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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There are a variety of relatively common implants and explants used in ophthalmology. The ED physician should be familiar with and recognize them when they present primarily or secondarily to the ED. The lids and lacrimal system harbor devices that improve physiologic function. The globe is home to the most common implant, the contact lens, and now increasingly, the intraocular lens after cataract surgery. Orbit fractures are often repaired with light metals or other alloplastic materials. The anophthalmic socket, depending on its age, has been filled with many types of implants, some of which may present years later with complications of migration or extrusion. All implants and explants used in ophthalmology can have complications and potentially appear in the ED. Complications that include ocular or orbital infections, especially sight-threatening intraocular infections, require immediate referral. The less-emergent problems mentioned can usually be seen in a few days. The need and timing of ophthalmic referral can be determined with a telephone consultation from the ED.
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PMID:Ophthalmic implants and explants. 806 2

Twenty-five patients presenting with stage I primary orbital and/or ocular adnexal lymphoma from May 1990 through January 1997 were retrospectively reviewed at National Taiwan University Hospital. Staging workups included physical examination, chest radiography, blood analysis, whole-body CT scan, CSF examination and bone marrow biopsy. The histological types, based on the National Cancer Institute working formulation, were 17 cases of low-grade and 8 of intermediate lymphoma. Twenty patients received radiotherapy, while five cases refused. All patients except two received a radiation dose of 40 Gy, the other two received 30 Gy. The mean follow-up period was 4.7 +/- 1.6 years (2-8 years). Local control of disease was achieved in all 20 patients, but one patient with low-grade lymphoma developed disseminated disease with parotid gland, bone marrow and lung involvement 43 months after radiotherapy. Two out of five patients who refused treatment with radiotherapy developed systemic involvement 24 months and 18 months after diagnosis. Dry eye (45%) and cataract formation (35%) were among the most frequent complications in this study. One patient developed a recalcitrant trophic corneal ulcer and ultimately required corneal transplantation. In conclusion, radiotherapy is a safe and effective local treatment in the management of primary orbital or adnexal lymphoma.
Orbit 2002 Jun
PMID:Results of radiotherapy for orbital and adnexal lymphoma. 1202 66

PURPOSE. The purpose of this study was to investigate the ocular, facial and radiological signs of Crouzon's syndrome in a group of older patients who had not undergone previous craniofacial surgery. METHODS. Six cases of Crouzon's syndrome, four of whom belonged to a three-generation family, were examined systemically, ophthalmologically and roentgenographically; five of these cases were additionally evaluated with computed tomography and compared with Apert syndrome. RESULTS. On radiologic evaluation, all cases had synostosis of all cranial sutures and fontanelles and brachycephalic skulls, crowding of the upper teeth due to maxillary hypoplasia, and serious nasal septum deviation. Bilateral ethmoidal, maxillary and sphenoidal chronic sinusitis was found in 50% of cases. Three patients had hypertelorism and two others had a tendency toward hypertelorism. The typical facial appearance with shallow orbits, globe protrusion and exorbitism was present in all cases. Two of them had V-pattern exotropia while the other four were orthophoric. The single case with mental retardation had bilateral cataract. CONCLUSION. Crouzon's syndrome can present with different findings and must be evaluated multidisciplinarly.
Orbit 1999 Dec
PMID:Evaluation of findings in Crouzon's syndrome. 1204 69

The incidence of ocular lesions in midfacial fractures ranges from 4 to 67%, depending on the criteria used in the previous examination. We report a retrospective study of 219 patients (233 fractures) who were admitted to our hospital between January 1990 and June 1994. The fractures are classified according to Henderson's classification (X-ray and Computed Tomography). We present the results of the ophthalmologic evaluation, after excluding palpebral lesions, and discuss the correlation with the etiology and the kind of fracture. The ocular lesions are divided into extraocular and intraocular ones. The extraocular lesions that we found are the following: damage to the lacrimal system, cranial nerve damage, displacement of the eye, corneal erosion and corneal foreign body and conjunctival lesions (subconjunctival hemorrhages, lacerations and chemosis). The intraocular lesions studied are divided into lesions of the anterior structures (hyphema, traumatic cataract, lens dislocation and hernia of the iris) and lesions of the posterior structures (vitreous and macular hemorrhage, eyeball perforation, optic nerve damage and Berlin's edema). Our conclusion is that comminuted fractures, fractures of the orbital rim only and those of the orbital floor are the most frequently associated with ocular damage, being mainly caused by automobile accidents and assaults.
Orbit 1998 Mar
PMID:Ocular injuries in midfacial fractures. 1204 18

A 70 year old man developed orbital haemorrhage after retrobulbar anaesthesia for cataract surgery and biopsy of a persistent lateral rectus mass suggested organising haematoma. Subsequent progression of the mass was shown, on repeated biopsy, to be due to metastatic renal cell carcinoma--a tumour recognised for its angiogenic and haemorrhagic potential.
Orbit 2005 Dec
PMID:Renal cell carcinoma metastasis masquerading as recurrent orbital haematoma. 1635 40

We prospectively compared 120 patients who underwent either phacoemulsification or extracapsular cataract (ECCE) surgery to establish the incidence of postoperative ptosis between the two techniques. Of the 120 patients, 60 underwent ECCE (unpublished data 1989) and 60 had phacoemulsification. Data was collected prospectively on upper and lower margin reflex distance, upper lid skin crease and levator function, preoperatively and 6 weeks postoperatively. Photographs were taken pre and postoperatively and examined by a blinded observer. At 6 weeks, ptosis was present in 18% of ECCE patients compared with 0% in the phacoemulsification group. By changing from ECCE to phacoemulsification the incidence of postoperative ptosis has reduced. The possibility to induce postoperative ptosis remains, potential mechanisms are discussed.
Orbit 2010 Dec
PMID:The incidence of ptosis following extracapsular and phacoemulsification surgery: comparison of two prospective studies and review of the literature. 2115 73

Blepharoptosis is a well-known complication following anterior segment surgery. However, its precise aetiology remains elusive. There are currently two widely held views on the pathogenesis of persistent postoperative ptosis, namely the speculum and bridle suture theories. However, both suggested explanations fail to address important anatomical and epidemiological features of this condition. Until now, the majority of published literature describing persistent postoperative ptosis following anterior segment surgery has largely concentrated on dehiscence of the levator aponeurosis as the common mechanism underlying this postoperative complication. However, numerous studies have failed to show any correlation between pre or postoperative skin crease positions in such patients. This review article discusses previously proposed mechanisms responsible for both transient and persistent ptosis. Furthermore, we propose an alternative mechanism for the development of ptosis following anterior segment surgery, namely horizontal stretch of the upper eyelid induced by the use of the speculum. This mechanism also provides a plausible explanation for less commonly described oculoplastic complications, such as lower lid malpositions, following anterior segment surgery. Postoperative ptosis may also act as a paradigm for the development of involutional ptosis in general. In view of the frequency with which ophthalmologists perform anterior segment procedures such as cataract surgery, postoperative ptosis represents a significant concern for all ocular surgeons. Identifying the underlying mechanism is imperative, not only to identify those patients at greatest risk, but also to perhaps provide novel surgical approaches to the management of this complication.
Orbit 2012 Aug
PMID:Blepharoptosis following anterior segment surgery: a new theory for an old problem. 2264 3

We report here the successful removal of a retrobulbar metallic foreign body in a patient with penetrating ocular trauma by a transconjunctival approach and combination management with C-arm fluoroscopy and extraocular muscle severance. A 37-year-old man sustained a penetrating injury to the right eye while using an iron hammer. Initial slitlamp examination revealed a corneoscleral laceration, iridocele, anterior chamber collapse, and a traumatic cataract. Visual acuity in the right eye was limited to the perception of hand motion. Computed tomography revealed an orbital foreign body in the retrobulbar area. The patient underwent corneoscleral suturing, severance of extraocular muscles, removal of the foreign body with guidance by C-arm fluoroscopy, pars plana lensectomy, and pars plana vitrectomy. Combination management with C-arm fluoroscopy and extraocular muscle severance may thus be a suitable approach to the removal of a retrobulbar metallic foreign body.
Orbit 2016 Jun
PMID:Combination management by C-arm fluoroscopy and extraocular muscle severance for penetrating ocular trauma with a retrobulbar foreign body. 2707 Jul 85

Patients with conjunctival cicatrizing disease may develop lacrimal obstruction. Little is published on lacrimal obstruction as the presenting feature of otherwise asymptomatic cicatrizing conjunctival disease. The records of all patients presenting between 1994 and 2015 with lacrimal obstruction found to have cicatrizing conjunctival disease were reviewed. Demographic details, clinical findings, disease progression and treatment were analyzed. Thirty-five patients (25 female), aged 43-91 years (median 74, mean 71.3 years) had epiphora and a mild conjunctival cicatrizing process. Nine patients had onset of epiphora after cataract surgery. All except one patient had obstruction of the proximal lacrimal system (punctum and/or canaliculus). In 14 cases, the obstruction was unilateral (both puncta or canaliculi), with one progressing to bilateral obstruction after 11 years. In 19, all 4 puncta or canaliculi were obstructed. Two patients had unilateral nasolacrimal duct obstruction; one developed contralateral canalicular obstruction 2 years later. Conjunctival biopsies were obtained in 19 of 35 cases (54%), and OCP immunohistochemistry was positive in 7/19 (37%). All other biopsies showed chronic inflammation. Two patients had lichen planus. In follow-up (range 0.1-11 years, mean 3.2 years), 2 patients' conjunctival disease progressed mildly, and 3 progressed moderately, with 2 of these 5 having positive OCP immunohistochemistry, and 1 having lichen planus. Patients with conjunctival cicatrization may present with lacrimal obstruction, usually punctal or canalicular. Conjunctival disease is usually mild and non-progressive, but patients should be monitored for disease progression.
Orbit 2016 Dec
PMID:Conjunctival cicatrizing disease presenting with lacrimal obstruction. 2755 21