Buggepanduro4743
worse performance in some tasks could reflect unexpected rod disease, lack of intensive training, or persistent limitations due to the need for cones for specific tasks. Perceptual learning through training regimes could enable patients to optimise use of the PRL and remaining peripheral vision. However, further studies are needed to design optimal training regimes.
To describe an unexpected sensory outcome in an adult male who is seeking ocular re-alignment for a psychosocially symptomatic large non-specific exotropia with suppression. The primary diagnosis was infant onset exodeviation of unclear diagnosis, was managed with bilateral strabismus surgery at two years of age, little memory of follow-up.
Measurable binocular single vision (BSV) was demonstrable following surgery at 17 years of age, albeit slowly between two weeks and six months postoperatively and subsequently enhanced. His newly acquired sub-optimal BSV led to symptomatic occupation-associated asthenopia. Following two subsequent operations over a 15-year period, he has stable, symptom-free ocular realignment within three prism diopters of orthophoria and performing tasks that require extended periods of near-vision activity.
Delayed high levels of stereovision were unexpectedly achieved in an adult with infant onset exotropia with pre-operative sensory suppression that was surgically aligned to near orthophoria. The re-establishment of BSV in such a clinical scenario has to attain a level that is robust enough to meet an individual's social and occupational needs.
Delayed high levels of stereovision were unexpectedly achieved in an adult with infant onset exotropia with pre-operative sensory suppression that was surgically aligned to near orthophoria. The re-establishment of BSV in such a clinical scenario has to attain a level that is robust enough to meet an individual's social and occupational needs.
There is little research that examines the accuracy of paediatric referrals into secondary and tertiary care, particularly those from general practicioners (GPs) to ophthalmology and orthoptic departments. Inaccurate referrals could have a detrimental effect on service delivery and NHS funding as well as patient experience. Available evidence shows GP referral accuracy to range between 39% and 90% across different areas of medicine with accuracy of GP referral to ophthalmology between 56% and 66%.
A retrospective case note analysis was carried out on 99 case notes to examine the accuracy of paediatric GP referrals (including those via the community optometrist) into the Orthoptic Department at Manchester Royal Eye Hospital (MREH).
GP referral accuracy was found to be 63% for strabismus cases, 50% for reduced vision/amblyopia cases, 45% for NAD cases, 100% of nystagmus cases and 92% of "other" cases. GPs were significantly less accurate than community optometrists (p = 0.01). Referrals from GPs alone hadove referral accuracy.
To describe a case of acquired Periodic Alternating Nystagmus (PAN) with oscillopsia treated with botulinum toxin injections into four horizontal rectus muscles.
A 22-year-old woman presented with sudden onset PAN. The only abnormality found following extensive investigations was bilateral superior cerebellar peduncle atrophy on MRI. Various treatment options were discussed, with reasonable response to baclofen, less so to gabapentin. However, she was keen for a longer-term solution without medication-related adverse effects. She was offered weakening of all four horizontal rectus muscles recessions, either with botulinum toxin or surgery, and she opted for the former to simulate the effects of surgery. 2.5 units of Dysport were injected into each horizontal rectus muscle without adverse effect.
Off all treatment, Snellen Visual Acuity (VA) was 6/12 in either eye with oscillopsia as a result of the PAN. Post-botulinum toxin VA was 6/5 and 6/6 on the right and left respectively, with both subjective and she underwent when the effects of the botulinum toxin had worn off. Botulinum toxin could be considered as a treatment option in acquired PAN, particularly in women of childbearing age and/or if intolerant or refractory to medical treatment, but ideally not as a long-term treatment option.We describe a rare case of cyclotorsion likely secondary to medial rectus and inferior rectus pathology in a patient with orbital trauma. Sequential orthoptic measurements including Hess charts are presented alongside relevant sections of the orbital CT scans over the course of the patient's treatment. Following the insertion of a plate to repair an orbital floor fracture, the patient developed cyclotorsion. check details A combined approach of sequential orthoptic assessment and imaging revealed the likely underlying mechanism. Inferior rectus mechanical restriction combined with displacement of the medial rectus pulley appear to be the likely culprits. Once the orbital plate was exchanged for a smaller sized plate the patient's symptoms and clinical features resolved. Although orbital plate malpositioning is not an uncommon event, medial rectus deviation as a cause of cyclotorsion has not previously been described. We discuss the alternative differentials for patients with similar orthoptic findings and how they were excluded.
A new amblyopia tracker app has been designed to provide parents with a method of monitoring a child's vision by presenting a single optotype size that the tester moves to identify the furthest distance the optotypes can be seen. The aim of this study is to evaluate this methodology in adults, comparing the findings to visual acuity (VA) measured with the iSight app and to determine the test retest variability.
Adults, aged 18-39 years, with no known eye condition and VA ≤ 0.7 logMAR were recruited. Bangerter filters were used to simulate amblyopia, where VA was reduced below 0.0 with an interocular difference of at least 0.2 logMAR. Testing for both apps was performed monocularly, with the test order being randomised.
Data from 32 subjects were analysed. For the test retest variability analysis, paired t-tests showed no statistically significant difference between the tests for either eye, either app or the interocular acuity difference (p > 0.3 in all cases). Bland Altman plots showed similar limits of agreement between the two apps.
