1/12. Linear IgA disease.PURPOSE: A case of linear IgA disease is reported to alert ophthalmologists and physicians to this unusual cause of chronic cicatrizing conjunctivitis. methods: Clinical records of a patient suffering from linear IgA disease were reviewed. RESULTS: A 65-year-old woman with a complicated medical history experienced rapidly progressive chronic cicatrizing conjunctivitis leading to corneal perforation. Undiagnosed gingivitis and palatal ulceration had been present for 5 years prior to the onset of ocular symptoms and vitamin C deficiency had followed the consequent dietary restrictions. A diagnosis of linear IgA disease was made on conjunctival biopsy, which demonstrated linear deposits of IgA along the epithelial basement membrane. The perforation was managed successfully with a conjunctival pediculate flap. Control of the inflammation was achieved with systemic prednisolone and cyclophosphamide but at the expense of serious systemic side-effects. CONCLUSIONS: Linear IgA disease causes progressive conjunctival cicatrization in many affected individuals.Although dapsone generally controls the inflammation, heavier systemic immunosuppression was required in this case. Involvement of skin or other mucosal surfaces may become symptomatic before the conjunctivitis, and physicians must be educated to refer patients for ophthalmological review on diagnosis. Conversely, ophthalmologists encountering ocular linear IgA disease should be aware of the possibility of other mucosal involvement requiring physician intervention.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/12. Successful treatment of ocular leishmaniasis.PURPOSE: To report successful treatment of a case of ocular leishmaniasis with combined stibogluconate and allupurinol. METHOD: A 32-year-old physician developed a non-tender reddish chalazion like lesion in his right lower lid, associated with conjunctivitis and nodular episcleritis. biopsy of the lesion in his eyelid and conjunctiva disclosed a dense inflammatory response including histiocytes containing typical leishmania organisms. RESULT: Therapy with stibogluconate, both intralesional and intramuscular, was initiated with some improvement. However recurrence of the lesion occurred. Systemic retreatment with combined stibogluconate and allupurinol led to complete healing of the lesion. CONCLUSION: Ocular leishmaniasis is a rare and potentially blinding disorder. Combined stibogluconate and allupurinol may be an effective therapy in such cases.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
3/12. Phthiriasis palpebrarum: an unusual blepharoconjunctivitis.Phthiriasis palpebrarum is an unusual cause of blepharoconjunctivitis and may easily be overlooked because of the failure of physicians to recognize phthirus pubis. We report a case of a 30-year-old woman with persistent itching in the left eyelid which was unsuccessfully treated under the diagnosis of allergic blepharoconjunctivitis. Careful ophthalmic examination revealed seven bugs with multiple red pinpoint excretions and numerous small translucent oval eggs (nits) coating the eyelashes. The patient was successfully treated with mechanical removal of all the lice and nits from the eyelashes. The specimen proved histopathologically to be the phthirus pubis infestation. The phthirus pubis infestation is usually associated with poor hygiene in overcrowded or undeveloped country. However, it may become a notable problem because of frequent traveling and commercial activities across the different countries.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
4/12. melkersson-rosenthal syndrome in the periocular area: a review of the literature and case report.A triad of facial palsy, facial edema, and furrowed tongue characterizes melkersson-rosenthal syndrome, a rare, noncaseating granulomatous disease of unknown cause. Although most reported cases of melkersson-rosenthal syndrome involve swelling of the perioral area, the authors present a case of melkersson-rosenthal syndrome involving the periocular area. Because of its rarity, the syndrome is usually ignored and misdiagnosed; however, the syndrome should not only be considered in the classic perioral presentation but also in the rare periocular form, which may be confused with orbital tumors and orbital pseudotumors. Biopsies should be performed routinely in all patients who present with eyelid edema of unknown etiology. The physician and surgeon who see patients with head and neck pathology should be familiar with melkersson-rosenthal syndrome, and with the possibility of its presentation in the orbit and periocular region.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
5/12. Apraxia of lid opening: dose-dependent response to carbidopa-levodopa.A 67-year-old woman with an 8-year history of Parkinson's disease and Lewy body dementia experienced difficulty in opening her eyelids (apraxia of lid opening [ALO]); she could close them without difficulty. This problem emerged 2 weeks after the patient's dosage of carbidopa 50 mg-levodopa 200 mg 3 times/day was decreased to twice/day. Two weeks after the onset of ALO the patient visited her physician, who suspected carbidopa-levodopa of causing the problem; the drug was discontinued. When the patient's condition worsened rather than improved, she was referred to a neuro-ophthalmologist, who confirmed the diagnosis of ALO. However, the neuro-ophthalmologist noted that this may not have been a true apraxia but rather a form of sustained blepharospasm that prevented the eyelid from opening. carbidopa-levodopa was restarted, and her condition improved dramatically when her dosage was increased gradually to carbidopa 50 mg-levodopa 200 mg in the morning and at noon, and carbidopa 25 mg-levodopa 100 mg in the evening. Clinicians should be aware of adverse reactions, such as AOL, in patients taking carbidopa-levodopa who have dementia of the Lewy body type.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
6/12. Eyelid mass as the presenting finding in a child with down syndrome and acute megakaryoblastic leukemia.Children with down syndrome are at increased risk of developing acute megakaryoblastic leukemia (AML). Therefore, physicians caring for children with down syndrome should be familiar with the presenting features of AML. We describe a child with down syndrome presenting with a left eyelid mass 1 month before a diagnosis of acute AML.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
7/12. A rare complication of endoscopic sinus surgery: necrotizing fasciitis of the eyelid.Necrotizing fasciitis is a soft tissue infection characterized by necrosis of fascia and subcutaneous tissue. It frequently involves the groin, abdomen and lower extremities, but rarely involves the head and neck region. An unusual occurrence of periorbital necrotizing fasciitis after a routine endoscopic sinus surgery in a 57-year-old woman with a history of type II diabetes mellitus is presented. Although the disease is very rare, all the physicians should be aware of the manifestations of this disorder and its treatment. Early recognition and prompt intervention plays an important role in minimizing the morbidity and mortality rates.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
8/12. Essential blepharospasm: nursing update.Essential blepharospasm is a chronic, potentially disabling disorder for which there is no known cause or cure. The term blepharospasm derives from the Greek word 'blepharon' meaning eyelid and the word 'essential' implies unknown cause. In neurological literature blepharospasm is classed as a focal dystonia. Lack of recognition of the disease may cause patients to consult numerous physicians as well as acupuncturists, chiropractors, faith healers and others in an effort to find a cure to what they are sure is not just a psychological problem. nurses who are knowledgeable about the disease entity can easily recognize the symptoms. They can also prevent disability by recommending appropriate professional help. Treatment for the control of symptoms has only recently become available. It is the purpose of this discussion to review current information about blepharospasm that has particular relevance for neuroscience nurses in their personal as well as professional lives.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
9/12. Complications of malpositioned Jones tubes.A Jones tube is an effective lacrimal drainage bypass device often associated with post-operative problems. Unsuspected migration of the tube may cause signs and symptoms that are not immediately identified with the prosthesis. Malposition of Jones tubes in three patients resulted in the following complications. The first patient had persistent episcleritis and atypical facial pain and numbness caused by migration of the tube against the globe and into the nasal septum. Bilateral tubes in the second patient were improperly oriented, causing severe scleral erosion and ulceration. The third patient's bilateral tubes migrated through the conjunctiva into the subcutaneous tissues and were manifested as lower eyelid inflammatory masses. Placement of a Jones tube requires long-term maintenance by the physician and the patient.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
10/12. Delayed fellow eye involvement in acute retinal necrosis syndrome.PURPOSE/METHOD: We studied a case of acute retinal necrosis in which a 30-year delay occurred between involvement of the first and fellow eyes. After systemic treatment with acyclovir and prednisolone, the fellow eye developed a retinal detachment requiring vitrectomy and silicone oil tamponade. RESULTS/CONCLUSION: The fellow eye retained a useful Snellen acuity of 20/120. In a patient who has had acute retinal necrosis, any symptoms or signs in the fellow eye, even several decades later, should alert the examining physician to the possibility of delayed involvement of the fellow eye.- - - - - - - - - - ranking = 0.33333333333333keywords = physician (Clic here for more details about this article) |
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