Biofeedback for ophthalmologic disorders.

The possible applications of biofeedback to the treatment of ophthalmologic disorders is reviewed. Studies have suggested utility in the management of blepharospasms, strabismus, nystagmus, and other eye movement disorders as well as the training of voluntary control of accommodation. Limitations of the current literature are discussed, as are prospects for the clinical use of biofeedback in ophthalmologic practice.

Biofeedback therapy of essential blepharospasm.

Eight patients with essential blepharospasm were given five consecutive sessions of electromyogram biofeedback from cutaneous electrodes placed over the frontalis muscle. Four of the eight patients demonstrated a 60% or greater reduction in blepharospasm frequency. Posttreatment electromyogram significantly predicted improvement of blepharospasm. These data suggest that electromyogram biofeedback may provide a therapeutic alternative to the treatment of this disabling condition.

Vitreous Hemorrhage complicating laser-induced chorioretinal anastomosis for central retinal vein occlusion.

PURPOSE: To report a severe complication of laser chorioretinal anastomosis for central retinal vein occlusion. METHOD: Case report. RESULTS: In the right eye of a 62-year-old woman with nonischemic central retinal vein occlusion, retinal neovascularization at the laser chorioretinal anastomosis site caused dense secondary vitreous hemorrhage. Vitreous hemorrhage prevented laser panretinal photocoagulation for subsequent iris neovascularization, necessitating vitrectomy surgery to clear the hemorrhage and allow the treatment. CONCLUSION: Laser chorioretinal anastomosis can result in severe vitreous hemorrhage and complicate efforts to manage later sequelae of central retinal vein occlusion.

Ocular vasodilation and angiogenesis in Potter's syndrome.

At autopsy we examined eight eyes of six infants with Potter's syndrome, an idiopathic multisystem condition with a constellation of ocular anomalies, to explore its ocular component more fully and systematically. A striking abnormality in some cases was the presence of dilated intraocular blood vessels, and these were sometimes associated with retinal and preretinal neovascularization reminiscent of the vasoproliferative stage of retrolental fibroplasia. Since oxygen therapy cannot be implicated in these cases, other causes, either genetic or environmental, must be sought. The presence of nonretinal ocular vascular anomalies, such as iris capillary dilation, peripapillary angioma formation, and vascular anomalies in nonocular tissue, point to a generalized derangement in the control of ocular angiogenesis. Our study indicated that an understanding of the pathogenesis of the vascular anomalies in Potter's syndrome is clearly relevant to other more common retinopathies that are associated with neovascularization.

A phase III, placebo controlled clinical trial of 0.5% levofloxacin ophthalmic solution for the treatment of bacterial conjunctivitis.

AIM: To compare the efficacy and safety of levofloxacin 0.5% ophthalmic solution (Quixin) with placebo for treatment of bacterial conjunctivitis. METHODS: In this prospective, randomised, placebo controlled, double masked, multicentre study, 249 patients with bacterial conjunctivitis received either 0.5% levofloxacin (n = 126) or placebo (n = 123) for 5 days, administered every 2 hours on days 1-2, then every 4 hours on days 3-5. Cultures were obtained and signs/symptoms evaluated at baseline, interim, and final visits. The end point was the last evaluable observation. Primary microbial outcomes were based on culture results; clinical outcomes were based on resolution of cardinal signs. RESULTS: 117 patients (60 levofloxacin, 57 placebo) were evaluated. Microbial eradication rates were significantly greater with levofloxacin at all time points, reaching 90% at end point. In a subgroup analysis, differences in eradication rates at end point were most pronounced in children but were also statistically significant for levofloxacin in adults. Clinical cure rates were significantly greater with levofloxacin at final visit and end point. Statistically significant differences favouring levofloxacin were measured at end point for resolution of conjunctival discharge, bulbar conjunctival injection, palpebral conjunctival injection, burning/stinging, itching, and photophobia. Adverse events were similar between groups. Safety composite scores analysed by age indicated significantly fewer children on levofloxacin experienced worsening symptoms. CONCLUSIONS: Levofloxacin 0.5% ophthalmic solution is safe and effective for treatment of bacterial conjunctivitis.

A simple technique for Doppler ophthalmodynamometry.

A novel method to assess carotid and intraocular blood flow and pulse pressures is presented. This procedure can be performed by personnel not trained in ophthalmoscopy, and is valid in eyes with opaque media. It is noninvasive, requires no elaborate equipment, and may be useful as an adjunct to ophthalmodynamometry.

Biofeedback techniques in the treatment of visual and ophthalmologic disorders: a review of the literature.

The literature on the use of biofeedback techniques in the treatment of visual and ophthalmologic disorders is reviewed. Although this consists mainly of case studies, there is mounting evidence that biofeedback may be applicable to the treatment of strabismus, nystagmus, blepharospasm, elevated intraocular pressure, and myopia. because of the success in applying biofeedback techniques in the treatment of other neuromuscular disorders, it is concluded that the use of these techniques in the treatment of blepharospasm and strabismus shows the most promise.