1/19. Bilateral orbital emphysema from compressed air injury.PURPOSE: To describe a patient who developed bilateral subconjunctival and orbital emphysema after an automobile tire explosion. METHOD: Case report. RESULTS: A 60-year-old man sustained bilateral ocular injury after a tire explosion. Ophthalmic examination disclosed bilateral subconjunctival air, with no visible conjunctival laceration. Computed tomography showed orbital emphysema, with no evidence of orbital fracture. Follow-up examination 2 weeks after the injury disclosed resolution of the subconjunctival air. Best-corrected visual acuity in the right eye was decreased after the explosion but improved to the baseline level of 20/40 2 weeks after the injury. CONCLUSION: Subconjunctival and orbital emphysema can occur from high-pressure air injury in the absence of an obvious entry site.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/19. Unilateral proptosis and chemosis caused by dural arteriovenous malformation of the superior sagittal sinus.We describe a patient with unilateral proptosis and chemosis resulting from a dural arteriovenous malformation (AVM) of the superior sagittal sinus (SSS) fed mainly by branches of both external carotid arteries. The symptoms may have been caused by increased SSS pressure and disturbance of venous flow by the dural AVM.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/19. Posttraumatic carotid-cavernous sinus fistula.BACKGROUND AND OBJECTIVES: Posttraumatic carotid-cavernous sinus fistula is a rare complication of maxillofacial trauma and is seldom discussed in the literature. Motor vehicle accidents, falls, and other crush injuries contribute to the incidence of basilar skull fractures and the formation of fistulae. When injuries occur in the vessel wall, the carotid artery has the potential to fill the low-pressure cavernous sinus. The symptoms include chemosis, proptosis, pulsating exophthalmos, diplopia, ophthalmoplegia, orbital pain, audible bruits, and blindness. methods AND MATERIALS: The conventional treatments include carotid ligation and embolization. These techniques have often proved to be ineffective. A new method--the occlusive balloon technique--has been developed and is described in this article. A clinical case is used to illustrate the procedure. RESULTS AND/OR CONCLUSIONS: Utilization of balloon catheters provides a minimally invasive technique to treat patients, without significant morbidity or mortality. The procedure is found to be successful and predictable.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/19. Bleb-limiting conjunctivoplasty for symptomatic circumferential trabeculectomy blebs.PURPOSE: To describe a new surgical technique for limiting symptomatic circumferential conjunctival blebs, an uncommon complication after trabeculectomy. methods: Four eyes of 2 patients underwent conjunctivoplasty to limit the extent of symptomatic circumferential blebs. An 8/0 virgin silk corneal traction suture was used to allow better exposure of the conjunctiva. Radial conjunctival and Tenon incisions were made down to bare sclera in approximately the 10:30 and 1:30 clock hour positions. The conjunctival incisions were sutured, tacking down to the sclera. RESULTS: Immediate flattening of the interpalpebral bulbar conjunctiva was noted on the first postoperative day and there was no elevation of intraocular pressure or loss of bleb function. Both patients experienced a rapid improvement in their symptoms and no complications of the procedure were noted. recurrence of bleb extension occurred in 1 eye 4 months postoperatively, and was treated with a repeat limiting conjunctivoplasty incision with a good result. CONCLUSIONS: Early results show that bleb-limiting conjunctivoplasty is an effective means of treating symptomatic circumferential trabeculectomy blebs.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/19. Severe conjunctival and eyelid involvement in pemphigus vulgaris.pemphigus vulgaris (PV) is only rarely associated with severe ocular involvement. We present a case of PV with bilateral severe swelling, induration and thickening of eyelids, and multiple conjunctival and lid margin erosions, complicated by high intraocular pressure secondary to steroid treatment. After successful systemic immunosuppressive, steroid, and antiglaucomatous treatment, clinical features were resolved, and intraocular pressure returned to normal. Severe ocular diseases without dermatological involvement may be present in PV patients.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
6/19. Migration of intravitreal silicone oil through a Baerveldt tube into the subconjunctival space.A 28-year-old patient developed proliferative diabetic retinopathy with florid rubeosis iridis and ultimately required the placement of a Baerveldt tube to control his secondary glaucoma. Eighteen months later, he underwent a pars plana vitrectomy, scleral buckle, lensectomy, and membrane peeling to reattach a severe diabetic retinal detachment. Ultimately, some of the 5000 cs silicone oil migrated through the tube to the episcleral region under the plate of the Baerveldt device. The oil intermittently blocked the shunt, causing elevated intraocular pressure. Despite ultimate surgical removal of the oil from around the tube and plate, a substantial amount remained encapsulated in the subconjunctival space. Prevention of this complication includes placement of a short tube well anterior to the iris in the inferior portion of the anterior chamber.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/19. Inadvertent sclerostomy with encysted bleb following trans-scleral contact diode laser cyclophotocoagulation.A 22-year-old woman underwent 360 degrees trans-scleral contact diode laser cyclophotocoagulation for refractory glaucoma. Conjunctival burns and scleral thinning were noticed inferonasally at the last laser application. intraocular pressure in the first week was normal. Six months later the patient presented with encysted filtering bleb and high intraocular pressure. Ultrasound biomicroscopy revealed a full thickness sclerostomy. This report suggests that inadvertent sclerostomy may present with encysted bleb months after trans-scleral contact diode laser cyclophotocoagulation.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
8/19. Subconjunctival and external hemorrhage secondary to oral anticoagulation.Recurrent, bilateral, and severe conjunctival hemorrhages mandate the search for an underlying etiology, such as a blood dyscrasia, blood clotting disorder, or recurrent increased intrathoracic pressure caused by repetitive vomiting or coughing spells. Medical and ophthalmic management is discussed in a case of subconjunctival and external hemorrhage from the eye secondary to prolonged prothrombin time in oral anticoagulation therapy.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/19. Causes of subconjunctival hemorrhage.We examined prospectively 8,726 patients in outpatient eye clinics. A total of 225 (2.9%) patients had subconjunctival hemorrhage. No sexual or age predilection was found. The most common causes for the condition were minor local trauma, systemic hypertension, and acute conjunctivitis. Subconjunctival hemorrhages resulting from local trauma were frequent in the summer, and those associated with systemic hypertension were noted most often in older patients. blood pressures should be examined in patients with subconjunctival hemorrhages, particularly in older patients.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/19. Management of large filtering blebs with the argon laser.Complications attributable to large conjunctival blebs after glaucoma filtering surgery range from annoying foreign-body sensation to devastating endophthalmitis. We used the argon laser to shrink large complicated blebs in four eyes of four patients who had previously undergone glaucoma filtering surgery. The eye is first anesthetized with a topical agent. The bleb surface is lightly abraded with a sterile cotton swab and then "painted" with a tissue-staining dye. Diffuse laser burns applied over the surface resulted in sufficient shrinkage to allow resolution of the respective symptoms or secondary complications in all four cases. The first two patients developed small leaks that we attribute to delivering laser burns to extremely thin areas of conjunctiva. In both cases the leaks gradually sealed over several weeks. None of the eyes developed increases in intraocular pressure or anterior segment inflammation. In each case, filtering capability was maintained.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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