1/10. Pediatric eye injury due to Avena fatua (wild oats).OBJECTIVE: We report on florid and unusual ophthalmic physical signs in three children where the trauma was caused by seeds from Avena fatua, a grass common in western north america. DESIGN: Case series and literature review. SETTING: Three local emergency departments (ED) during the fall of 1998. patients OR PARTICIPANTS: Three children reporting to an ED with an acutely painful eye from which the foreign body was identified botanically as Avena fatua. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Symptoms, interventions, duration of problem. RESULTS: Three male children (6, 10, 14 years) presented separately following incidents in which they had sustained direct eye injury. Each child immediately experienced severe pain and profuse watering of the eye. Severe localized edema of the conjunctiva and inflammation was evident with conjunctival vessel injection leading to bleeding, reminiscent of a chemical "burn." Initially, two children appeared to have an eyelash caught behind the lower lid. In both instances, the emergency physicians initially dismissed the possibility of there being a significant foreign body, but because of the severity of the pain, conjunctival vessel injection, and edema, they attempted to remove the "lash." Removal of the foreign body proved difficult in all three cases, requiring far greater traction than anticipated. Intact seedpods had become embedded in the subconjunctival space. Ophthalmic analgesia relieved the pain immediately, but in one child who was treated with topical antibiotic alone, significant pain was experienced for 18 hours, until steroid-antibiotic therapy was instituted. All injuries occurred in late summer when the grass propagates. CONCLUSIONS: The physical signs of scleral vasculitis and conjunctival edema can be mistaken for chemical injury or allergic chemosis, but where a foreign body resembling a hair or eyelash is visible, the presence of a seed-pod retained in the subconjunctival space must be considered, particularly if the patient reports exposure to wild grass. Application of local analgesia, foreign body removal, and steroid-antibiotic treatment is recommended.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/10. Accidentally discovered large metallic intra-orbital foreign body.A 6.2 cm long and 2.7 cm thick metallic foreign body was accidentally found and removed from a 62 years old man. He was sent to a minor operation theater for repair of left lower lid laceration secondary to trauma after a fight. Subsequent investigation, management, patient follow-up and outcome are discussed. Importance of careful history taking, thorough physical examination and proper investigations are stressed.- - - - - - - - - - ranking = 6.3513818280151keywords = physical examination, physical (Clic here for more details about this article) |
3/10. A case of retained wooden foreign body in orbit.A 41-year-old man visited our clinic complaining of esodeviation of the right eye. He had been operated on for corneal laceration 3 years before. One month later, exodeviation of the right eye had developed. The result of computed tomography (CT) was reported as orbital abscess and cellulitis. Although antibiotic treatment was administered for 2 weeks, the exodeviation didn't improve. On ocular examinations performed in our hospital in November-2001, his right eye was esotropic and had a relative afferent pupillary defect. Vision of the right eye was decreased to 0.02. Fundus examination showed optic atrophy. A new CT scan disclosed a foreign body introduced into the right medial orbital wall, nasal cavity and ethmoidal sinus. Although foreign body was surgically removed, vision and eye movement were not improved. In the case of a patient who has undergone orbital trauma, complete history taking and physical examinations must be performed. On suspicion of a foreign body, imaging study such as CT or MRI must be performed. However, because CT findings can be variable, careful follow-up is needed.- - - - - - - - - - ranking = 6.3513818280151keywords = physical examination, physical (Clic here for more details about this article) |
4/10. Papillary conjunctivitis induced by an epithelialized corneal foreign body.This report of papillary conjunctivitis induced by a corneal foreign body suggests that papillogenesis may result from physical/mechanical tissue trauma. A case is presented with an epithelialized corneal foreign body in the peripheral cornea during a 9-month period. The overlying corneal epithelial surface was elevated, and corresponding upper tarsal conjunctiva revealed localized, elevated papillae. One month after the foreign body was excised, the papillae resolved. An epithelialized foreign body, elevated cornea, and coincidental papillae support the role of physical trauma for the development of papillae--a feature of the syndrome of contact-lens-associated giant papillary conjunctivitis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/10. Specular microscopy of traumatic posterior annular keratopathy.Specular microscopic studies in two patients with traumatic posterior annular keratopathy demonstrated that the endothelial rings consist of disrupted and swollen endothelial cells. The damaged cells were still evident many days after the rings had disappeared. The amount of endothelial cell loss depends on the severity of the injury, and a measurable decrease in cell density occurs only in the more severely injured patients. A physical explanation for the occurrence of these endothelial rings is discussed.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
6/10. Value of computed tomography for the diagnosis of a ruptured eye.The diagnosis of scleral perforation of the globe following ocular trauma is often obvious on physical examination, but occult perforations occur frequently. In addition to locating intraorbital foreign bodies and associated facial bone fractures, computed tomography of the orbit can suggest an occult scleral rupture. Posterior collapse of the sclera causes flattening of the posterior contour of the globe, the "flat tire" sign. Other associated findings that are suggestive of scleral rupture are intraocular foreign body or gas, thickening of the sclera posteriorly, and a blood-vitreous fluid-fluid level.- - - - - - - - - - ranking = 6.3513818280151keywords = physical examination, physical (Clic here for more details about this article) |
7/10. Differential diagnosis of pediatric conjunctivitis (red eye).Because eye injuries and diseases may potentially result in serious vision impairments, accurate diagnosis and treatment of ophthalmic conditions are imperative. A symptom common to eye impairments is conjunctivitis, or red eye, a commonly seen manifestation in an ambulatory pediatric population. Because conjunctivitis is caused by various etiologies, clinicians must derive a differential diagnosis. This article examines possible causes of conjunctivitis after the neonatal period in this population. Differential diagnosis is dependent on a complete history, distinct physical findings, and use of adjunct diagnostic tests. Treatment, which depends on a sound differential diagnosis, should be targeted according to the cause of the problem.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
8/10. Wooden foreign body in the orbital cavity: a case report.Orbital foreign bodies in thailand are uncommon. The diagnosis depends on history taking, physical examination and complete investigations. A case of orbital foreign body was reported with satisfactory result of treatment by transethmoidal approach: ethmoidectomy with antrostomy.- - - - - - - - - - ranking = 6.3513818280151keywords = physical examination, physical (Clic here for more details about this article) |
9/10. Unusual orbital foreign bodies.PURPOSE: To describe the clinical features of patients with unusual orbital foreign bodies. methods: The clinical histories, preoperative photographs, imaging studies, and surgical pathologic findings of five patients with unusual orbital foreign bodies are presented. Additionally, published reports pertaining to similar cases were reviewed. RESULTS: The five patients treated by the authors had good outcomes. CONCLUSIONS: An orbital foreign body may be overlooked because a small penetrating wound may be accompanied by minimal or no signs of inflammation early in the clinical course. A careful history and physical examination, imaging studies, and a strong suspicion are helpful for establishing the diagnosis of an orbital foreign body.- - - - - - - - - - ranking = 6.3513818280151keywords = physical examination, physical (Clic here for more details about this article) |
10/10. Ultrasound biomicroscopy as a tool for detecting and localizing occult foreign bodies after ocular trauma.OBJECTIVE: To show the utility of ultrasound biomicroscopy (UBM) in imaging small ocular foreign bodies of the anterior segment. DESIGN: Retrospective case series. PARTICIPANTS: Twelve eyes of 12 consecutive patients evaluated in the emergency department or referred to specialty services at 1 institution between August 1994 and November 1997 were examined. INTERVENTION: Ocular ultrasound biomicroscopy was performed. MAIN OUTCOME MEASURES: Detection and localization of an ocular foreign body were measured. RESULTS: An intraocular or superficial foreign body was detected by UBM in 9 (75%) of 12 eyes. The foreign body was classified as corneal in two eyes, subconjunctival in two, intrascleral in three, and intraocular in two eyes. The foreign body was not visible by ophthalmic physical examination in seven of the nine eyes with a confirmed ocular foreign body. In the remaining two eyes, UBM was used to determine the depth of a visible foreign body. In three of the eyes with a confirmed foreign body, computed tomography and/or contact B-scan ultrasonography was obtained and failed to show a foreign body. Six of the foreign bodies were nonmetallic. CONCLUSIONS: Clinical detection of ocular foreign bodies after trauma can be hindered by small size, haziness of the optical media, poor patient cooperation, or hidden location. Ultrasound biomicroscopy is a valuable adjunct in the evaluation of suspected ocular foreign bodies, especially in cases involving small, nonmetallic objects.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
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