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

The use of B-scan ultrasonography in the diagnosis of oral contraceptive-related optic neuritis is presented. A 23-year-old woman complaining of pain in the right upper eyelid, followed by blurred vision in that eye, of approximately 6 days duration claimed to be in good health and took no medication but an oral contraceptive. In light of visual field changes, noted upon clinical examination, and positive Marcus-Gunn swinging flashlight test results, it was decided to compare optic nerve images with the Bronson-Turner B-scan ultrasonogram. The test disclosed a definite enlargement of the right optic nerve as seen in retrobulbar neuritis (figures included). A tentative diagnosis of optic neuritis secondary to oral contraceptive use seemed born out by the reversion to normal of the optic nerve after discontinuation of oral contraceptive therapy.
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PMID:B-scan ultrasonography in the diagnosis of oral-contraceptive related optic neuritis. 45 3

A middle-aged man had blurred vision, redness, and pain in the right eye. Ophthalmoscopic examination revealed slowly progressive necrotizing retinitis in the peripheral superonasal quadrant. The clinical impression was toxoplasmic retinochoroiditis, but lesions failed to respond to steroids, pyrimethamine, and sulfonamides. The eye was enucleated and, histopathologically, showed necrotizing granulomatous retinochoroiditis and optic neuritis, numerous cigarshaped, yeast-like organisms located within the necrotic retina and subretinally, and a subretinal asteroid body. Organisms were identified as Sporotrichum schenkii by immunofluorescence techniques. Electron microscopical studies of the fungus disclosed an unusually thickened capsule with a well-developed cell wall, the outer portion of which exhibited a radiating pattern of granular filamentous material. The ability of S schenkii to cause endophthalmitis in a patient without apparent primary infection should be remembered in the differential diagnosis of a cryptogenic, slowly progressive intraocular infection.
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PMID:Granulomatous necrotizing retinochoroiditis caused by Sporotrichum schenkii. Report of a case including immunofluorescence and electron microscopical studies. 78 27

The authors report the case of an AIDS patient with rare neurologic manifestations: primary vasculitis of the central nervous system and VIII cranial nerve dysfunction. The authors make a review on the subject, and call special attention for the differential diagnosis. In fact, the patient, a 36 year old woman, with promiscuous life, presented with dizziness, gait ataxia, nausea, headache and hypoacusia. Seven days after the admission, she noted blurred vision in both eyes and soon she became blind. The physical examination showed bilateral optic neuritis and vestibulocochlear dysfunction, stiff neck and fever. No abnormalities were detected on CT scan. CSF showed 40 mononuclear cells/mm3, 79 mg/dl of proteins and normal glucose content. Microbiological research was negative. Serum anti-HIV test was positive. The hypothesis of primary CNS vasculitis was made, and pulse methylprednisolone therapy was introduced with good recovery of neurological syndrome except for persistent amaurosis.
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PMID:[Isolated vasculitis of the central nervous system and involvement of the 8th cranial nerve: rare manifestations of acquired immunodeficiency syndrome]. 130 67

In a prospective study of hitherto 70 patients with acute optic neuritis (ON), 18 patients aged 15-49 years (12 women, 6 men) were diagnosed as having very subtle form of ON (bilateral in 4 patients), characterized by normal visual acuity. However, their symptoms were sudden functional visual disturbances, most frequently blurred vision accompanied by pain in or around the affected eye(s). In 5 patients, the ON was a manifestation of clinically definite multiple sclerosis (MS); the remaining 13 patients had monosymptomatic ON. The duration of visual symptoms ranged from 2 to 28 days (median 7 days) at the time of examination. Although 18 patients had a normal visual acuity, i.e. 6/6 c.c. (Snellen's notation) or better, extensive studies of the visual functions (using sensitive supplementary tests) revealed various abnormalities, primarily various visual field defects, abnormal contrast sensitivity, abnormal VEP and colour vision deficiencies (often of blue-yellow type). Magnetic resonance imaging (MRI) of the brain revealed demyelinating lesions in 10 of the 13 patients with monosymptomatic ON, and in all 5 patients with definite MS. The extended disease spectrum gives reason to hypothesixe that ON may occur more frequently than previously reported, and that the described subtle form of ON could be an unnotified precocious manifestation of the demyelinating disease.
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PMID:Acute optic neuritis with normal visual acuity. Comparison of symptoms and signs with psychophysiological, electrophysiological and magnetic resonance imaging data. 192 20

Neuromyelitis optica also named Devic's disease is an acute combined optic neuritis and transverse myelitis. It is thought to be a variant of multiple sclerosis, but its clinical presentation probably has only one attack without further recurrence and exacerbation. We present a 12-year-old girl who suffered from sudden onset of lower extremeties weakness, sensory loss and blurred vision after a prodromal URI symptom. CSF examination showed mild pleocytosis, elevated immunoglobulins, mild elevation of protein concentration. No oligoclonal band was detected. Serum virology showed high titer of anti-EB virus antibody. Visual evoke potential showed prolong of latency and decreased amplitude of both eyes. After prednisolone treatment, her visual accuity began to improve on the 7th hospital day and motor function improved on the 11th hospital day. Two years later, she has normal visual accuity, normal motor function and shows no evidence of disease recurrence.
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PMID:Neuromyelitis optica (Devic's disease) report of one case. 256 81

It is important for eye care professionals to be aware of the ocular toxicities of systemic medications. Optimally, there should be a comprehensive eye and vision baseline before administration of certain drug therapies so that the effect of treatment can be monitored. This article summarizes the optometric implications of treatment with the phenothiazines, antimalarials, cortocosteroids, topical steroid therapy, digitalis glycosides, diuretics, and oral contraceptives (OCs). These side effects can range from mild, intermittent blurred vision to irreversible loss of visual acuity and visual field. The exact nature of side effects associated with OC us remains unclear. However, the potential for severe toxicity, including retrobulbar or optic neuritis and papilledema secondary to pseudotumor cerebri, has been established. Retinal toxicity may result from damage to retinal vasculature. Central or branch vein or artery occlusion as well as perimacular edema have been noted. Ocular toxicity associated with these preparations is an indication that the drug therapy should be altered.
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PMID:Optometric implications of systemic drug therapy. 407 6

Optic neuritis occurred in three of our patients receiving treatment with alpha interferon-2b (Intron-A; 3MU thrice weekly) for chronic hepatitis. The complication appeared within, 1, 9 1/2 and 10 months of treatment, respectively. In all cases, blurred vision was the initial complaint and subsequent electrophysiologic investigation confirmed the presence of optic tract neuropathy. The patients had no other neurologic signs. Computerized tomography and magnetic resonance image of the brain were not remarkable. Psychiatric symptoms, in the form of an interferon-associated depressive reaction, were present in two of them; in one case, it was severe enough to require immediate discontinuation of treatment. In two patients the visual symptoms resolved and the parameters of neurophysiologic testing returned to normal within 1 month after stopping interferon. In one case, however, residual optic tract impairment associated with a unilateral central scotoma and a substantial decrease of visual acuity was present 2 years later, despite a course of methylprednizolone. In this patient the interferon treatment was continued for 3 months despite the visual symptoms, and he later received two additional interferon courses because of relapses of hepatitis. We conclude that clinically evident optic tract neuropathy may complicate interferon administration. Candidates for interferon treatment may need routine examination of optic fields and visual evoked potentials, before and during administration of the drug to avoid possibly permanent visual sequelae.
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PMID:Optic tract neuropathy complicating low-dose interferon treatment. 783 21

A 35-year-old man with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with acute bilateral optic neuritis is described. At age 33, he noticed a tingling sensation in his toes followed by weakness in the lower limbs. He was admitted to our hospital because he became unable to walk without support. His motor and sensory symptoms gradually resolved during 7 months admission only with physical rehabilitation. At age 35, in July 1988, he noticed a tingling sensation in his toes and fingers, which reached to the knees and elbows in October 1988, when he developed weakness in the lower limbs. Motor and sensory symptoms were almost stationary thereafter and in March 1989, he experienced bilateral blurred vision of acute onset without ocular pain. He was readmitted to our hospital in April 1989. The neurological examination revealed decreased visual acuity of both eyes without any abnormality of the optic disks, mild weakness on flexion and extension of toes, an absence of Achilles reflex, and distal impairment of pain and touch sensations in the upper limbs, and of pain, touch and vibration sensations in the lower limbs. After laboratory examinations, CSF protein was elevated (122 mg/dl), and sensory nerve conduction velocity of the right median nerve was decreased (37.1 m/sec). The sural nerve action potential was not elicited on electrical stimulation. Central scotoma was found in both eyes by the visual field examination. P100 latency was seen to be normal by repeated pattern-reversal visual evoked potential (VEP) studies. CT and MRI of the brain were unremarkable.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with acute bilateral optic neuritis with normal findings on pattern-reversal visual evoked potential study]. 801 88

A 5-year-old boy with left side optic neuritis, which manifested itself 21 days after the onset of rubella eruption, is reported. Seven days after the onset of rash which persisted for 3 days, he was found to be excessively somnolent and disoriented, and a diagnosis of rubella encephalitis was made at our clinic. Clinical symptoms spontaneously subsided 3 days later. Twenty-one days after the appearance of rash (16 days after the onset of encephalitis) he complained of left frontal headache and blurred vision of left eye. The funduscopic examination revealed the left papillitis. Pattern reversal VEP (PVEPs) evoked by stimuli of left eye showed absence of N75 wave, and a prolonged conduction time and low amplitude of P100 wave. Corticosteroid therapy improved his complaints, funduscopic and PVEPs findings. When the treatment was stopped, the funduscopic findings were exacerbated but were improved soon again by the additional corticosteroid therapy. A delayed onset of optic neuritis after the initial infection and a prompt response to corticosteroid therapy may suggest an involvement of some autoimmune process in the pathogenesis of postinfectious optic neuritis in our case.
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PMID:[A case of optic neuritis following rubella encephalitis]. 839 34

The term junctional scotoma of Traquair is used to describe a unilateral temporal visual field defect due to pathology of the ipsilateral optic nerve where it joins the chiasm. We report a 26-year-old woman who presented with blurred vision of her left eye. Examination revealed visual acuity of 20/20 OU, AO-HRR color plates 6/6 OD and 4.5/6 OS, and a 0.3 log unit relative afferent pupillary defect on the left side. Computer and Goldmann perimetry revealed a normal visual field OD and a paracentral temporal scotoma OS. Magnetic resonance imaging scan disclosed a sellar mass, expanding mainly into the left suprasellar area. Laboratory findings and pathological studies were consistent with a prolactin-secreting pituitary adenoma. While involvement of the temporal visual field in only one eye (junctional scotoma of Traquair) is found in about 10% of patients with pituitary adenoma, involvement of only the paracentral temporal visual field in one eye is rare (1-2%). Recognition of this rare syndrome is important because careful visual field analysis discloses a vertical step and helps to avoid misdiagnosing optic neuritis.
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PMID:Pituitary adenoma revealed by paracentral junctional scotoma of traquair. 1042 Jan 15


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