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Corneal Reflex

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102. Cenegermin (Oxervate) - neurotrophic keratitis

that occurs as a result of partial or total impairment of trigeminal innervation, leading to a reduction (hypoesthesia) in or loss (anaesthesia) of corneal sensation (Bonini et al., 2003; Sacchetti et al, 2014; Semeraro et al, 2014). Impairment of corneal trigeminal innervation causes a reduction in the lacrimation reflex, as well as morphological and metabolic corneal epithelial disturbances, with subsequent development of recurrent or persistent epithelial defects. 2.1.2. Epidemiology As the underlying (...) : ‘Treatment of moderate (persistent epithelial defect) or severe (corneal ulcer) neurotrophic keratitis in adults.’ The legal basis for this application refers to: Article 8.3 of Directive 2001/83/EC - complete and independent application. The applicant indicated that cenegermin was considered to be a new active substance. The application submitted is composed of administrative information, complete quality data, non-clinical and clinical data based on applicants’ own tests and studies

2017 European Medicines Agency - EPARs

103. Recommendations for the Management of Cerebral and Cerebellar Infarction with Swelling

infarction, a decrease in level of consciousness occurs as a result of brainstem compression and therefore may include early loss of corneal reflexes and the development of miosis. Standardized definitions should be established to facilitate multicenter and population-based studies of incidence, prevalence, risk factors, and outcomes. Identification of patients at high risk for brain swelling should include clinical and neuroimaging data. If a full resuscitative status is warranted in a patient (...) physiological parameters, but early extubation in patients with a decompressive craniectomy for cerebellar infarcts can be problematic because of abnormal oropharyngeal function, lack of strong cough, and copious thick secretions. 90 The presence of a cough and gag reflex and normal eye movements may predict successful extubation. 91 Airway and Mechanical Ventilation: Recommendations 1. Maintaining normocarbia is reasonable (Class IIa; Level of Evidence C). 2. Intubation may be considered for patients

2014 Congress of Neurological Surgeons

105. Effect of sedation with butorphanol on variables pertaining to the ophthalmic examination in dogs. (PubMed)

: menace response, dazzle reflex, corneal blink reflex, phenol red thread tear test (PRT), Schirmer tear test-1 (STT-1), pupil size (PS) measurement, and rebound tonometry. Then, butorphanol was injected intramuscularly at a dose of 0.2 mg/kg and these procedures were repeated 10, 20, 30, and 45 min postadministration. A sedation score graded 0 to 3 was also established at these time points. Statistical analyses were performed on quantitative data using ANOVA.The sedative effect was not associated (...) with any changes in globe and nictitating membrane position; did not affect the results of the menace response, dazzle reflex, and corneal blink reflex; and had no significant effect on PRT values. However, butorphanol administration was associated with a statistically significant decrease in STT-1 and PS values (P < 0.005), and a statistically significant increase in IOP (P < 0.05). All these variations remained in the range of normal values.Butorphanol administered intramuscularly at 0.2 mg/kg

2018 Veterinary ophthalmology

106. Influence of sedation on onset and quality of euthanasia in sheep. (PubMed)

was accomplished with a pentobarbital/phenytoin overdose given IV. The time to apnea, asystole, cessation of audible heartbeat, and absence of corneal reflex were recorded by two blinded investigators. If any muscle spasms, contractions, vocalization, and/or dysrhythmias were noted, the time was recorded and type of ECG abnormality was described. An overall score of the euthanasia event was assigned using a numeric rating scale (NRS) after the animal was declared dead. The time to loss of corneal reflex

2018 Research in veterinary science

107. Retrobulbar vs peribulbar regional anesthesia techniques using bupivacaine in dogs. (PubMed)

ventrolateral and dorsomedial sites). The contralateral eye acted as control. Injectate distribution was evaluated by computed tomography. Following intramuscularly administered atipamezole, corneal and periocular skin sensation, intraocular pressure (IOP), and ocular reflexes, and appearance were evaluated for 24 hours. Comparisons were performed with mixed-effects linear regression (IOP) or the exact Wilcoxon signed rank test (scores). Significance was set at P ≤ .05.Injectate distribution was intraconal (...) in 2/6 RBA- and 4/6 PBA-injected eyes. Eyes undergoing PBA had significantly reduced lateral, ventral, and dorsal periocular skin sensation for 2-3 hours, and significantly reduced corneal sensitivity for 4 hours, relative to control eyes. Chemosis and exophthalmos occurred in 33%-40% of eyes undergoing RBA and 83%-100% eyes undergoing PBA but resolved within 14 hours. Anterior uveitis developed in 2/6 and 1/6 eyes of RBA and PBA, respectively, of them corneal ulcer developed in one eye of each

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2018 Veterinary ophthalmology

108. Neurotrophic keratitis: current challenges and future prospects (PubMed)

Neurotrophic keratitis: current challenges and future prospects Neurotrophic keratitis (NK) is a degenerative corneal disease caused by damage of trigeminal corneal innervation, which leads to spontaneous epithelial breakdown and corneal ulceration. The impairment of corneal sensory innervation causes the reduction of both protective reflexes and trophic neuromodulators that are essential for the vitality, metabolism, and wound healing of ocular surface tissues. A wide range of ocular (...) and systemic conditions, including herpetic keratitis, ocular chemical burns, corneal surgery, diabetes, multiple sclerosis, and neurosurgical procedures, can cause NK by damaging trigeminal innervation. Diagnosis of NK requires careful investigation of any ocular and systemic condition associated with the disease, complete ocular surface examination, and quantitative measurement of corneal sensitivity. The clinical stages of NK range from corneal epithelial alterations (stage 1) to persistent epithelial

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2018 Eye and brain

109. Easy Stretch Toolkit: A Pilot Study

] function of cranial nerve III and IV as measured by following a finger for letter "H" Screening of cranial nerve function for CN III and IV [ Time Frame: completed at week 8 ] function of cranial nerve III and IV as measured by following a finger for letter "H" Screening of cranial nerve function for CN V [ Time Frame: completed at week 1 ] function of cranial nerve V as measured by corneal reflex test, clenching the teeth, among other actions Screening of cranial nerve function for CN V [ Time Frame (...) : completed at week 8 ] function of cranial nerve V as measured by corneal reflex test, clenching the teeth, among other actions Screening of cranial nerve function for CN VII [ Time Frame: completed at week 1 ] functional of cranial nerve VII as measured by closing the eyes, creasing the forehead, puffing out the cheeks, among other actions Screening of cranial nerve function for CN VII [ Time Frame: completed at week 8 ] functional of cranial nerve VII as measured by closing the eyes, creasing

2018 Clinical Trials

110. Astigmatism in Keratoconus Patients

of corneal ectasia, with an incidence of 50-230 per 100,000 persons.Pentacam used diagnose & detect the progression in patients with keratoconus and also provide a detailed information about corneal tomography and topography. In the last few years, it has been shown that in healthy individuals the posterior corneal surface has not only a different amount of astigmatism but also a different alignment of the steep meridian. The aim of this research is to compare the amount and axis alignment of anterior (...) and posterior corneal astigmatism in keratoconus with a healthy controlled group . Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 100 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Screening Official Title: Comparison of Anterior and Posterior Corneal Astigmatism in Patients With Keratoconus and Controls Estimated Study Start Date : October 1, 2019 Estimated

2018 Clinical Trials

111. Universal ocular screening of 481 infants using wide-field digital imaging system. (PubMed)

assessment, eye position examination, external eye check, pupillary light reflex, red reflex examination, anterior and posterior ocular segments were examined using flashlight, ophthalmoscope, and wide-field digital imaging system.A total of 481 infants at 45.1 ± 6.1 days after birth were enrolled in the study. 198 infants had abnormal findings (41.2%). Retinal white spots and retinal white areas were the most common findings (42.9% of abnormalities and 17.7% of all infants screened). The second major (...) finding was retinal hemorrhage (16.2% of abnormalities and 6.7% of all infants screened). Other abnormal findings include retinal pigmentation, concomitant exotropia, neonatal dacryocystitis, retinopathy of prematurity, 'albinism-like fundus', congenital nasolacrimal duct obstruction, familial exudative vitreoretinopathy, immature retina, corneal dermoid tumor, large physiologic cupping of optic disc, congenital persistent pupillary membrane, entropion trichiasis, subconjunctival hemorrhage

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2018 BMC Ophthalmology

112. Early Electroencephalography Findings in Cardiogenic Shock Patients Treated by Venoarterial Extracorporeal Membrane Oxygenation. (PubMed)

electroencephalography, was performed in consecutive cardiogenic shock patients requiring venoarterial extracorporeal membrane oxygenation. Associations between electroencephalography findings and outcome, defined as a composite of acute brain injury or death at 14 days, were investigated.Twenty-two patients with a median Full Outline of Unresponsiveness score of 4 (interquartile range, 3-6) were studied. Pupillary light reflex, corneal reflex, and cough reflex were preserved in 20 (90%), 17 (77%), and 17 (77

2018 Critical Care Medicine

113. Dry Eye After LASIK. (PubMed)

suggested that the loss of corneal innervation caused by flap-making is the major cause, affecting the corneal-lacrimal gland, corneal-blinking, and blinking-meibomian gland reflexes, resulting in decreased aqueous and lipid tear secretion and mucin expression. A new type of corneal refractive surgery, SMILE, which has less impact on corneal nerves, induces less postoperative dry eye, supporting the association between corneal denervation and postoperative dry eye. As LASIK enhancement by flap-lifting (...) Dry Eye After LASIK. Post-LASIK dry eye is the most common postoperative dry eye after ophthalmic surgeries. The clinical signs of post-LASIK dry eye include positive vital staining of the ocular surface, decreased tear breakup time and Schirmer test values, reduced corneal sensitivity, and decreased functional visual acuity. The symptoms and signs usually last for about 1 month after LASIK. A small number of patients continue to experience symptoms more than 1 year postoperatively. It has been

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2018 Investigative Ophthalmology & Visual Science

114. Feline dry eye syndrome of presumed neurogenic origin: a case report (PubMed)

(STT-1) and tear film breakup time revealed corneal hypoesthesia, and quantitative and qualitative tear film deficiency OU. Noxious olfactory stimulation caused increased lacrimation relative to standard STT-1 values suggesting an intact nasolacrimal reflex. Various lacrimostimulants were administered in succession; namely, 1% pilocarpine administered topically (15 days) or orally (19 days), and topically applied 0.03% tacrolimus (47 days). Pilocarpine, especially when given orally, was associated (...) Feline dry eye syndrome of presumed neurogenic origin: a case report A 14-year-old female spayed Abyssinian cat, which about 1 year previously underwent thoracic limb amputation, radiotherapy and chemotherapy for an incompletely excised vaccine-related fibrosarcoma, was presented for evaluation of corneal opacity in the left eye (OS). The ocular surface of both eyes (OU) had a lackluster appearance and there was a stromal corneal ulcer OS. Results of corneal aesthesiometry, Schirmer tear test-1

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2018 JFMS Open Reports

115. Prediction of Pseudophakodonesis of Intraocular Lenses

stability. Several techniques have been used to measure IOL decentration and tilt, such as slitlamp examination, retroillumination photography, Scheimpflug imaging and the analysis of purkinje reflexes. Slitlamp examination is a subjective method that allows approximate decentration measurements, but no quantitative tilt measurements. For this measurement the pupil has to be dilated. Scheimpflug imaging also needs a sufficiently dilated pupil to make the optic edge and the posterior surface of the IOL (...) to be clinically irrelevant Written informed consent Pseudoexfoliation syndrome or history of blunt ocular trauma - for the study group Exclusion Criteria: Pseudoexfoliation syndrome or history of blunt ocular trauma - for the control group History of penetrating ocular trauma Relevant other ophthalmic diseases that could affect corneal transparency or the ability for fixation Any relevant ophthalmic disease leading to limited visual acuity prognosis after cataract surgery In case of pregnancy (pregnancy test

2018 Clinical Trials

116. Upper eyelid levator-recession and anterior lamella repositioning through the grey-line: Avoiding a skin-crease incision (PubMed)

and symptom improvement.Eleven eyelids of eight patients were included in the study, and underwent the procedure described. Lid margin position measured as the marginal reflex distance lowered (improved) in 72.7% of patients. Lid margin eversion was achieved in all eyes (100%). Corneal punctate epithelial erosions markedly improved, being present in 72.7% of patients preoperatively, and only 9.1% of patients postoperatively. Eight of eleven eyes showed symptomatic improvement, with six (54.5%) being

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2018 Indian journal of ophthalmology

117. Prognostication after cardiac arrest (PubMed)

Prognostication after cardiac arrest Hypoxic-ischaemic brain injury (HIBI) is the main cause of death in patients who are comatose after resuscitation from cardiac arrest. A poor neurological outcome-defined as death from neurological cause, persistent vegetative state, or severe neurological disability-can be predicted in these patients by assessing the severity of HIBI. The most commonly used indicators of severe HIBI include bilateral absence of corneal and pupillary reflexes, bilateral

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2018 Critical Care

118. Cerebral Malaria in a Patient with HIV, Hepatitis B, and Hepatitis C (PubMed)

Cerebral Malaria in a Patient with HIV, Hepatitis B, and Hepatitis C Cerebral malaria is one of the most common causes of non-traumatic encephalopathy. A 25-year-old man who is a known intravenous and oral drug abuser presented to our clinic with fever and sore throat for two days prior and an altered level of consciousness for one day. On examination, the patient was icteric, and his Glasgow coma scale score on arrival was 10/15; he had dilated pupils reactive to light and a positive corneal (...) reflex. All cranial nerves were intact; however, signs of meningeal irritation were positive. Motor examination showed an increased tone and rigidity in all limbs, patellar reflex was 3+, plantars were down-going, and clonus was negative. A fundoscopic examination was unremarkable. Additional investigations revealed he was positive for Plasmodium falciparum, HIV, hepatitis B, and hepatitis C. In addition, a test of his cerebrospinal fluid revealed evidence of cerebral malaria. We initiated artemether

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2018 Cureus

119. Effect of Exercise and Surgical Weight Loss on Polyneuropathy

in Intraepidermal Nerve Fiber Density (IENFD) at distal leg. [ Time Frame: Baseline, 3 months, 12 months and 24 months ] As assessed by 3mm skin biopsies. Linear mixed effects regression modeling will account for multiple time points of the same measure. Corneal Confocal Microscopy (CCM) [ Time Frame: Baseline, 3 month, 12 months and 24 months ] 24-2 Frequency Doubling Technology (FDT) [ Time Frame: Baseline, 3 month, 12 months and 24 months ] Retinal Fundus Photography [ Time Frame: Baseline, 3 month, 12 (...) of probable neuropathy [ Time Frame: 24 months ] Toronto definition of probable neuropathy-2 out of 3 of abnormal sensory examination, reflexes, and symptoms. Michigan Neuropathy Screening Instrument (MNSI) [ Time Frame: Baseline, 3 month, 12 months and 24 months ] Utah Early Neuropathy Score [ Time Frame: Baseline, 3 month, 12 months and 24 months ] Scale 0-48, higher is more severe polyneuropathy Modified Toronto Neuropathy Score (mTNS) [ Time Frame: Baseline, 3 month, 12 months and 24 months ] Range 0

2018 Clinical Trials

120. Repeatability and Reproducibility of the IOLMaster 700 Vers 1.70 and Agreement With IOLMaster 700 Vers. 1.50 and Pentacam

ocular infection or inflammation. Poor tear film/insufficient corneal reflex. Best corrected visual acuity worse than 20/200 in the study eye. Physical inability to be positioned at the slit-lamp biomicroscope or study devices (e.g. torticollis, head tremor, etc.). Insufficient eyelid opening or eyelashes which partially conceal alignment or keratometry reflections and prevent capture of all measurements. Inability to fixate (e.g. due to nystagmus, amblyopia or ocular disease, such as macular (...) and reproducibility of the IOLMaster 700 SW Vers 1.70. The following parameters will be evaluated for Total Keratometry, (TK) and Posterior Corneal Surface (PCS): cylinder (CYL), Axis (A) spherical equivalent (SE) Specific Objectives: To compare the agreement of SE between IOLMaster 700 SW Vers. 1.70 and IOLMaster 700 SW Vers. 1.50 (Carl Zeiss Meditec AG, Jena, Germany) To compare the agreement of Cylinder magnitude and axis between IOLMaster 700 SW Version 1.70 and Pentacam To evaluate the repeatability

2018 Clinical Trials

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