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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eyes are very sensitive to sulfur mustard (SM) gas because they have wet surfaces. The severity of ocular damage is related to the dose and duration of exposure to SM, and recovery may take up to several years after the exposure. We conducted a large cohort study to evaluate the ocular signs and symptoms of 367 chemical war victims in Sardasht City, Iran, 20 years after their exposure to mustard gas. The results of these chemical war victims (i.e., the cases) were compared with the results for 128 unaffected civilians (i.e., the controls). Photophobia was the most significant symptom in the cases (36.8%) (compared with 20.3% in the controls) (p < or = .001). Ocular surface discomfort (burning, itching, and redness) was the second most significant symptom in the cases (29.2%) (compared with 19.5% in the controls) (p = .034). Other symptoms such as foreign-body sensation, tearing, pain, blurring of vision, and dry eye sensation were not significantly different between the 2 groups. In the slit-lamp findings, bulbar conjunctival abnormality was the most significant sign in the cases (9.3%) (compared with 1.6% in the controls) (p = .004). Limbal tissue changes were the second most significant sign in the cases (3.0%) (compared with 0.0% in the controls) (p = .048). Other slit-lamp findings related to tearing and abnormalities in the lids and cornea were not significantly different between the 2 groups. Our findings in the present study showed that photophobia and ocular surface discomfort (burning, itching, and redness) were the most significant symptoms. In addition, bulbar conjunctival abnormalities and limbal tissue changes were the most significant signs among the sulfur mustard chemical war victims.
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PMID:Long-term ocular complications of sulfur mustard in the civilian victims of Sardasht, Iran. 1903 64

Suprachoroidal hemorrhage is a rare but dreadful event. We report the case of an 86-year-old man with age-related macular degeneration (ARMD) in both eyes. He had been receiving anticoagulation therapy for several years for systemic disease. He presented with severe headache and intractable pain in his right eye. Vision was no light perception, and the intraocular pressure was 50 mmHg in the right eye despite maximal antiglaucoma medications. Slit-lamp and B-scan examination disclosed suprachoroidal hemorrhage in the right eye. Nine days later, he underwent choroidal drainage, which only relieved the symptoms for 1 day. Suprachoroidal hemorrhage recurred and evisceration was performed. This case illustrates how ARMD with anticoagulation therapy could cause spontaneous suprachoroidal hemorrhage. Therefore, anticoagulants should be meticulously prescribed with prothrombin time monitored regularly in ARMD patients.
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PMID:Spontaneous suprachoroidal hemorrhage associated with age-related macular degeneration and anticoagulation therapy. 1958 Nov 47

Clinical findings and treatment of keratomycosis caused by Beauveria bassiana, an entomopathogenic filamentous fungus, are described for an 80-year-old woman, who was referred to the hospital for ocular pain and redness on the 9th day after an ocular injury caused by the frame of her glasses. She had a long history of recurrent diabetic iritis and continuously used topical antibiotics and corticosteroids. At her first visit, a slit-lamp examination indicated a corneal ulcer confined within the superficial stromal layer, along with a slight infiltration and edema. Only a very few inflammatory cells were seen in the anterior chamber. Direct microscopic examination of corneal scrapings revealed septate fungal hyphae with zig-zag rachis and budding that was subsequently identified as B. bassiana by slide culture. Topical voriconazole with miconazole, pimaricin and oral itraconazole were effective and the lesion disappeared leaving only a mild scar at 2 months. The sensitivity of B. bassiana to various antimycotic agents was confirmed by broth microdilution, agar dilution with the Clinical Laboratory Standard Institute standard, and a disk method using topically applied concentrations. B. bassiana, which exhibits a characteristic appearance in smears and causes superficial keratomycosis, is sensitive to voriconazole with miconazole, pimaricin, and itraconazole.
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PMID:The characteristics of keratomycosis by Beauveria bassiana and its successful treatment with antimycotic agents. 1966 74

We report on a patient in whom intractable infectious keratitis and subsequent lamellar flap necrosis necessitating flap amputation after laser in situ keratomileusis (LASIK). A 34-year-old woman undergoing LASIK complained of blurred vision and pain in the left eye. The best spectacle-corrected visual acuity was 0.01, and slit-lamp examination showed a marked presence of stromal infiltrates involving the flap and the underlying stroma in that eye. The patient was treated topically with hourly instillation of micronomicin, levofloxacin, and cefmenoxime, together with systemic administration of imipenem, but the left eye developed corneal flap necrosis. We performed surgical debridement of the diseased stroma and excised the lamellar flap. Since nontuberculous mycobacterium was detected on the surgical instruments, we then added oral clarithromycin, and substituted systemic administration of amikacin with that of imipenem. At one month after the flap removal, the visual acuity gradually improved to 0.7, but the stromal opacity of the central cornea and hyperopic shift of +3.0 diopters remained. LASIK can cause intractable keratitis, resulting in significant visual disturbance that presumably results from insufficient antisepsis of the medical instruments used for this surgery, supporting the importance of strict sterilization of these instruments.
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PMID:A case of intractable infectious keratitis and subsequent flap necrosis after laser in situ keratomileusis. 1978 61

Live intraocular nematode is a rare occurrence that is mostly reported in South East Asian countries. Herewith we report such a case from Nayagarh district of Odisha. A 28 year old female presented with swelling, redness, lacrimation, pain & diminished vision of left eye since 2 1/2 years. Slit lamp examination revealed a worm piercing iris muscle. The worm was removed by paracentesis of anterior chamber and sent to the Department of Microbiology. It was identified to be Gnathostoma spinigerum basing on the typical morphology of its cephalic end. The patient responded completely to oral albendazole therapy.
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PMID:Intraocular Gnathostoma spinigerum: a case report. 2006 13

Corneal abrasions and lacerations injure the 'windshield' of the eye, exposing the patient to potential vision loss and infection. Diagnosis rests on physical examination of the eye, using fluorescein stain and a penlight; further examination with a slit lamp is often required for lacerations. Treatment of abrasions includes application of topical antibiotics and except in contact-lens users and perhaps with certain small abrasions patching the eye. Lacerations require urgent referral to an ophthalmologist, who usually repairs the defect surgically. Topical anesthetics, though effective pain relievers, should never be prescribed for home use.
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PMID:Treating corneal abrasions and lacerations. 2008 90

Venom ophthalmia caused by venoms of spitting elapid and other snakes: report of ten cases with review of epidemiology, clinical features, pathophysiology and management. Chu, ER, Weinstein, SA, White, J and Warrell, DA. Toxicon XX:xxx-xxx. We present ten cases of ocular injury following instillation into the eye of snake venoms or toxins by spitting elapids and other snakes. The natural history of spitting elapids and the toxinology of their venoms are reviewed together with the medical effects and management of venom ophthalmia in humans and domestic animals including both direct and allergic effects of venoms. Although the clinical features and management of envenoming following bites by spitting elapids (genera Naja and Hemachatus) are well documented, these snakes are also capable of "spraying" venom towards the eyes of predators, a defensive strategy that causes painful and potentially blinding ocular envenoming (venom ophthalmia). Little attention has been given to the detailed clinical description, clinical evolution and efficacy of treatment of venom ophthalmia and no clear management guidelines have been formulated. Knowledge of the pathophysiology of ocular envenoming is based largely on animal studies and a limited body of clinical information. A few cases of ocular exposure to venoms from crotaline viperids have also been described. Venom ophthalmia often presents with pain, hyperemia, blepharitis, blepharospasm and corneal erosions. Delay or lack of treatment may result in corneal opacity, hypopyon and/or blindness. When venom is "spat" into the eye, cranial nerve VII may be affected by local spread of venom but systemic envenoming has not been documented in human patients. Management of venom ophthalmia consists of: 1) urgent decontamination by copious irrigation 2) analgesia by vasoconstrictors with weak mydriatic activity (e.g. epinephrine) and limited topical administration of local anesthetics (e.g. tetracaine) 3) exclusion of corneal abrasions by fluorescein staining with a slit lamp examination and application of prophylactic topical antibiotics 4) prevention of posterior synechiae, ciliary spasm and discomfort with topical cycloplegics and 5) antihistamines in case of allergic kerato-conjunctivitis. Topical or intravenous antivenom and topical corticosteroids are contraindicated. Clinical outcome of venom ophthalmia is largely dependent on prompt treatment and appropriate follow-up.
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PMID:Venom ophthalmia caused by venoms of spitting elapid and other snakes: Report of ten cases with review of epidemiology, clinical features, pathophysiology and management. 2033 93

To evaluate the use of 5% povidone-iodine drop with subconjunctival injection of dexamethasone and gentamicin combination at the completion of phacoemulsification cataract surgery. This prospective randomized study was conducted at the department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July, 2005 to June 2006. Senile & pre-senile cataract patients undergoing phacoemulsification cataract surgery were included in the study. Thirty patients were randomly included in Group A, receiving sub-conjunctival injection of dexamethasone and gentamicin combination and 30 patients in Group- B, receiving 5% povidone-iodine drop at the end of phacoemulsification surgery. Protocol for pre-operative medications, phacoemulsification technique and post-operative medications were similar in both groups. All patients were followed for 6 months post-operatively. Outcome measures were i) patients experience of pain and discomfort post-operatively ii) grade of inflammation post-operatively and iii) visual outcome. Difference of data between two groups was analyzed by unpaired 't' test and chi-square test. In Group A, mean age were 56.86+/-10.25 (SD) years and in Group B, mean age was 57.70+/-10.25 (SD) years. In Group A, 18(60%) patients were male and 12(40%) were female. In Group B, 16(53.33%) were male and 14(46.67%) were female. Pain and discomfort perceived by patients were measured by VAS at the end of operation, on 1st POD and after 7 days post-operatively. Mean VAS score was 5.7 in Group A and 2.7 in Group B at the end of surgery, 2.5 in Group A and 2.2 in Group B on 1st POD and 0.7 in Group A and 0.6 in Group B on 7th POD. Post-operative inflammation was assessed by slit lamp considering conjunctival congestion, chemosis, corneal striation, corneal oedema, cells and flare in anterior chamber. No significant difference was observed between two groups. Mean visual acuity was 0.16+/-0.12 in Group A and 0.15+/-0.13 in Group B. Anti-inflammatory, anti-infective effects and visual outcome are similar in both groups. But sub-conjunctival injection resulted more pain and hence less acceptable to patients.
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PMID:Use of povidone-iodine drop instead of sub-conjunctival injection of dexamethasone and gentamicin combination at the end of phacoemulsification cataract surgery. 2039 17

A case of ocular dirofilariasis in a female patient is presented. The zoonosis caused by parasites of the genus Dirofilaria is relatively rare in humans, with a higher incidence in south and central Europe, Asia and Africa. In Europe, dirofilariasis is mostly caused by the species Dirofilaria repens. In the past 50 years, the number of individuals involved has been on an increase, with about 780 cases reported in the literature to date. Dirofilaria is a parasite found in the dog, cat, racoon and bear. The parasite replicates in the animal's body and enters circulation in the form of microfilariae. These microfilariae reach the insect's digestive tract and are transmitted to another animal or human with subsequent mosquito bites. When transmitted to humans, the parasite is found in the skin and subcutaneous tissue, mucous membranes, and less frequently visceral organs. Concerning ocular involvement, infections of the eye and adnexa oculi and tumorous noninfectious growth of eyelid or orbit have been described to date. The symptoms of the disease vary and include local pain, proptosis, diplopia, palpebral and conjunctival edema, redness, feeling of foreign body, and impaired vision. The diagnosis is generally made by histologic identification of the parasite micro- and macroscopic characteristics, Dirofilaria DNA analysis by the method of polymerase chain reaction, and serology (ELISA) demonstrating the presence of Dirofilaria antibodies in serum. Treatment includes surgical excision of the parasite as an appropriate and efficient therapeutic procedure. A 76-old-female patient presented to outpatient ophthalmology clinic for occasional sensation of pain, rubbing and redness in her right eye. Initial therapy was introduced, resulting in short-lasting improvement. In two weeks, the patient was re-examined for recurrence of discomforts. Slit lamp examination performed temporally revealed a whitish motile, live parasite under the injected and chemotic bulbar conjunctiva. Upon surgical extirpation of the parasite, the diagnosis of dirofilariasis was verified by microbiologic identification.
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PMID:[Ocular dirofilariasis: a case report]. 2065 24

A 13-year-old girl with a right intraorbital optic nerve glioma (ONG) was referred to our glaucoma clinic because of uncontrolled intraocular pressure (IOP) in her right eye. The IOP reached as high as 80 mmHg. Several months earlier, she had undergone stereotactic image-guided robotic radiosurgery using the CyberKnife for her ONG; the mass had become smaller after treatment. Her visual acuity was no light perception. Slit lamp examination revealed rubeosis iridis, a swollen pale optic disc, and vitreous hemorrhage. After medical treatment, the IOP decreased to 34 mmHg, and no pain was reported. Although the mass effect of an ONG can cause neovascular glaucoma (NVG), this case shows that stereotactic radiosurgery may also cause NVG, even after reducing the mass of the tumor. Patients who undergo radiosurgery targeting the periocular area should be followed carefully for complications.
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PMID:Neovascular glaucoma following stereotactic radiosurgery for an optic nerve glioma: a case report. 2116 42


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