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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In three cases of bacterial endophthalmitis following pars plana vitrectomy the important diagnostic findings included increased orbital pain, decreased visual acuity, and the presence of a hypopyon. Despite agressive antibiotic therapy, all three eyes became blind, and two progressed rapidly to phthisis.
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PMID:Endophthalmitis after pars plana vitrectomy. 59 96

A middle-aged man had blurred vision, redness, and pain in the right eye. Ophthalmoscopic examination revealed slowly progressive necrotizing retinitis in the peripheral superonasal quadrant. The clinical impression was toxoplasmic retinochoroiditis, but lesions failed to respond to steroids, pyrimethamine, and sulfonamides. The eye was enucleated and, histopathologically, showed necrotizing granulomatous retinochoroiditis and optic neuritis, numerous cigarshaped, yeast-like organisms located within the necrotic retina and subretinally, and a subretinal asteroid body. Organisms were identified as Sporotrichum schenkii by immunofluorescence techniques. Electron microscopical studies of the fungus disclosed an unusually thickened capsule with a well-developed cell wall, the outer portion of which exhibited a radiating pattern of granular filamentous material. The ability of S schenkii to cause endophthalmitis in a patient without apparent primary infection should be remembered in the differential diagnosis of a cryptogenic, slowly progressive intraocular infection.
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PMID:Granulomatous necrotizing retinochoroiditis caused by Sporotrichum schenkii. Report of a case including immunofluorescence and electron microscopical studies. 78 27

A 29-year-old white man with growth-onset diabetes developed fulminant endophthalmitis after vitreous lavage. The only significant symptom was severe pain 36 hours after surgery. The endophthalmitis rapidly became more severe. Despite systemic antibiotics, therapeutic vitrectomy and lensectomy, followed by the intraocular injection of antibiotics 48 hours postoperatively, the eye was lost.
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PMID:Endophthalmitis after vitrectomy. 108 74

We reviewed data from 47 patients who were treated for endophthalmitis at our hospital during the 11-year period 1980-90. The most common clinical features were hypopyon (75%), diminished vision (72%), ocular pain (68%), discharge (57%), corneal oedema (51%), conjunctival injection (49%), abnormal red reflex (34%), corneal ulcer (32%) and corneal perforation (6%). A total of 54 isolates were obtained from 41 (87%) of the 47 patients. Gram-positive bacteria were more common (72%), than Gram-negative organisms (22%). Two cases were due to fungi, and herpes simplex virus was isolated from one case. The two most common Gram-positive organisms were coagulase-negative staphylococci (25%), and Staphylococcus aureus (11%), while Pseudomonas aeruginosa predominated among the Gram-negative bacteria isolated (15%). Mixed bacterial species were obtained from 29% of the infected patients, including one from whom Vibrio fluvialis was isolated. Predisposing factors included ocular surgery (60%)--mostly for cataract extraction (47%), penetrating trauma (15%) and periocular (15%) or systemic (11%) infections. All patients received antibiotics (generally chloramphenicol and/or a beta-lactamase-stable penicillin plus an aminoglycoside) prior to culture, when treatment was adjusted according to specific aetiological agents. Seventy-nine per cent of patients received topical or systemic steroids. Vitrectomy (diagnostic and therapeutic) was performed on 21% of patients. Sixty-three per cent of culture-positive patients lost vision (no perception of light) in the affected eye, compared to 17% of culture-negative cases (P < 0.05 Fisher exact test). Similarly, a better visual outcome (acuity of 6/12 or better) was associated with coagulase-negative staphylococcal infection than with streptococcal or fungal infections.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Endophthalmitis at the Bristol Eye Hospital: an 11-year review of 47 patients. 136 6

We studied 39 blind painful eyes in 39 patients who were treated with retrobulbar injection of absolute (96%) alcohol for their severe ocular pain at the King Khaled Eye Specialist Hospital from January 1984 to January 1987. There were 21 (54%) male and 18 (46%) female patients; all were followed for at least three months. The protracted ocular pain was mainly due to: end-stage (absolute) glaucoma in 31 (80%) eyes, uveitis or endophthalmitis in four (10%) eyes, or corneal ulcer in two (5%) eyes. One eye had painful phthisis bulbi, and one eye had infraorbital neuralgia. The complications encountered were transient and included blepharoptosis in eight (21%) eyes, external ophthalmoplegia, and corneal epithelial defect. The effective time of the injection to relieve pain ranged from two weeks to two years (mean, 29 weeks). The authors believe that there is still a place for retrobulbar alcohol injection for blind painful eyes when enucleation or evisceration is not possible.
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PMID:Retrobulbar alcohol injection in blind painful eyes. 170 80

We examined a 67-year-old man with autosomal-dominant polycystic kidney disease who had right ocular pain and visual loss. Escherichia coli was grown from the vitreous aspirate. Despite treatment, no visual improvement was obtained, and the right globe was enucleated. We believe that the patient had a rare case of endogenous E. coli endophthalmitis.
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PMID:Endogenous Escherichia coli endophthalmitis in a patient with autosomal-dominant polycystic kidney disease. 178 3

Endophthalmitis has typically been described as occurring within the first 24-48 hours postoperatively and having a rapid progression. Classical signs and symptoms include intense ocular pain, decreased visual acuity, and exaggerated inflammatory response not commensurate with the level of the patient's recuperative process. This article presents a case wherein a patient, following cataract surgery and implant, developed endophthalmitis of a more indolent nature with a later onset of symptomatology and associated sequelae. Reasons this delayed onset of symptoms may occur are discussed. Etiological considerations, current treatment modalities, and management protocol are reviewed.
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PMID:Postoperative endophthalmitis. 181 61

Six patients with chronic herpes simplex keratouveitis developed a rapidly progressive ocular inflammation unresponsive to corticosteroid and antiviral therapy. Severe secondary glaucoma unresponsive to maximum medical therapy ensued and was treated by cyclocryotherapy in five patients. Ocular ischemia with secondary corneal and scleral calcification subsequently developed in all six patients. All had also received prolonged topical therapy with topical antiviral agents, corticosteroids, beta adrenergic blockers and epinephrine compounds. Three eyes eventually required enucleation for the relief of pain; one stabilized, and two others became phthisical. One of the phthisical eyes developed a secondary fungal endophthalmitis. Histopathologic examination of the three enucleated globes revealed extensive corneal, scleral and conjunctival calcification, secondary angle closure, iris and ciliary body necrosis, focal choroiditis, retinal necrosis and atrophy. The syndrome recognized in these patients appears to be a rare but devastating complication of herpes simplex keratouveitis, possibly exacerbated by the application of cyclocryotherapy and other factors.
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PMID:Anterior segment ischemia in chronic herpes simplex keratouveitis. 186 88

There is little information concerning the outcome of severely traumatized eyes, with little visual potential, which are not removed. We studied 50 eyes, which had suffered severe globe rupture, had visual acuities of no better than hand motion, and were not removed within 2 weeks of injury. Seventeen (34%) of the 50 eyes were later removed. Of the 17, nine had become painful. The other 33 eyes, which were not removed, remained comfortable over a mean follow-up of 66 months (12-161 months). Thirty (70%) of 43 eyes, which had follow-up of at least two months, became phthisical. There were no cases of sympathetic ophthalmia. These results suggest that the majority of severely-injured eyes become phthisical, but do not require removal for pain.
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PMID:Long-term follow-up of severely injured eyes following globe rupture. 191 26

A 65-year-old woman with a 7-year history of chronic lymphocytic leukemia presented with acute visual loss, pain, and redness in her right eye. Results of stains and cultures of anterior chamber fluid were negative. Neurologic problems, bronchopulmonary pneumonia, recurrent skin lesions, and a low-grade fever developed. Progressive respiratory distress ensued, and the patient died 1 month after presentation. Cultures from antemortem sputum and skin samples were positive for Aspergillus terreus. Postmortem histologic results showed extensive A terreus invasion of the posterior vitreous, retina, choroid, and anterior optic nerve. This organism was also found in histologic sections from the right adrenal gland, left kidney, thyroid, urinary bladder, right lung, skin, esophagus, sputum, vessels of the myocardium, and brain. To our knowledge, A terreus endophthalmitis has not been reported previously.
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PMID:Aspergillus terreus endophthalmitis in a patient with chronic lymphocytic leukemia. 198 25


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