Current opinion in ophthalmology
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Curr Opin Ophthalmol · Jan 2011
ReviewAre ocular injection anesthetic blocks obsolete? Indications and guidelines.
In this era of topical anesthesia for ocular surgery, anesthetic ocular blocks are still important when profound anesthesia and akinesia are required. Although injection ocular blocks, retrobulbar and peribulbar anesthesia, have been supplanted for most ocular surgery in many centers by sub-Tenon's irrigation block because of its superior safety profile, still worldwide, injection blocks remain popular. ⋯ Sub-Tenon's block should be performed in the operating theatre in preference to retrobulbar or peribulbar anesthesia except for limited indications. When injection ocular block is deemed necessary, we feel that retrobulbar anesthesia with the technique described may be safer than peribulbar anesthesia.
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Curr Opin Ophthalmol · Nov 2010
ReviewOphthalmologic features of the common spinocerebellar ataxias.
The spinocerebellar ataxias (SCAs) are a phenotypically and genetically diverse group of autosomal dominant disorders that cause pathological degeneration in the cerebellum, brainstem, and retina, resulting in a wide variety of ophthalmologic signs and symptoms. ⋯ The ophthalmologist may be the first to encounter a patient with SCA, and a review of the most common genetic subtypes of this disorder is helpful in diagnosis and management.
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Curr Opin Ophthalmol · Jan 2010
ReviewUpdate on pediatric cataract surgery and intraocular lens implantation.
Cataract surgery is the most commonly performed intraocular surgery in the pediatric population worldwide. Although the basic surgical techniques have not significantly changed over the last several years, there are many related issues under continual debate and research. These include use of local perioperative anesthesia, capsular management, type and power of intraocular lenses (IOLs), sutured IOLs, and risk of subsequent glaucoma. This review will primarily focus on postsurgical outcomes and IOL-related controversies. ⋯ Worldwide experiences with pediatric cataract surgery and IOL implantation are constantly evolving. Expectations of good outcomes by the patients, families, and surgeons are also increasing therefore continued efforts to improve techniques and formulas specific to the pediatric population are critical.
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Visual disturbances and ocular symptoms are common manifestations of two primary headache disorders, migraine and trigeminal autonomic cephalalgias, and many secondary headache disorders. ⋯ Ophthalmologists are often the first physicians to evaluate patients presenting with headaches and ocular pain or visual symptoms. Knowledge of primary and secondary headache disorders, a detailed history, and a thorough clinical examination are prerequisites for accurate diagnosis and appropriate management.
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Curr Opin Ophthalmol · May 2009
ReviewSub-Tenon's anaesthesia: a well tolerated and effective procedure for ophthalmic surgery.
To report recent advancements with sub-Tenon's anaesthesia for ocular surgery, accentuating the efficacy and safety of this technique. Further clinical implications are reviewed with regard to its technique, indications, benefits, and reported complications. ⋯ Currently, there is no absolutely well tolerated orbital regional block technique. However, well founded evidence appears to support sub-Tenon's block as a safer option. Sound knowledge of orbital anatomy, pharmacology of anaesthetic agents, and prevention of potential complications are therefore crucial to perform sub-Tenon's block effectively and safely.