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

Pain is one of the classically described symptoms of postoperative bacterial endophthalmitis, and has been thought to be a useful and early warning symptom. Three cases, however, of culture-proved endophthalmitis presented without pain. Detection of abnormal physical findings suggested the diagnosis in each case, and led to the appropriate microbiologic evaluation and therapy. Early and frequent postoperative ocular inspection is the responsibility of the ophthalmologist. Exclusive reliance on symptoms experienced by the patient in the postoperative period is insufficient if complications such as endophthalmitis are to be diagnosed and treated optimally.
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PMID:Painless endophthalmitis after cataract surgery. 633 64

In many countries the statutory use of silver nitrate prophylaxis as soon as possible after birth has recently been reviewed from both a human rights and a medical standpoint. It has been argued that silver nitrate does not prevent all cases of gonococcal ophthalmia neonatorum (GON) and that it causes chemical conjunctivitis, pain and visual impairment, which may interfere with parent-infant bonding. Furthermore, the low incidence of GON, better methods of prenatal diagnosis, and the availability of suitable alternative prophylactic medication and of effective methods of treatment of GON have prompted recommendations that alternative prophylaxis be legally allowed or that mandatory prophylaxis be eliminated altogether. This paper reviews the situation and provides updated recommendations.
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PMID:Silver nitrate prophylaxis. 637 48

A 75 year woman with chronic vitreous hemorrhage underwent extraction of a senile cataract. Surgery was complicated by the flow of brown fluid from the vitreous to the anterior chamber, which was not entirely removed. Post-operatively there was pain, 2 mm of brown hypopyon and intraocular pressure elevation to 60 mm Hg with the preoperative diagnosis of endophthalmitis, a pars plana vitreous tap and instillation of intravitreal antibiotics was performed. Bacterial cultures were negative and the presence of erythrocyte "ghost cells" established the diagnosis of hemolytic glaucoma. As medical management proved ineffective, a pars plana vitrectomy was performed. One year post-operatively the patient had a visual acuity of 0.4-0.5, normal intraocular pressure without medication and evidence of an old branch retinal vein occlusion. The mechanism of hemolytic "ghost-cell" glaucoma in this case is discussed.
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PMID:[A case of secondary ghost cell glaucoma with pseudohypopyon after cataract extraction]. 647 Apr 16

Four cases of bacterial endophthalmitis occurred after more than 2,800 closed vitrectomies. Despite vigorous antibiotic therapy, all four eyes were lost. The poor outcome seems to result from difficulties in diagnosing this condition in its early stages. Important clinical indications, such as orbital pain, corneal edema and infiltrate, excessive intraocular inflammatory reaction, hypopyon, and diminished fundus reflex, are often masked by the usual postoperative course. According to our study, the incidence of endophthalmitis after closed vitreous surgery is 0.14%. Three of the four patients with endophthalmitis were diabetic. Our clinical findings are compared with those in the four other cases reported in the literature.
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PMID:Bacterial endophthalmitis after closed vitrectomy. 660 26

Candida endophthalmitis developed in the left eye of a 71-year-old man two months after he underwent extracapsular cataract extraction and intraocular lens implantation. The symptoms included decreased vision and redness but no pain. The discovery of the cause of the endophthalmitis was delayed because it was initially treated as a sterile postoperative inflammation. Vitrectomy with intracameral amphotericin B and treatment with topical and systemic amphotericin B and flucytosine led to resolution of the infection and a final visual acuity of 20/80. It was not necessary to remove the intraocular lens.
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PMID:Successful treatment of postoperative Candida endophthalmitis in an eye with an intraocular lens implant. 672 Aug 38

Endophthalmitis is an ocular disaster that frequently leads to blindness. With the advent of vitrectomy and the opportunity for intraocular injection of antibiotics more of the eyes can be salvaged. In 11 patients the infection was controlled by vitrectomy. All had dramatic relief of pain, and eight showed an improvement in visual acuity. Pathogens were cultured from the aqueous or the vitreous, or both, of 64%, and from the conjunctival swabs of the remainder.
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PMID:Management of infective endophthalmitis by pars plana vitrectomy. 698 82

Corneal edema was found in 24 of 43 eyes with anterior segment complications of intraocular lenses. Keratoplasty was performed in 20 eyes. Three eyes required other surgical therapy for edema while medical treatment of edema was done in one case. Thirty-two lenses were removed because of pain, inflammation, bleeding or glaucoma. Nineteen of these were removed at the time of keratoplasty. Three eyes were enucleated because of absolute glaucoma, retinal detachment and endophthalmitis.
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PMID:Management of anterior segment complications of intraocular lenses. 699 90

1. Aspergilli are unique fungi found in soil, household dust, and vegetable matter. 2. Blurred vision is the most common early complaint of Aspergillus-induced endophthalmitis. It may be accompanied by pain, photophobia, and iridocyclitis. Later visual loss can be significant. 3. Retinal findings include cloudy vitreous, preretinal and subretinal exudate, and retinal hemorrhages. 4. Treatment is a pars plana vitrectomy with vitreous biopsy and intravitreal injection of amphotericin B.
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PMID:Aspergillus-induced endophthalmitis. 761 85

Fewer than 15 cases of cellulitis and subconjunctival abscess after extraocular muscle surgery have been reported in detail. In an effort to provide greater information about this serious complication, the members of the American Association for Pediatric Ophthalmology and Strabismus (AAPO&S) were surveyed and contributed cases were analyzed. Among the 25 cases of cellulitis, there was a predominance of preschool age patients and Staphylococcus aureus cultures. Many cases presented after a normal initial postoperative visit. The most common symptoms were marked swelling and pain. Possible predisposing factors included unsuspected sinusitis, eye rubbing, and poor hygiene. Two patients had documented bacteremia, but no patient developed endophthalmitis. All cases resolved on antibiotics, but only five patients were successfully treated with oral antibiotics alone. Periocular infections after extraocular muscle surgery can present after a normal initial postoperative visit. Symptoms of marked swelling and pain are cause for closer inspection. S. aureus is the most common organism and oral antibiotics alone can fail to halt the infection.
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PMID:Periocular infection after strabismus surgery. The Periocular Infection Study Group. 775 33

We present an unusual case of Aspergillus fumigatus endogenous endophthalmitis in a 27 year old Hispanic male with no history of ocular trauma, surgery, hematologic malignancy, compromised immune system, or intravenous drug use. The patient presented with a two-day history of pain, redness, and visual acuity of bare count fingers in his right eye. He was originally suspected of having toxoplasmic retinochoroiditis, but clinically worsened on systemic anti-toxoplasma medication and corticosteroids. He subsequently underwent pars plana vitrectomy and treatment with intravenous and intravitreal amphotericin B. Aspergillus fumigatus was isolated and identified in the vitreous aspirate. With aggressive medical and surgical management, he eventually regained visual acuity of 20/30 in his right eye. This case illustrates the occurrence of endogenous Aspergillus endophthalmitis in a patient with no history of intravenous drug use, ocular trauma, or compromised immune system, and successful outcome with combined medical and surgical management.
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PMID:Endogenous Aspergillus endophthalmitis in an immunocompetent individual. 826 11


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