Search

Copyright of Die Ophthalmologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and purpose: The etiological distribution of oculomotor nerve palsy has varied amongst the studies. This study aimed to define the clinical features and underlying etiologies of isolated oculomotor nerve palsy by recruiting patients from all departments in a referral‐based university hospital. Methods: The medical records of 672 patients who had a confirmed diagnosis of isolated oculomotor nerve palsy at all departments of Seoul National University Bundang Hospital, Seongnam, South Korea, from 2003 to 2020 were reviewed. A proportion of the etiology of isolated oculomotor nerve palsy was also compared with that of patients pooled from the previous studies that were searched on PubMed in May 2022. Results: The most common etiology was microvascular (n = 168, 26.5%), followed by vascular anomalies (n = 110, 17.4%), neoplastic (n = 86, 13.6%), inflammatory (n = 79, 12.5%), idiopathic (n = 60, 9.5%) and traumatic (n = 53, 8.4%). Neurologists were mainly involved in the management of microvascular and inflammatory oculomotor nerve palsies whilst ophthalmologists mainly participated in the care of idiopathic, neoplastic and traumatic palsies. Neurosurgeons mostly took care of oculomotor nerve palsy due to vascular anomalies. Conclusions: The proportion of etiologies of isolated oculomotor nerve palsy may differ according to the specialties involved in the management. The results of previous studies on the etiological distribution of isolated oculomotor nerve palsy should be interpreted with this consideration. [ABSTRACT FROM AUTHOR]

Background: Computer devices have become an important part of human life because they make work easier and thus increase output. However, the use of computer devices has led to the occurrence of computer vision syndrome (CVS). The current study was aimed at determining the demographic characteristics, influence of ABO blood groups, and diseases associated with CVS in Lagos, Nigeria. Materials and Methods: Structured questionnaires were used to collect demographic information from 153 CVS patients at Unique Eyes Center, Lagos. The data collected includes age, gender, educational level, ethnicity, religion, type of device use, duration spent on devices, marital status, and diseases frequently expressed. The ABO blood groups of the participants were thereafter collected from their medical records. Results: The results showed that 89 (58.70%) of the respondents were males, while 64 (41.83%) were females. Most of the respondents were > 40 years old, with 78 members (50.98%), followed by age class 21–40 with 48 members (31.37%) and age class 10–20 with 27 members (17.65%).With respect to respondents educational status, 2(1.31%) had primary education, 28(18.30%) had secondary education while the majority 123(80.39%) had tertiary education. Regarding the marital status, married participants were 72 (47.06%) in number, others included singles 48 (31.37%), divorced 18 (11.76%), and widowed 15 (9.80%). There were 81 (52.94%) Christians, and 72(47.06%) Muslims. The Yoruba ethnic group made up 78 (50.98%), while others were Igbo 43 (28.10%), and Hausa/Fulani were 32 (20.92%). A total of 110 (71.90%) used desktops, 28 (18.30%) used androids, and 15 (9.80%) used laptops or iPads. One hundred and sixteen (75.82%) participants used computer devices continuously, while 37 (24.13%) used them intermittently. People with non-O blood types constituted the majority, of which those with type A blood were the most affected, having accounted for 51 (33.33%) of the overall population. Headache, blurred vision, eye strain, double vision, and neck/shoulder/back pain were strongly associated with CVS in the study area. Conclusion: The results suggest that demographic characteristics and ABO blood groups genotypes influence susceptibility to CVS among computer users in Lagos. Non-O blood group individuals, mainly type A blood are particularly at risk. People are advised to limit time spent on computer devices and get regular eye tests.

A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double vision. The ophthalmic examination revealed paralysis of III (n. oculomotorius) and VI (n. abducens) cranial nerves with ptosis, deficit in elevation and abduction of the left eye. The patient underwent urgent MRI imaging of the brain/orbits and paranasal sinuses, and urgent neurological assessment. MRI revealed a volume-occupying process, starting from the posterior wall of the left maxillary sinus with perineural diffusion and involvement of the homolateral trigeminal nerve, intracranial spread in the medial cranial fossa and involvement of the cavernous, sphenoidal sinuses and the orbital apex on the left side. Biopsy was performed, and the histology resulted in sinonasal squamous cell carcinoma with intracranial spread. [ABSTRACT FROM AUTHOR]

Introduction: Although the reported frequency of diplopia is between 10 to 40% of patients with Parkinson's disease (PD) and other movement disorders, it remains one of the most undiagnosed non-motor symptoms. Furthermore, it has a major impact on the quality of life of these patients. The aim of this study is to systematically review the literature regarding the frequency, causes, and implications of diplopia in movement disorders. Methodology: An electronic search was conducted in March and June 2023 using the PubMed database in order to identify appropriate studies. Studies that were written in English, that represented observational, analytical studies, and case reports, and that provided information regarding diplopia in movement disorders were included in the systematic review. Results: A total of 686 articles were identified out of which 43 met the inclusion criteria. The studies included in the systematic review ranged from descriptive studies (case reports and case series) to analytical–observational studies (cross-sectional studies, prospective and retrospective cohort studies, and case–control studies). In Parkinson's disease, the incidence of diplopia ranged from 10 to 38%. In these patients, diplopia was linked to the presence of visual hallucinations and cognitive decline but also to convergence insufficiency and the presence of motor fluctuations. Cases of diplopia secondary to deep brain stimulation were also reported. Diplopia was associated with longer disease duration and worse motor and non-motor scores. Diplopia was also reported in other movement disorders such as multiple system atrophy (frequency as high as 18%) and progressive supranuclear palsy (frequency as high as 39%) and was associated with increased mortality and shorter duration in life span. Conclusions: Diplopia occurs in up to 38% of patients with movement disorders and has a negative impact on their health-related quality of life. Treating physicians should actively ask about diplopia and other ophthalmological symptoms, as many patients do not spontaneously report them. The pathophysiology of diplopia is complex, and it involves heterogeneous peripheral and central mechanisms. The management of these patients should involve a multidisciplinary team of health professionals in order to provide appropriate, tailored management. [ABSTRACT FROM AUTHOR]

A 77-year-old-man with arterial hypertension, diabetes mellitus type II presented at our clinic for a routine ophthalmological exam. He complained of intermittent double vision. The ophthalmic examination revealed paralysis of III (n. oculomotorius) and VI (n. abducens) cranial nerves with ptosis, deficit in elevation and abduction of the left eye. The patient underwent urgent MRI imaging of the brain/orbits and paranasal sinuses, and urgent neurological assessment. MRI revealed a volume-occupying process, starting from the posterior wall of the left maxillary sinus with perineural diffusion and involvement of the homolateral trigeminal nerve, intracranial spread in the medial cranial fossa and involvement of the cavernous, sphenoidal sinuses and the orbital apex on the left side. Biopsy was performed, and the histology resulted in sinonasal squamous cell carcinoma with intracranial spread.

Background and Purpose: The etiologies of abducens nerve palsy have shown a large variability among studies. This study aimed to establish the clinical features and underlying etiologies of isolated abducens nerve palsy by recruiting patients from all departments in a referral‐based university hospital. Methods: We reviewed the medical records of 807 patients with a confirmed diagnosis of isolated abducens nerve palsy at all departments of Seoul National University Bundang Hospital, Seongnam, Republic of Korea, from 2003 to 2020. We also compared the proportion of etiology with that of the patients pooled from the previous studies. Results: The most common etiology was microvascular (n = 296, 36.7%), followed by idiopathic (n = 143, 17.7%), neoplastic (n = 115, 14.3%), vascular anomalies (n = 82, 10.2%), inflammatory (n = 76, 9.4%), and traumatic (n = 35, 4.3%). Patients were mostly managed by ophthalmologists (n = 576, 71.4%), followed by neurologists (n = 479, 59.4%), emergency physicians (n = 278, 34.4%), neurosurgeons (n = 191, 23.7%), and others (n = 72, 8.9%). The proportion of etiology significantly differed according to the age and sex of the patients and the specialties involved in the management (p < 0.001). Compared to the pooled data from the previous reports, the current study showed a higher prevalence of microvascular cause but a lower occurrence of traumatic and neoplastic causes. Conclusions: The results of previous studies on etiologic distribution of isolated abducens nerve palsy should be interpreted with consideration of the demographic features of patients recruited and the specialties involved. [ABSTRACT FROM AUTHOR]

Background and objectives: The etiologic distribution and clinical features of diplopia may differ according to the specialties involved in the management. This study aimed to establish the clinical features and underlying etiologies of diplopia by recruiting patients from all departments. Methods: We reviewed the medical records of 4127 patients with diplopia as the chief complaint, who had been recruited from all departments at Seoul National University Bundang Hospital, Seongnam, Republic of Korea, from 2003 to 2020. Results: Diplopia was binocular in 3557 (94.2%) and monocular in 219 (5.8%) patients. The common causes of binocular diplopia included microvascular (n = 516, 14.5%), strokes (n = 412, 11.6%), neoplastic (n = 304, 8.5%), myasthenia gravis (n = 253, 7.1%), traumatic (n = 240, 6.7%), and decompensated phoria (n = 232, 6.5%), and comprised more than a half of the causes. Patients with binocular diplopia were usually managed by neurologists (2549/3557, 71.7%), followed by ophthalmologists (2247/3557, 63.2%), emergency physicians (1528/3557, 43.0%), neurosurgeons (361/3557, 10.1%), and others (271/3557, 7.6%). The etiologies of binocular diplopia differed markedly according to the patients' age and the specialties involved in the management (p < 0.001). Conclusions: Given the differences in the etiologic distribution of diplopia according to the patients' age and the specialties involved in the management, the results of previous reports on the characteristics and etiology of diplopia, primarily performed in a single specialty department, should be interpreted with a possible selection bias. [ABSTRACT FROM AUTHOR]

Questions about artificial memory have become particularly urgent in recent years since memory is so crucial. it must show up in modern art. Artists question its practical role and attempt to unravel the complex web of societal and personal expectations surrounding it. Pat Barker's Double Vision (2003) actively explores such concern in which she tries to reflect the effect of the artificial memory throughout her characters in their actions by using their experiences in the war to be beneficial for people who didn't experience war before. Whereas the critical conversation has often boiled the complexity of the relationship between the traumas that the characters had experienced during the war and the artificial memory down to a debate for or against the view of not facing reality and pretending that the world is more secure than it is, That is, when the burden of the memory becomes too much to bear, a person may seek temporary relief by escaping to his mind by creating an imaginary world. Barker's quintessentially narrative and dialogic solution suggests a new and unusual way to come to terms with the problem. Rather than simply rehashing the debate, The novel underlines both the need of putting into words what was formerly unutterable and the immense impact that the system of memory has on one's life and surroundings. [ABSTRACT FROM AUTHOR]

This interview between the writer and critic Erik Morse and the artist and theorist Warren Neidich took place over the course of two months in the fall/winter 2021–2022. The interview focuses on a body of work entitled the Hybrid Dialectics produced between 1997–2002 that served as bridge between his earlier perfomative reenactments and fictitious documents entitled, American History Reinvented,1985–1993, and his more recent neon sculptures most notably the Pizzagate Neon, 2017–2021 and his A Proposition for an alt Parthenon Marbles Recoded: The Phantom as Other (2021–2022). Neidich's project extends his interdisciplinary experiments carried out in the fields of cinema studies, structural film and apparatus theory which foregrounded cinematic devices and tools at the expense of the image. This forms the foundation of Neidich's engagement with photographic medium as a form of politicized aesthetics embedded in a bidirectional embodied and extended cognition. His hybrid dialectics take off where artists like Michael Snow and Tony Conrad left off. They are the result of grafted neuro-opthalmologic devices, used in the measurement of squint and skewed gaze, upon the photographic lens which results in a destabilized and estranged image; making them other and queered while at the same time challenging the stillness of the photographic object. The neuro-photographic assemblages release the vibrant energy of their human and non-human subjects distributing them across the surface of the photographic paper. These portray a lexicon of control that would later appear again, in his recent neon sculptures in the form of the Google effect, meme magic, and click bait. The Hybrid Dialects represented forms of dissensus against what Guy Debord called the Society of the Spectacle where as Neidich's recent neon work is a rebuttal of the consciousness industry of social media and Big Data. [ABSTRACT FROM AUTHOR]

Background and Purpose: Trochlear palsy is the most common cause of vertical diplopia. The etiologies of trochlear palsy have shown a large discrepancy among studies. This study aimed to establish the clinical features and underlying etiologies of isolated trochlear palsy by recruiting the patients from all departments in a referral‐based university hospital. Methods: We reviewed the medical records of 1258 patients who had a confirmed diagnosis of isolated trochlear palsy at all departments of Seoul National University Bundang Hospital, Seongnam, South Korea, from 2003 to 2020. We also compared the proportion of etiologies with that of the patients pooled from previous studies. Results: The most common etiology was congenital (n = 330, 32.4%), followed by idiopathic (n = 256, 25.1%), microvascular (n = 212, 20.8%), and traumatic (n = 145, 14.2%). These four etiologies explained 92.5% of isolated trochlear palsy. Patients were mostly managed by ophthalmologists (n = 841, 82.5%), followed by neurologists (n = 380, 37.3%), emergency physicians (n = 197, 19.3%), neurosurgeons (n = 75, 7.4%), and others (n = 18, 1.8%). The etiologic distribution of isolated trochlear palsy in the current study did not differ from that of 2664 patients pooled from the previous studies. Conclusions: The proportion of etiologies of isolated trochlear palsy differs according to the age ranges of the patients and specialties involved in the management. The etiologic distribution of isolated trochlear palsy in the current study was comparable to the pooled result of previous reports. [ABSTRACT FROM AUTHOR]

Understanding the brand determines its nature as it is a dynamic information tool that is subject to interpretation and reformulation of all associated understanding, remembering and response, so companies focus on developing their design from competitiveness; And it sets future strategies based on the consumer and society. The use of a dual vision opens the door for the brand to live up to a new level of vision in which an information context is formulated and designed in an appropriate manner that ensures the process of remembering, responding, and entrenching the name of the company with the consumer and the market. The research is the necessity to study the use of dual meaning in brand design and the different meanings that it may bear, and converting ideas into innovations and practical facts, using the double vision? Can dual design values be derived from the exploitation of spaces as visual support elements in brand design? The importance of it lies in emphasizing the value of strong trademarks in the differential effect of consumer awareness of them and their response to the product, stressing the importance of visual space that creates a double vision in the meaning that serves its purpose in brand design, and emphasizing the effect of this double vision on the consumer remembering it? It aims to study the hidden ideas resulting from the double vision in designing brands and their role in creating the required response, and the analytical critical research approach for a group of brands in which the double vision method was used and its role in the audience's remembrance of it and consolidating the mental image of the company.

Background: The increase in online learning during the pandemic has been linked to various ocular complaints. This study determined the prevalence and factors associated with ocular complaints among schoolchildren aged 12-19 years during the COVID-19 lockdown in Trinidad and Tobago (T&T). Methods: A cross-sectional study was conducted between January and May 2021, during the COVID-19 lockdown in T&T among secondary school students studying remotely. A two-stage cluster sampling method was employed. A modified web-based Computer Vision Syndrome questionnaire was administered to students. Data on demography, duration of digital device use, and ocular complaints were collected, and multilevel logistic regression was used to determine factors associated with ocular complaints among school children, 12-19 years of age in T&T. Results: A total of 435 schoolchildren (mean age, standard deviation, 15.2 ± 1.9 years range 12-19 years) responded to the questionnaire. The prevalence of self-reported symptoms of headache, blurred vision, dry eyes, itchy eyes, and double vision were 75.0%, 65.1%; 56.8%; 46.4%; and 33.5%, respectively. Schoolchildren aged 18-19 years, those that used spectacles for correction of their refractive errors, and spent more than 6 h on average on digital devices, reported a high prevalence of any ocular complaints. Analysis also revealed that age (14-15 years) was associated with dry eyes, blurred vision, and headaches, while gender (more prevalently females) was associated with blurred vision and headache. Those that had an eye examination in the last year and schoolchildren that took action to resolve ocular complaints were more likely to experience nearly all ocular complaints. Conclusions: During the COVID-19 lockdown, over three in four students in T&T reported ocular complaints from digital devices for online learning. Tailored interventional messages to reduce all forms of ocular complaints should target older students, particularly females, those who laid down when learning online via their devices and people who regularly examine their eyes. [ABSTRACT FROM AUTHOR]

Exposure to welding is associated with many diseases, especially some of the eye injuries. We present a 49-year-old male patient applied to us with the complaints of double vision and blurred vision for a week. The symptoms started after looking welding machine light for a few minutes without protective glasses. After excluding another cause, the diagnosis of idiopathic abducens paralysis was made. As a result of exposure to metals and ultraviolet radiation, conjunctival disorders, presbyopia, refractive errors, corneal damage, and retinal pathologies can be seen in patients. It is also known that UV is a stress factor that will initiate reactions that lead to apoptosis of neurons. We think that exposure to UV rays may have played a role in the possible etiological process in our case. The patient was followed up with conservative treatment and all symptoms resolve within a month. [ABSTRACT FROM AUTHOR]

Background The increase in online learning during the pandemic has been linked to various ocular complaints. This study determined the prevalence and factors associated with ocular complaints among schoolchildren aged 12–19 years during the COVID-19 lockdown in Trinidad and Tobago (T&T). Methods A cross-sectional study was conducted between January and May 2021, during the COVID-19 lockdown in T&T among secondary school students studying remotely. A two-stage cluster sampling method was employed. A modified web-based Computer Vision Syndrome questionnaire was administered to students. Data on demography, duration of digital device use, and ocular complaints were collected, and multilevel logistic regression was used to determine factors associated with ocular complaints among school children, 12–19 years of age in T&T. Results A total of 435 schoolchildren (mean age, standard deviation, 15.2 ± 1.9 years range 12–19 years) responded to the questionnaire. The prevalence of self-reported symptoms of headache, blurred vision, dry eyes, itchy eyes, and double vision were 75.0%, 65.1%; 56.8%; 46.4%; and 33.5%, respectively. Schoolchildren aged 18–19 years, those that used spectacles for correction of their refractive errors, and spent more than 6 h on average on digital devices, reported a high prevalence of any ocular complaints. Analysis also revealed that age (14–15 years) was associated with dry eyes, blurred vision, and headaches, while gender (more prevalently females) was associated with blurred vision and headache. Those that had an eye examination in the last year and schoolchildren that took action to resolve ocular complaints were more likely to experience nearly all ocular complaints. Conclusions During the COVID-19 lockdown, over three in four students in T&T reported ocular complaints from digital devices for online learning. Tailored interventional messages to reduce all forms of ocular complaints should target older students, particularly females, those who laid down when learning online via their devices and people who regularly examine their eyes.

Lemierre's syndrome is a serious disease that typically causes oropharyngeal infection with internal jugular vein thrombosis, followed by distant infection focus, such as septic pulmonary embolism. The main causative organisms are anaerobic bacteria in the oral cavity, namely Fusobacterium necrophorum. We encountered an extremely rare case of Lemierre's syndrome, where double vision was found to be the first symptom. The patient's blood culture results showed the presence of F. nucleatum , which spread from the sphenoid sinus to the skull base because of chronic sinusitis; the patient presented with longus colli abscess, clivus osteomyelitis, venous thrombosis, and hematogenous infection. Antibiotic treatment with sulbactam/ampicillin was continued for 14 weeks, and no recurrence has been observed so far. Lemierre's syndrome can be complicated with atypical symptoms such as double vision if the cranial nerves are involved. It might be important to consider this disease in the differential diagnosis in the presence of cranial nerve symptoms of unknown origin with fever or inflammatory findings. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Multiple Sclerosis (MS) is one of the most destructive demyelinating diseases of the nervous system, and it manifests through broad involvement of the visual system. The present study was aimed to evaluate the frequency of ocular symptoms among MS patients admitted to the Kingdom Hospital in Saudi Arabia. PATIENTS AND METHODS: This is a crosssectional study aiming at investigating the prevalence of eye disease among MS patients referred to Hawtat Sudair Hospital, Zulfi General Hospital, Majmaah General Hospital, and Kingdom Hospital in Riyadh (Saudi Arabia) from January 2020 to December 2020. The sample size was made of 100 MS patients including 50 males and 50 females, all presented with eye disorders. The data were analyzed with SPSS 25, Chisquare test, and descriptive statistics. RESULTS: The examined patients included 100 patients with MS symptoms aged 35 years, ranging from 20 to 70 years. The results showed a considerable lack of sharpness of vision among patients (80%), and the rate of double vision was reported to be about 49% among them which was the most prevalent vision problem from the onset of the disease until the examination time. CONCLUSIONS: The achieved data from this study demonstrated that multiple sclerosis could cause eye diseases. Initial recognition of this syndrome provides the possibility of having an appropriate evaluation of patients to clinicians. Moreover, after the prevalence of MS, other ocular symptoms may occur consequently. [ABSTRACT FROM AUTHOR]

Pure representationalism or intentionalism for phenomenal experience is the theory that all introspectible qualitative aspects of a conscious experience can be analyzed as qualities that the experience non-conceptually represents the world to have. Some philosophers have argued that experiences such as afterimages, phosphenes and double vision are counterexamples to the representationalist theory, claiming that they are non- representational states or have non-representational aspects, and they are better explained in a qualia-theoretical framework. I argue that these states are fully representational states of a certain kind, which I call “automatically non-endorsed representations”, experiential states the veridicality of which we are almost never committed to, and which do not trigger explicit belief or disbelief in the mind of the subject. By investigating descriptive accounts of afterimages by two qualia theorists, I speculate that the mistaken claims of some anti-representationalists might be rooted in confusing two senses of the term “seeming”.

Myasthenia gravis is a well-understood autoimmune disease of the neuromuscular synapse that is medicinally treatable with favorable results and therefore should not be overlooked in the differential diagnostic evaluation of vertical diplopia. Myasthenia is primarily a clinical diagnosis. Positive indications include double vision of fluctuating severity, diurnal variations, double vision after lengthy gaze fixation on a distant object and in the primary position as well as diplopia in various visual directions, often associated with a varying extent of ptosis. Clinical tests are the Simpson test, the ice on eyes test and the probatory administration of pyridostigmine. Positive results corroborate this diagnosis but negative results do not exclude myasthenia. The same applies for the determination of specific autoantibodies. In addition to ocular symptoms it is important to search for generalized symptoms and bulbopharyngeal symptoms in particular should prompt immediate neurological diagnostics. In addition to symptomatic treatment a wide range of immunotherapeutic agents are available. Thymectomy is also used for immunomodulatory indications according to the 2023 revised guidelines. Patient-centered treatment goals, patient education and comprehensive information, also via the self-help organization German Myasthenia Society, are essential components of successful treatment of myasthenia., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Diplopia or double vision has various aetiologies and often presents to the ophthalmologist. The purpose of our study was to study in detail the aetiology, progression, and outcome in patients of diplopia presenting to the ophthalmology department of a tertiary care centre. In a prospective observational study, all patients presenting to the emergency services and the outpatient department of a tertiary care centre over a period of 1 year were recruited. One hundred and sixty patients who presented with diplopia with a mean age of 40 (range 7–76) years were included. There were 112 (70%) males and 48 (30%) females. The most common cause for binocular diplopia was vasculopathy in 43 (28.66%) followed by trauma in 37 (24.66%). In those less than 20 years decompensating heterophorias were most common and had the best prognosis. Traumatic causes were common in the age group 20–40 years and vascular in the >40 years age group. For all other aetiologies, elderly patients had more resolution than young patients (p =.04). Larger deviation at presentation, younger age group, and a history of trauma were associated with late recovery (p =.03. p =.04 and p =.04, respectively). [ABSTRACT FROM AUTHOR]

Background: Some patients with Parkinson Disease (PD) report double vision, but its prevalence and determinants are unknown. Objectives: To determine the prevalence and risk factors for diplopia in PD. Methods: Using data from 26,790 PD patients and 9257 controls in the Fox Insight Study, we compared the prevalence of diplopia using the Non‐Movement Symptom Questionnaire. Associations with age, race, gender, disease duration, and scores on MDS‐UPDRS part II, and Penn Parkinson's Daily Activity Questionnaire were assessed with generalized estimating equations. Results: The point prevalence of diplopia was higher in PD (18.1%) than controls (6.3%, P < 0.001) at baseline, and 28.2% of all PD patients reported diplopia at least once during the study (period prevalence). PD patients with diplopia were more likely to be older, non‐white, have greater disease duration, and report greater motor, non‐motor, and daily activity limitations. Conclusions: Diplopia is common and associates with motor and non‐motor severity in PD. [ABSTRACT FROM AUTHOR]

A 34-year-old female patient required surgical removal of lower left third molar under local anesthesia. Two percent lignocaine with 1:80000 adrenaline was used for administrating inferior alveolar nerve block at dental clinic. Twenty five minutes after the surgical removal, patient developed diplopia on the left eye. This transient diplopia could be due to retro flow of local anesthetic agent through the inferior alveolar artery and indirectly to the ophthalmic artery paralyzing the lateral rectus muscle. Patient recovered after 60 minutes. This article discusses the possible etiologies of diplopia, the mechanism behind this ophthalmic complication, and the review of various reported literature.

Myasthenia gravis (MG) is a rare disorder that most commonly presents with ocular symptoms. Despite the highly sensitive blood work that can be used to diagnose the disease, it is frequently misdiagnosed until the disease becomes systemic. Literature, however, shows that those who begin treatment with acetylcholinesterase inhibitors before systemic presentation have a better prognosis. We discuss the case of a patient who presented to the clinic with a chief complaint of diplopia that was subsequently referred to ophthalmology. It was not until lab work was done by a subspecialist that the diagnosis of MG was made. The patient quickly responded to an acetylcholinesterase inhibitor and has since had a great prognosis. Here, we are advocating for the inclusion of routine lab work in the evaluation of patients who present to the primary care setting with diplopia in the absence of red flag symptoms. This approach aids in deciphering the potential involvement of MG in diplopia or ptosis. While such symptoms justify referral to ophthalmology, logistical challenges often hinder a prompt evaluation. Early diagnosis with the incorporation of routine lab work offers the potential to expedite the diagnosis of a rare disease. In doing so, providers can improve prognosis and potentially mitigate additive medical consultations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Dietlein et al.)

Copyright of Association of Arab Universities Journal of Engineering Sciences (JAARU) is the property of Association of Arab Universities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Diagnosing stroke as a cause of acute vertigo, dizziness, or double vision remains a challenge, because symptom characteristics can be variable. The purpose of this study was to prospectively investigate lesion-symptom relationships in patients with acute vestibular or ocular motor stroke.Methods: Three hundred and fifty one patients with acute and isolated vestibular or ocular motor symptoms of unclear etiology were enrolled in the EMVERT lesion trial. Symptom quality was assessed by the chief complaint (vertigo, dizziness, double vision), symptom intensity by the visual analog scale, functional impairment by EQ-5D-5L, and symptom duration by daily rating. Acute vestibular and ocular motor signs were registered by videooculography. A standardized MRI (DWI-/FLAIR-/T2-/T2*-/3D-T1-weighted sequences) was recorded within 7 days of symptom onset. MRIs with DWI lesions were further processed for voxel-based lesion-symptom mapping (VLSM).Results: In 47 patients, MRI depicted an acute unilateral stroke (13.4%). The chief complaints were dizziness (42.5%), vertigo (40.4%) and double vision (17.0%). Lesions in patients with vertigo or dizziness showed a large overlap in the cerebellar hemisphere. VLSM indicated that strokes in the medial cerebellar layers 7b, 8, 9 were associated with vertigo, strokes in the lateral cerebellar layer 8, crus 1, 2 with dizziness, and pontomesencephalic strokes with double vision. Symptom intensity and duration varied largely between patients. Higher symptom intensity and longer duration were associated with medial cerebellar lesions. Hemispheric lesions of the cortex were rare and presented with milder symptoms of shorter duration.Conclusions: Prospective evaluation of patients with acute vestibular or ocular motor stroke revealed that symptom quality, intensity and duration were not suited to differentiating peripheral from central etiologies. Lesions in the lateral cerebellum, thalamus, or cortex presented with unspecific, mild and transient symptoms prone to being misdiagnosed.

This paper presents the use of space and time function applied simultaneously into the silicon microring system arrangement for double vision problem solving and enhancement. The eye structure formed by three silicon ring resonators, in which the 3D imaging constructed and modulated by the space function and time function rings, respectively. The double vision problem manipulated by the interference of the whispering gallery modes generated by the system, the final image information connected the central nerve cells. The 3D imaging constructed by the space function formed by the whispering gallery modes (WGMs) named as object and reference beams. The image information modulated by the WGM of time function signals from the small ring (3rd eye). By using the suitable parameters, the WGMs of light beams within a system generated, from which the coupling of an object and reference beams used for imaging perception. The control part is the WGM beam generated by the time function that inputs into the small ring. The simulation results obtained have shown that the double vision control and adjust by the space-time function achieved, in which the vision wavelength and frequency can be expanded from 0.40–1.80 μm and 150–700 THz, respectively, which has the potential for artificial eye application. [ABSTRACT FROM AUTHOR]

Background: Diagnosing stroke as a cause of acute vertigo, dizziness, or double vision remains a challenge, because symptom characteristics can be variable. The purpose of this study was to prospectively investigate lesion-symptom relationships in patients with acute vestibular or ocular motor stroke. Methods: Three hundred and fifty one patients with acute and isolated vestibular or ocular motor symptoms of unclear etiology were enrolled in the EMVERT lesion trial. Symptom quality was assessed by the chief complaint (vertigo, dizziness, double vision), symptom intensity by the visual analog scale, functional impairment by EQ-5D-5L, and symptom duration by daily rating. Acute vestibular and ocular motor signs were registered by videooculography. A standardized MRI (DWI-/FLAIR-/T2-/T2*-/3D-T1-weighted sequences) was recorded within 7 days of symptom onset. MRIs with DWI lesions were further processed for voxel-based lesion-symptom mapping (VLSM). Results: In 47 patients, MRI depicted an acute unilateral stroke (13.4%). The chief complaints were dizziness (42.5%), vertigo (40.4%) and double vision (17.0%). Lesions in patients with vertigo or dizziness showed a large overlap in the cerebellar hemisphere. VLSM indicated that strokes in the medial cerebellar layers 7b, 8, 9 were associated with vertigo, strokes in the lateral cerebellar layer 8, crus 1, 2 with dizziness, and pontomesencephalic strokes with double vision. Symptom intensity and duration varied largely between patients. Higher symptom intensity and longer duration were associated with medial cerebellar lesions. Hemispheric lesions of the cortex were rare and presented with milder symptoms of shorter duration. Conclusions: Prospective evaluation of patients with acute vestibular or ocular motor stroke revealed that symptom quality, intensity and duration were not suited to differentiating peripheral from central etiologies. Lesions in the lateral cerebellum, thalamus, or cortex presented with unspecific, mild and transient symptoms prone to being misdiagnosed. [ABSTRACT FROM AUTHOR]

Background: Prolonged near work is a potential source of visual problems, which deteriorates work performance and reduces productivity. The present study aims to report the association between visual symptoms and ocular-visual abnormalities in thangka artists. Methods: In a descriptive cross-sectional study, 342 emmetropic thangka artists were enrolled in the study from six randomly selected clusters of thangka painting schools from Kathmandu. Before eye examination, the Nepali version of the questionnaire on the symptoms of visual strain was administered to every subject to assess visual symptoms. Eye examination included visual acuity testing, refraction, cover test, fusional vergence, amplitude of accommodation, lag of accommodation, accommodative facility, convergence, Schirmer test, blink rate, colour vision, and stereopsis. Multivariate logistic regression analysis was used to determine the association between symptoms and ocular-visual abnormalities. Results: Accommodative insufficiency (p<0.001) and accommodative infacility (p=0.001) were significantly associated with middle-age adults (>30 years). Regarding visual symptoms, blurred vision (56.4%) and burning eyes (56.0%) were reported with the greatest frequency. However, tired eyes and double vision were mostly correlated with ocular-visual abnormalities. Tired eyes was especially correlated with accommodative infacility (p<0.001) and accommodative insufficiency (p=0.001), whereas double vision was correlated with fusional insufficiency at both distance (p=0.001) and near (p=0.048). Conclusion: Thangka artists have a greater prevalence of ocular-visual abnormalities, along with visual symptoms. Accommodative insufficiency, accommodative infacility, and fusional insufficiency are associated with symptoms of tired eyes and double vision in this population. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Image & Graphics is the property of Editorial Office of Journal of Image & Graphics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)