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Corneal Reflex

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601. Macular Disorders

. Abnormalities of any of the answers suggest macular pathology. Patients can use the grid at home and test themselves (remind them to do one eye at a time) [ ] . Examination of the macula Ophthalmoscopy - the macula is visible as a dark circular patch between the vascular arches, the fovea being about 1 disc diameter lateral to the disc itself. The foveola is usually seen as a bright pinpoint yellow reflex at the centre of the macula. If you ask the patient to look directly at the light, the macula (...) . The optimal management for these conditions is discontinuation of the medication where possible and observation in the ophthalmology outpatient clinic. Many resolve in time. Chloroquine and hydroxychloroquine - these both have the potential for retinotoxicity and may also result in corneal deposits. The retinopathy is related to the total cumulative dose and is more marked with chloroquine. Patients present with decreased vision (which may be severe in end-stage chloroquine maculopathy - less than 6/60

2008 Mentor

602. Lowe's (Oculo-cerebro-renal) Syndrome

and because of the propensity to develop . Glaucoma develops in about half and is difficult to treat. Surgical implantation of artificial valves to control the release of intraocular fluid is often required. Corneal keloids may require surgical removal of the scar tissue, or radiation therapy. Corneal transplantation is difficult because of problems in administering the required intensive postoperative care. Sometimes surgical correction of is required. Other surgery Orchidopexy may be required. Medical (...) predisposes to dehydration and metabolic imbalance, which can be severe. They have a tendency to develop due to hypotonia and poor cough reflex. Other causes of death include infection and , and sudden unexplained death can occur. Death usually occurs in the second or third decade of life. Genetic counselling If the proband represents a new mutation, the risk to subsequent children is low. If the mother is a carrier, there is a 50% chance of any son being affected and any daughter being a carrier. Did you

2008 Mentor

603. corneal ulceration

infiltration and later, corneal oedema blood vessel dilatation is typically concentrated around the limbus - circumcorneal injection often, the conjunctiva is also inflamed - keratoconjunctivitis discharge is usually present and may be watery, mucoid or purulent; notably, it is absent in keratoconjunctivitis sicca pupil may be small due to reflexive miosis; photophobia is common fluorescein readily demonstrates any ulceration (an epithelial breach) Keratitis an cause significant loss of vision from (1 (...) corneal ulceration corneal ulceration - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search corneal ulceration Keratitis is inflammation of the cornea. This may result from a variety of bacterial, viral or fungal infections, or may be non-infective, for example due to trauma or associated with an auto-immune disease. Inflammation of the cornea commonly presents as a painful red eye with reduced visual acuity due to cellular

2010 GP Notebook

604. corneal inflammation

to cellular infiltration and later, corneal oedema blood vessel dilatation is typically concentrated around the limbus - circumcorneal injection often, the conjunctiva is also inflamed - keratoconjunctivitis discharge is usually present and may be watery, mucoid or purulent; notably, it is absent in keratoconjunctivitis sicca pupil may be small due to reflexive miosis; photophobia is common fluorescein readily demonstrates any ulceration (an epithelial breach) Keratitis an cause significant loss of vision (...) corneal inflammation corneal inflammation - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search corneal inflammation Keratitis is inflammation of the cornea. This may result from a variety of bacterial, viral or fungal infections, or may be non-infective, for example due to trauma or associated with an auto-immune disease. Inflammation of the cornea commonly presents as a painful red eye with reduced visual acuity due

2010 GP Notebook

605. visual reflexes (anatomical basis)

visual reflexes (anatomical basis) visual reflexes (anatomical basis) - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search visual reflexes (anatomical basis) There are several quite distinct neuronal pathways involved in the following visual reflexes: the accommodation reflex the direct and consensual light reflexes the corneal reflex the visual body reflex the pupillary skin reflex Links: General Practice Notebook General

2010 GP Notebook

606. corneal reflex

corneal reflex corneal reflex - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search corneal reflex The corneal reflex that is dependent on the integrity of the Vth and the VIIth cranial nerves. Method: distract the patient by asking them to gaze upwards. lightly touch the cornea with a wisp of cotton wool, bringing the wool from the side of the eye. Interpretation of results: reflex blinking of both eyes - normal patient can (...) feel the touch of the cotton wool - via the ophthalamic division of the trigeminal nerve - but there is no reflex blink - via facial nerve innervation of orbicularis oculi muscles. This indicates facial nerve palsy. unable to feel touch of cotton wool - indicates trigeminal nerve palsy. Links: General Practice Notebook General Practice Notebook The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed medical practitioner should be consulted

2010 GP Notebook

607. Implantable miniature telescope for macualar degeneration (Update)

of visual tasks. External telescopes are generally cumbersome and cosmetically unappealing, and the visual field they offer is severely restricted (5 to 10 degrees, compared to 36 degrees for the IMT). Patients can also experience nausea when using external 2 Update Implantable miniature telescope for macular degeneration: August 2007 telescopes because of the vestibular ocular reflex conflict caused by the need to scan the visual field using head movement rather than natural eye movement (Peli 2002 (...) stage AMD. All patients were 60 years of age or older (mean age 80 years), with best-corrected visual acuity (BCVA) between 20/80 and 20/400 in both eyes. At 12 months, ten of the 13 patients who underwent surgery gained two or more lines of either distance or near BCVA, while eight of 13 gained three or more lines. Mean endothelial cell density decreased by 13 per cent after 12 months, indicating that the corneal endothelium tolerated the procedure well. Finally, all adverse events in the study

2007 Australia and New Zealand Horizon Scanning Network

608. Implantable Miniature Telescope for the treatment of age-related macular degeneration

inappropriate for a large number of visual tasks. External telescopes are generally cumbersome and cosmetically unappealing, and the visual field they offer is severely restricted (5 to 10 degrees, compared to 36 degrees for the IMT). Patients can also experience nausea when using external telescopes because of the vestibular ocular reflex conflict caused by the need to scan the visual field using head movement rather than natural eye movement (Peli 2002). A number of non-optical treatments for AMD have (...) of age or older (mean age 80 years), with best-corrected visual acuity (BCVA) between 20/80 and 20/400 in both eyes. At 12 months, ten of the 13 patients who underwent surgery gained two or more lines of either distance or near BCVA, while eight of 13 gained three or more lines. Mean endothelial cell density decreased by 13 per cent after 12 months, indicating that the corneal endothelium tolerated the procedure well. Finally, all adverse events in the study were resolved with appropriate

2006 Australia and New Zealand Horizon Scanning Network

609. Prediction of outcome in comatose survivors after cardiopulmonary resuscitation

months. Results: The authors identified four class I studies, three class II studies, and five class III studies on clinical findings and circumstances. The indicators of poor outcome after CPR are absent pupillary light response or corneal reflexes, and extensor or no motor response to pain after 3 days of observation (level A), and myoclonus status epilepticus (level B). Prognosis cannot be based on circumstances of CPR (level B) or elevated body temperature (level C). The authors identified one (...) predicted poor outcome (level B). Ten class IV studies on brain monitoring and neuroimaging did not provide data to support or refute usefulness in prognostication (level U). Conclusion: Pupillary light response, corneal reflexes, motor responses to pain, myoclonus status epilepticus, serum neuron-specific enolase, and somatosensory evoked potential studies can reliably assist in accurately predicting poor outcome in comatose patients after cardiopulmonary resuscitation for cardiac arrest. Despite

2006 American Academy of Neurology

610. Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest. (PubMed)

neurological outcome: absent corneal reflexes at 24 hours (LR, 12.9; 95% confidence interval [CI], 2.0-68.7), absent pupillary response at 24 hours (LR, 10.2; 95% CI, 1.8-48.6), absent withdrawal response to pain at 24 hours (LR, 4.7; 95% CI, 2.2-9.8), no motor response at 24 hours (LR, 4.9; 95% CI, 1.6-13.0), and no motor response at 72 hours (LR, 9.2; 95% CI, 2.1-49.4). The proportion of individuals' dying or having a poor neurological outcome was calculated by pooling the outcome data from the 11

2004 JAMA

611. Hereditary sensory and autonomic neuropathy, type 4

signs of the disease. The cardinal feature is absence of sweating on the trunk and extremities, with occasional patients producing some moisture on the forehead, tip of the nose and gluteal sulcus. The skin becomes thick and callused with lichenification of palms, areas of hypotrichosis on the scalp and dystrophic nails. Deep tendon reflexes are usually present. Pain insensitivity is profound resulting in self-mutilation, auto-amputation, and corneal scarring but some patients retain temperature

2007 Orphanet

612. Hereditary sensory and autonomic neuropathy, type 2

preponderance. Clinical description Disease onset is typically in infancy and is non-progressive. Initial symptoms (from birth to 3 years) include lack of crying with trauma, self-mutilation (tongue, lips), swallowing and feeding problems. Gastroesophageal reflux is common. Sensory dysfunction is manifested by reduced or absent pain and temperature perception, and depressed or absent deep tendon reflexes. Corneal reflexes are reduced or absent. Muscle strength is preserved and there is no atrophy. Sensation (...) to fine touch, position, vibration, taste, and gag reflexes may be diminished. Unrecognized injuries (e.g., burns, skin and corneal ulcers) and fractures of hands, feet, and limbs, sometimes resulting in osteomyelitis, as well as Charcot joints are frequent. Some patients have hearing loss. Autonomic involvement is limited to reduced lacrimation. Patients do not typically have orthostatic hypotension or sweating abnormalities. Etiology Causal mutations in several genes have been identified and include

2005 Orphanet

613. Lowe syndrome

The estimated prevalence is 1/500,000 and males are almost exclusively affected. Clinical description OCRL is a neonatal disorder characterized by ocular abnormalities (bilateral congenital discoid cataracts, glaucoma with or without buphthalmos, strabismus, hypermetropia and corneal and conjunctival cheloids), neurological involvement (developmental delay, seizures, hypotonia present at birth typically with absence of deep tendon reflexes), stereotypic behavior (temper tantrums, aggressiveness

2006 Orphanet

614. What other possible causes of watering eye are there other than blocked tear ducts or infection which have been discounted?

caused by emotional or reflex stimulation of the lacrimal gland. Chronic lacrimation may deplete the lacrimal gland to such an extent that tear formation appears normal or reduced. Major causes: • corneal foreign body, abrasion or inflammation • entropion Less frequently: • crocodile tears • psychic stimulation - crying • cholinergic or anticholinesterase drugs • dacryoadenitis • lacrimal gland tumours.” [2] Concerning epiphora, GPNotebook states: “ This describes excessive tearing due to defective

2007 TRIP Answers

615. Efficacy and Safety Study for Ecabet Ophthalmic Solution for Treating Dry Eye Syndrome

that could interfere with study Diagnosis of Sjogren's syndrome, lacrimal obstruction, reflex, lid-related or contact lens-related dry eye syndrome(DES); significant anterior blepharitis or meibomianitis Contraindications or hypersensitivity to use of study meds or components Wear contact lenses Secondary dry eye to surgery Eye surgery (including laser) within 6 months Use of systemic or topical ophthalmic meds within 14 days Punctal plugs in one or both eyes in place for <45 days Permanent occlusion (...) -CS01 First Posted: September 20, 2005 Last Update Posted: March 14, 2013 Last Verified: March 2013 Additional relevant MeSH terms: Layout table for MeSH terms Syndrome Keratoconjunctivitis Sicca Dry Eye Syndromes Disease Pathologic Processes Keratoconjunctivitis Conjunctivitis Conjunctival Diseases Eye Diseases Keratitis Corneal Diseases Lacrimal Apparatus Diseases Pharmaceutical Solutions Ophthalmic Solutions Ecabet Anti-Infective Agents Anti-Ulcer Agents Gastrointestinal Agents Protease

2005 Clinical Trials

616. Intra-arterial Microplasmin Administration in Patients With Acute Intracranial Vertebrobasilar Artery Occlusion

of the onset of neurological symptoms Age 18-75 (inclusive). Exclusion Criteria: Patients with coma > 6 hrs duration and complete loss of brain stem reflexes (corneal reflex, gag reflex, VOR, pupil reflexes) as measured at the last assessment before sedation/intubation Rapidly improving neurologic signs at any time before initiation of study drug administration. Known contrast agent-sensitivity Uncontrolled hypertension defined as a systolic blood pressure > 180 mm Hg or a diastolic blood pressure > 100 mm

2005 Clinical Trials

617. Botulinum toxin for aberrant facial nerve regeneration: double-blind, placebo-controlled trial using subjective endpoints. (PubMed)

facial movements using videotaping and a physicians' grading scale.The videotape measurements of corneal light reflex to upper lid margin distance and vertical palpebral distance were made during adynamic and active facial expression. Thirty-six patients were studied (six in an open-label pilot study design and 30 in a multicenter, double-blind, placebo-controlled trial). Botulinum toxin type A injections consistently suppressed the degree of involuntary eyelid movement associated with smiling

2005 Plastic and reconstructive surgery

618. Alternative Dosing and Regimen of Replagal to Treat Fabry Disease

and 1 month after the last infusion. Safety evaluations are done periodically and include vital sign measurements, physical examination, blood and urine tests, review of drug side effects, electrocardiogram (ECG), Holder monitor (2 hour ECG), and QSART (NIH only). The QSART (quantitative sudomotor axon reflex test) measures the amount of sweat in a particular area of skin, mostly the forearm. For this test, a cup partly filled with a liquid is strapped on the arm. A weak electric current is turned (...) in plasma or serum or less than 8% of average mean normal in leukocytes). Subject must have one or more clinical manifestations of Fabry disease including neuropathic pain, angiokeratoma, corneal verticillata, cardiomyopathy, hypo- or anhydrosis, abdominal pain and/or diarrhea, serum creatinine greater than 1.0 mg/dl or proteinuria greater than 300 mg/24 hours. Subject must have voluntarily signed an Institutional Review Board (IRB) approved informed consent form after all relevant aspects of the study

2004 Clinical Trials

619. Screening Aid to Identify Corneas That May Have Pathologies or Other Conditions

mires, distortion of the retinoscopic, or ophthalmoscopic red reflex (or a combination of these) At least one of the following biomicroscopic signs: Vogt's striae, Fleischer's ring of >2 mm arc, or corneal scarring consistent with keratoconus. Contact lens wearers should discontinue use preferably 1 day or at least half an hour prior to imaging. Myopic Laser Vision Correction Patients who have undergone myopic: LASIK PRK LASEK Hyperopic Laser Vision Correction Patients who have undergone hyperopic (...) by distorted keratometry mires, distortion of the retinoscopic, or ophthalmoscopic red reflex (or a combination of these) At least one of the following biomicroscopic signs: Vogt's striae, Fleischer's ring of >2 mm arc, or corneal scarring consistent with keratoconus. Contact lens wearers should discontinue use preferably 1 day or at least half an hour prior to imaging. Myopic Laser Vision Correction Patients who have undergone myopic: LASIK PRK LASEK Hyperopic Laser Vision Correction Patients who have

2006 Clinical Trials

620. Efficacy of T1675 Versus Placebo in Patients With Bilateral Treated Moderate Dry Eye Syndrome

, BUT and Schirmer, performed within the last 12 months before Inclusion Visit, for both eyes. Bilateral symptomatology suggestive of dry eye defined by: at least one of the following ocular symptoms suggestive of dry eye (burning, stinging, dryness feeling, sandy and/or gritty sensation, light sensitivity, reflex tearing, ocular fatigue) and Questioning on patient’s feeling (score >=3). Fulfilling the following criteria of dry eye syndrome in both eyes defined by: Keratoconjunctivitis defined by a lissamine (...) -GARCHER, Professor CHU of Dijon, France More Information Go to Layout table for additonal information ClinicalTrials.gov Identifier: Other Study ID Numbers: LT1675-PIICA-04/04 PHASE II First Posted: July 27, 2006 Last Update Posted: July 27, 2006 Last Verified: July 2006 Additional relevant MeSH terms: Layout table for MeSH terms Syndrome Keratoconjunctivitis Sicca Dry Eye Syndromes Disease Pathologic Processes Keratoconjunctivitis Conjunctivitis Conjunctival Diseases Eye Diseases Keratitis Corneal

2006 Clinical Trials

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