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Poster 29
282 telescope/surgical is more cosmetically acceptable in a hospital setting because of its common use in surgical procedures and marketing for hospitals.
Ocular Disease Poster 29 Delayed Visual Maturation Jeffrey J. Kenyon, O.D., and Karen Fern, O.D., University of Houston, College of Optometry, 505 J. Davis Armistead Building, Houston, Texas 77204 Background: Delayed visual maturation (DVM), a retrospective diagnosis, is a condition of poor visual attentiveness in early infancy with subsequent improvement in visual attention and behavior. DVM is reported to be associated with ocular anomaly, neurodevelopmental abnormality, or perinatal complication, or may occur as an isolated condition in an infant in the absence of ocular or systemic associations. The mechanism of visual impairment and subsequent improvement is unknown. Case Report(s): The findings from 3 infants with DVM who displayed diverse associated ocular and systemic conditions are presented. Severely reduced vision early in life with dramatically improved visual acuity by age 1 year was noted in each. Patient 1 was born prematurely with hydrocephalus; no fixation could be elicited at 3 months with improvement of acuity to 20/80 by age 3 years, 7 months. Patient 2, born full-term with an unremarkable birth, was visually inattentive with acuity of 20/1400 and nystagmus at 3 months; over the next 3 years, the patient developed normally with 20/94 acuity at 1 year and at least 20/64 at 2 and 3 years of age. The third patient experienced anoxia at birth (full-term) and displayed nystagmus, visual inattentiveness, and poor visual fixation at 3 months of age, leading to a diagnosis of cortical blindness; at age 10 months, acuity was 20/63 with nystagmus still present. Ocular health was unremarkable in all these patients and did not suggest other ocular sequalae responsible for the early lack of visual attentiveness. Conclusions: DVM is a retrospective diagnosis that can be made when substantial improvement in visual acuity or visual behavior is noted over time. The prognosis for the magnitude of improvement in vision may be impacted by associated ocular and systemic conditions. This poster will highlight the associated conditions and the changes in visual function. With the current efforts to increase awareness of early examination of infants, the diagnosis of DVM should be familiar to all clinical practitioners. Poster 30 Rethinking the Four F’s of Pseudotumor Cerebri Anney Kunthara, O.D., and Thao Vu, O.D., Lake City VAMC, 619 South Marion, Lake City, Florida 32025
Optometry, Vol 78, No 6, June 2007 Background: Pseudotumor cerebri, a predominantly female disease, must be included in the list of differentials for a male with bilateral optic disc edema. Potentially life-threatening etiologies exist for bilateral optic disc edema; therefore, a complete workup must be ordered to rule out hydrocephalus, malignant hypertension, meningitis, and tumors. Unremarkable neuroimaging test results, normal CSF composition, along with increased intracranial pressure is diagnostic of pseudotumor cerebri—a diagnosis of exclusion. Pseudotumor cerebri may be associated with oral contraceptives, vitamin A, tetracycline, chronic respiratory insufficiency, intracranial venous thrombosis, hypoparathyroidism, or anemia. Signs include normal or decreased vision, contrast sensitivity, and color. Diplopia, visual field defects, and bilateral optic disc edema are other findings. Treatment options consist of lifestyle changes, medication, and surgery. Clinicians must be aware of treatment protocols when the first-line medication is contraindicated. Case Report: A 27-year-old black male presented with headaches worse in the morning. Medical history included hypertension, sleep apnea, glucose 6 phosphate dehydrogenase deficiency, and sulfa allergy. Entering acuities were 20/20 in each eye. Pupils, extraocular motility, and anterior segment examinations were unremarkable. Dilated fundus examination revealed bilateral optic disc edema. Humphrey visual field findings showed bilateral inferior nasal depressions. Results of a complete workup were positive only for increased opening intracranial pressure. The patient was diagnosed with pseudotumor cerebri. First-line medical therapy of Diamox was not initiated due to the patient’s G6PD deficiency and subsequent sulfa allergy. Alternative treatment was initiated with Lasix and vitamin K supplements. Conclusion: Clinicians must know how to diagnose and manage an atypical case of bilateral optic disc edema. Pseudotumor cerebri often occurs in obese women between the ages of 20 and 45 years. This case supports the fact that the disease should not be excluded in atypical patients with signs and symptoms consistent with the diagnosis. In addition, alternative treatments for pseudotumor cerebri in sulfa allergic patients are necessary to prevent vision loss. Poster 31 Treatment Outcome of Acute Corneal Hydrops in a Keratoconic Patient Scott Schatz, O.D., Ph.D., and Hadley Saitowitz, O.D., Nova Southeastern University, College of Optometry, 3200 South University Drive, Ft. Lauderdale, Florida 33328 Background: Acute corneal hydrops is a late-stage debilitating condition that occurs in keratoconus (KS) patients secondary to rupture of Descemet’s membrane. The condition is characterized by pain and corneal edema accompanied by a decrease in visual acuity (VA). Presenting patients require immediate care for this acute condition.
Ocular Disease Poster 29 Delayed Visual Maturation Jeffrey J. Kenyon, O.D., and Karen Fern, O.D., University of Houston, College of Optometry, 505 J. Davis Armistead Building, Houston, Texas 77204 Background: Delayed visual maturation (DVM), a retrospective diagnosis, is a condition of poor visual attentiveness in early infancy with subsequent improvement in visual attention and behavior. DVM is reported to be associated with ocular anomaly, neurodevelopmental abnormality, or perinatal complication, or may occur as an isolated condition in an infant in the absence of ocular or systemic associations. The mechanism of visual impairment and subsequent improvement is unknown. Case Report(s): The findings from 3 infants with DVM who displayed diverse associated ocular and systemic conditions are presented. Severely reduced vision early in life with dramatically improved visual acuity by age 1 year was noted in each. Patient 1 was born prematurely with hydrocephalus; no fixation could be elicited at 3 months with improvement of acuity to 20/80 by age 3 years, 7 months. Patient 2, born full-term with an unremarkable birth, was visually inattentive with acuity of 20/1400 and nystagmus at 3 months; over the next 3 years, the patient developed normally with 20/94 acuity at 1 year and at least 20/64 at 2 and 3 years of age. The third patient experienced anoxia at birth (full-term) and displayed nystagmus, visual inattentiveness, and poor visual fixation at 3 months of age, leading to a diagnosis of cortical blindness; at age 10 months, acuity was 20/63 with nystagmus still present. Ocular health was unremarkable in all these patients and did not suggest other ocular sequalae responsible for the early lack of visual attentiveness. Conclusions: DVM is a retrospective diagnosis that can be made when substantial improvement in visual acuity or visual behavior is noted over time. The prognosis for the magnitude of improvement in vision may be impacted by associated ocular and systemic conditions. This poster will highlight the associated conditions and the changes in visual function. With the current efforts to increase awareness of early examination of infants, the diagnosis of DVM should be familiar to all clinical practitioners. Poster 30 Rethinking the Four F’s of Pseudotumor Cerebri Anney Kunthara, O.D., and Thao Vu, O.D., Lake City VAMC, 619 South Marion, Lake City, Florida 32025
Optometry, Vol 78, No 6, June 2007 Background: Pseudotumor cerebri, a predominantly female disease, must be included in the list of differentials for a male with bilateral optic disc edema. Potentially life-threatening etiologies exist for bilateral optic disc edema; therefore, a complete workup must be ordered to rule out hydrocephalus, malignant hypertension, meningitis, and tumors. Unremarkable neuroimaging test results, normal CSF composition, along with increased intracranial pressure is diagnostic of pseudotumor cerebri—a diagnosis of exclusion. Pseudotumor cerebri may be associated with oral contraceptives, vitamin A, tetracycline, chronic respiratory insufficiency, intracranial venous thrombosis, hypoparathyroidism, or anemia. Signs include normal or decreased vision, contrast sensitivity, and color. Diplopia, visual field defects, and bilateral optic disc edema are other findings. Treatment options consist of lifestyle changes, medication, and surgery. Clinicians must be aware of treatment protocols when the first-line medication is contraindicated. Case Report: A 27-year-old black male presented with headaches worse in the morning. Medical history included hypertension, sleep apnea, glucose 6 phosphate dehydrogenase deficiency, and sulfa allergy. Entering acuities were 20/20 in each eye. Pupils, extraocular motility, and anterior segment examinations were unremarkable. Dilated fundus examination revealed bilateral optic disc edema. Humphrey visual field findings showed bilateral inferior nasal depressions. Results of a complete workup were positive only for increased opening intracranial pressure. The patient was diagnosed with pseudotumor cerebri. First-line medical therapy of Diamox was not initiated due to the patient’s G6PD deficiency and subsequent sulfa allergy. Alternative treatment was initiated with Lasix and vitamin K supplements. Conclusion: Clinicians must know how to diagnose and manage an atypical case of bilateral optic disc edema. Pseudotumor cerebri often occurs in obese women between the ages of 20 and 45 years. This case supports the fact that the disease should not be excluded in atypical patients with signs and symptoms consistent with the diagnosis. In addition, alternative treatments for pseudotumor cerebri in sulfa allergic patients are necessary to prevent vision loss. Poster 31 Treatment Outcome of Acute Corneal Hydrops in a Keratoconic Patient Scott Schatz, O.D., Ph.D., and Hadley Saitowitz, O.D., Nova Southeastern University, College of Optometry, 3200 South University Drive, Ft. Lauderdale, Florida 33328 Background: Acute corneal hydrops is a late-stage debilitating condition that occurs in keratoconus (KS) patients secondary to rupture of Descemet’s membrane. The condition is characterized by pain and corneal edema accompanied by a decrease in visual acuity (VA). Presenting patients require immediate care for this acute condition.