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Sclera

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121. A 54-year-old woman with bluish discoloration of her sclera (PubMed)

A 54-year-old woman with bluish discoloration of her sclera 23362374 2013 01 31 2018 11 13 1542-8958 16 2 2010 Digital journal of ophthalmology : DJO Digit J Ophthalmol A 54-year-old woman with bluish discoloration of her sclera. 6-8 10.5693/djo.03.2010.02.002 Phan Isabella I Oregon Health and Science University; Kaiser Rachel R Chiu Cynthia C eng Journal Article 2010 05 08 United States Digit J Ophthalmol 9605355 1542-8958 2013 1 31 6 0 2010 1 1 0 0 2010 1 1 0 1 ppublish 23362374 10.5693/djo

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2010 Digital Journal of Ophthalmology : DJO

122. Inhibition of matrix metalloproteinase activity in the chick sclera and its effect on myopia development. (PubMed)

Inhibition of matrix metalloproteinase activity in the chick sclera and its effect on myopia development. To investigate the contribution of matrix degradation in the two-layer avian sclera to the development of myopia.Tissue inhibitor of metalloproteinase-2 (TIMP-2) was used to inhibit chick scleral collagen degradation with (3)H-proline, a marker for this effect. Ex vivo scleral culture experiments confirmed TIMP-2 doses for in vivo experimentation. Ocular growth and refractive response (...) to exogenous TIMP-2 (11.25, 2.25, and 0.45 picomoles, plus vehicle only) were monitored in 7-day-old chicks during the induction of myopia over 4 days with a translucent occluder. Collagen degradation was assessed, in whole sclera and in separated scleral layers by using the same paradigm (11.25 picomoles TIMP-2; vehicle only).Approximately 60% of collagen degradation was inhibited with low (2 nM) doses of TIMP-2 in the ex vivo sclera. Degradative activity in the in vivo chick sclera increased

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2010 Investigative Ophthalmology & Visual Science

123. Microinvasive subconjunctival insertion of a trans-scleral gelatin stent for primary open-angle glaucoma

at the same time as phacoemulsification and intraocular lens insertion for treating cataracts. 2.5 Under local or topical anaesthesia, a small incision is made in the cornea, and the anterior chamber is filled with viscoelastic. A preloaded implant injector is then advanced through the same corneal incision and directed towards the scleral spur. The injector needle is directed through the sclera to emerge under the conjunctiva, approximately 2 mm to 3 mm behind the limbus. The soft and permanent gelatin (...) stent is then injected, to traverse the anterior chamber, sclera and conjunctival space. After placement is checked (using a gonioscopy mirror) the viscoelastic is exchanged for a balanced salt solution and the injector is withdrawn. The corneal incision is usually self-sealing but is sometimes sutured. Subconjunctival injection of mitomycin-C may be done during the procedure. 3 3 Committee consider Committee considerations ations The e The evidence vidence 3.1 T o inform the committee, NICE did

2018 National Institute for Health and Clinical Excellence - Interventional Procedures

124. Neonatal jaundice

includes phototherapy and/or exchange transfusion. The major complication of unconjugated hyperbilirubinaemia is kernicterus. Definition Neonatal jaundice is the yellowing discoloration of the skin and sclera of a neonate, which is caused by increased levels of bilirubin in the blood. A neonate refers to an infant in the first 28 days of life. This topic focuses on recognising and managing early neonatal jaundice, which is most commonly caused by unconjugated hyperbilirubinaemia. While prolonged

2019 BMJ Best Practice

125. Porcine sclera as a model of human sclera for in vitro transport experiments: histology, SEM, and comparative permeability (PubMed)

Porcine sclera as a model of human sclera for in vitro transport experiments: histology, SEM, and comparative permeability To evaluate porcine sclera as a model of human sclera for in vitro studies of transscleral drug delivery of both low and high molecular weight compounds.Human and porcine scleras were characterized for thickness and water content. The tissue surface was examined by scanning electron microscopy (SEM), and the histology was studied with hematoxylin-eosin staining. Comparative (...) permeation experiments were performed using three model molecules, acetaminophen as the model compound for small molecules; a linear dextran with a molecular weight of 120 kDa as the model compound for high molecular weight drugs; and insulin, which was chosen as the model protein. Permeation parameters such as flux, lag time, and permeability coefficient were determined and compared.Human and porcine scleras have a similar histology and collagen bundle organization. The water content is approx 70

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2009 Molecular vision

126. Uveitis

corticosteroids are usually adequate for acute non-infectious anterior uveitis, but intermediate and posterior uveitis usually requires injected local corticosteroids or systemic steroids, or other immunosuppression. Definition Uveitis is an inflammation of one or all parts of the uvea, or the vascular area between the retina and sclera of the eye. The anterior uvea is composed of the iris and ciliary body; an irritation of this segment, or anterior uveitis, leads to acute painful symptoms and photophobia

2018 BMJ Best Practice

127. Cirrhosis

sclera) abdominal features (e.g., collateral circulation, hepatosplenomegaly, distension) altered mental status constitutional symptoms lower extremity swelling hepatic fetor muscle wasting peripheral oedema recurrent infections decreased libido chest wall features (e.g., gynaecomastia) dyspnoea chest pain syncope alcohol misuse intravenous drug use unprotected intercourse obesity blood transfusion tattooing Diagnostic investigations liver function tests gamma-glutamyl transferase (GGT) serum albumin

2018 BMJ Best Practice

128. Assessment of jaundice

Assessment of jaundice Assessment of jaundice - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of jaundice Last reviewed: February 2019 Last updated: June 2018 Summary Jaundice (icterus) is the result of accumulation of bilirubin in the bloodstream and subsequent deposition in the skin, sclera, and mucous membranes. The normal range for total bilirubin is 3.4 to 20 micromol/L (0.2-1.2 mg/dL). Jaundice may

2018 BMJ Best Practice

129. Neonatal jaundice

includes phototherapy and/or exchange transfusion. The major complication of unconjugated hyperbilirubinaemia is kernicterus. Definition Neonatal jaundice is the yellowing discoloration of the skin and sclera of a neonate, which is caused by increased levels of bilirubin in the blood. A neonate refers to an infant in the first 28 days of life. This topic focuses on recognising and managing early neonatal jaundice, which is most commonly caused by unconjugated hyperbilirubinaemia. While prolonged

2018 BMJ Best Practice

130. Kaiser Permanente National Cholesterol and Cardiovascular Risk Clinician Guide

the risk of myopathy. } During statin therapy, consider measuring CK in individuals with muscle symptoms, including pain, tenderness, stiffness, cramping, weakness, or generalized fatigue. Hepatic Function } Perform baseline measurement of ALT before initiating statin therapy. } During statin therapy, consider measuring hepatic function if symptoms suggesting hepatotoxicity arise (e.g., unusual fatigue or weakness, loss of appetite, abdominal pain, dark-colored urine or yellowing of the skin or sclera

2018 Kaiser Permanente National Guideline Program

131. Headache

. Characteristic findings of IIH on MRI include flattening of the posterior sclera, distension of perioptic subarachnoid space, enhancement and protrusion of the intraocular optic nerve, and an empty sella. If the neuroimaging study reveals no structural etiology for IIH, a lumbar puncture is performed. In addition to measuring the opening pressure, the CSF is analyzed for cell count and differential, glucose, protein, and sensitivity to microbial agents [106]. In individuals with contraindication to MRI (eg

2019 American College of Radiology

132. Pigmented Fundus Lesions

. Ophthalmology. 2005;112(10):1784-9 Sumich P, Mitchell P, Wang JJ. Choroidal nevi in a white population: the Blue Mountains Eye Study. Arch Ophthalmol. 1998;116(5):645-50 Further information Lay summary A Choroidal Naevus (similar to a mole on the skin) occurs inside the eye in the choroid, which is the layer of nourishing and supportive tissue between the retina (the part of the eye that receives light and sends images to the brain) and the sclera (the ‘white’ of the eye). Choroidal naevus cannot be seen

2019 College of Optometrists

133. Uveitis (Anterior, Acute and Recurrrent)

-16 Lay Summary The uvea is the coloured part of the eye, lying beneath the white part of the eye (the sclera) and comprising the iris (which gives the eye its blue, brown or other colour), the ciliary body (which controls focussing and secretes the clear fluid that fills the front of the eye) and the choroid (which nourishes the outer layers of the retina). Inflammation of the uvea is called uveitis. When this inflammation affects the iris and the ciliary body only, it is known as anterior

2019 College of Optometrists

134. Trachoma

trichiasis (the contact of 1 or more lashes on any part of the globe) corneal opacification Herbert's pits (small pits around the margin of the cornea) asymptomatic ocular and nasal discharge red eye painful watery eye limbal (at the border of the cornea and sclera) follicles pannus (vessels growing over the clear cornea) children (active infection) poor facial hygiene female gender poverty poor community hygiene residence in or emigration from an endemic area Diagnostic investigations PCR (conjunctival

2017 BMJ Best Practice

135. Kaiser Permanente National Dyslipidemia Clinician Guide

fatigue. Hepatic Function ? Perform baseline measurement of ALT before initiating statin therapy. ? During statin therapy, consider measuring hepatic function if symptoms suggesting hepatotoxicity arise (e.g., unusual fatigue or weakness, loss of appetite, abdominal pain, dark-colored urine or yellowing of the skin or sclera). TABLE 2. STATIN THERAPY OPTIONS BY INTENSITY HIGH INTENSITY* Daily dose lowers LDL-C by approx. = 50% MODERATE INTENSITY Daily dose lowers LDL-C by approx. 30-50% LOW INTENSITY

2017 Kaiser Permanente National Guideline Program

136. Bruising

with gingival bleeding, prolonged bleeding after surgical procedures, and menorrhagia. Abnormalities in capillary structure and deficiencies of perivascular collagen cause vascular fragility, and blood vessels may rupture when subject to shearing forces. Has an estimated prevalence of 1 in 1000 people. Osteogenesis imperfecta This is characterised by blue sclerae, short stature, bone fragility, dentinogenesis imperfecta, and adult hearing loss. Easy bruising after minimal or no trauma is thought to occur

2017 Prodigy

137. Spot the Diagnosis! The Case of the Dropsical Child

towards the woman’s hand in a possible gesture of being too weak to even support their own head. As a contrast to the pointed gazes of the man and the woman, the child’s gaze is unfixed and their affect completely flat. What signs does the child display that could point to a diagnosis? The child displays many signs pointing towards a pathology. Ashen blue / grey skin Grey / blue sclera and lips Significant swelling to the abdomen, face and eyes Unfixed gaze Flat affect Seemingly needing support from

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2018 CandiEM

138. Conjunctivitis: Bacterial, Viral and Allergic

Conjunctivitis: Bacterial, Viral and Allergic Conjunctivitis: Bacterial, Viral and Allergic - medSask Home - College of Pharmacy and Nutrition - University of Saskatchewan Toggle Menu Search the U of S Search Conjunctivitis: Bacterial, Viral and Allergic Infectious or non-infectious Inflammation of the conjunctiva of one or both eyes The conjunctiva is the translucent covering of the sclera (white area) of the eye (bulbar area) and the undersurface of the eyelids (palpebral area) Infectious (...) body sensation (cannot keep eye open), may be visible opacities in cornea. Contact lens wearers are at higher risk ) Iritis / uveitis - Inflammation of the anterior uveal tract is called iritis or anterior uveitis; red ring around iris (ciliary flush); different sized pupils: no foreign body feeling, usually no discharge. ) Corneal abrasion from foreign body – history of trauma to eye ) Subconjunctival hemorrhage – defined areas of redness in the sclera (white of the eye) caused by hemorrhaging

2018 medSask

140. Pterygium

) Management category B2: alleviation/palliation; normally no referral B1: refer to ophthalmologist if pterygium: threatens visual axis induces irregular astigmatism is associated with chronic inflammation is cosmetically unacceptable Possible management by ophthalmologist Acute inflammation topical steroids non steroidal anti-inflammatory agents A variety of surgical techniques, including: surgical excision (bare sclera resection) surgical excision plus conjunctival closure, conjunctival flap closure (...) or conjunctival autografting; or amniotic membrane grafting adjunctive treatment sometimes given; includes: beta irradiation (post-op) topical thiotepa (post-op) mitomycin C (intra- or post-op) A recent systematic literature review concluded that bare sclera resection was associated with high rates of recurrence. By contrast, conjunctival or limbal autograft was associated with lower rates of recurrence Evidence base *GRADE: Grading of Recommendations Assessment, Development and Evaluation ( ) Sources

2018 College of Optometrists

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