Survey of ophthalmology
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Survey of ophthalmology · Mar 2016
ReviewManaging juvenile idiopathic arthritis-associated uveitis.
Bilateral chronic anterior uveitis is an extra-articular feature of juvenile idiopathic arthritis. Although figures vary, uveitis occurs in approximately 11%-13% of patients with this disease and is most commonly associated with the female gender, oligoarthritis, and presence of antinuclear antibodies. The disease has an insidious onset and is often asymptomatic. ⋯ Small scale studies and practice have provided the evidence to undertake randomized control trials to evaluate the efficacy, safety, and cost-effectiveness of anti-tumor necrosis factor-α therapies, such as infliximab and adalimumab. These have demonstrated promising results, with further data awaited from ongoing trials for adalimumab (as SYCAMORE and ADJUVITE trials). Lower grade evidence is supporting the use of newer biologics such as rituximab, daclizumab, tocilizumab, and abatacept in those cases refractory to anti-tumor necrosis factor-α therapy.
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Survey of ophthalmology · May 2015
ReviewFactors associated with postoperative pain and analgesic consumption in ophthalmic surgery: a systematic review.
Pain in ophthalmic surgery is a neglected area. We systematically reviewed the factors associated with postoperative pain and analgesic consumption in ophthalmic surgery and found 12 studies with 1,515 participants. The median number of patients in the included studies was 59. ⋯ Type of surgery, type of anesthesia, and patient satisfaction with anesthesia were associated with increased analgesic consumption. The studies reviewed were heterogeneous in terms of surgical procedures, patient populations, tools for pain assessment, and timing of postoperative pain measurement. Multiple factors may be associated with increased postoperative pain and analgesic consumption and warrant further research.
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Survey of ophthalmology · Jan 2015
ReviewPalinopsia revamped: a systematic review of the literature.
Palinopsia, the persistence or recurrence of visual images after the stimulus has been removed, is a nonspecific term that describes multiple types of visual symptoms with a wide variety of etiologies. For example, palinopsia may be the presenting symptom of a potentially life-threatening posterior cortical lesion, yet it may also be a benign medication side effect. We comprehensively review all published cases and subdivide palinopsia into two clinically relevant categories: illusory palinopsia and hallucinatory palinopsia.
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Survey of ophthalmology · Jan 2015
ReviewPalinopsia revamped: a systematic review of the literature.
Palinopsia, the persistence or recurrence of visual images after the stimulus has been removed, is a nonspecific term that describes multiple types of visual symptoms with a wide variety of etiologies. For example, palinopsia may be the presenting symptom of a potentially life-threatening posterior cortical lesion, yet it may also be a benign medication side effect. We comprehensively review all published cases and subdivide palinopsia into two clinically relevant categories: illusory palinopsia and hallucinatory palinopsia.
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Survey of ophthalmology · May 2014
ReviewUrrets-Zavalia syndrome (fixed and dilated pupil following penetrating keratoplasty for keratoconus) and its variants.
Urrets-Zavalia Syndrome (UZS) was described 50 years ago as the appearance of a fixed and dilated pupil following penetrating keratoplasty for keratoconus in patients receiving atropine. The mechanism of UZS has still not been fully determined, but an acute increase in intraocular pressure and ischemia of the iris most probably play a major role. ⋯ Some have questioned the existence of this syndrome, as well as the linkage to keratoconus and use of mydriatics. We review the pathophysiology, etiology, and clinical presentation of fixed and dilated pupils following ophthalmic procedures.