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Oxford, United Kingdom

Fu L.,University of Manchester | Bundy C.,University of Manchester | Sadiq S.A.,Manchester Royal Eye Hospital
Eye | Year: 2011

Aims: Psychological distress is well documented in people with facial disfigurement. However, the prevalence of psychological distress in patients with facial palsy has not been studied. This study aims to establish the prevalence of psychological distress and the extent of anxiety and depression in a sample of facial palsy patients from the Northwest of England. Method: A total of 103 participants with facial palsy completed a questionnaire pack comprising the Illness Perception Questionnaire-Revised (IPQ-R), a demographic questionnaire, and the Hospital Anxiety and Depression Scale (HADS). The severity of participants' facial palsy was measured by the House-Brackmann scale. Results: In all, 32.7 and 31.3% of the sample had significant levels of anxiety and depression, respectively. The mean age of participants was 59, and 35.9% had grade 6 facial palsy. Significant associations were found between participants' perception of consequences, duration, timeline, and the level of distress. No significant associations were found between clinical severity of facial palsy and levels of distress. Females had significantly higher levels of anxiety compared with males. Conclusions: There was a significant level of distress in this study group. The levels of psychological distress were higher than the levels found in other outpatient attenders. There were significant associations between participants' illness perceptions and their level of distress. © 2011 Macmillan Publishers Limited All rights reserved. Source

Sharma V.,Manchester Royal Eye Hospital
Journal of pediatric ophthalmology and strabismus | Year: 2012

Reports of intraocular bleeding in infants from nonabusive causes are rare. The authors report a case of visually significant vitreous hemorrhage in an infant with a persistent hyaloid artery who also had raised intracranial pressure secondary to an intraventricular bleed. Copyright 2012, SLACK Incorporated. Source

McLeod D.,Manchester Royal Eye Hospital | McLeod D.,University of Manchester | Beatty S.,Waterford Institute of Technology | Beatty S.,Institute of Eye Surgery
Progress in Retinal and Eye Research | Year: 2015

The rationale behind hyperacute fibrinolytic therapy for cerebral and retinal arterial occlusion is to rescue ischaemic cells from irreversible damage through timely restitution of tissue perfusion. In cerebral stroke, an anoxic tissue compartment (the "infarct core") is surrounded by a hypoxic compartment (the "ischaemic penumbra"). The latter comprises electrically-silent neurons that undergo delayed apoptotic cell death within 1-6 h unless salvaged by arterial recanalisation. Establishment of an equivalent hypoxic compartment within the inner retina following central retinal artery occlusion (CRAO) isn't widely acknowledged. During experimental CRAO, electroretinography reveals 3 oxygenation-based tissue compartments (anoxic, hypoxic and normoxic) that contribute 32%, 27% and 41% respectively to the pre-occlusion b-wave amplitude. Thus, once the anoxia survival time (≈2 h) expires, the contribution from the infarcted posterior retina is irreversibly extinguished, but electrical activity continues in the normoxic periphery. Inbetween these compartments, an annular hypoxic zone (the "penumbra obscura") endures in a structurally-intact but functionally-impaired state until retinal reperfusion allows rapid recovery from electrical silence. Clinically, residual circulation of sufficient volume flow rate generates the heterogeneous fundus picture of "partial" CRAO. Persistent retinal venous hypoxaemia signifies maximal extraction of oxygen by an enduring "polar penumbra" that permeates or largely replaces the infarct core. On retinal reperfusion some days later, the retinal venous oxygen saturation reverts to normal and vision improves. Thus, penumbral inner retina, marginally oxygenated by the choroid or by residual circulation, isn't at risk of delayed apoptotic infarction (unlike hypoxic cerebral cortex). Emergency fibrinolytic intervention is inappropriate, therefore, once the duration of CRAO exceeds 2 h. © 2015 Elsevier Ltd. Source

Muqit M.M.,Manchester Royal Eye Hospital
Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye | Year: 2010

In this prospective study, the authors report fourier-domain optical coherence tomography (FD-OCT) imaging of gas-inner retinal tamponade following surgery for full-thickness macular hole and evaluate postoperative posturing based on FD-OCT findings. Patients underwent FD-OCT 1 day after pars plana vitrectomy, internal limiting membrane peel, and gas injection. Three-dimensional FD-OCT and high-resolution line scans demonstrated gas-inner retinal tamponade across the macula with the apex of tamponade located at the fovea. Inner and outer retina landmarks could be accurately identified along the curvature of the eye using FD-OCT in x-, y-, and z-planes. No patients required face-down positioning postoperatively based on FD-OCT findings. Satisfactory gas-inner retinal tamponade with 75% fill of any gas agent in the upright position was observed. Full-thickness macular hole closure was successful in 90% at 1 day, 2 weeks, and 12 weeks postoperatively. These FD-OCT findings may support decisions to not require face-down positioning postoperatively. Copyright 2010, SLACK Incorporated. Source

Tan S.Z.,Manchester Royal Eye Hospital
BMJ case reports | Year: 2013

A 52-year-old gentleman presented with 1-week history of severe right-sided headache associated with reduced vision in his right, amblyopic eye. Examination revealed raised intraocular pressure at 64 mm Hg. The anterior chamber (AC) was shallow and there was a dense cataract with no red reflex or fundal view. The contralateral eye had a deep anterior chamber with normal pressure and a clear lens. He was treated initially for acute angle closure glaucoma. The anterior chamber remained shallow and the intraocular pressure uncontrolled, despite maximum medical therapy. Owing to the absent fundal view and unilateral AC shallowing, further imaging was performed and a choroidal mass was found to be responsible for anterior displacement of the lens and shallowing of the angle. He went on to have an enucleation of the right eye, and histological examination confirmed the diagnosis of choroidal melanoma. Source

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