Disease Reviews - American Academy of Ophthalmology

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1-20 of 102 results

Strabismus Following Extraocular Muscle Trauma

MAY 31, 2018 By Andrea Delia Molinari MD

Trauma to the extraocular muscles will often result directly in specific ocular motility disorders that can pose a real challenge for treatment. Recent advances in orbital imaging, surgical techniques, and new information on different trauma mechanisms have improved the outc…

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Nystagmus in Infancy and Childhood

MAR 21, 2018 By Louis Frank Dell'Osso PhD

Ocular motor research in the past half-century has produced remarkable advances in our understanding of the underlying mechanisms of the several types of nystagmus seen in infancy and childhood. Research results to better enable the clinician to make accurate diagnoses and p…

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Leber Congenital Amaurosis

DEC 06, 2017 By Razek Georges Coussa, MD, Robert K Koenekoop MD PhD, Elias I Traboulsi MD

Leber congenital amaurosis (LCA) manifests itself in the first 6 months of life with significant visual loss and sensory, pendular nystagmus. Visual acuity (VA) in children with LCA varies significantly among patients with differing gene mutations; this variability has led i…

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Aqueous Humor as a Surrogate Tumor Biopsy for Retinoblastoma

NOV 27, 2017 By Jesse L. Berry, MD; Liya Xu, PhD; A. Linn Murphree, MD; Subramanian Krishnan, PhD; Kevin Stachelek, BS; Thomas C. Lee, MD; Anders Carlsson, PhD; Peter Kuhn, PhD; Jonathan W. Kim, MD; David Cobrinik, MD, PhD; James Hicks, PhD

Retinoblastoma (Rb) is a primary intraocular cancer that develops in the eyes of young children most often under the age of 5 years.Access to the acueous humor AH of eyes with active Rb has enabled the first-ever genetic analyses of Rb tumors in situ (ie, without enucleation…

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Norrie Disease

NOV 20, 2017 By Jing Sun, BA; Robert A Sisk, MD; Elias I. Traboulsi, MD, MEd; Virginia Miraldi Utz, MD

Patients with ND present with blindness due to leukocoria caused by immature retinal cell masses (pseudogliomas) and retinal detachments at birth. Treatment strategies include early laser photocoagulation or vitrectomy to prevent retinal detachment.

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Down Syndrome (Trisomy 21)

NOV 20, 2017 By Mary G Kunesh, BS, W Walker Motley, MD, Virginia M Miraldi Utz, MD

Significant refractive error is found in approximately 50%-80% of children with Down syndrome, and there is substantial underaccommodation in these patients regardless of refractive error. Patients should be followed annually until age 5 evaluating for refractive errors, str…

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Anatomy of the Angle

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

The purpose of gonioscopy is to permit visualization of the iridocorneal angle (or simply “angle”). Before exploring gonioscopic techniques and findings, it is important to review the anatomy and function of the structures of the angle.

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Gonioscopic Grading Systems

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

Grading systems permit the recording of gonioscopic findings for communication and for future reference. The three primary alphanumeric systems that are currently used for grading the angle are those of Scheie, Shaffer, and Spaeth.

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Color Atlas of Gonioscopy

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

Color Atlas of Gonioscopy, by Wallace L.M. Alward, MD, and Reid A. Longmuir, MD, is a brief, but comprehensive, introduction to gonioscopy. Gonioscopy is a visual science, so the greater part of the book is devoted to illustrations of gonioscopic and slit-lamp findings, norm…

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Techniques of Slit-Lamp Gonioscopy

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

The eye should be examined carefully with the slit lamp before beginning gonioscopy. One might see a prominent Schwalbe’s line, atrophy of the iris, or evidence of previous inflammation, surgery, or trauma.

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Abnormalities Associated With a Closed Angle

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

Among the abnormalities associated with a closed angle are pupillary block, plateau iris, aqueous misdirection, and secondary pupillary block, Hyperopic eyes are at highest risk of angle closure; such eyes have shallow anterior chambers and small corneas.

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Abnormalities Associated With an Open Angle

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

There are no characteristic gonioscopic abnormalities in primary open-angle glaucoma, ocular hypertension, or normal-tension glaucoma. Among the abnormalities that can occur with an open angle are pigment dispersion syndrome, and oculodermal melanocytosis.

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Anterior Segment Imaging

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

While gonioscopy remains the gold standard by which the angle is evaluated, numerous anterior segment imaging techniques exist to assist in determining anterior segment structure. The two most commonly employed techniques are ultrasound biomicroscopy (UBM) and slit-lamp…

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Gonioscopic Laser Surgery

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

Both laser and incisional surgery are performed with the aid of gonioscopic visualization of the angle. Incisional surgery includes goniotomy, goniosynechialysis, internally created filtration procedures, and internal revisions of filtration fistulas.

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Principles of Gonioscopy

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

Viewing the anterior chamber of a normal eye directly is not possible. Light from the junction of the iris and cornea strikes the tear–air interface at a shallow angle, and it is totally reflected back into the eye; this is the principle of total internal reflection.

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The Normal Angle

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

The best preparation for recognizing angle pathology is to become familiar with the many variations of normal. Careful gonioscopic evaluation of the anterior segment follows a routine that evaluates all visible structures in a systematic fashion.

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Developmental Abnormalities of the Angle

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

Primary infantile glaucoma results from failure of the angle to develop normally. The diagnosis of infantile glaucoma is usually made when parents notice photophobia with blepharospasm, tearing, cloudy corneas, or large eyes.

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A Brief History of Gonioscopy

NOV 08, 2017 By Wallace L M Alward MD, Reid A Longmuir MD

Gonioscopy is a relatively young science, having been developed entirely within the twentieth century. The Greek ophthalmologist Alexios Trantas, who first reported examination of the angle in 1907, viewed the angle in a patient with keratoglobus using a direct ophthalmo…

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Third-Nerve Palsy

SEP 28, 2017 By John Roarty, MD, MPH

In the pediatric patient, 3rd nerve palsy usually is congenital, traumatic (surgical), or caused by a tumor, or aneurysm. An ophthalmic assessment can determine the extent of the motility limitation, ptosis, and pupillary status.

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Infantile Nystagmus

SEP 27, 2017 By Avery H Weiss MD

Evaluation of the infant or child with infantile nystagmus syndrome (INS) is very challenging because INS can be an isolated abnormality or appear in association with a wide variety of underlying visual sensory and systemic disorders.

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