1/264. Cataracts, bilateral macular holes, and rhegmatogenous retinal detachment induced by lightning.PURPOSE: To report ocular injuries, including a unilateral rhegmatogenous retinal detachment, induced by lightning. METHOD: Case report. A 30-year-old man was injured by lightning. RESULTS: The patient developed a severe decrease in visual acuity in both eyes, an afferent pupillary defect in his left eye, bilateral cataracts, posterior vitreous detachments, macular holes, and an inferotemporal retinal detachment with an associated flap retinal tear in his left eye. CONCLUSIONS: This is a case of bilateral cataracts, posterior vitreous detachments, macular holes, and a unilateral retinal detachment associated with lightning. We postulate that the heating of the retinal surface, the concussive forces on the eye, and a sudden lateral contraction of the attached vitreous resulted in bilateral posterior vitreous detachments and a unilateral peripheral retinal break.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
2/264. Normal visual development after unilateral complete ptosis at birth.We report on a 5-year-old boy who was born with a unilateral complete ptosis secondary to a lid hematoma sustained at birth, which resolved spontaneously over the course of 6 weeks. visual acuity and binocularity have developed normally. This case adds evidence to the proposal of a latent period before the onset of a sensitive period in visual development.- - - - - - - - - - ranking = 5keywords = visual (Clic here for more details about this article) |
3/264. Epikeratoplasty for traumatic corneal ectasia.PURPOSE: To evaluate the efficacy of epikeratoplasty in a case of traumatic corneal ectasia. METHOD: Epikeratoplasty using a manually dissected donor lenticule was used to treat traumatic corneal ectasia after an iron nail injury. RESULT: No intra- or postoperative complication was encountered. At the end of 6 months' follow-up, the patient's best corrected visual acuity was 6/12. CONCLUSION: Epikeratoplasty is a useful technique to treat traumatic corneal ectasia.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
4/264. Paintball ocular injuries.INTRODUCTION: Six cases of ocular injury following paintball injuries sustained during war games are described. A CO2-powered rifle shoots a 14 mm plastic-coated paintball at participants. The muzzle velocity of the gun is 250 ft/sec (76 m/sec). Locally manufactured paintballs are harder than the more expensive imported varieties and may account for the severity of our reported injuries. METHOD: Six patients presented to a retinal specialist with various ocular injuries, predominantly of the posterior pole. RESULTS: All patients were young males. There were no cases of ocular penetration. A variety of retinal pathologies was noted, with three cases requiring surgery; however this did not significantly improve the visual outcome. CONCLUSIONS: These cases highlight the severe ocular injuries that may occur from paintball injuries. Recommendations to avoid ocular injury are made.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
5/264. Ocular explosion during cataract surgery: a clinical, histopathological, experimental, and biophysical study.INTRODUCTION: An increasing number of cases are being recognized in which a peribulbar anesthetic for cataract surgery has been inadvertently injected directly into the globe under high pressure until the globe ruptures or explodes. We reviewed the records of 6 such cases (one of which was reported previously by us), and one additional case has been reported in the literature. Surprisingly, 2 of these 7 cases went unrecognized at the time, and the surgeons proceeded with the cataract operation; all of the patients ultimately developed severe visual loss and/or loss of the eye. OBJECTIVES: To reproduce this eye explosion in a live anesthetized rabbit model and to perform a clinical, histopathological, experimental, biophysical, and mathematical analysis of this injury. methods: Eyes of live anesthetized rabbits were ruptured by means of the injection of saline directly into the globe under high pressure. The clinical and pathological findings of the ruptured human and animal eyes were documented photographically and/or histopathologically. An experimental, biophysical, and mathematical analysis of the pressures and forces required to rupture the globe via direct injection using human cadavers, human eye-bank eyes, and classic physics and ophthalmic formulas was performed. The laws of Bernoulli, LaPlace, Friedenwald, and Pascal were applied to the theoretical and experimental models of this phenomenon. RESULTS: The clinical and pathological findings of scleral rupture, retinal detachment, vitreous hemorrhage, and lens extrusion were observed. In the exploded human and rabbit eyes, the scleral ruptures appeared at the equator, the limbal area, or the posterior pole. In 2 of the 7 human eyes, the anterior segments appeared entirely normal despite the rupture, and cataract surgery was completed; surgery was canceled in the other 4 cases. In 4 of the 5 injected and ruptured rabbit eyes, the anterior segments appeared essentially normal. The experiments with human eye-bank eyes and the theoretical analyses of this entity show that the pressure required to produce such an injury is much more easily obtained with a 3- or 5-mL syringe than with a syringe 10 mL or larger. CONCLUSIONS: Explosion of an eyeball during the injection of anesthesia for ocular surgery is a devastating injury that may go unrecognized. The probability of an ocular explosion can be minimized by careful use of a syringe 10 mL or larger with a blunt needle, by discontinuing the injection if resistance is met, and by inspecting the globe prior to ocular massage or placement of a Honan balloon. When ocular explosion occurs, immediate referral to and intervention by a vitreoretinal surgeon is optimal. Practicing ophthalmologists should be aware of this blinding but preventable complication of ocular surgery.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
6/264. Management of traumatic cyclodialysis cleft associated with ocular hypotony.BACKGROUND AND OBJECTIVE: To evaluate the efficacy of direct cyclopexy for treatment of traumatic cyclodialysis cleft associated with ocular hypotony. patients AND methods: Eyes with traumatic cyclodialysis cleft were treated with direct cyclopexy or 1.0% atropine eyedrop. RESULTS: Five eyes with a large cyclodialysis cleft were treated with direct cyclopexy. Postoperatively, these eyes obtained normal intraocular pressure. Four of the 5 eyes had good visual acuity, and 1 eye that had preoperative subretinal hemorrhage in the macula had poor visual acuity. Of the 3 eyes treated with 1.0% atropine eyedrops, 1 had good visual acuity, and 2 with retinal folds had fairly good and poor visual acuity. CONCLUSION: The present study showed that direct cyclopexy is useful for the treatment of traumatic cyclodialysis cleft associated with ocular hypotony, and that the cyclodialysis should be surgically treated before irreversible retinal folds develop.- - - - - - - - - - ranking = 4keywords = visual (Clic here for more details about this article) |
7/264. Focal retinal pigment epithelial dysplasia associated with fundus flavimaculatus.BACKGROUND: One or more focal dysplastic lesions of the retinal pigment epithelium (RPE) occurred in 15 eyes of 10 patients with fundus flavimaculatus. methods: review of patient records including an attempt to obtain follow-up information concerning a history of previous ocular trauma. RESULTS: Mild antecedent ocular trauma occurred to the eye with a dysplastic lesion in two patients. Dysplastic lesions were most frequently solitary and located temporal to the macula. Subretinal neovascularization accompanied two of the dysplastic lesions. The lesions were multifocal and present bilaterally in two patients. CONCLUSIONS: In fundus flavimaculatus, progressive lipofuscin storage is responsible for engorgement and hypertrophy of the RPE. Dysplastic lesions of the RPE probably result from reactive hyperplasia and fibrous metaplasia of RPE cells in response to acute disruption of fragile, hypertrophied RPE cells that may be enormously enlarged in the area of yellow flecks. This disruption may occur in response to trauma, focal inflammation, or other localized stimuli. patients with fundus flavimaculatus should be cautioned concerning the possible role of trauma in causing dysplastic changes in the RPE and visual loss.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
8/264. Treatment of traumatic cyclodialysis with vitrectomy, cryotherapy, and gas endotamponade.An aphakic patient with severe chronic hypotony had an alternative treatment of a traumatic cyclodialysis cleft: a 3-port pars plana vitrectomy, cryotherapy of the cleft, and fluid-gas exchange with subsequent supine positioning. The therapeutic principle was mechanical apposition of the detached ciliary muscle to the scleral spur by the gas bubble and scar induction by cryotherapy. intraocular pressure increased to within normal ranges, and visual acuity improved over a 15 month follow-up.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
9/264. Traumatic cataract presenting with unilateral nasal hemianopsia.A 56-year-old man developed a nasal field defect in his left eye 3 months after a traumatic accident. An examination showed a posterior subcapsular cataract in the left eye with no neurologic deficits. Humphrey 24-2 visual field testing revealed a nasal hemianopsia in the left eye. After cataract extraction and intraocular lens implantation, the patient's visual field returned to normal. This case shows that a cataract can present with a localized visual field deficit, which may be corrected by cataract extraction.- - - - - - - - - - ranking = 3keywords = visual (Clic here for more details about this article) |
10/264. 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 = visual (Clic here for more details about this article) |
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