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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Xerophthalmia and keratomalacia are public health problems of great magnitude which are usually associated with multiple vitamin and protein deficiencies. The authors report the case of a 27-year-old commune member who subjected herself to a bizarre protein and vitamin deficient diet for many months. This ultimately produced nyctalopia, xerophthalmia and keratomalacia with bilateral corneal perforation. Despite therapy, she remained comatose and expired shortly after admission. Ocular pathological changes included bilateral corneal melting with prolapse of intraocular contents, conjunctival epidermidalization, goblet cell atrophy and thinning of the outer nuclear layer of the retina. It is noted that ocular findings in pure avitaminosis A produced experimentalyy include epithelial atrophy followed by keratinization.
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PMID:Keratomalacia. 108 44

The medical records of 32 horses treated for iris prolapse (IP) during an 8 year period, at the University of Florida Veterinary Medical Teaching Hospital, were reviewed. Iris prolapse was associated with perforated corneal ulcers in 15 horses (47%), ruptured stromal abscesses in 2 horses (6%), and full thickness corneal lacerations in 15 horses (47%). Initial ophthalmic examinations revealed IP with severe iridocyclitis in all eyes and keratomalacia in 8 eyes with corneal ulcers, one with a stromal abscess and 1 with a corneal laceration. Hyphema was present in 7 eyes with corneal lacerations. Thirty horses were managed with combined medical and surgical therapy. Two horses were only treated medically with topically administered antibiotics. Of the 24 perforations surgically repaired, 21 were closed primarily and 13 were then covered with a conjunctival graft. After combined therapy and a minimum of 4 months of follow-up, vision was retained in 6 of the horses (40%) with perforating corneal disease and 5 of the horses (33%) with perforating corneal lacerations. Post operatively, of the 11 (37%) horses blind at discharge, 6 (55%) subsequently developed phthisis bulbi. Enucleations were performed in 4 cases with extensive keratomalacia and/or endophthalmitis, 2 cases with limbal rupture and total hyphema, and one case with a chronic IP. One horse was subjected to euthanasia after 3 surgical treatments failed to stabilise stromal melting. Horses presented with ulcerative keratitis of fewer than 15 days duration, or horses with corneal lacerations less than 15 mm in length, tended to have a favourable visual outcome. Keratomalacia, hyphema, corneal lacerations longer than 15 mm and lacerations extending to, along, or beyond the limbus, adversely influenced visual outcome. Iridectomy did not appear clinically to exacerbate anterior uveitis or adversely affect visual outcome. Ocular survival following combined therapy was 80% (12/15) in horses with corneal lacerations and 67% (10/15) in horses with ulcerative keratitis.
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PMID:Visual outcome and ocular survival following iris prolapse in the horse: a review of 32 cases. 903 61

Purpose To describe 11 clinical cases of ulcerative keratitis in horses associated with beta-hemolytic Streptococcus equi in Florida, USA. METHODS: Retrospective clinical study (1996-99). RESULTS: Beta-hemolytic Streptococcus equi was cultured from 11 horses with deep ulcers, descemetoceles or iris prolapse (n = 8), a suture abscess found with a penetrating keratoplasty for a stromal abscess (n = 1), and ulceration that developed following keratectomy/irradiation for corneal squamous cell carcinoma (n = 2). Beta-hemolytic Streptococcus equi subspecies zooepidemicus was found in 10 eyes and subspecies equi in one. Marked signs of uveitis including miosis and hypopyon were present in 8/11 (72.7%) eyes. Keratomalacia was severe in all eyes. The mean diameter of the ulcers associated with beta-hemolytic Streptococcus was 10.2 +/- 6.1 mm. Eight of the eyes required conjunctival flap surgery (four grafts dehisced) and one eye corneal transplantation. Two eyes were treated with medication only. Isolate sensitivity to antibiotics included ampicillin (6/11), bacitracin (11/11), cephalothin (11/11), chloramphenicol (11/11), gentamicin (5/11), polymyxin B (2/11), and tobramycin (1/11). All isolates were resistant to neomycin. The average healing time was 44.7 +/- 26.7 days. The visual outcome was positive in 8/11 eyes, and the globe retained in 9/11 eyes. CONCLUSIONS: Although Gram-positive bacteria predominate in the normal conjunctival microflora of horses throughout the world, Gram-negative bacteria and fungi are more often isolated from equine ulcers. Beta-hemolytic Streptococcus spp. are associated with a very aggressive ulcerative keratitis with the capability to digest conjunctival graft tissue. Clinical signs are pronounced. Aggressive surgical and intensive medical therapy with topical antibiotics and protease inhibitors is indicated.
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PMID:Ulcerative keratitis caused by beta-hemolytic Streptococcus equi in 11 horses. 1139 93