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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 acute methyl alcohol intoxication were studied in 24 men during an outbreak in Port Moresby, Papua New Guinea. The visual acuity, pupillary reactions to light, fundal appearances and visual fields were recorded in all patients within 72 hours of ingestion of methanol and again three months later. Three groups were identified. Nine patients had no ocular abnormality (Group 1). Seven patients had only transient ocular abnormalities (Group 2). Eight patients had permanent ocular abnormalities (Group 3). Transient abnormalities included peripapillary oedema, optic disc hyperaemia, diminished pupillary reactions to light, and central scotomata. Permanent ocular abnormalities included optic disc pallor, attenuation of arterioles, sheathing of arterioles, diminished pupillary reaction to light, diminished visual acuity, central scotomata, and other nerve fibre bundle defects. Complete blindness occurred in two patients, while severe visula deficit resulted in four others. The incidence of permanent ocular abnormalities was found to correlate with the incidence of metabolic acidosis (P less than 0.01), and with the stated volume of methanol consumed (P less than 0.05). An inverse correlation was found between stated volume of methanol consumed and onset of blurred vision. The difficulties in management and rehabilitation of these patients are discussed.
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PMID:Ocular manifestations and complications of acute methyl alcohol intoxication. 73 40

Visual field defect due to pituitary adenoma ordinarily shows bitemporal hemianopsia. But we experienced a case presenting binasal inferior quadrants hemianopsia. A 60-year-old woman was admitted to our hospital complaining of headache and blurred vision. At ophthalmologic examination, the visual acuity on the right was 0.02 and on the left 0.3. Visual field showed a loss of bilateral inferior nasal quadrants. There was neither pallor nor edema of either of the optic disks. A computerized tomography (CT) scan showed an enhancing mass in the intra- and suprasellar region. But despite remarkable suprasellar expansion of the tumor, the straight view of bilateral carotid angiograms revealed no elevation of the first part of the anterior cerebral arteries (ACA). On the lateral view, the terminal portion of the precommunicating part of the left ACA showed rather marked anteroinferior displacement. 2 mm thin sliced CT scans at the suprasellar region revealed that the left internal carotid artery had been touching the lateral portion of the tumor and the ACA had been displaced anteriorly by the tumor. Two weeks after admission, transsphenoidal tumor resection was carried out. Total removal was achieved and histological examination showed that the tumor was nonfunctioning chromophobe adenoma. The postoperative course was uneventful except for transient diabetes insipidus. The patient's visual acuity rapidly improved to 0.8 on the right and 0.5 on the left two weeks after operation. Although there was still a tendency for left inferior nasal field defect, remarkable improvement was obtained subjectively and objectively. According to the findings of CT scans and cerebral angiograms, binasal hemianopsia may have been produced by the mechanism as follows.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of pituitary adenoma presenting binasal inferior quadrants hemianopsia]. 261 6

Complications from mydriatic and cycloplegic drugs are rare compared with their extensive use. Adverse effects are often related to dosage or other factors. The ocular complications include increased intraocular pressure, pigmentation of the conjunctiva and cornea, pigment in the anterior chamber, lacrimal duct blockage, macular edema, corneal endothelium damage, hyperemia, allergy, discomfort, and blurred vision. The systemic complications are those common to sympathomimetic and parasympatholytic drugs and include tachycardia, hypertension, headache, faintness. pallor, trembling, excessive sweating, palpitations, arrhythmias, confusion, hallucinations, drowsiness, ataxia, flushed skin, high fever, dysarthria, thirst, dry mouth, convulsions, disorientation, nervousness, coma, and death. An understanding of all possible side effects is of paramount importance to those using these drugs in the treatment of anticholinesterase poisoning. This review is intended as a ready reference to the adverse effects of mydriatic and cycloplegic drugs.
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PMID:Mydriatic and cycloplegic drugs: a review of ocular and systemic complications. 703 29

This paper investigates the acute effects of carbofuran in workers of two pesticide-formulating plants. Mean airborne carbofuran concentrations ranged from 0.025 to 1.115 mg/m3 in plant A and from 0.018 to 0.067 mg/m3 in plant B, respectively. In workers of plant A the post-shift blood cholinesterase activity was significantly reduced, compared to pre-shift values. No difference in blood cholinesterase activity was found between pre- and post-shift values in workers of plant B. During the investigation, 25 cases of acute carbofuran poisoning were diagnosed by their clinical picture and depressed cholinesterase activity in blood. Usual symptoms included dizziness, weakness, blurred vision, nausea and sweating. Pallor, epigastric pain, vomiting and chest tightness occurred only in a few cases. Myosis was recorded in 24 cases. Fasciculation of muscle gastrocnemius induced by percussion was found in 6 cases, and four of them had also fasciculation of muscle orbicularis oculi. Inhibition of cholinesterase activity in the blood was related with the clinical features; however, the inhibition was rapidly reversible. In most cases, recovery was complete within 2-3 hours, with or without atropine treatment, after the subjects were removed from exposure. Rapid onset, mild illness and quick recovery are typical characteristics of occupational acute carbofuran poisoning.
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PMID:Acute effects of carbofuran in workers of two pesticide plants. 1021 31

We herein report a case of a variant form of septo-optic-pituitary dysplasia (SOPD). A 40-year-old man was admitted due to sudden occurrence of left blurred vision and lasting polyuria. He showed short statue of height of 144 cm and the neurological examination revealed hypesthesia of the left trigeminal nerve and temporal pallor in the left fundus oculi. Brain MR imaging demonstrated agenesis of the septum pellucidum and hypoplasia of the corpus callosum with subcortical spotty lesions, but optic nerve hypoplasia was not detected. The left eye showed a prolonged P100 latency of pattern reversal VEPs. He was diagnosed as having hypopituitarism since growth hormone-releasing factor did not stimulate growth hormone secretion and restriction of water-intake did not induce secretion of antidiuretic hormone. Thus we regarded this case as a variant form of SOPD. The mutation of HESX 1 gene, however, was not detected in the case. P100 of the left eye showed a reduction in latency four months after discharge. This case was considered to be a variant form of SOPD complicated by acute optic neuritis.
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PMID:[A variant form of septo-optic-pituitary dysplasia (SOPD) complicated with acute optic neuritis]. 1167 63

Malignant hypertension may be the first manifestation of systemic hypertension. We report a clinical case of a Caucasian 41-year-old man with no previous history of blood hypertension seen at casualty because of blurred vision. Fundus examination disclosed optic disk swelling, retinal hemorrhages and infarcts. The blood pressure was 220/130 mmHg. After the appropriate management of hypertension, optic disk and retinal edema resolved, leaving minor changes as mild optic disk pallor and hard exudates.
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PMID:Malignant hypertension: ocular manifestations. 1649 16

A 34-year-old obese woman developed blurred vision in both eyes soon after large-volume liposuction of the dorsum and gluteus region bilaterally associated with abdominal dermolipectomy. An ophthalmic examination revealed severe bilateral visual loss and pallid optic disc edema. The patient gave a history of transient obscurations of vision in the past. Neuroimaging studies were non-revealing, but a lumbar puncture disclosed a markedly elevated intracranial pressure. The patient was diagnosed as having had bilateral ischemic optic neuropathy superimposed on pre-existing idiopathic intracranial hypertension (IIH). Acetazolamide treatment was used. Some visual improvement occurred, and optic disc edema evolved into severe optic disc pallor. This case shows that visual loss from optic disc infarction may be a devastating complication of high-volume liposuction in patients with underlying IIH. Because liposuction is frequently performed on obese patients, physicians should screen for signs and symptoms of IIH before undertaking this procedure.
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PMID:Bilateral visual loss complicating liposuction in a patient with idiopathic intracranial hypertension. 1651 64

Optic neuritis (ON) is a rare neurological complication of measles infection. Little is known about measles-associated retrobulbar ON. Here, we report a distinct patient with unilateral retrobulbar ON due to measles infection. A 26-year-old woman developed maculopapular rash and Koplik spots. On the following 3 days, she noticed blurred vision in the left eye. A Goldmann visual field test showed inferior nasal quadrantanopsia in the left eye. Visual acuity was 20/20 in OD and 20/100 in OS. Pupillary size was 2.0 mm in the right eye and 4.0 mm in the left eye. Light reflexes were slightly sluggish in the left eye. Ophthalmoscopy showed mild pallor of the left optic disc. Central critical flicker fusion frequency (CFF) was 40.7 Hz in the right eye and 10.1 Hz in the left eye (normal =29.0). Visual evoked potentials showed that P100 latencies were delayed on the left side (133 ms). Brain and spinal cord MRI was normal. Orbital MRI displayed abnormal enhancement in the left optic nerve. Serum and cerebrospinal fluid IgG titers of anti-measles antibodies were increased. Left measles-associated ON was diagnosed. Methylprednisolone pulse therapy followed by oral administration of prednisolone ameliorated visual acuity, visual field and CFF. The neuroophthalmic profile of our patient indicated that measles infection triggered isolated retrobulbar ON, leading to unusual visual deficits. Thus, physicians should pay more attention to variable patterns of measles-associated ON.
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PMID:Unilateral Measles-Associated Retrobulbar Optic Neuritis without Encephalitis: A Case Report and Literature Review. 2111 82

An uncommon case of allergic fungal rhinosinusitis presented to the ophthalmology outpatient department of our hospital with complaints of blurred vision in the right eye of a few days duration and vague complaints of pain around the eyes. The visual acuity on examination was grossly reduced in the right eye and normal in the left eye. Color vision was normal. Anterior segment examination including pupils was normal. Dilated fundus examination was normal except for temporal pallor in the right optic disc. Automated perimetry and magnetic resonance imaging (MRI) scan of brain and orbit were done. The imaging report showed a bilateral pansinusitis with pressure on the right optic nerve. Perimetry showed a superior field defect on the right side. ENT consultation and computed tomography (CT) with contrast helped to diagnose this as a case of allergic fungal rhinosinusitis. The patient was started on systemic steroids under the care of the ENT surgeon. After a few days, pre-operative assessment showed a gross improvement of visual acuity. Endoscopic sinus surgery was done to remove the polyps and thick mucus material. Histopathologic examination confirmed allergic fungal mucin. Days after surgery, the visual acuity improved further and repeat perimetry showed gross improvement in the visual field. Good history taking and a detailed ophthalmic examination, keeping in mind the probable causes of loss of vision of few days duration with no findings other than a decreased visual acuity and a suspicious disc, were key to the early diagnosis and investigation in this case. This helped in early referral and management of the case before permanent damage and irreversible visual loss occurred. The optic nerve is a cranial nerve which, once damaged permanently, will not regenerate. The amount of sinus involvement was extensive on both sides and invariably the left optic nerve would have been involved in a few days, if intervention was delayed.
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PMID:Optic neuropathy due to allergic fungal rhinosinusitis. 2189 86

After emerging from a coma caused by enterohemorrhagic Escherichia coli (EHEC) sepsis with severe neurological and renal involvement a 53-year-old female patient complained of blurred vision. Due to hemolytic-uremic syndrome (HUS) the patient also suffered from dialysis-dependent acute kidney failure. Horizontal visual field defects of the lower hemifield and corresponding segmental optic disc pallor were found in both eyes. Bilateral anterior ischemic optic neuropathy (AION) was diagnosed presumably caused by high volume shifting and hypotonia due to sepsis and dialysis. The literature revealed that bilateral AION is often seen after complex surgical procedures or in patients with severe metabolic disorders. This ophthalmologic complication should always be taken into consideration because of the serious permanent visual damage.
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PMID:[Bilateral anterior ischemic optic neuropathy following EHEC sepsis and hemolytic-uremic syndrome]. 2324 4


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