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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The ocular manifestations of viral infection vary greatly. Involvement of the anterior segment is generally mild and self-limited, except in cases of congenital infection which are often associated with significant alteration of ocular structures or in cases of childhood infection with herpes simplex virus or varicella-zoster virus, in which prolonged inflammation may lead to corneal thinning or perforation, glaucoma and cataract formation. Involvement of the posterior structures is potentially sight-threatening. Retinal or optic nerve involvement should be suspected in any patient who complains of acute onset of blurred vision in the absence of anterior segment inflammation or opacities in the ocular media. Fortunately retinal viral infection is rare in immunocompetent hosts. Optic neuropathy may occur as an isolated sign but is more often associated with more generalized involvement of the central nervous system. While specific therapy is not always available, early diagnosis of ocular viral disease should aid in the amelioration of acute symptoms and prevention of long term complications.
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PMID:Ocular viral infections. 608 28

A man aged 43 in good health complaints of sudden blurred vision in his right eye, 12 days after a generalized chickenpox eruption. Examination shows an intraocular inflammation with retinal necrosis in temporal periphery. The serum antibodies against varicella-zoster are positive for the IgM and IgG, confirming a recent infection by varicella zoster. Bacterial serology is negative, as well as the serology for the HSV, HIV and CMV. An intraocular production of anti varicella-zoster antibodies is also found by an anterior chamber puncture (Goldmann-Witmer ratio = 1338). A general treatment by acyclovir and corticoids is started, completed by local treatment and cryocoagulation of the retinal periphery. The evolution is favorable, with recovery of the visual acuity and cicatrization of the lesions. The severity of acute retinal necrosis as a complication of a chickenpox infection usually is moderate, with a good visual prognosis as by our patient.
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PMID:[Post-varicella acute retinal necrosis]. 749 77

We report the frequency and type of infectious ocular complications following orthotopic liver transplantation (OLT) and review diagnostic and therapeutic strategies. During the period September 1988 through November 1994, 684 patients underwent OLT at Mount Sinai Hospital (New York). Nine orthotopic liver transplant patients (1.3%) developed ocular infections: Candida albicans endophthalmitis (2), Aspergillus fumigatus endophthalmitis (1), cytomegalovirus retinitis (4), herpes simplex virus keratitis (1), and varicella-zoster virus panophthalmitis (1). The mean time from OLT to ocular symptoms was 42 days for patients with fungal infections and 128 days for patients with viral infections. Blurred vision was the commonest symptom (five of nine cases). The mean duration of follow-up was 2 years (range, 33 days to 5 years). Permanent loss of vision occurred in three patients, five had improvement in visual acuity, and one died of disseminated aspergillosis 33 days after OLT. Infectious ocular complications following OLT may occur as isolated events or with disseminated disease. Fungal infections occur earlier (mean, 42 days after OLT) than viral infections (mean, 4 months after OLT). The clinical presentation may be atypical; aggressive vitreoretinal procedures and serial examinations may be required to establish the diagnosis. Cytomegalovirus retinitis in orthotopic liver transplant patients may not require life-long maintenance therapy with antiviral agents.
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PMID:Infectious ocular complications in orthotopic liver transplant patients. 919 78

Chickenpox may lead to several neurologic complications, but optic neuritis has rarely been described. We report on a 6-year-old immunocompetent patient who presented with unilateral optic neuritis and severe visual loss because of varicella infection. A week after varicella eruption, the child experienced blurred vision. An examination revealed decreased visual acuity of his right eye, a right pupil poorly reactive to light, and almost no color vision in his right eye. A history of chickenpox, the fundus examination, and the measurement of visual-evoked potentials allowed us to make a diagnosis of optic neuritis caused by varicella infection. The patient received only symptomatic relief with antipyretics. Three months later, his visual acuity improved to 20/40 in the right eye.
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PMID:Optic neuritis caused by varicella infection in an immunocompetent child. 1767 31

A 45-year-old man, a case of acquired immunodeficiency syndrome, received a highly active antiretroviral therapy at the outpatient service for 4 years without regular follow-up. He experienced progressively blurred vision for 6 months and a cutaneous zoster on his back 3 months ago. He was diagnosed with progressive outer retinal necrosis by polymerase chain reaction-restriction fragment length polymorphism using an aqueous humor sample, which revealed an existence of varicella zoster virus. He was given a combination of systemic, intravitreal antiviral and a highly active antiretroviral therapy. Occlusive vasculitis, an unusual finding for progressive outer retinal necrosis, developed in both eyes 1 week after the secondary intravitreal injection. Unfortunately, his vision deteriorated to no light perception in both eyes within 2 weeks. Progressive outer retinal necrosis is characterized clinically as showing minimal or no inflammation in the aqueous and vitreous humors, absence of retinal vasculitis, and patches of yellowish spots located deep in the retina. Physicians should pay attention to this rare case of progressive outer retinal necrosis associated occlusive vasculitis with very poor prognosis in spite of aggressive treatment.
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PMID:Progressive outer retinal necrosis associated with occlusive vasculitis in acquired immunodeficiency syndrome. 2600 29

Varicella zoster virus-associated neuroretinitis is rare. We report a patient who presented with blurred vision of the left eye and extraocular movement pain. A fundoscopic examination revealed disc edema, hyperemia, and macular edema. The impression was neuroretinitis. Intravenous methylprednisolone pulse therapy was administered. However, visual recovery was incomplete with optical coherence tomography (OCT) imaging showing photoreceptor layer disruption. The laboratory data were rechecked and demonstrated a high varicella zoster virus immunoglobulin G titer. Varicella zoster virus-associated neuroretinitis was suspected and oral acyclovir was prescribed. His visual acuity improved to 0.9 after 2 weeks of treatment, and OCT showed photoreceptor layer restoration. Spectrum-domain OCT provides useful information when evaluating the disease course of neuroretinitis.
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PMID:Varicella zoster virus-associated neuroretinitis. 2901 97

Varicella-zoster virus (VZV) has been known to cause various eye disorders in both immunocompetent and immunocompromised patients. We present a case of a forty-nine-year-old female patient with acquired immunodeficiency syndrome (AIDS) who presented with headache, fever, and blurred vision. Cerebrospinal fluid (CSF) analysis was consistent with VZV meningitis. Magnetic resonance imaging (MRI) of the brain showed enhancement of the right optic nerve indicative of optic neuritis. She responded well to acyclovir and steroids and discharged on the same. Four weeks after discharge, she presented with sudden onset blindness in the left eye. A cerebral angiogram revealed left retinal artery occlusion and was treated with tissue plasminogen activator (tPA). Funduscopic examination showed patchy areas of necrosis in the periphery which were rapidly progressive, diagnostic of posterior outer retinal necrosis (PORN). She was started on ganciclovir and cidofovir and experienced significant improvement in her visual acuity.
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PMID:Varicella Zoster Meningitis, Optic Neuritis Preceding the Development of Posterior Outer Retinal Necrosis, and Central Retinal Artery Occlusion in a HIV Patient. 3146 56