Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 50-year-old woman was admitted because of severe exophthalmos associated with Graves disease. She underwent methimazole (MMI) and methylprednisolone pulse therapy against exophthalmos. She noticed photophobia and blurred vision 3 weeks after the start of pulse therapy and she was diagnosed as having uveitis. Methylprednisolone pulse therapy was performed again for both exophthalmos and uveitis, followed by daily administration of 20 mg of prednisolone and instillation of betamethasone for 2 weeks and the uveitis was improved. Western blot analysis confirmed that human T lymphotropic virus type 1 (HTLV-1) antibody was present in her serum. Propylthiouracil was substituted for MMI and HTLV-1-associated uveitis (HAU) has not recurred. Six months after the beginning of administration of PTU, anti-neutrophil cytoplasmic antibody-related vasculitis developed in the patient. We review 43 cases of HAU with Graves disease, including the present case, in the literature. Only 2 of 27 cases (except unknown cases) (7.4%) had Graves ophthalmopathy. To the best of our knowledge, there has been no investigation of HAU and Graves ophthalmopathy.
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PMID:Severe graves ophthalmopathy accompanied by HTLV-1-associated uveitis (HAU) and anti-neutrophil cytoplasmic antibody-related vasculitis: a case report and a review of the literature of HAU with Graves disease. 1218 5

Progressive, painful blurred vision and proptosis developed in the left eye of a 32-year-old man over an 8-day period. On initial neuro-ophthalmic evaluation the visual acuity in the left eye was no light perception. Erythema of the periorbital skin, 5 mm of proptosis, and ophthalmoplegia were noted on the left side. Funduscopy revealed occlusion of the central retinal artery and central retinal vein. Computed tomography and magnetic resonance imaging revealed marked distension of the left optic nerve and enhancement of the contents within the left orbit, with clear paranasal sinuses. The diagnosis of orbital inflammatory pseudotumour was made and the orbital signs improved rapidly with 80 mg of prednisone per day. Combined occlusion of the central retinal artery and vein is a rare complication of orbital inflammatory pseudotumour. It is postulated that marked distension of the optic nerve caused mechanical compression of the central retinal vessels leading to the vascular occlusions.
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PMID:Combined central retinal artery and vein occlusion from orbital inflammatory pseudotumour. 1528 83

Cellulitis of the orbit is a common cause of proptosis in children, and also frequently arises in the elderly and the immunocompromised. The condition is characterized by infection and swelling of the soft tissues lining the eye socket, pushing the eye ball outwards and causing severe pain, redness, discharge of pus and some degree of blurred vision. There is a small risk of infection spreading to the meninges of the brain and causing meningitis. This paper reports the case of an adult in whom polymicrobial bilateral orbital cellulitis had developed due to Staphylococcus aureus and Neisseria gonorrhoeae infection. N. gonorrhoeae infections are acquired by sexual contact. Although the infection may disseminate to a variety of tissues, it usually affects the mucous membranes of the urethra in males and the endocervix and urethra in females. To the authors' knowledge this is the first report of polymicrobial bilateral orbital cellulitis due to S. aureus and N. gonorrhoeae in medical literature.
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PMID:Bilateral orbital cellulitis due to Neisseria gonorrhoeae and Staphylococcus aureus: a previously unreported case. 1588 72

Giant cell arteritis (GCA) often presents with symptoms of headache, jaw claudication, polymyalgia rheumatica, and blurred vision. GCA is relatively rare and may have atypical manifestations in Asians, including multiple cranial nerve palsy and reversible proptosis. A high suspicion of GCA is suggested when any older Asian suffers from headache that is new-onset or different from the previous pattern, even without other typical manifestations of GCA.
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PMID:Giant cell arteritis with multiple cranial nerve palsy and reversible proptosis: a case report. 1805 56

An 85-year-old female presented with a 3-month history of worsening hyperlacrimation and blurred vision following blunt head injury. Her past medical history was unremarkable. Her blood examination identified no abnormal findings. Neuroophthalmological inspection revealed extraocular movement disorder and mild exophthalmos on the affected side. Her visual acuity was not disturbed. Neuroimaging showed a cystic mass located extraconally in the superolateral compartment of the anterior orbit, without enhancement by contrast medium. Surgical exploration resulted in escape of chocolate-colored, liquefied hematoma during dissection. No vascular lesion was found. A grayish-white cyst wall was found adhering strongly to the lateral and superior rectus muscles. The lacrimal gland was not identified. The mass was totally resected. Histological examination indicated dermoid cyst with inflammatory interstitial hemorrhage. No component of vascular malformation or atypia was found. Hyperlacrimation and extraocular movement improved postoperatively. We thought that the previous blunt head injury might have induced intratumoral hemorrhage in the preexisting dermoid cyst and that the escaped contents caused inflammatory irritation, resulting in the hyperlacrimation. Dermoid cyst may show atypical presentation with intratumoral hemorrhage and should always be included in the differential diagnosis of orbital tumor.
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PMID:Orbital dermoid cyst with intratumoral inflammatory hemorrhage: case report. 1871 27

Ophthalmopathy is a common manifestation of autoimmune thyroid disease. Periorbital swelling, eyelid lag, exophthalmos, and impaired vision may occur. From 25% to 50% of patients with Graves' hyperthyroidism will have some features of ophthalmopathy. All of the clinically significant eye symptoms and findings among patients with Graves' ophthalmopathy can be traced to one of two phenomena: swelling in the retrobulbar space due to deposition of glycosaminoglycans (GAG) or restriction of extraocular muscle motion, which is attributed to initial swelling and later fibrosis. Patients with Graves' eye disease typically complain of ocular or periocular pain, lacrimation, photophobia, blurred vision, diplopia, or impaired perception of colour. On examination, they exhibit orbital congestion, proptosis, optic neuropathy, restricted gaze, divergent visual axis, corneal exposure, lid retraction, and periorbital edema. This paper describes the main clinical features of Graves' ophthalmopathy, in order to establish measurable and reproducible classifications that can be used in the surgery setting to record changes and to guide and assess therapy. Finally, we recommend the use of objective measurements for proptosis, extraocular movements, corneal alterations, and the optic nerve, using the clinical activity scale or a recorded change in objective measurements to document disease activity, and lastly, documenting the patients' perception of their disease status.
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PMID:[Clinical manifestations of thyroid ophthalmopathy]. 1916 94

Sinonasal lymphoma, a rare nonepithelial malignant tumor often originates from the nose and paranasal sinuses. Typically, these lymphomas present with symptoms of nasal obstruction, discharge, epistaxis and facial swelling. Orbital extension results in ocular symptoms like proptosis, blurred vision and diplopia. In this case report, we describe persistent blepharoconjunctivitis, an unusual ocular presentation of sinonasal lymphoma. The tumor was positively identified with immunoreactivity of biopsy specimen; Appropriate chemotherapy lead to successful remission of the disease.
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PMID:Sinonasal lymphoma masquerading as persistent blepharoconjunctivitis. 1922 43

Spontaneous intraorbital arteriovenous fistulas are extremely rare. A 50-year-old man presented with progressive right blurred vision for 1 year and right proptosis for 2 months. He had no trauma history or family history of vascular disorders. Orbital MRI showed increased vascularity in the right orbital apex and bilateral dilated superior ophthalmic veins. Digital subtraction angiography of the carotid circulation demonstrated several small fistulas between the right ophthalmic artery and the right superior and inferior ophthalmic vein. He did not receive any intervention treatment for the intraorbital arteriovenous fistulas because of technical difficulty and high risk. His vision and symptoms gradually improved over a follow-up interval of 6 months. Patients with intraorbital arteriovenous fistulas without significant loss of visual function could be observed for spontaneous resolution.
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PMID:Spontaneous resolution of intraorbital arteriovenous fistulas. 1945 47

Sarcoidosis is a chronic disease of unknown aetiology. Neurosarcoidosis is registered in 5% of patients with sarcoidosis. Clinical manifestations of sarcoidosis are numerous and diverse. Manifestation of Neurosarcoidosis includes partial- and grand-mal seizures, low-grade fever, headache, increased intracranial pressure, visual disturbances, diabetes insipidus, amenorrhea- galacterorrhea syndrome and pituitary failure, hypogonadotropic hypogonadism, hyperprolactinemia, unilateral and bilateral facial palsy, infiltration of meninges (aseptic meningitis) and nerve roots, leptominingitis, pachymeningitis with cranial neuropathies, pseudotumor, mild cognitive disorder, psychosis, delirium, dementia, disorientation, amnesia, progressive visual deterioration and proptosis, axonal polyneuropathies, mononeuropathies, chronic polyradiculoneuritis, peripheral neuropathy, cranial nerve abnormalities, radiculopathies, peripheral neuropathy, mononeuritis multiplex, progressive numbness and deep sensation disturbance in bilateral lower extremities, hemiplegia, hyperreflexia with pathological reflexes and hypesthesia, upward gaze palsy, spinal cord compression, dysarthria, dysphagia, weakness, episodes of blurred vision, diplopia, intracerebral hemorrhage, neuro-ophthalmic manifestations, intranuclear ophthalmoplegia, dysorientation, vasculitis presenting with strokes, intracranial hypothalamic lesion, paresthesis, hemiparesis, myelopathy in the cervico-thoracic region, lumbar pain, sensory level and inability of lateral gaze (Tab. 2, Ref. 60).
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PMID:Clinical manifestations of neurosarcoidosis. 1982 43

A 43-year-old Asian man with idiopathic CD4+ lymphocytopenia (human immunodeficiency virus [HIV]-negative acquired immunodeficiency syndrome [AIDS]) noted blurred vision OD. Visual acuity was 20/30 OD and 20/15 OS. The right eye showed features of axial proptosis (2 mm), blepharoptosis, upgaze restriction, conjunctival chemosis, color desaturation, and choroidal folds. The OS was unremarkable. There was no lymphadenopathy. Orbital MRI showed a well-circumscribed mass indenting the globe. Excision revealed diffuse large-B-cell lymphoma. Systemic evaluation was negative and adjuvant external beam radiotherapy to the right orbit was performed. Idiopathic CD4+ lymphocytopenia is a rare hematologic condition characterized by depletion of CD4+ T cells in HIV-negative patients. This condition closely resembles AIDS but HIV serology is negative. Similar to AIDS, patients are at risk for opportunistic infections and neoplasia, including systemic lymphoma. This is the first case, to the authors' knowledge, of orbital lymphoma with idiopathic CD4+ lymphocytopenia.
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PMID:Orbital lymphoma in the setting of idiopathic CD4+ lymphocytopenia (HIV-negative AIDS). 2124 46


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