Thyroid-associated ophthalmopathy is the most frequent extrathyroidal involvement of Graves’ disease but it sometimes occurs in euthyroid or hypothyroid patients. Thyroid-associated ophthalmopathy is an autoimmune disorder, but its pathogenesis is not completely understood. Autoimmunity against putative antigens shared by the thyroid and the orbit plays a role in the pathogenesis of disease. There is an increased volume of extraocular muscles, orbital connective and adipose tissues. Clinical findings of thyroid-associated ophthalmopathy are soft tissue involvement, eyelid retraction, proptosis, compressive optic neuropathy, and restrictive myopathy. To assess the activity of the ophthalmopathy and response to treatment, clinical activity score, which includes manifestations reflecting inflammatory changes, can be used. Supportive approaches can control symptoms and signs in mild cases. In severe active disease, systemic steroid and/or orbital radiotherapy are the main treatments. In inactive disease with proptosis, orbital decompression can be preferred. Miscellaneous treatments such as immunosuppressive drugs, somatostatin analogs, plasmapheresis, intravenous immunoglobulins and anticytokine therapies have been used in patients who are resistant to conventional treatments. Rehabilitative surgeries are often needed after treatment.
Background. Cerebral visual impairment (CVI) is an increasingly common type of visual disturbance in infants and children. The increased incidence is associated with improved neonatal intensive care services and survival of premature infants, especially in developed countries and our country. For accurate ophthalmological evaluation, it is important to know the behavioral responses to visual stimuli that are unique to CVI such as color preference, need for movement, visual latency, visual field preference, and difficulty in visual complexity. Methods. This review is prepared to draw attention to the subject within the scope of Ankara University Vision, Artificial Vision and Low Vision Rehabilitation training programs. Results. The most common causes are hypoxia and perinatal ischemia. Ocular structures are generally normal or are not sufficient to explain the visual impairment. Diagnosis and habilitation methods differ from visual impairment of ocular origin. As a result, early diagnosis of CVI in infants and toddlers and an effective visual habilitation with a multidisciplinary approach where ophthalmologists and pediatricians lead the team is very valuable. Conclusions. Early diagnosis and early visual habilitation will increase the quality of life of babies and will provide important gains for families and therefore the whole society. Pediatricians should be familiar with this group of disturbances and the available resources, as they are best placed to refer the child for evaluation and rehabilitation and encourage the family for follow-up.
Treatment of patients with dry eye for 6 months with topical cyclosporine A resulted in an increase in Schirmer test results, an increase in BUT scores, and an improvement in cytological grade of the disease.
Behçet's disease (BD) is a multisystemic autoimmune inflammatory disorder characterized by oral aphthous lesions, genital ulcerations, iridocyclitis with hypopyon, and skin lesions. While ocular manifestations occur in nearly 50% of the patients with Behçet's disease, ocular involvement is the initial manifestation in only less than 20% of the patients. Ocular Behçet's disease clinically presents iridocyclitis with or without hypopyon, vitritis, retinitis, occlusive retinal vasculitis, and cystoid macular edema. However, anterior uveitis is usually the only initial ocular manifestation; the most common form is panuveitis. The usual course of the disease is characterized by recurrent inflammatory periods. Recurrent inflammatory attacks may result in irreversible damage and significant visual loss. Early and effective treatment is required to prevent ocular morbidity. Recent developments in the treatment of ocular Behçet's disease like biological agents are promising with a rapid effect and high remission rates.
Due to the increasing age of the global population, rates of visual disability are increasing. Visual rehabilitation is an effective method for increasing quality of life among individuals with low vision or blindness due to unpreventable or untreatable causes. The goal of low vision rehabilitation is to produce people who are independent, have an economically viable profession or skill, and are able to enjoy their lives. The stages of modern low vision rehabilitation include the intake interview, assessment of residual visual functions, assessment of residual functional vision, interventions and recommendations, and vision rehabilitation therapies.
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