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Messages - splatty

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General Discussion / Re: Wilmer Eye Institute Science Seminar Series (WSSS)
« on: December 14, 2020, 07:36:52 PM »
Hi everyone! Hope you are all doing great.

Here is a schedule of upcoming virtual seminars held by the Johns Hopkins Wilmer Eye Institute where clinicians and researchers across the world will talk about their work! Please let me know if you're interested in attending!

There are 10 seminar speakers over the next 10 months, including 5 international speakers, 3 Chairs of Ophthalmology Departments (Berlin, Kyoto, Toyko), and the incoming Director of the NEI.
Monday, October 19, 2020

Dr. Shigeru Kinoshita, Professor and Chairman of Ophthalmology at Kyoto Prefectural University of Medicine

Hosted by Dr. Carlo Iomini

Monday November 2, 2020

Dr. Valerie Wallace, Director of Vision Sciences and Chair of the Vision Science Research Program, University of Toronto

Hosted by Dr. Mandeep Singh

Monday December 7, 2020

Dr. Vinit Mahajan, Associate Professor of Ophthalmology, Stanford University Medical Center

Hosted by Dr. Jamie Spangler

Monday January 11, 2021

Dr. Kip Connor, Associate Professor, Ophthalmology, Harvard Medical School/Massachusetts Eye and Ear Infirmary

Hosted by Dr. Malia Edwards

Tuesday February 9, 2021

Dr. Ales Cvekl, Professor, Department of Ophthalmology & Visual Sciences, Albert Einstein College of Medicine

Hosted by Dr. Amer Riazuddin

Tuesday February 23, 2021

Dr. Kaustabh Ghosh, Associate Professor, Department of Ophthalmology, University of California, Los Angeles‐ghosh

Hosted by Dr. Rangaramanujam Kannan

Tuesday March 23, 2021

Dr. Magali Saint‐Geniez, Associate Professor of Ophthalmology, Harvard Medical School/MEEI

Hosted by Dr. Ian Pitha

Tuesday April 27, 2021

Dr. Alan Stitt, Professor & Dean of Innovation and Impact, School of Medicine, Dentistry, and Biomedical Sciences, Queen’s University Belfast

Hosted by Dr. Jerry Lutty

May 2021 (date TBD)

Dr. Michael Chiang, Professor of Ophthalmology, Oregon Health Sciences Center/incoming Director, National Eye Institute

Hosted by Dr. Tom Johnson

Thursday June 10, 2021

Dr. Kyoko Ohno‐Matsui, Professor and Chair of Ophthalmology and Visual Science, Tokyo Medical and Dental University‐ohno‐matsui‐md‐phd/

Hosted by Dr. Peter Campochiaro

The Kinoshita talk was great! He is an amazing speaker.

General Discussion / Re: Stay Safe!
« on: September 08, 2020, 12:59:56 PM »
Hope everyone is staying safe in these trying times! :)
Make sure to wash your hands!

 :D :D Stay safe! Hope this ends soon!

my state is about to reopen  :-X :-X

same! next week for me, but at least its online

My daughter's university is going hybrid for this upcoming semester

Have been virtual for a few weeks working on school classes through Zoom. Really weird experience and my eyes get tired staring at the bright computer screen  8)

General Discussion / Re: Stay Safe!
« on: August 25, 2020, 02:20:30 AM »
Hope everyone is staying safe in these trying times! :)
Make sure to wash your hands!

 :D :D Stay safe! Hope this ends soon!

my state is about to reopen  :-X :-X

same! next week for me, but at least its online

General Discussion / Re: Glaucoma, Feedback Pathway
« on: August 09, 2020, 05:00:53 PM »

Found this to be interesting!

"Researchers at the University of South Florida (USF) have discovered a novel feedback pathway from the brain to the eye that modulates eye pressure -- a significant advancement in the effort to diagnose and treat glaucoma. Glaucoma is associated with increased pressure in the eye due to a reduce ability of the eye to maintain proper fluid drainage. The heightened pressure applies mechanical strain to the optic nerve as the nerve exits the eye, resulting in vision loss and potential blindness."

Love sciencedaily!  8)

General Discussion / Re: Mental Health Resources
« on: August 08, 2020, 02:15:58 AM »
Hey, some resources during these troubling times

If you're protesting, please remember to be aware and stay safe

Mental health apps like Calm are great for daily meditation and breathing exercises too
Used it as a university student

Calm is great! Use it every morning before I get out of bed

Unwind on the App Store for iPhone is great for meditation as well. I love the design too

I love Unwind! Great for yoga exercises

Crisis Text Line and 7Cups are online free emotional support websites I've tried before too

General Discussion / Re: Mental Health Resources
« on: July 31, 2020, 09:52:04 PM »
Hey, some resources during these troubling times

If you're protesting, please remember to be aware and stay safe

Mental health apps like Calm are great for daily meditation and breathing exercises too
Used it as a university student

Calm is great! Use it every morning before I get out of bed

Unwind on the App Store for iPhone is great for meditation as well. I love the design too

I love Unwind! Great for yoga exercises

General Discussion / Re: Mental Health Resources
« on: July 07, 2020, 04:34:03 PM »
Hey, some resources during these troubling times

If you're protesting, please remember to be aware and stay safe

Mental health apps like Calm are great for daily meditation and breathing exercises too
Used it as a university student

Calm is great! Use it every morning before I get out of bed

Unwind on the App Store for iPhone is great for meditation as well. I love the design too

General Discussion / Re: Stay Safe!
« on: May 11, 2020, 02:07:10 PM »
Hope everyone is staying safe in these trying times! :)
Make sure to wash your hands!

 :D :D Stay safe! Hope this ends soon!

General Discussion / Social Distancing
« on: April 06, 2020, 03:05:24 PM »
Hope everyone is staying safe and social distancing!

Especially in areas like NYC,etc.  :o

General Discussion / Re: COVID-19 Map
« on: March 22, 2020, 02:34:44 PM »

"More cases of COVID-19 are likely to be identified in the United States in the coming days, including more instances of community spread. It’s likely that at some point, widespread transmission of COVID-19 in the United States will occur. Widespread transmission of COVID-19 would translate into large numbers of people needing medical care at the same time. Schools, childcare centers, and workplaces, may experience more absenteeism. Mass gatherings may be sparsely attended or postponed. Public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and sectors of the transportation industry may also be affected. Healthcare providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy."

Scary! Stay safe and avoid large crowds, especially if you like in states like California or New York!

I'm in New York right now and the situation seems a little crazy! Everyone stay safe!

General Discussion / Re: LASIK
« on: March 22, 2020, 02:34:12 PM »
My mom got it and said it was a great decision

General Discussion / Support Groups
« on: February 28, 2020, 08:47:23 PM »
If anyone is looking for a support group here are some that i came across. You're not alone!  :)

Support Group Resources
The AFB Directory of Services allows you to find local support groups as well as organizations that offer counseling and adjustment services, low vision services, mobility training, and vocational rehabilitation.

MD (Macular Degeneration) Support offers The International Low Vision Support Group network with a directory of groups which meet all over the world. It provides materials and resources for leaders, archived audio-visual presentations and a Facilitator's Kit to get a group started. In addition, it hosts TeleSupport, a year-round program of monthly group support sessions held over the telephone. It is designed for low vision seniors anywhere in the U.S. who have no access to the Internet or cannot attend a live support group.

The American Council of the Blind (ACB) has a list of helpful resources for people with vision loss and their families. It also has a national directory of affiliates in each state. Seniors can find information through the ACB affiliate Alliance on Aging and Vision Loss.

Low vision issues are addressed through the Council of Citizens with Low Vision International.

The Hadley Institute for the Blind and Visually Impaired offers tuition-free distance education courses in various media on topics, such as participating in or even initiating a a self-help groups and dealing with many issues related to blindness and low vision.

The National Federation of the Blind Seniors Initiative provides low vision resources and online discussion groups.

Vision Exchange is an online resource for support group leaders who facilitate support groups for adults with vision loss. The purpose is to exchange ideas, information, and community resources to help adults with low vision be more independent.

The Family Caregiver Alliance (FCA) was the first community-based nonprofit organization in the country to address the needs of families and friends providing long-term care at home. FCA now offers programs at national, state, and local levels to support and sustain caregivers, and has an online family support group.

General Discussion / Re: Faster than the human eye can see
« on: February 22, 2020, 10:25:52 PM »
Wonder if our eye could take images like these ... ultrafast images of transparent phenomena at 1 TRILLION frames per second

Wow! thats some pretty crazy tech  :o

General Discussion / NYC area opthal
« on: February 22, 2020, 10:23:38 PM »
Does anyone have any good recommendations for ophthalmologists in the New York City area? I just moved here so I am wondering if anyone has any they would like to share or has had a good experience with a certain place

General Discussion / Re: ANP — Abducen Nerve Palsy
« on: February 22, 2020, 10:21:30 PM »
Sixth nerve palsy, or abducens nerve palsy, is a disorder associated with dysfunction of cranial nerve VI (the abducens nerve), which is responsible for causing contraction of the lateral rectus muscle to abduct (i.e., turn out) the eye. The inability of an eye to turn outward and results in a convergent strabismus or esotropia of which the primary symptom is diplopia (commonly known as double vision) in which the two images appear side-by-side. Thus the diplopia is horizontal and worse in the distance.


The nerve dysfunction induces esotropia, a convergent squint on distance fixation. On near fixation the affected individual may have only a latent deviation and be able to maintain binocularity or have an esotropia of a smaller size. Patients sometimes adopt a face turned towards the side of the affected eye, moving the eye away from the field of action of the affected lateral rectus muscle, with the aim of controlling diplopia and maintaining binocular vision.

Diplopia is typically experienced by adults with VI nerve palsies, but children with the condition may not experience diplopia due to suppression. The neuroplasticity present in childhood allows the child to 'switch off' the information coming from one eye, thus relieving any diplopic symptoms. Whilst this is a positive adaptation in the short term, in the long term it can lead to a lack of appropriate development of the visual cortex giving rise to permanent visual loss in the suppressed eye; a condition known as amblyopia.


Because the nerve emerges near the bottom of the brain, it is often the first nerve compressed when there is any rise in intracranial pressure. Different presentations of the condition, or associations with other conditions, can help to localize the site of the lesion along the VIth cranial nerve pathway.

The most common causes of VIth nerve palsy in adults are:

More common: Vasculopathic (diabetes, hypertension, atherosclerosis), trauma, idiopathic.
Less common: Increased intracranial pressure, giant cell arteritis, cavernous sinus mass (e.g. meningioma, Brain stem Glioblastoma aneurysm, metastasis), multiple sclerosis, sarcoidosis/vasculitis, postmyelography, lumbar puncture, stroke (usually not isolated), Chiari Malformation, hydrocephalus, intracranial hypertension, tuberculosis meningitis.
In children, Harley reports typical causes as traumatic, neoplastic (most commonly brainstem glioma), as well as idiopathic. Sixth nerve palsy causes the eyes to deviate inward (see: Pathophysiology of strabismus). report that benign and rapidly recovering isolated VIth nerve palsy can occur in childhood, sometimes precipitated by ear, nose and throat infections.


The first aims of management should be to identify and treat the cause of the condition, where this is possible, and to relieve the patient's symptoms, where present. In children, who rarely appreciate diplopia, the aim will be to maintain binocular vision and, thus, promote proper visual development.

Thereafter, a period of observation of around 6 months is appropriate before any further intervention, as some palsies will recover without the need for surgery.

Symptom relief and/or binocular vision maintenance

This is most commonly achieved through the use of fresnel prisms. These slim flexible plastic prisms can be attached to the patient's glasses, or to plano glasses if the patient has no refractive error, and serve to compensate for the inward misalignment of the affected eye. Unfortunately, the prism only correct for a fixed degree of misalignment and, because the affected individual's degree of misalignment will vary depending upon their direction of gaze, they may still experience diplopia when looking to the affected side. The prisms are available in different strengths and the most appropriate one can be selected for each patient. However, in patients with large deviations, the thickness of the prism required may reduce vision so much that binocularity is not achievable. In such cases it may be more appropriate simply to occlude one eye temporarily. Occlusion would never be used in infants though both because of the risk of inducing stimulus deprivation amblyopia and because they do not experience diplopia.

Other management options at this initial stage include the use of botulinum toxin, which is injected into the ipsilateral medial rectus (botulinum toxin therapy of strabismus). The use of BT serves a number of purposes. Firstly, it helps to prevent the contracture of the medial rectus which might result from its acting unopposed for a long period. Secondly, by reducing the size of the deviation temporarily it might allow prismatic correction to be used where this was not previously possible, and, thirdly, by removing the pull of the medial rectus it may serve to reveal whether the palsy is partial or complete by allowing any residual movement capability of the lateral rectus to operate. Thus, the toxin works both therapeutically, by helping to reduce symptoms and enhancing the prospects for fuller ocular movements post-operatively, and diagnostically, by helping to determine the type of operation most appropriate for each patient.

A Cochrane Review on interventions for eye movement disorders due to acquired brain injury, last updated June 2017, identified one study of botulinum toxin for acute sixth nerve palsy. The Cochrane review authors judged this to be low-certainty evidence; the study was not masked and the estimate of effect was imprecise.


If adequate recovery has not occurred after the 6 month period (during which observation, prism management, occlusion, or botulinum toxin may be considered), surgical treatment is often recommended.

If the residual esotropia is small, or if the patient is unfit or unwilling to have surgery, prisms can be incorporated into their glasses to provide more permanent symptom relief. When the deviation is too large for prismatic correction to be effective, permanent occlusion may be the only option for those unfit or unwilling to have surgery.


The procedure chosen will depend upon the degree to which any function remains in the affected lateral rectus. Where there is complete paralysis, the preferred option is to perform vertical muscle transposition procedures such as Jensen's, Hummelheim's or whole muscle transposition, with the aim of using the functioning inferior and superior recti to gain some degree of abduction. An alternative approach is to operate on both the lateral and medial rectii of the affected eye, with the aim of stabilising it at the midline, thus giving single vision straight ahead but potentially diplopia on both far left and right gaze. This procedure is often most appropriate for those with total paralysis who, because of other health problems, are at increased risk of the anterior segment ischaemia associated with complex multi-muscle transposition procedures.

Where some function remains in the affected eye, the preferred procedure depends upon the degree of development of muscle sequelae. In a sixth nerve palsy one would expect that, over the 6 month observation period, most patients would show the following pattern of changes to their ocular muscle actions: firstly, an overaction of the medial rectus of the affected eye, then an overaction of the medial rectus of the contraletral eye and, finally, an underaction of the lateral rectus of the unaffected eye - something known as an inhibitional palsy. These changes serve to reduce the variation in the misalignment of the two eyes in different gaze positions (incomitance). Where this process has fully developed, the preferred option is a simple recession, or weakening, of the medial rectus of the affected eye, combined with a resection, or strengthening, of the lateral rectus of the same eye. However, where the inhibitional palsy of the contralateral lateral rectus has not developed, there will still be gross incomitance, with the disparity between the eye positions being markedly greater in the field of action of the affected muscle. In such cases recession of the medial rectus of the affected eye is accompanied by recession and/or posterior fixation (Fadenoperation) of the contraleral medial rectus.

The same approaches are adopted bilaterally where both eyes have been affected.

One of my friends had this! It was only temporary for him and went away within a month.

General Discussion / Glaucoma 2020
« on: February 04, 2020, 04:09:51 PM »
For those experience glaucoma themselves or just interested in reading more about some recent discoveries dealing with it!

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