Aims: To evaluate the sensitivity and specificity of 0.5% apraclonidine test in the diagnosis of oculosympathetic paresis (OSP). Method: Apraclonidine (0.5%) was administered to 31 eyes, nine with a diagnosis of Horner syndrome (HS), 22 with bilateral OSP caused by diabetes, and to 54 control eyes. All were confirmed with the cocaine test. The effects on pupil diameter and upper eyelid level were observed 1 hour later. Results: Apraclonidine caused a mean dilation of 2.04 mm (range 1-4.5) (p,0.001) in the pupils with OSP and it caused pupillary constriction in the control eyes with a mean change of 20.14 mm (range 0.5 to 21) (p,0.05). It caused reversal of anisocoria in all HS cases. Its effects on both pupil diameters and upper lid levels differed significantly between the groups (p,0.001). The mean elevation in the upper lid was 1.75 mm (range 1-4) in the OSP group (p,0.001) and 0.61 mm (range 0-3) in the control group (p,0.001). Conclusion: The effect of the apraclonidine (0.5%) test on the pupil diameter was diagnostic for OSP and had at least the same sensitivity and specificity as the cocaine test for the diagnosis of OSP.
Topical medications have a very important role in chronic glaucoma treatment. Long-term use of these medications can cause significant changes on ocular surfaces. In this study, the ocular surfaces of 20 control subjects (group I), 20 primary open-angle glaucoma patients (group II) treated (mean 21.20 +/- 1.32 months) with 0.50% timolol maleate, and 20 primary open-angle glaucoma patients (group III) treated (mean 21.70 +/- 1.34 months) with 0.50% timolol maleate + 1% dipivefrin hydrochloride were evaluated. Studied parameters included Schirmer's test, tear break-up time, conjunctiva impression cytology and goblet cell density. These results suggest that long-term applications of topical anti glaucoma medications damage the ocular surface.
Purpose To investigate the causes of glaucoma in children following removal of cataracts. Methods In total, 24 patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma following cataract removal were studied retrospectively. Cataract morphology, surgical technique, postoperative complications, time to glaucoma onset, gonioscopic findings, the presence of microcornea, and the histopathologic characteristics of the filtration angle in one case were the studied parameters. Results We found a bimodal onset of glaucoma. Early-onset glaucoma occurred at a mean age of 6 months in 15 eyes and delayedonset glaucoma at a mean age of 12 years in 22 eyes. Early-onset glaucoma was significantly (P ¼ 0.018) more likely to be due to angle closure. With delayed-onset glaucoma, the filtration angle is open in 86% of eyes and significantly (P ¼ 0.006) more eyes in the delayed-onset group had microcornea. Conclusions Performing cataract surgery very early in life in microphthalmic eyes and leaving residual lens material increases the risk for glaucoma. We recommend a prophylactic iridectomy in eyes at risk for pupillary block. Eyes with delayed-onset glaucoma have open filtration angles but with findings consistent with incomplete development of filtration structures. Early age at cataract extraction and microcornea are risk factors for delayed-onset glaucoma.
The restoration of binocular vision is possible in adults with a long-term history of strabismus and both AS-20 and A&SQ questionnaires are sensitive to detect additive effect of binocular vision on functional aspects of the quality of life. To increase this sensitivity, questionnaires can be modified to include items inquiring tasks that require fine stereopsis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.