1/5. Infectious crystalline keratopathy with ring opacity.A 41-year-old physician was treated for 3 months with antiviral medications, antibiotics, and steroids for presumed herpetic keratitis. When seen by us, an annular infiltrate was observed, along with crystalline-like opacities in the superficial one third of the stroma. Cultures of scrapings and of subsequent biopsies were positive for streptococcus mitis of the viridans group; histopathology demonstrated large aggregates of cocci between the stroma lamellae. Tapering of topical corticosteroids and treatment with topical penicillin resulted in resolution of the infiltrates. The clinical appearance and findings in this patient suggest that infectious crystalline keratitis can produce an annular infiltrate. Injection of the organism into rabbit corneas produced a crystalline infiltrate, but no annular opacity was observed. Corticosteroids altered the clinical and histopathologic appearance of the lesions in rabbits.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. Suprachoroidal septic effusion leading to panophthalmitis following strabismus surgery.We describe a case of endophthalmitis following strabismus surgery. drainage of the suprachoroidal effusion with injection of antibiotics was unsuccessful in salvaging vision. endophthalmitis following strabismus surgery may present with findings simulating a choroidal effusion or hemorrhage. Treating physicians should be alert to signs and symptoms of this severe complication of strabismus surgery in preverbal children.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/5. Bilateral serratia marcescens keratitis after simultaneous bilateral radial keratotomy.PURPOSE/methods: After bilateral simultaneous radial keratotomy, serratia marcescens keratitis, which involved multiple incisions of both eyes, developed in a 46-year-old physician. The keratitis was treated with repeated wound debridement, fortified topical antibiotics, and topical povidone-iodine. RESULTS/CONCLUSIONS: Six months after radial keratotomy, uncorrected visual acuity was R.E.: 20/25 and L.E.: 20/60, both eyes correctable to 20/20. health-care workers who undergo refractive surgery may be at increased risk of acquired postoperative infections because of their work environment. Although the occurrence of simultaneous bilateral ulcerative keratitis after simultaneous bilateral radial keratotomy is rare, it is nonetheless a real possibility, making it prudent to perform radial keratotomy on one eye at a time.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/5. neurosyphilis with associated retinitis.A 59-year-old black male presented with an acute unilateral central scotoma and decreased visual acuity in each eye. Ocular examination revealed bilateral vitritis, nerve fiber layer hemorrhages and infarcts, arteritis, serous macular edema and optic nerve head edema with telangiectasia. Vascular work-up was remarkable for a reactive FTA-ABS, VDRL and RPR. lymphocytes, monocytes, basophils and platelet count were elevated. hiv tests were nonreactive. Ocular, serologic and cerebrospinal fluid findings along with past sexual history were consistent with a diagnosis of early neurosyphilis. Prompt referral to an infectious disease physician and subsequent treatment with parenteral penicillin resulted in complete resolution of the vitreoretinitis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/5. Atypical mycobacterial infection of the orbit.PURPOSE: To describe the clinical presentation and successful management of an orbital infection caused by mycobacterium abscessus, a formerly unrecognized cause of orbital disease after penetrating trauma. methods: An orbital infection due to M. abscessus is described, and previously reported ocular and extraophthalmic infections caused by M. abscessus are reviewed. RESULTS: A 5-year-old boy had acute, painless visual loss shortly after being struck in his left lower eyelid with a fishing rod. Radiologic evaluation established a mass in the orbital apex. Initial biopsy and cultures of the apex mass were negative; however, additional orbital exploration and cultures demonstrated M. abscessus to be the causative organism. The orbital infection was treated successfully with long-term oral clarithromycin. review of the literature on ocular/adnexal and soft tissue infections caused by atypical mycobacteria shows characteristic clinical and histopathologic features. CONCLUSIONS: To the authors' knowledge, only seven patients with atypical mycobacterial infections of the ocular adnexa have been reported. The patient reported in the current study illustrates the difficulty in establishing the preoperative diagnosis of atypical mycobacterial infections of the orbit. A chronic draining wound or a localized orbital abscess, after penetrating trauma, should alert the physician to the possibility of an M. abscessus infection. clarithromycin, an oral macrolide antibiotic, appears to be the most effective medical therapy for these patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |