BCK Patel | University of Utah (original) (raw)
Papers by BCK Patel
British Journal of Ophthalmology, 1991
The onset of periorbital xanthogranuloma in adults is rare and may be accompanied by haematologic... more The onset of periorbital xanthogranuloma in adults is rare and may be accompanied by haematological abnormalities and malignancy. The appearance ofthe eyelid lesions is virtually diagnostic, producing readily recognisable diffuse, yellow plaques, and affected patients should be investigated and reviewed regularly for systemic disease. Three cases are described, in which periorbital cutaneous plaques were associated with abnormal tissues in the superior part of the orbit; these abnormal tissues caused displacement or restricted movement of the globe or upper eyelid. The possibility that two cases represent a necrobiotic type of xanthogranuloma is presented. Nine years after the onset of xanthogranuloma one patient developed non-Hodgkin's lymphoma. A multiple-drug regimen of systemic chemotherapy, given for lymphoma, caused a marked clinical reduction in the periorbital xanthogranuloma.
Eye, 1990
The results of extracapsular cataract extraction, with or without posterior chamber intraocular l... more The results of extracapsular cataract extraction, with or without posterior chamber intraocular lens (IOL) implantation, in Fuchs Heterochromic Uveitis, are reported. Twenty-nine patients underwent 30 operations. Twenty-two patients (73%) obtained a visual acuity of 6/ 12 or better. Post-operative uveitis or glaucoma were encoun tered in 13 eyes, including 11 "f20 eyes with IOL implantation (55%), and two of ten eyes without IOL implantation (20%). IOL implantation is a significant additional factor in cataract surgery in patients with FHU. Preoperative risk factors include severe iris atrophy, secondary glaucoma, and severe abnormalities of iris vas culature. IOL implantation is not recommended in these eyes. The routine post operative use of anti-glaucoma medication is recommended. Long-term postoperative follow-up is important.
Journal of Neurosurgery, 2012
Object Lesions of the cavernous sinus remain a technical challenge. The most common surgical appr... more Object Lesions of the cavernous sinus remain a technical challenge. The most common surgical approaches involve some variation of the standard frontotemporal craniotomy. Here, the authors describe a surgical approach to access the cavernous sinus that involves the removal of the lateral orbital wall. Methods To achieve exposure of the cavernous sinus, a lateral canthal incision is performed, and the lateral orbital rim and anterior lateral wall are removed, for later replacement at closure. The posterior lateral orbital wall is removed to the region of the superior and inferior orbital fissures. With reflection of the dural covering of the lateral cavernous sinus and removal of the anterior clinoid process, the cavernous sinus is exposed. Results Exposure and details of the procedure were derived from anatomical study in cadavers. After the approach, with removal of the anterior clinoid process, the entire cavernous sinus from the superior orbital fissure anteriorly to the Meckel ca...
Archives of Otolaryngology–Head & Neck Surgery, 2003
To evaluate the outcomes of a new surgical approach in children with acute sinusitis and medial o... more To evaluate the outcomes of a new surgical approach in children with acute sinusitis and medial orbital subperiosteal abscess.
International Ophthalmology, 1992
The fluorescein angiographic findings immediately following a tear of the retinal pigment epithel... more The fluorescein angiographic findings immediately following a tear of the retinal pigment epithelium are presented and the mechanisms of fluid movement from the retina to the choroid are discussed. Our case represents a clinical correlate to recent experimental reports on fluid movement across the retinal pigment epithelium-Bruch's membrane complex.
The British journal of ophthalmology, Jan 16, 2015
To review our approach of cautious surgical correction of blepharoptosis in patients with myasthe... more To review our approach of cautious surgical correction of blepharoptosis in patients with myasthenia gravis (MG) to minimise risk of exposure complications. Retrospective case note review of 30 patients with symptomatic eyelid concerns despite appropriate medical treatment, who underwent eyelid surgery. The mean age at diagnosis was 47 years. 13/30 patients had systemic MG, 14/30 ocular MG and 3/30 congenital MG. The main outcome measures were improvement in eyelid height and/or position, duration of a successful postoperative result, need for further surgical intervention, and intraoperative or postoperative complications. 38 blepharoptosis procedures were performed on 23 patients. Mean age at time of surgery was 62 years, with an average follow-up of 29 months. 10 patients (16 eyelids) underwent anterior approach levator advancement, 4 patients (5 eyelids) posterior approach surgery and 8 patients (15 eyelids) brow suspension. One patient (2 eyelids) had tarsal switch surgery. An ...
Emergency Medicine Journal, 1988
A review of all penetrating eye injuries treated by the Manchester Eye Hospital over four years (... more A review of all penetrating eye injuries treated by the Manchester Eye Hospital over four years (1 February 1982-31 January 1986) was undertaken. One hundred and ninety-six penetrating eye injuries were seen, of which 16 (8-2%) were due to road traffic accidents. Eight patients (nine eyes) were seen in the 12 months prior to the introduction of the seat-belt legislation on 1 February 1983. None of these patients was wearing a seat-belt whereas two of the eight patients (10 eyes) seen after the seat-belt legislation were. Both these patients suffered severe visual loss due to intraocular glass from shattered windscreens. Three patients had bilateral penetrating eye injuries, one before and two after the seat-belt legislation. Two of the nine eyes involved prior to the legislation and three of the 10 eyes after the legislation had an eventual visual acuity of 6/12 or better. In the majority of patients, failure to wear seat-belts or defective use is to blame. Flying glass from shattered toughened windscreens is a preventable danger. Nine of the 16 patients were first seen in the general accident and emergency department and, of these, seven did not have visual acuities recorded prior to referral to an ophthalmologist. The importance of measurement of the visual acuity and detection of an afferent pupillary defect is stressed based on these findings.
surgical in-patients andalso ashome parenteral nutrition (HPN), largely inpatients with intestina... more surgical in-patients andalso ashome parenteral nutrition (HPN), largely inpatients with intestinal failure. Catheter sepsis isawellknown complication inthese patients buttherisk ofsystemic candidiasis isgenerally underestimated. Systemic candidiasis isfrequently unrecognized because ofalack of clinical signs. However, endophthalmitis isfrequently apresenting feature ofsystemic candidiasis' andits early detection iscrucial tosuccessful management. Clinical studies indicate that early detection improves theprobability oftherapeutic success withlower morbidity andimproved patient survival.' Wepresent twocases ofcandidal endophthalmitis inpatients receiving TPN.
Acta Ophthalmologica, 2009
Corneal sensation was found to be decreased in eyes affected by acute angle closure glaucoma. In ... more Corneal sensation was found to be decreased in eyes affected by acute angle closure glaucoma. In those patients with a short history (less than four days) the difference in sensation between the two eyes was only detectable using the Cochet-Bonnet aesthesiometer and not by using cotton wool. Patients with a longer history had a more marked decrease in corneal sensation that was detectable by both methods. Corneal sensation in both groups tended to recover partially on normalization of the intraocular pressure.
Acta Ophthalmologica, 2009
A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over 5 year... more A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over 5 years (January 1st 1982 to December 31st 1986) was undertaken. There were 258 penetrating eye injuries of which 69 (26.7%) were due to work-related accidents. All were men and 52 (75.4%) of them were under the age of 40 years. Hammering and chiselling were the commonest activities at the time of the injury and accounted for 25 cases (36.2%). Thirty-six patient (52.1%) had intraocular foreign bodies. Thirty-six patients (52.1%) achieved a good visual result (6/12 or better) and 9 had no perception of light, 7 of whom had enucleations. The period of inpatient treatment ranged from 1 to 26 days. From the analysis of the activities at the time of the injury, 61 injuries (88.4%) may be considered to be preventable with appropriate eye protection. Key words: penetrating eye injurieswork-relatedoccupationsactivitiesvisual outcomeprevention.
British Journal of Ophthalmology, 1991
The onset of periorbital xanthogranuloma in adults is rare and may be accompanied by haematologic... more The onset of periorbital xanthogranuloma in adults is rare and may be accompanied by haematological abnormalities and malignancy. The appearance ofthe eyelid lesions is virtually diagnostic, producing readily recognisable diffuse, yellow plaques, and affected patients should be investigated and reviewed regularly for systemic disease. Three cases are described, in which periorbital cutaneous plaques were associated with abnormal tissues in the superior part of the orbit; these abnormal tissues caused displacement or restricted movement of the globe or upper eyelid. The possibility that two cases represent a necrobiotic type of xanthogranuloma is presented. Nine years after the onset of xanthogranuloma one patient developed non-Hodgkin's lymphoma. A multiple-drug regimen of systemic chemotherapy, given for lymphoma, caused a marked clinical reduction in the periorbital xanthogranuloma.
Eye, 1990
The results of extracapsular cataract extraction, with or without posterior chamber intraocular l... more The results of extracapsular cataract extraction, with or without posterior chamber intraocular lens (IOL) implantation, in Fuchs Heterochromic Uveitis, are reported. Twenty-nine patients underwent 30 operations. Twenty-two patients (73%) obtained a visual acuity of 6/ 12 or better. Post-operative uveitis or glaucoma were encoun tered in 13 eyes, including 11 "f20 eyes with IOL implantation (55%), and two of ten eyes without IOL implantation (20%). IOL implantation is a significant additional factor in cataract surgery in patients with FHU. Preoperative risk factors include severe iris atrophy, secondary glaucoma, and severe abnormalities of iris vas culature. IOL implantation is not recommended in these eyes. The routine post operative use of anti-glaucoma medication is recommended. Long-term postoperative follow-up is important.
Journal of Neurosurgery, 2012
Object Lesions of the cavernous sinus remain a technical challenge. The most common surgical appr... more Object Lesions of the cavernous sinus remain a technical challenge. The most common surgical approaches involve some variation of the standard frontotemporal craniotomy. Here, the authors describe a surgical approach to access the cavernous sinus that involves the removal of the lateral orbital wall. Methods To achieve exposure of the cavernous sinus, a lateral canthal incision is performed, and the lateral orbital rim and anterior lateral wall are removed, for later replacement at closure. The posterior lateral orbital wall is removed to the region of the superior and inferior orbital fissures. With reflection of the dural covering of the lateral cavernous sinus and removal of the anterior clinoid process, the cavernous sinus is exposed. Results Exposure and details of the procedure were derived from anatomical study in cadavers. After the approach, with removal of the anterior clinoid process, the entire cavernous sinus from the superior orbital fissure anteriorly to the Meckel ca...
Archives of Otolaryngology–Head & Neck Surgery, 2003
To evaluate the outcomes of a new surgical approach in children with acute sinusitis and medial o... more To evaluate the outcomes of a new surgical approach in children with acute sinusitis and medial orbital subperiosteal abscess.
International Ophthalmology, 1992
The fluorescein angiographic findings immediately following a tear of the retinal pigment epithel... more The fluorescein angiographic findings immediately following a tear of the retinal pigment epithelium are presented and the mechanisms of fluid movement from the retina to the choroid are discussed. Our case represents a clinical correlate to recent experimental reports on fluid movement across the retinal pigment epithelium-Bruch's membrane complex.
The British journal of ophthalmology, Jan 16, 2015
To review our approach of cautious surgical correction of blepharoptosis in patients with myasthe... more To review our approach of cautious surgical correction of blepharoptosis in patients with myasthenia gravis (MG) to minimise risk of exposure complications. Retrospective case note review of 30 patients with symptomatic eyelid concerns despite appropriate medical treatment, who underwent eyelid surgery. The mean age at diagnosis was 47 years. 13/30 patients had systemic MG, 14/30 ocular MG and 3/30 congenital MG. The main outcome measures were improvement in eyelid height and/or position, duration of a successful postoperative result, need for further surgical intervention, and intraoperative or postoperative complications. 38 blepharoptosis procedures were performed on 23 patients. Mean age at time of surgery was 62 years, with an average follow-up of 29 months. 10 patients (16 eyelids) underwent anterior approach levator advancement, 4 patients (5 eyelids) posterior approach surgery and 8 patients (15 eyelids) brow suspension. One patient (2 eyelids) had tarsal switch surgery. An ...
Emergency Medicine Journal, 1988
A review of all penetrating eye injuries treated by the Manchester Eye Hospital over four years (... more A review of all penetrating eye injuries treated by the Manchester Eye Hospital over four years (1 February 1982-31 January 1986) was undertaken. One hundred and ninety-six penetrating eye injuries were seen, of which 16 (8-2%) were due to road traffic accidents. Eight patients (nine eyes) were seen in the 12 months prior to the introduction of the seat-belt legislation on 1 February 1983. None of these patients was wearing a seat-belt whereas two of the eight patients (10 eyes) seen after the seat-belt legislation were. Both these patients suffered severe visual loss due to intraocular glass from shattered windscreens. Three patients had bilateral penetrating eye injuries, one before and two after the seat-belt legislation. Two of the nine eyes involved prior to the legislation and three of the 10 eyes after the legislation had an eventual visual acuity of 6/12 or better. In the majority of patients, failure to wear seat-belts or defective use is to blame. Flying glass from shattered toughened windscreens is a preventable danger. Nine of the 16 patients were first seen in the general accident and emergency department and, of these, seven did not have visual acuities recorded prior to referral to an ophthalmologist. The importance of measurement of the visual acuity and detection of an afferent pupillary defect is stressed based on these findings.
surgical in-patients andalso ashome parenteral nutrition (HPN), largely inpatients with intestina... more surgical in-patients andalso ashome parenteral nutrition (HPN), largely inpatients with intestinal failure. Catheter sepsis isawellknown complication inthese patients buttherisk ofsystemic candidiasis isgenerally underestimated. Systemic candidiasis isfrequently unrecognized because ofalack of clinical signs. However, endophthalmitis isfrequently apresenting feature ofsystemic candidiasis' andits early detection iscrucial tosuccessful management. Clinical studies indicate that early detection improves theprobability oftherapeutic success withlower morbidity andimproved patient survival.' Wepresent twocases ofcandidal endophthalmitis inpatients receiving TPN.
Acta Ophthalmologica, 2009
Corneal sensation was found to be decreased in eyes affected by acute angle closure glaucoma. In ... more Corneal sensation was found to be decreased in eyes affected by acute angle closure glaucoma. In those patients with a short history (less than four days) the difference in sensation between the two eyes was only detectable using the Cochet-Bonnet aesthesiometer and not by using cotton wool. Patients with a longer history had a more marked decrease in corneal sensation that was detectable by both methods. Corneal sensation in both groups tended to recover partially on normalization of the intraocular pressure.
Acta Ophthalmologica, 2009
A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over 5 year... more A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over 5 years (January 1st 1982 to December 31st 1986) was undertaken. There were 258 penetrating eye injuries of which 69 (26.7%) were due to work-related accidents. All were men and 52 (75.4%) of them were under the age of 40 years. Hammering and chiselling were the commonest activities at the time of the injury and accounted for 25 cases (36.2%). Thirty-six patient (52.1%) had intraocular foreign bodies. Thirty-six patients (52.1%) achieved a good visual result (6/12 or better) and 9 had no perception of light, 7 of whom had enucleations. The period of inpatient treatment ranged from 1 to 26 days. From the analysis of the activities at the time of the injury, 61 injuries (88.4%) may be considered to be preventable with appropriate eye protection. Key words: penetrating eye injurieswork-relatedoccupationsactivitiesvisual outcomeprevention.