bluuebunny/crossref_metadata_2025_split huggingface dataset:
Desmoplastic malignant melanoma presenting with orbital involvement
Authors: Ellis Mark , Drewe Ross , O'Day Justin 
Published: November 2007

AbstractDesmoplastic malignant melanoma (DMM) is a rare variant of spindle cell melanoma. We report a case of DMM of the forehead secondarily involving the orbit. The diagnosis was based on light microscopic features, including prominent peripheral cell nest formation and spindle cell fascicles in densely collagenous stroma. Immunohistochemical studies showed strong uniform staining for S100 antigen throughout the tumour. It was negative for HMB 45, smooth muscle actin, desmin, cytokeratins and Type IV collagen. Electron microscopy showed neither melanosomes nor myelin figures. The clinical and histological characteristics of desmoplastic malignant melanoma, and its differential diagnosis of malignant schwannoma, are discussed. DMM has a poor prognosis, since it tends to invade deeply, recur locally and metastasise readily.
Arthrogryposis multiplex congenita: a report of two cases
Authors: Brooks James G , Coster Douglas J 
Published: November 2007

AbstractArthrogryposis multiplex congenita refers to a group of birth defects characterised by multiple joint contractures. The syndrome is caused by neuropathic disease, myopathic disease, or any other cause of decreased fetal joint mobility. Multiple and usually symmetric joint abnormalities with associated muscular and soft tissue hypoplasia are noted at birth. A variety of associated congenital anomalies affecting many organ systems are frequently found. Ocular and orbital findings have been described in patients with arthrogryposis but corneal disease has only rarely been reported. We present corneal findings in two patients with arthrogryposis and discuss the implications for disease pathogenesis. Previous ophthalmologic reports are also reviewed.
Paediatric dacryocystorhinostomy
Authors: Hakin KN , Sullivan TJ , Sharma A , Welham RAN 
Published: November 2007

AbstractOf 258 cases of dacryocystorhinostomy performed on children in the period September 1981 to September 1991, 130 were for simple, unresolved congenital nasolacrimal duct obstruction. Other indications for surgery included punctal agenesis, lacrimal fistula, post‐traumatic and post‐inflammatory canalicular obstruction. Of 177 children without canalicular pathology, 171 (96%) were relieved of symptoms with one operation, without canalicular intubation. Of 81 cases with canalicular disease, 55 of 70 (79%) who underwent DCR plus canalicular intubation, and 10 of 11 who underwent DCR plus Lester‐Jones tube, were substantially improved with one operation. No child required peroperative or postoperative blood transfusion. Dacryocystorhinostomy in childhood, in experienced surgical hands, is a safe procedure, achieving relief of symptoms in most cases, particularly in the absence of canalicular disease.
The long‐term results of fistulising trabeculotomy in chronic open‐angle glaucoma
Authors: Gillies WE , Brooks AMY 
Published: November 2007

Abstract
Background
: Fistulising trabeculotomy has been used for nearly 20 years to combine the minimally invasive surgery of trabeculotomy with production of a subconjunctival fistula.
Methods
: The canal of Schlemm was unroofed 2mm on one side of a 3mm half‐thickness scleral flap. A trabeculotomy probe was passed about 30° along the canal on the opposite side and rotated into the anterior chamber.
Results
: Of 99 eyes of 74 patients, 35 eyes of 25 patients were available for follow‐up at 10 or more years. The mean IOP was 14 ± 4 mmHg (range 7 to 23 mmHg) from a preoperative IOP of 29 ± 8 mmHg (17 to 60 mmHg). Results in 44 similar patients undergoing trabeculectomy and 44 undergoing fistulising trabeculotomy were very similar at five‐year follow‐up.
Conclusion
: Fistulising trabeculotomy was effective for lowering intraocular pressure with a low complication rate and a large area of subconjunctival fistulisation.
Albipunctatus retinopathy in inherited interstitial nephritis
Authors: Colville Deb , Savige Judy 
Published: November 2007

AbstractWe describe here a patient with familial interstitial nephritis and albipunctatus retinopathy. Albipunctatus is often seen in patients with Alport syndrome, which is an X‐linked disorder characterised in affected males by renal failure by the age of 25, high‐tone sensorineural deafness, anterior lenti‐conus and albipunctatus. The diagnosis of Alport syndrome depends on the electron microscopic appearance of a trabeculated glomerular basement membrane (GBM); and mutations have been demonstrated in the gene for the alpha 5 chain of type IV collagen. In the familial interstitial nephritis described here, the inheritance was autosomal dominant, renal failure developed in middle age, and there was no associated hearing loss or anterior lenticonus.The finding of albipunctatus retinopathy in this patient suggests that the genetic mutation responsible involves a protein common to both retinal and interstitial basement membranes. In addition, we conclude that the demonstration of albipunctatus in an individual with familial nephritis does not necessarily indicate that the underlying disease is Alport syndrome.
Treatment of orbital capillary haemangioma with interferon
Authors: Teske Scott , Ohlrich Stephen J , Gole Glen , Spiro Paul , Miller Malcolm , Sullivan Timothy J 
Published: November 2007

Abstract Background: Capillary haemangiomas are vascular tumours of childhood characterised by proliferative and involutional phases and affecting 1% to 2% of newborns. Recently, recombinant interferons have been used in the treatment of life and sight threatening complications of these tumours. Methods: The history, results of examination, investigations, management and outcome of two patients with sight‐threatening orbital capillary haemangiomas treated with recombinant interferon alpha‐2a and 2b respectively were reviewed. Results: Orbital and systemic lesions displayed good response to interferons. Side effects noted were transient pyrexia and elevated serum aminotransferase levels. Disturbed liver function test results occurred in one case and normalised with temporary cessation of therapy. Conclusions: The interferons are a useful alternative treatment of orbital capillary haemangioma in selected cases.
Necrotising anterior scleritis after pterygium surgery
Authors: Galanopoulos A , Snibson G , O'Day J 
Published: November 2007

AbstractNecrotising anterior scleritis is a rare sequela of ocular surgery. Typically an intnse scleral inflammation develops at or adjacent to the site of the previous surgery. Necrosis supervenes and may then progress circumferentially to involve much of the anterior sclera. Surgically induced necrotising scleritis (SINS) has been previously described after cataract extraction, trabeculectomy, retinal detachment and strabismus surgery. We report three cases of SINS following pterygium excision. In each case the disease was prolonged, progressive and required protracted immunosuppressive therapy.
Community photoscreening of six to nine month old infants for amblyopiogenic risk factors
Authors: Hope Carolyn , Roulston Joanne , Hoey Caroline , Wong Andrew , Clover Gillian 
Published: November 2007

AbstractPhotorefraction (PR) is gaining acceptance as potentially the most effective objective screening technique for amblyopia risk factors in the preverbal child. This study determined the validity and feasibility of using the Auckland eccentric photorefractor in the detection of amblyopiogenic factors in six to nine month old infants in an established community‐based vision screening program. Photographs were analysed and compared to results of clinical examination including cycloplegic refraction.Amblyopia risk factors were present in 7.2% of the infants clinically examined. Analysis only of readable photographs in children who were also clinically examined, gave sensitivities ranging from 71% to 79%, and specificities ranging from 81% to 86%. Inclusion in the analysis of photo‐failures lowered sensitivity figures to 56% to 61%, and specificity to 63% to 70%. Photofailures were predominantly due to poor operator technique. Calculation of kappa scores indicated fair observer reliability.In conclusion, PR could provide a feasible and sufficiently reliable screening technique in the infant, but requires adequate training and auditing of screening personnel performance for optimum effectiveness.
Scedosporiutn prolificans sclerokeratitis
Authors: Sullivan Laurence J , Snibson Grant , Joseph Catherine , Taylor Hugh R 
Published: November 2007

Abstract
Background
: The fungus Scedosporium prolificans was first described as a human pathogen in 1984, and has been associated with metastatic endophthalmitis and one previously reported case of sclerokeratitis.
Methods
: We report a case of S. prolificans sclerokeratitis in the setting of late scleral necrosis complicating pterygium surgery with adjunctive (3‐irradiation.
Results
: A poor clinical response to topical natamycin and amphotericin B, and systemic itraconazole and ketoconazole was encountered. Enucleation was required, with subsequent microbiological cure. Pathological correlation is described.
Conclusions
: S. prolificans infections often respond poorly to medical therapy. Early surgical intervention is indicated in culture‐proven scleritis due to Scedosporium prolificans.
Brisbane GPs' perceptions of screening for primary open‐angle glaucoma
Authors: Jackson C , Hirst L 
Published: November 2007

Abstract Background: Primary open‐angle glaucoma (POAG) is one of the three leading causes of blindness in Australia, often causing considerable visual field loss before the patient becomes symptomatic. Recent years have seen a quickening of public health interest in primary open‐angle glaucoma. Our study evaluates the attitudes and skills of Brisbane GPs with regard to screening for POAG. Objectives: To evaluate general practitioners' current use of possible screening modalities for POAG. To evaluate general practitioners' attitudes to screening for POAG. To evaluate general practitioner's levels of satisfaction with their knowledge and skills in the diagnosis of common ophthalmological conditions. Method: A questionnaire was distributed to 130 randomly selected GPs in the Brisbane metropolitan area. Response rate was 94%. Results: Tonometry and funduscopy were infrequently used in Brisbane general practice. Only 15% of the sample were satisfied with their current knowledge and skills concerning the detection of POAG. 88% felt that patients >50 years should be screened for POAG and nominated a variety of sources — 75% advocating ophthalmology screeners, 65% GP screeners, and 41% optometrist screeners. Ninety‐nine per cent believed ophthalmologists should be treating glaucoma patients, and 57% believed GPs should have a role in management. Only 1 % supported a therapeutic role for optometrists. Major perceived barriers to glaucoma screening in the elderly were the inaccuracy of current general practice screening tools (65%) and paucity of information concerning the desirability of screening (32%). Conclusion: Brisbane general practitioners believe patients >50 years old should be screened for POAG. They advocated a role for screening by ophthalmologists, GPs and optometrists. Major perceived barriers to current screening in general practice are the inaccuracy of current general practice tools (65%) and paucity of information on the subject (32%). The majority (85%) requested further information and provision of skills in this area.
Scanning laser ophthalmoscopy of choroidal neovascularisation using indocyanine green
Authors: Chan Tang Kong , Liu Henry A. 
Published: November 2007

Abstract Background: Choroidal neovascularisation is an important cause of visual loss in age‐related macular degeneration. Visualisation of these choroidal abnormalities with fluorescein angiography may be difficult, particularly if there is haemorrhage, excessive pigment, or excessive fluorescence. We report on our experience with indocyanine green (ICG) angiography in demonstrating choroidal neovascularisation. Method: Patients with suspected choroidal neovascularisation were assessed with indocyanine green angiography using the Rodenstock Scanning Laser Ophthalmoscope and results recorded on a videotape. Fluorescein angiograms were also obtained in a similar fashion. The angiograms were then compared. Results: In some instances ICG angiography was able to demonstrate the margins and structure of choroidal neovascular membranes more clearly than fluorescein, particularly in the presence of haemorrphage, excessive fluorescence and blocked fluorescence. However, there were instances where it was difficult to interpret the choroidal abnormalities found. Some illustrative cases are discussed. Conclusion: We conclude that ICG angiography is a useful adjunct to fluorescein angiography in detection and delineation of choroidal neovascularisation, but that further study is needed.
Amyloidosis of the conjunctiva
Authors: O'Donnell Brett , Wuebbolt Gordon , Collin Richard 
Published: November 2007

Abstract Background: Amyloid of the eyelid conjunctiva is an extremely rare condition which may result in chronic discomfort and multiple surgeries. Methods: A retrospective study of four patients from Moorfields Eye Hospital is presented to assess the clinical features and results of surgical treatment. Results: Three patients had persistent ocular irritation and required multiple surgical procedures for recurrent amyloid. However, one patient has been followed for nearly 30 years with relatively few symptoms, and has required only infrequent surgical intervention. All patients underwent debulking and ptosis surgery at least once. The more severe clinical course was not related to the type of amyloid protein present. Shave excision of recurrent tarsal conjunctival arnyloid with split‐thickness mucous membrane grafting was successfully tried in one patient in order to minimise postoperative cicatrisation of the posterior lamella. Conclusion: The clinical course of patients with eyelid amyloid may vary greatly. Management should be conservative when possible, but surgery is an integral part of management since debulking of amyloid deposits and ptosis surgery was required in all patients in this series.
Acute glaucoma ‐1941
Authors: Lowe Ronald F. 
Published: November 2007

Abstract Purpose: To describe the treatment of acute glaucoma before the technological and pharmacological advances that followed World War 2. Method: A narrative of personal experience is presented. Conclusions: In 1941, acute congestive glaucoma received heroic treatment ‐ strong miotics, bloodletting by leeches, purging with mercury. If satisfactory response did not occur within four hours, a broad iridectomy was performed on the hard, congested eye. Affected eyes commonly remained blind or with severely reduced vision.
Reversible ophthalmoplegia in CPEO
Authors: Dunlop Iain S. , Dunlop Patricia 
Published: November 2007

Abstract Purpose: To present a case of improvement of ocular motility in a patient with chronic progressive external ophthalmoplegia (CPEO) with Coenzyme Q10. Methods: Coenzyme Q10 300 mg daily was given for three years with a three‐day trial period of 200 mg daily after one year. Ocular ductions were measured by synoptophore. Results: Ocular ductions improved with treatment with Coenzyme Q10. Conclusion: Coenzyme Q10, is effective in limiting the severity of ophthalmoplegia in this case.
Prospective study of 210 consecutive cases of endocapsular phacoemulsification using the AM0 SI‐30NB 3‐piece foldable lens
Authors: Irvine Simon , Francis Ian C. , Kappagoda Medduma B. , Haylen Margaret J. , Alexander Stella , Schumacher R Steve , Boytell Keny A. 
Published: November 2007

Abstract Purpose: To assess the acceptability of clinical outcome achieved with use of the SI‐30NB lens, as well as the incidence of any lens related complications. Methods: This prospective study evaluated 210 consecutive eyes undergoing endocapsular phacoemulsification cataract surgery (EPECS), with implantation of the AM0 SI‐30NB foldable three‐piece lens, commencing with the first patient in our practice receiving this implant. There was 99% follow‐up for at least three months, with a mean of nine months, and a range of three to 14 months. Incisions were a maximum of 3.2 mm in size, and this allowed minimisation of astigmatism, and maximisation of early visual rehabilitation. Results: The final visual acuity results were excellent, with 95% of cases achieving corrected vision of 6/12 or better. All cases without pre‐existing ocular pathology achieved corrected vision of 6Y6, apart from a single case which achieved 6/9, but the patient died before follow‐up. The lens‐related complication rate was less than 1% (two patients). No decentration of any other implant ocurred, and no patient complained of edge glare. There were no cases of iris chafing or pigment dispersion. Only three patients (1.4%) required Yag posterior capsulotomy in the first 14 months of the study. Central bag‐bag fixation was achieved in 206 of the 210 cases in the study (98%). Conclusion The results achieved using the SI‐30NB lens with a small incision phaco procedure were excellent. Lens‐related complications occurred in only two cases and very few cases have had problems with posterior capsular opacification.
Trichotillomania: ophthalmic presentation
Authors: BS Justine R Smith MB 
Published: November 2007

Abstract
Purpose:
A case of trichotillomania, or compulsive hair‐pulling, involving the eyelids is presented to alert ophthalmologists to this common, but frequently overlooked cause of eyelash and eyebrow alopecia.
Methods and results:
Clinical records of a 33‐year‐old woman suffering from trichotillomania were reviewed. Compulsive hair‐pulling began in childhood and had become chronic. Psychiatric intervention was unsuccessful.
Conclusions:
The diagnosis of trichotillomania is made on history and slit‐lamp examination findings. A skin biopsy may be necessary to exclude alopecia areata. Adults should be referred to a psychiatrist. Although childhood disease is usually benign, often reflecting a disturbed parent‐child relationship, in adults hair‐pulling is generally chronic and associated with psychiatric illness.
Vision testing in atrophic macular degeneration
Authors: Littlewood Ross , Johnson Gary , House Phillip 
Published: November 2007

Abstract Purpose:To determine the correlation between a group of vision tests in atrophic macular degeneration (AMD) in an office setting. Methods:Patients with documented vision loss from atrophic macular degeneration in one eye were invited to attend an eye clinic every three months for a series of six vision tests for their good eye followed by fundus photography. Modified contrast sensitivity, blue/yellow anomaloscopy, flicker fusion frequency, Amsler grid, and photo‐stress recovery time were correlated with Snellen acuity using the Pearson correlation coefficient. The regression of the Snellen acuity result on sex, age and the presence of disciform macular degeneration in the other eye was obtained using a general linear model. Results:The correlation with Snellen acuity result was low for all tests. It was highest for Amsler grid abnormality (r= ‐0.33345) and blue/yellow anomaloscopy matching range (r= ‐0.20742), where r denotes the correlation coefficient. Patient age was strongly correlated with Snellen results (P= 0.0001), but it was not significantly related to sex (P= 0.1187) or the presence of disciform macular degeneration in the other eye (P= 0.9989). The photostress recovery time showed enormous inter‐visit variations and poor correlation with Snellen acuity (P= 0.0526). Conclusions:The course of AMD is routinely assessed by Snellen acuity and any of several additional tests. When employing a test battery in an office setting, a clinician needs to know the relative utility and correlation between the tests at his disposal. Of the tests used in this study, the Amsler grid was the most useful addition to the Snellen acuity at all stages of atrophic macular degeneration, and blue/yellow anomaloscopy was useful only in mild macular degeneration where Snellen acuity was 6/12 or better.
A clinical trial of MK‐507, Trusopt, for raised intraocular pressure ‐ The Australian Experience
Authors: Gillies W E. , Brooks Anne MV 
Published: November 2007

Abstract Background: Since the introduction of carbonic anhydrase inhibitors, a topical preparation has been sought to avoid the complications of systemic medication while retaining the effect of lowering intraocular pressure. Recently, a topical carbonic anhydrase inhibitor, MK‐507, has been found superior to others and introduced for multicentre clinical trial. Patients and methods: As part of an international rnulticentre trial, we compared MK‐507 with beta blockers for one year in 20 patients with raised intraocular pressure, both as monotherapy and in combination. Results: Twelve patients with a mean peak pressure of 31.9 ± 6.8 mmHg (range, 22 to 49 mmHg) off all medication received MK‐507. After two weeks, mean peak pressure was 24.7 ± 6.1 mmHg (range, 14 to 41 mmHg) — a 22.6% fall in pressure. Six of these patients had a mean peak pressure of 27.8 ± 6.4 mmHg (range, 21 to 41 mmHg), a fall of 19.2% from day one and were given timolol as add‐on therapy. This resulted in a fall to 19.1 ± 2.8 (range, 15 to 24 mmHg) at year one, a fall of 31.3% after add‐on. Four patients on timolol and four on betaxolol gave similar falls in pressure with an additional fall when MK‐507 was used as add‐on therapy. Conclusions: MK‐507 demonstrated its effectiveness as an ocular hypotensive agent in this trial of patients with an unusually high rise in pressure. It showed a hypotensive effect roughly equivalent to beta blockers. It is likely that either a topical carbonic anhydrase inhibitor or a cardioselective beta blocker will be the medication of first choice in newly diagnosed glaucoma.
The effectiveness of sub‐Tenon's infiltration of local anaesthesia for cataract surgery
Authors: Verghese Indira , Sivaraj R. , Lai YK 
Published: November 2007

Abstract Purpose: To determine if adequate anaesthesia and akinesia could be obtained using an inferonasal quadrant sub‐Tenons anaesthesia for cataract surgery. Methods: The sub‐Tenons method of local anaesthesia was used in 50 patients undergoing extracapsular cataract extraction and lens implantation. The technique followed was that described by JD Stevens in his study of 50 patients. Posterior sub‐Tenons space was approached through a conjunctival incision in the inferonasal quadrant and the anaesthetic solution delivered by an irrigating cannula. The patients were assessed for residual ocular movements just before surgery. Effectiveness of anaesthesia was assessed during surgery using a verbal pain rating score. Scoring was based on the concept of a visual analogue pain score chart. Results: Total akinesia was obtained in 20% patients and total anaesthesia in 24% patients. The remainder of the patients had adequate akinesia and anaesthesia to proceed with and complete the surgery. Conclusion: This method provides satisfactory anaesthesia for cataract surgery.