Asunto(s)
Antagonistas Adrenérgicos alfa/efectos adversos , Extracción de Catarata , Complicaciones Intraoperatorias/inducido químicamente , Iris/efectos de los fármacos , Hiperplasia Prostática/tratamiento farmacológico , Quinazolinas/efectos adversos , Anciano de 80 o más Años , Humanos , Masculino , SíndromeRESUMEN
PURPOSE: Rhegmatogenous retinal detachment combined with spontaneous pre-operative choroidal detachment (RDCD) represents a rare but specific entity, which has in the past been associated with a poor prognosis. This study was designed to determine the efficacy of pars plana vitrectomy with silicone oil injection in the management of this very difficult vitreoretinal problem. METHODS: A retrospective analysis was carried out of 13 eyes of 13 consecutive patients who underwent vitrectomy and silicone oil exchange. RESULTS: In a total of 10 eyes (77%) the first procedure produced anatomical success. Two eyes required a further procedure to achieve retinal reattachment, producing a final anatomical success rate of 92%. CONCLUSION: Pars plana vitrectomy with silicone oil exchange is an effective technique for managing RDCD.
Asunto(s)
Enfermedades de la Coroides/cirugía , Desprendimiento de Retina/cirugía , Aceites de Silicona/uso terapéutico , Vitrectomía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de la Coroides/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Desprendimiento de Retina/complicaciones , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
PURPOSE: To assess the effect of pupil dilation on vision and driving ability. METHODS: A series of tests on various parameters of visual function and driving simulator performance were performed on 12 healthy drivers, before and after pupil dilation using guttae tropicamide 1%. A driving simulator (Transport Research Laboratory) was used to measure reaction time (RT), speed maintenance and steering accuracy. Tests of basic visual function included high- and low-contrast visual acuity (HCVA and LCVA), Pelli-Robson contrast threshold (CT) and Goldmann perimetry (FIELDS). Useful Field of View (UFOV--a test of visual attention) was also undertaken. The mean differences in the pre- and post-dilatation measurements were tested for statistical significance at the 95% level using one-tail paired t-tests. RESULTS: Pupillary dilation resulted in a statistically significant deterioration in CT and HCVA only. Five of 12 drivers also exhibited deterioration in LCVA, CT and RT. Little evidence emerged for deterioration in FIELDS and UFOV. Also, 7 of 12 drivers appeared to adjust their driving behaviour by reducing their speed on the driving simulator, leading to improved steering accuracy. CONCLUSIONS: Pupillary dilation may lead to a decrease in vision and daylight driving performance in young people. A larger study, including a broader spectrum of subjects, is warranted before guidelines can be recommended.
Asunto(s)
Conducción de Automóvil , Midriáticos/efectos adversos , Tropicamida/efectos adversos , Trastornos de la Visión/inducido químicamente , Adulto , Sensibilidad de Contraste/efectos de los fármacos , Femenino , Humanos , Masculino , Pruebas de Visión/métodos , Agudeza Visual/efectos de los fármacosAsunto(s)
Blefaritis/etiología , Síndrome de la Vena Cava Superior/diagnóstico , Anciano , Edema/etiología , Cara , Humanos , Masculino , CuelloRESUMEN
PURPOSE: Approximately 6% of general practitioners have worked in ophthalmology but to our knowledge the relevance of this training has not previously been evaluated. METHODS: We sent an anonymous questionnaire to all doctors who had held general practitioner registrar (vocational training) posts in ophthalmology in the Northern Region during a 5-year period (1989-1994). RESULTS: Twenty-six of 48 (54%) questionnaires were returned. Twenty-five of 26 respondents (96%) thought the training was useful, with 22 (91.7%) continuing to use some ophthalmic practical skills and 17 (65.4%) said they had received adequate and relevant clinical exposure. Twenty-one (87.5%) of those in general practice felt that they were more confident with eye problems than their peers and 12 (50%) said their referral patterns differed. Eleven (46%) had provided advice for colleagues. However, 9 (34.6%) commented on the large service commitment and 5 (19%) felt that supervision had been inadequate. Only 9 (34.6%) had received relevant teaching and 18 (69%) thought more was necessary. CONCLUSION: We conclude that general practitioner registrar posts in ophthalmology are useful and rewarding but that there is scope for improvement.
Asunto(s)
Actitud del Personal de Salud , Educación de Postgrado en Medicina/normas , Medicina Familiar y Comunitaria/educación , Oftalmología/educación , Inglaterra , Humanos , Encuestas y CuestionariosRESUMEN
Diclofenac is a non-steroidal anti-inflammatory drug available in an ophthalmic preparation. We present a prospective randomised double-masked placebo-controlled trial involving 40 patients that assessed the effectiveness of topical diclofenac in relieving pain from traumatic corneal abrasions. Statistical analysis of visual analogue and categorical pain scores revealed a significant reduction in pain experienced by subjects in the diclofenac group (p < 0.02).
Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Lesiones de la Cornea , Diclofenaco/uso terapéutico , Dolor/tratamiento farmacológico , Administración Tópica , Adulto , Anciano , Método Doble Ciego , Humanos , Persona de Mediana Edad , Dolor/etiología , Dimensión del Dolor , Estudios ProspectivosRESUMEN
A case of an epidermoid cyst in the cerebello-pontine angle presenting with facial pain is reported. The tumour was discovered during neurovascular decompression of the fifth nerve. A pre-operative CT scan was normal. The role of neuroradiological investigation in young patients with trigeminal neuralgia is discussed.