1/8. Bilateral cataract surgery combined with implantation of a brown diaphragm intraocular lens after trabeculectomy for congenital aniridia.A 17-year-old male patient was referred for poorly controlled glaucoma on maximal medication, congenital aniridia, cataract, nystagmus, and hypoplasia of the macula. A bilateral filtering procedure was performed to control the glaucoma. Three months later, a slow motion phacoemulsification and implantation of a brown diaphragm intraocular lens (IOL) was attempted. Despite the presence of nystagmus and hypoplasia of the macula, the visual acuity improved from 20/300 to 20/100 in the right eye and from 20/400 to 20/150 in the left eye. Both aniridia IOLs were well centered, the anterior segment was quiet with normal intraocular pressure without medication, and all of the patient's glare symptoms disappeared. A single-piece iris diaphragm and optical lens offer a safe alternative for patients who previously had no viable options for iris reconstruction. The most serious postoperative problem, glaucoma, should be addressed before the cataract and lens implantation is performed to avoid a possible acceleration of the glaucoma progression by the large aniridia IOL.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/8. Bottle-cork injury to the eye: a review of 13 cases.PURPOSE: To analyze the anatomic and functional consequences of wine-cork injury to the eye in relation to the patient's age and the type of cork and wine. methods: We retrospectively studied 13 patients, six women and seven men, presenting to our department with bottle-cork injury to the eye between January 1999 and June 2001. RESULTS: All patients presented with closed-globe injury according to Kuhn et al's classification. All the cases were injured by bottle corks from sparkling wine: white in ten cases and red in three. Mean visual acuity at admission was 20/100 (range, hand motion to 20/20). The most frequent early injury was anterior chamber hyphema (84.6%), followed by corneal injury (62.2%), ocular hypertension (46.1%), lens subluxation (30.8%), traumatic cataract (23.1%), and post-traumatic retinal edema (23.1%). Mean final visual acuity was 20/25; the follow-up ranged from 3 to 29 months, averaging 16.1 months. Late complications were as follows: pupil motility anomalies (38.5%), traumatic cataract (30.8%), iridodialysis (15.4%), traumatic optic neuropathy (7.7%), post-traumatic glaucoma (7.7%), and traumatic maculopathy (15.4%). Surgical treatment was necessary in two cases (15.4%). CONCLUSIONS: Bottle-cork eye injuries account for 10.8% of post-traumatic hospital admissions to our department. Most of them are due to sparkling white wine served at room temperature. There is no correlation between ocular injury and the eye-bottle distance or the type of cork.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/8. Preventing and managing visual disability in primary care: clinical applications.Clinicians in primary care settings are well positioned to participate in the prevention and management of visual disability. They can have a significant impact on their patients' visual health by screening for vision problems, aggressively controlling known risk factors for visual loss, ensuring adherence to ophthalmologic treatment and continuity of eye care, and by timely referral of specific patient populations to qualified eye care professionals (eg, ophthalmologists and optometrists). Using their knowledge about common ophthalmic medications, clinicians can detect adverse effects of these agents, including exacerbations of heart or lung disease. They can ensure that appropriate patients are screened for common serious eye diseases, such as glaucoma, and that patients with disabilities related to vision problems are assessed for treatable conditions, such as cataracts or refractive error. Finally, clinicians can direct patients with low vision from any cause to resources designed to help enhance patient function and emotional support.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/8. Treatment of post-traumatic trabecular mashwork thrombosis and secondary glaucoma with intracameral tissue plasminogen activator in previously unrecognized sickle cell anemia.Intracameral tissue plasminogen activator (t-PA) application in a child with previously unrecognized sickle cell anemia, post-traumatic hyphema, thrombosis in trabecular mashwork and consecutive acute glaucoma showed positive results. Thirteen year-old boy, son of African father and Caucasian mother, was admitted to hospital, with symptoms of acute glaucoma and partial hyphema after right eye trauma. visual acuity of affected eye was 0.5 and intraocular pressure (IOP) 46 mm Hg. Despite a common therapy three days later clinical condition of patient's right eye was getting worst. visual acuity was only hand motion (HM) and IOP 53 mmHg. At this point rose suspicion of sickle cell disease (SCD) and decision about injecting t-PA (20 microg) into anterior chamber was made. Cytological examination of aqueous humor revealed 10% sickled erythrocytes. Hemoglobin electrophoresis discovered hemoglobin S so that diagnosis of SCD was confirmed. Intraocular application of t-PA showed excellent results in post-traumatic hyphema with trabecular mashwork thrombosis in the patient with sickle cell anemia. Two-years follow up confirmed permanent normalisation of IOP and visual acuity. Successful outcome with anterior chamber paracentesis and intracameral injection of t-PA is promising novel approach, which we recommend in treatment of post-traumatic hyphema in SCD.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/8. Delayed nonexpulsive suprachoroidal hemorrhage.Eight cases of delayed nonexpulsive suprachoroidal hemorrhage occurred after filtering operations in aphakic eyes. Sustained hypotonia resulting in serous choroidal detachments, scleral infolding, or both was observed prior to the hemorrhage in seven of the eight eyes. The prognosis was related to the extent of the hemorrhage and possibly to whether or not surgical drainage was performed. Only one of the five patients with massive hemorrhages recovered visual acuity better than hand motions; that patient had undergone prompt surgical drainage of the suprachoroidal blood.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/8. Lensectomy for secondary angle-closure glaucoma in advanced cicatricial retrolental fibroplasia.A study of 15 patients with secondary angle-closure glaucoma associated with advanced cicatricial retrolental fibroplasia is presented. Eight patients developed glaucoma acutely, while 7 showed a chronic course. In four patients the fellow eye became involved acutely within 1 month of the first eye. Seven others were also bilateral, but on a chronic basis. Twelve of the 15 presented after age 2. All were treated with lensectomy which cured the glaucoma. All have extremely poor vision in the range of light perception to hand motion, but have retained their eyes on a pain-free basis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/8. Secondary angle-closure glaucoma in cicatricial retrolental fibroplasia.Five patients had cicatricial retrolental fibroplasia with a complication of secondary angle-closure glaucoma. In all the patients, the glaucoma occurred after age 2 years. All were treated with a pars plana lensectomy and anterior vitrectomy, which alleviated the glaucoma. They all achieved normal intraocular pressure and a pain-free eye. However, visual acuity was poor, in the range of light perception to hand motions. All patients have been followed up for one year and in only one patient has the fellow eye developed secondary angle-closure glaucoma.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/8. An unusual case of cryptococcal endophthalmitis.BACKGROUND: Cryptococcal endophthalmitis is a rare disorder, almost invariably diagnosed after enucleation or at postmortem examination. There are therefore few guidelines as to its identification or treatment. methods: A case of culture-positive cryptococcal endophthalmitis in a patient with chronic uveitis was diagnosed by vitreous biopsy at the time of retinal detachment repair. The patient was treated with oral fluconazole for 5 months. All reported cases of cryptococcal endophthalmitis were reviewed and compared. RESULTS: After oral fluconazole therapy, the patient was culture negative on repeat tap. Despite conversion to culture-negative status, however, visual acuity declined to hand motions because of hyphema and hypotony. The organism was successfully identified as a non-neoformans species, cryptococcus laurentii, previously unreported as an ocular pathogen. CONCLUSION: This unique case demonstrates that cryptococcal disease can be diagnosed antemortem by vitreous biopsy, and should be added to the differential diagnosis in cases of chronic smoldering uveitis. A non-neoformans organism is also identified for the first time as a cause of ocular cryptococcosis. fluconazole, used here for the only time of which we are aware to treat cryptococcal endophthalmitis, produced successful conversion to culture negativity and resolution of the uveitis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |