Optometry : journal of the American Optometric Association
-
Craniopharyngiomas are uncommon intracranial tumors that arise from remnants of the embryonic craniopharyngeal duct. Although benign in nature, craniopharyngiomas can contribute to significant morbidity. When located near critical structures such as the optic chiasm, pituitary, and hypothalamus, craniopharyngiomas have the potential to cause severe visual, neurological, and endocrine deficits. ⋯ To facilitate early diagnosis and treatment, eye care professionals should be aware that craniopharyngiomas can present with decreased visual acuity and bitemporal hemianopia. Visual deficits can arise from both the aggressive nature of craniopharyngiomas as well as the therapeutic intervention. Patients treated for craniopharyngiomas are at risk for recurrence and need to be followed up on a long-term basis.
-
Comparative Study
Visual function in patients followed at a Veterans Affairs polytrauma network site: an electronic medical record review.
This observational study describes the "Polytrauma System of Care" used by the Veterans Health Administration to guide medical care and rehabilitation of injured military personnel serving in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) and reports the visual function of patients with polytrauma and/or traumatic brain injury (TBI) at the Hines, Illinois, Polytrauma Network Site (PNS). ⋯ It is important for optometrists to be aware of the high rates of self-reported symptoms and visual problems in military personnel returning from deployment to the wars in Iraq and Afghanistan. Post-traumatic stress disorder and depression may complicate optometric evaluation and management.
-
Review Case Reports
Charles Bonnet syndrome: case presentation and literature review.
Charles Bonnet syndrome (CBS) is an under-recognized and under-reported disorder that involves visual hallucinations in visually impaired individuals. These patients have intact cognition, do not have hallucinations in any other sensory modalities, and retain insight into the unreal nature of their hallucinations. ⋯ Optometrists should be aware of the potential for visual hallucinations in patients with visual impairment. Early recognition by clinicians of the symptoms of CBS, and sharing proper information, treatment, and advice, can alleviate distress or suffering experienced by patients with CBS.
-
Discrete extraocular muscle (EOM) metastasis is rarely reported. Clinical signs and symptoms of EOM metastasis can often be indistinguishable from primary idiopathic orbital myositis, posing a significant clinical challenge. ⋯ This case illustrates discrete adenocarcinoma metastasis of an EOM, initially displaying characteristics predominantly consistent with orbital myositis. There is a paucity of epidemiologic data on EOM cancer, and clinical characteristics are derived only from a selection of case reports in the literature. Thus, the predominant features of global orbital metastatic cancer versus primary inflammation are highlighted in this presentation. This case shows that the variable characteristics of each process prohibit identification of any clinical feature that would prove pathognomonic for either disorder. The varied practice philosophies and standard of care regarding the proper time to biopsy are reviewed. This case shows the importance of early referral for orbital biopsy, even in the presentation of isolated, discretely edematous, and painful EOM enlargement.