1/3. mucus fishing syndrome: case report and new treatment option.BACKGROUND: mucus fishing syndrome (MFS) is a cascading cyclic condition characterized by continuous extraction of mucous strands from the eye. It is usually initiated by ocular irritation. In response to irritation, ocular surface cells produce excess mucus. A "snow balling" cycle begins when the patient extracts ("fishes") excess mucus from the ocular surface, thereby causing further irritation and a more-profound mucous discharge. To date, treatment includes eliminating the initiating element and educating the patient not to touch the eye when extracting the excess mucus, CASE REPORT: Presented is a case of mucus fishing syndrome initiated by dry eye. The patient's diagnosis, MFS, was identified by persistent mucous discharge, his admittance and demonstration of digitally extracting mucus from the ocular surface, and a characteristic rose bengal staining pattern. The conventional treatment initiated by using artificial tears for the dry eye condition and educating the patient not to touch the ocular surface did not provide relief from the excess mucous discharge. Therefore, a new approach to treatment was pursued. In order to break the cycle, a mucolytic agent and an antihistamine-mast cell stabilizer were prescribed, until the ocular surface healed. After treatment, the patient reported alleviation of symptoms and demonstrated improvement in ocular surface integrity by a profound reduction in rose bengal staining. CONCLUSION: mucus fishing syndrome is challenging to resolve with conventional treatment because it requires a certain level of psychological tolerance and perseverance from the patient. By eliminating the present mucus and diminishing mucous production pharmacologically, the practitioner is able to remove the stimulus for digital extraction and thus accelerate ocular surface healing. We present a proposed new treatment option for patients who are refractory to conventional treatments.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/3. Cataract surgery in stevens-johnson syndrome.Cataract surgery can be safely performed in patients with stevens-johnson syndrome (SJS) with visually significant cataracts. Maintaining ocular surface integrity improves the prognosis of cataract surgery in this high-risk population. We present the outcome of cataract surgery in a retrospective chart review of 3 eyes in 2 patients with SJS. Uneventful extracapsular cataract extraction with intraocular lens implantation was performed. Follow-up ranged from 3 to 24 months. The visual acuity and ocular surface integrity were reviewed. The preoperative visual acuity was counting fingers at 1 meter in all 3 eyes. The best corrected visual acuity (BCVA) improved to 20/40 in 2 eyes and 20/50 in 1 eye postoperatively. A drop in BCVA ranging from 20/100 to 20/200 was noted during follow-up.- - - - - - - - - - ranking = 0.5keywords = extraction (Clic here for more details about this article) |
3/3. The correction of unilateral aphakia in children treated for orbital rhabdomyosarcoma.The survival rate of children with localized orbital rhabdomyosarcoma is now greater than 90% 3 years after diagnosis as a result of advances in radiation and chemotherapy. Ninety percent of these children develop cataracts within 1 to 4 years after the completion of radiotherapy. The correction of aphakia in these children is complicated by the concurrent keratoconjunctivitis and dryness associated with radiotherapy. Three patients with a diagnosis of orbital rhabdomyosarcoma underwent treatment for uniocular cataract. Two of the patients were unable to use extended wear contact lenses. Both underwent epikeratophakia with poor results. One patient who had clinically significant ocular drying prior to cataract extraction underwent successful implantation of an intraocular lens as a primary procedure, with excellent visual results. Clinicians should be aware of the difficulties associated with contact lens wear and epikeratophakia tissue lenses in children who have had high doses of radiation for orbital rhabdomyosarcoma. Such patients are probably best served by primary intraocular lens implantation or by preservation of the posterior capsule at the time of cataract extraction to allow secondary lens implantation if contact lens wear is unsuccessful.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |