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Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
Case Study: Congenital Cataracts
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Case Study: Congenital Cataracts

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Kathy Miller's powerpoint presentation from the 2005 ADVISOR workshop.

Kathy Miller's powerpoint presentation from the 2005 ADVISOR workshop.

Published in: Health & Medicine, Business
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  • Transcript

    • 1. Case Study Congenital Cataract
    • 2. Surgery to Remove Cataract
    • 3. Other Forms of Cataract
    • 4. Other Forms of Cataract
    • 5. Early History <ul><li>Congenital Cataract removed at 3 months </li></ul><ul><li>Contact lens correction to manage high refractive error </li></ul><ul><li>Family history: grandmother and mother have different manifestations of disease </li></ul>
    • 6. Contact Lens Placement
    • 7. Contact Lens Placement
    • 8. EUA(exam under anesthesia) at 1.5 years <ul><li>Corneal Diameter OD 12.25mm </li></ul><ul><li>OS 9.75mm </li></ul><ul><li>IOP OD 29mmHg </li></ul><ul><li>OS 20mmHg </li></ul><ul><li>C/D OD 100 % </li></ul><ul><li>OS 50% </li></ul><ul><li>Refractive error +24.00 </li></ul><ul><li>Goniotomy </li></ul><ul><li>Medical therapy </li></ul>
    • 9. Increased Cupping of the Optic Nerve Increased cupping Normal fundus
    • 10. Increased cupping of the optic nerve
    • 11. Cloudy Corneas
    • 12. Increased Corneal Diameter
    • 13. EUA at 2.5 years <ul><li>Corneal Diameter OD 12.25mm </li></ul><ul><li>OS 10.0mm </li></ul><ul><li>IOP OD 32mmHg </li></ul><ul><li>OS 32mmHg </li></ul><ul><li>C/D OD 100% </li></ul><ul><li>OS 60% </li></ul><ul><li>Refractive Error +20.00 </li></ul>
    • 14. Exam at Age 6 years <ul><li>VA OD NLP </li></ul><ul><li>OS 20/125 ETDRS </li></ul><ul><li>Refractive Error +20.00/+3.00 </li></ul><ul><li>IOP OD 21mmHg </li></ul><ul><li>OS 14mmHg </li></ul><ul><li>Learning Braille </li></ul><ul><li>Large Print (using 48pt) </li></ul><ul><li>Black marker/Bold lined paper for writing </li></ul><ul><li>Aide in the classroom </li></ul>
    • 15. Exam at Age 7 years <ul><li>VA cc OD LP </li></ul><ul><li> cc OS 10/100 </li></ul><ul><li>cc OU 10/100(20/200) Feinbloom </li></ul><ul><li>Near VA 0.4/3M (20/150) Lighthouse </li></ul><ul><li>Fundus Exam: </li></ul><ul><li>OD complete cupping </li></ul><ul><li>OS 80% cupping with good rim </li></ul><ul><li>Current Meds: Timoptic, pilocarpine and diamox </li></ul>
    • 16. Low Vision Recommendations at Age 7 years <ul><li>Spectacle Prescription </li></ul><ul><li>OD +20.00/+3.00 add </li></ul><ul><li>OS +20.00/+3.00 add </li></ul><ul><li>1.8X bright field magnifier (20/40) </li></ul><ul><li>3X illuminated magnifier with battery plug–in-handle (20/40) </li></ul><ul><li>4.2X12 telescope (10/25) </li></ul>
    • 17. Stand Magnifiers
    • 18. Illuminated Stand Magnifiers
    • 19. Telescopic Devices
    • 20. Low Vision Recommendations at Age 7 years <ul><li>External light source at work area </li></ul><ul><li>Services of TVI </li></ul><ul><li>Services of O + M (caning) </li></ul><ul><li>Braille /hypotonia and poor touch sensitivity are an issue </li></ul><ul><li>CCTV introduced </li></ul><ul><li>Bold-lined paper/ black felt tipped pen </li></ul>
    • 21. Braille
    • 22. Closed Circuit Television
    • 23. Lap Desk,Bold-lined Paper and Marker
    • 24. Vision Concerns at age 9 years <ul><li>Difficulty reading standard print without use of CCTV </li></ul><ul><li>Cannot see blackboard </li></ul><ul><li>Teacher using overhead projector </li></ul><ul><li>Hand devices prescribed last time seem insufficient to enhance vision </li></ul>
    • 25. Exam Findings at Age 9 Years <ul><li>VA cc OD LP </li></ul><ul><li> cc OS 10/120 </li></ul><ul><li>cc OU 10/120 Feinbloom </li></ul><ul><li>Near VA cc 0.4/3M (20/150) </li></ul><ul><li>Lighthouse </li></ul><ul><li>Visual Field restriction </li></ul>
    • 26. Progression of Visual Field Loss Age 9 years Age 11 years
    • 27. Low Vision Recommendations at Age 9 years <ul><li>Spectacles </li></ul><ul><li>CCTV/only mag device effective </li></ul><ul><li>Hard copies of overhead projections at his desk </li></ul><ul><li>Telescope is of limited benefit because of reduction in visual field and contrast sensitivity </li></ul><ul><li>Intense Braille studies </li></ul>
    • 28. Exam Findings Age 11 years <ul><li>VA cc OD LP </li></ul><ul><li>cc OS 10/200 Feinbloom </li></ul><ul><li>Near VA cc 0.4/5M (20/250) </li></ul><ul><li>Visual Field Restriction </li></ul><ul><li>continued decline </li></ul>
    • 29. Low Vision Recommendations Age 11 years <ul><li>Braille – can type well but reading Braille is slow due to poor touch sensitivity </li></ul><ul><li>Kurzweil reader for longterm reading </li></ul><ul><li>Talking calculator for math </li></ul><ul><li>Audiotapes in class and books on tape </li></ul>
    • 30. Low Vision Recommendations Age 11 years <ul><li>Jaws (screen reading program for word processing/ Internet) </li></ul><ul><li>Notebook computer with Jaws and Zoomtext </li></ul><ul><li>CCTV still effective (prefers 72 point) </li></ul>

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