms.
View Article and Find Full Text PDFBrain Behav
January 2025
Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Background: While automated methods for differential diagnosis of parkinsonian syndromes based on MRI imaging have been introduced, their implementation in clinical practice still underlies considerable challenges.
Objective: To assess whether the performance of classifiers based on imaging derived biomarkers is improved with the addition of basic clinical information and to provide a practical solution to address the insecurity of classification results due to the uncertain clinical diagnosis they are based on.
Methods: Retro- and prospectively collected data from multimodal MRI and standardized clinical datasets of 229 patients with PD (n = 167), PSP (n = 44), or MSA (n = 18) underwent multinomial classification in a benchmark study comparing the performance of nine machine learning methods.
J Pak Med Assoc
January 2025
Department of Ophthalmology and Visual Sciences, Dow University of Health Sciences, Karachi, Pakistan.
Tolosa-Hunt Syndrome (THS) is an exceptionally rare disorder characterised by recurrent episodes of excruciating ophthalmoplegia, commonly affecting one side of the face and involving the third, fourth, sixth, and fifth cranial nerves. This syndrome results from non-specific inflammation affecting the cavernous sinus, superior orbital fissure (SOF), and/or orbital apex. In this case report, we present the clinical features, diagnostic evaluation, and management of a 46-year-old female with THS.
View Article and Find Full Text PDFCerebellum
January 2025
Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea.
Alexander's law states that spontaneous nystagmus increases when looking in the direction of fast-phase and decreases during gaze in slow-phase direction. Disobedience to Alexander's law is occasionally observed in central nystagmus, but the underlying neural circuit mechanisms are poorly understood. In a retrospective analysis of 2,652 patients with posterior circulations stroke, we found a violation of Alexander's law in one or both directions of lateral gaze in 17 patients with lesions of unilateral lateral medulla affecting the vestibular nucleus.
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