Convergence excess esotropia has been treated with bifocals, miotics, medial rectus recession(s), fadenoperation, or a combination of these. However, comparatively few studies on the sensory status of these patients exist. We present the sensory findings in 31 children treated surgically. Age at surgery (years) 5*7 (range 2-5 to 9 0) 6-8 (range 5*5 to [7][8] Age at end of follow-up 8-1 (range 5-0 to 12-0) 9-6 (range 8-0 to 15 0)Preop. near deviation (PD) 35 6 (range 25 to >45) 32-0 (range 25 to >45) Postop. near stereoacuity (arc')
Whiplash or indirect injuries to the neck as a consequence of motor vehicle collisions are a common occurrence in which the frequency of ocular complications is largely unknown. Ophthalmic and oculomotor function was investigated in a longitudinal study of 39 cases who had their initial ophthalmological assessment within one week of the whiplash injury. Ten of 39 cases had ocular symptoms and signs which developed shortly after the accident. The principal abnormality in 6 of these was decreased convergence and accommodation, superior oblique muscle paresis in 2, decreased stereoacuity in 1 and bilateral vitreous detachments in 1 patient. All but 2 had complete resolution of their symptoms within 9 months. Four other patients were asymptomatic but had ophthalmic signs which resolved within 3 months. Oculomotor abnormalities following whiplash injuries are generally mild, have a good prognosis, and would appear from this study to be commoner than hitherto expected.
We report the frequency of troublesome diplopia in 17 patients (11 patients less than or equal to 21 years) who underwent surgical repair of traumatic orbital blowout fractures. Thirteen patients had primary surgery performed within 21 days of injury, 2 patients at 4 and 6 weeks and 2 cases at 6 and 24 months. The latter continues to complain of diplopia. Contrary to previous studies, we found that young patients were no more likely to suffer from symptomatic post-operative residual diplopia than their adult counterparts.
SUMMARY A patient is presented who had unrecognised Wilson's disease. He had developed a clinically obvious Kayser-Fleischer ring in only one eye. The eye without the corneal ring had been injured in childhood and had a low intraocular pressure. Possible mechanisms for formation of a Kayser-Fleischer ring are reviewed and the lack of Kayser-Fleischer ring in this case is discussed.
Case historyThe patient first noticed a slight tremor of his hand and slight unsteadiness of gait at the age of 35. These symptoms progressed very slowly, and he was first seen by a neurologist at the age of 52. Signs present at that time were unsteadiness, cerebellar dysarthria, and ataxia of the hands, the right more than the left. The right eye was blind and divergent, the result of a penetrating injury by a dart at the age of 7.His past medical history revealed an episode of jaundice as a teenager and a urinary infection at the age of 40. Relevant family history was that his identical twin brother had died of hepatitis at the age of 47. He had also suffered from ataxia of a similar severity.Heredofamilial ataxia was diagnosed.
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