DOCSLIB.ORG

Conclusion References Acknowledgements

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Conclusion References Acknowledgements FITTING HYDROPHILIC LENSES WITH SPECIAL OPTICAL ZONES AFTER CORNEAL TRAUMATISMS, SYNECHIA AND PHYSIOLOGICAL LARge pupils: 4 case studies Mercedes Burgos-Martínez1, BSc, MSc, Mónica Álvarez1, BSc, Laura Berasategui2, BSc, Santiago Jeremías3, BSc, Ramón García3, BSc, Pedro Rubio4, BSc, Mónica Monzón5, BSc, Steve Wright6, DO, FBDO CL 1. mark´ennovy Personalized Care, Madrid, Spain / 2. Ópticas 2000, Madrid, Spain / 3. General Óptica, Vigo, Spain / 4. Ripovisio Centre Optic, Ripollet, Spain / 5. Óptica Prima Luce, Sevilla, Spain / 6. mark’ennovy Personalized Care, UK [email protected] INTRODUCTION Technical characteristics of the contact lenses are shown in Table 1. A summary of visual results and parameters is shown in Table 2. CONCLUSION DIAMETER BASE CURVE SPHERE CYLINDER SNELLEN- Special Custom contact lenses are a viable option for special cases with deformed or very Occasionally standard contact lenses do not provide the right solution for special cases. In CHARACTERISTICS (mm) (mm) (D) (D) AXES LOGMAR VA WITH large pupils, the torical and spherical 4TUV® and SPH4UV®, that can be commonly found these cases special parameters are needed. CONTACT FOZD FINAL CONTACT CONTACT Optoform Lathed Lens TYPE LENS MATERIAL (MM) SPECS RX BSCVA LENS PARAMS LENS in the high street practice. Suitable contact lenses in special cases can improve vision quality compared to spectacles Hioxifilcon B 49% 8.00 to 9.80 +/-23.00 -0.75 to -8.00 Traumatism Tc: 0.09 Prism: 1D 14.50 0.25 to +/-10.00 0.25 to -4.00 All 5º by tennis ball, Hioxifilcon +9.50 with Special suitable contact lenses, by decreasing or removing reflections and halos, improve and improve the quality of life for these patients. 0.30 Steps 0.50 from +/-10.50 0.50 from -4.50 A SPH4UV 10.00 bifocal of 1.0 15.00 8.60 +10.50 1.0 UV + Blue Handling Tint absence of B (49%) +2.50 add the quality of life for these patients. Four clinical cases are presented where larger optical zones are needed due to physical 1 Orientation Line crystalline lens Torn iris due to +9.00 -1.00 reasons to avoid reflections, halos and obtain appropriate vision. an explosion 50º and Table 1. Summary of technical characteristics of the contact lenses fitted. B of a grenade, 4TUV Hioxifilcon 9.00 near reading 0.7 14.50 8.30 +11.00 0.7 REFERENCES absence of B (49%) glasses of -1.25 40º crystalline lens +2.50 All patients reported reflections and halos with standard contact lenses, none reached METHOD +14.50 and 1. Gonzalez-Meijome JM, Jorge J, Almeida JB, Parafita MA. Soft contact lenses for comfortable vision with them. Most of them were intolerant to RGPs or fitting was not Complication Hioxifilcon near reading C of IOL implant SPH4UV A (59%) 8.00 glasses of 0.8 14.50 8.90 +16.50 0.80 keratoconus: Case report. Eye Contact Lens. 2006;32:143-7. satisfactory due to decentred lenses and bad vision as a consequence. The patient with and synechia +2.50 Patient A, 21 years old, presented with a displaced and deformed pupil due to an impact 2. Burgos M, Carballo J. Fitting hydrofilic toric contact lenses with special parameters after synechia also felt dryness with her current lenses and wanted to also improve comfort. Large of a tennis ball when she was 9 years old. There was absence of a crystalline lens. Contact physiological Hioxifilcon -6.50 -1.25 14.50 8.60 -6.00 intracorneal ring surgery: two case studies. Clinical Conference of the British Contact D pupil (right 4TUV B (49%) 11.00 100º 0.8 -1.00 100º 1.25 lens (CL) prescription (Rx) was +10.50 D. Contralateral eye presented CL Rx of -5.50 D. eye) Lens Association. Birmingham. 2008; 29 de mayo-1 de junio. Poster. Patient B showed a torn iris due to an explosion of a grenade during military service and Large Hioxifilcon -7.25 -0.50 3. Yamazaki ES, Da Silva VC, Morimitsu V, Sobrinho M, Fukushima N, Lipener C. RESULTS AND DISCUSSION physiological SPH4UV B (49%) 11.00 80 0.65 14.50 8.60 -6.75 1.25 the absence of crystalline lens. CL Rx was +11.00 -1.25 40º. No Rx in contralateral eye. pupil (left eye) Keratoconus special soft contact lens fitting. Eye Contact Lens. 2007 Nov;33(6 Pt 1):300-3. Patient C suffered from a complication of IOL implant, with synechia and anisocoria Table 2. Summary of visual results and parameters for each case. posterior to crystalline lens dislocation. CL Rx needed was +15.50 D. All patients achieved satisfactory vision with visual acuity equal to or better than spectacles 4. Olali C, Mohammed M, Ahmed S, Gupta M. Contact lens for failed pupilloplasty. J Patient D had physiological pupils of 9.50 mm. Slit lamp and topographer were used and reflections disappeared. The one exception was the anisocoric patient that finally Cataract Refract Surg. 2008 Nov;34(11):1995-6. discontinued due to getting demotivated after a few tests, returning to her previous lenses to determine the size of the pupil diameter. Patient reported she had never achieved Corneal integrity was not significantly affected in any case after three months with wearing 5. Reed JW. Corneal tattooing to reduce glare in case of traumatic iris loss. Cornea. 1994 despite not being an ideal solution. satisfactory vision with any contact lens or spectacles. times of between 6 and 15 hours. Comfort was good all day as well as handling in all cases. Sep;13(5):401-5. Hioxifilcon B (49%) was employed to manufacture special front optical zones of 10.00, Physical fitting was correct, with good centration and movement, and the toric lenses In order to minimise modifications to contact lenses and to reduce the risk of patient 9.00, 8.00 and 11.00 mm respectively. Diameters and base curves were also custom-made. stable. A fitting is shown in Figure 2. demotivation an optical diameter larger than the standard of 8.00 is an option, for example ACKNOWLEDGEMENTS Lenses were bicurve, and back surface toric with prism ballast, designs of 4T UV and 4SH the successful cases between 9.00 and 11.00 mm. UV geometry is shown in figure 1. Special lenses are described in literature for irregular corneas such as keratoconus, intracorneal rings implantation, pellucid marginal degeneration,.. 1 – 3, but the majority of The authors would like to thank. these cases don’t require larger front optical zones in soft lenses, which are quite commonly GEOMETRY found in high street practice. If halos were persistent, a second action would be to tint Jesús Carballo and the Technical Team of Customer Services of mark´ennovy (Esther cosmetic iris over these lenses 4, 5 with these parameters in order to remove them and Giménez, Elena Durán, M.Jesús Vázquez,…) as well as Professional Services (Beatriz maintain optical quality. Fernández and Elsa García). Ophtalmic lenses are not an optionfor most of these patients due to their high refractive errors and anisometropia. Contact lenses are a more adequate solution for their. FRONT OPTICAL ZONE Figure 2. Eye with torn iris, decentred pupil and absence of crystalline lens. Fitted with 14.50 8.30 +11.00 -1.25 40º Hioxifilcon B 49%. 14.50 MM 1D PRISM BICURVE , BACK TORIC SURFACE Figure 1. Geometry of lens fitted..
Load more

Recommended publications
  • MIOTICS in CATARACT SURGERY by Harold Beasley, MD
    MIOTICS IN CATARACT SURGERY BY Harold Beasley, MD PROMPT MIOSIS OF the pupil after delivery of the lens in round pupil cataract surgery is recommended to protect the vitreous face, to prevent iris incarceration, and to facilitate the postplacement of corneoscleral sutures.1 It has been postulated that miosis also prevents the formation of peripheral anterior synechia, but this has not been demonstrated experimentally.2 An ideal miotic should produce prompt pupillary constriction and for a duration of 12 to 24 hours. It should also be nonirritating to anterior chamber structures. Acetylcholine ( 1.0 per cent)37 and a weak solution of carbachol (0.01 per cent) ,8 as well as pilocarpine, have been found to be satisfactory for this purpose. The purposes of this study were (1) to evaluate the effectiveness of miotics in preventing peripheral anterior synechia and in preserving the integrity of the vitreous face; and (2) to compare the effectiveness of acetylcholine 1 per cent and carbachol 0.01 per cent as miotics in round pupil cataract surgery. PROCEDURE This study compared three experimental treatments in a double blind procedure in which the code was left unbroken until all the data were accumulated. Selected patients were gonioscoped prior to surgery and only patients with grades Im or iv angles were chosen for this study. All patients were predosed with 2 per cent homatropine and 10 per cent phenylephrine. Prior to the injection of the test solution the pupillary diameters were measured before the section was made and immediately after lens extraction. Measurements were then made at two minutes and at five minutes after the intracameral instillation of 0.4- to 0.5-cc of the test solutions.
    [Show full text]
  • Ocular Complications of Endocarditis
    7 Ocular Complications of Endocarditis Ozlem Sahin Middle East Technical University Health Sciences Department of Ophthalmology, Ankara Turkey 1. Introduction Cardiac complications are the most common complications in patients with infective endocarditis, and they can be related to significant mortality and morbidity. (1) Extra- cardiac manifestations along with their historical descriptions such as splinter hemorrhages, emboli, Osler’s nodes, Janeway and Bowman lesions of the eye, Roth’s spots, patechiae and clubbing generally result from thromboemboli or septic emboli. (2) Inflammatory complications may occur as a result of septic emboli, and these include endogenous (metastatic) endophthalmitis, focal abscess, and vasculitis. (3) In this chapter we mainly focus on the endogenous endophthalmitis arising as a complication of infective endocarditis. Endogenous (metastatic) endophthalmitis is an inflammatory condition of the intraocular structures including the aqueous, iris, lens, ciliary body, vitreous, choroid and retina. (4-6) It results from the hematogenous spread of organisms from a distant source of infection, most commonly infective endocarditis, gastrointestinal tract and urinary tract infections and wound infections. (7-9) Other sources of infection have included pharyngitis, pneumonia, septic arthritis and meningitis. (10,11) Compared with endophthalmitis following trauma or surgery, endogenous endophthalmitis is relatively rare, accounting 2-8% of all reported endophthalmitis cases. (5) However, endogenous endophthalmitis carries with it the danger of bilateral infection in 15-25% of cases. (6,12) 2. Epidemiology Endogenous endophthalmitis has been reported to occur at any age and no sexual predilection. (13) However, in the recent years the mean age of endogenous endophthalmitis has shifted to 65 years possibly because of the reduction in the incidence of rheumatic heart disease.
    [Show full text]
  • Clinical Practice Guidelines: Care of the Patient with Anterior Uveitis
    OPTOMETRY: OPTOMETRIC CLINICAL THE PRIMARY EYE CARE PROFESSION PRACTICE GUIDELINE Doctors of optometry are independent primary health care providers who examine, diagnose, treat, and manage diseases and disorders of the visual system, the eye, and associated structures as well as diagnose related systemic conditions. Optometrists provide more than two-thirds of the primary eye care services in the United States. They are more widely distributed geographically than other eye care providers and are readily accessible for the delivery of eye and vision care services. There are approximately 32,000 full-time equivalent doctors of optometry currently in practice in the United States. Optometrists practice in more than 7,000 communities across the United States, serving as the sole primary eye care provider in more than 4,300 communities. Care of the Patient with The mission of the profession of optometry is to fulfill the vision and eye Anterior Uveitis care needs of the public through clinical care, research, and education, all of which enhance the quality of life. OPTOMETRIC CLINICAL PRACTICE GUIDELINE CARE OF THE PATIENT WITH ANTERIOR UVEITIS Reference Guide for Clinicians Prepared by the American Optometric Association Consensus Panel on Care of the Patient with Anterior Uveitis: Kevin L. Alexander, O.D., Ph.D., Principal Author Mitchell W. Dul, O.D., M.S. Peter A. Lalle, O.D. David E. Magnus, O.D. Bruce Onofrey, O.D. Reviewed by the AOA Clinical Guidelines Coordinating Committee: John F. Amos, O.D., M.S., Chair Kerry L. Beebe, O.D. Jerry Cavallerano, O.D., Ph.D. John Lahr, O.D.
    [Show full text]
  • Ophthalmic Drugs
    A Supplement to 22nd EDITION Randall Thomas, OD, MPH Patrick Vollmer, OD The Clinical Guide to Dr. Melton Ophthalmic[ [ Dr. Thomas Drugs Dispense as writ ten — no substit utions. Refills: unlimit ed. May 15, 2018 Dr. Vollmer Peer-to-peer advice to help boost your prescribing prowess. Supported by an unrestricted grant from Bausch + Lomb 001_dg0518_fc.indd 3 5/11/18 10:52 AM FROM THE AUTHORS DEAR OPTOMETRIC COLLEAGUES: Supported by an Welcome to the 2018 edition of our annual Clinical Guide to Ophthalmic unrestricted grant from Drugs. Herein, we provide updates on our collective clinical experiences and Bausch + Lomb heavily season them with pertinent excerpts from the literature. This guide is intended to bring solid, scientifically accurate and clinically relevant information to our optometric colleagues. If you want to understand CONTENTS how the three of us treat, and what factors led us to develop these methods, you’ll find it explained here. The methods and opinions represented are our own. We recognize that other doctors may use alternative approaches. That First-year Impressions ...........3 is true in all of health care. But this three-doctor writing team has logged over 75 combined years of clinical optometry, and we bring that ‘real-world’ spirit to the discussions that follow. Know that, above all, we are doctors who are genuinely concerned for our patients’ well-being and who endeavor to Glaucoma Care .......................... 6 provide them the best of care, and we write from that perspective. The two topics of greatest interest and need for most eye physicians right now are glaucoma and dry eye disease.
    [Show full text]
  • Findings of Perinatal Ocular Examination Performed on 3573
    BJO Online First, published on February 20, 2013 as 10.1136/bjophthalmol-2012-302539 Br J Ophthalmol: first published as 10.1136/bjophthalmol-2012-302539 on 20 February 2013. Downloaded from Clinical science Findings of perinatal ocular examination performed on 3573, healthy full-term newborns Li-Hong Li,1 Na Li,1 Jun-Yang Zhao,2 Ping Fei,3 Guo-ming Zhang,4 Jian-bo Mao,5 Paul J Rychwalski6 1Maternal and Children’s ABSTRACT children who despite screening go undetected with Hospital, Kunming, Yunnan, Objective To document the findings of a newborn eye respect to vision and eye disorders. A careful China 2Beijing Tongren Ophthalmic examination programme for detecting ocular pathology review of Pubmed revealed no published literature Center, Capital University of in the healthy full-term newborn. on the universality, much less the sensitivity and Medical Sciences, Beijing, Methods This is a cross-sectional study of the majority false-negative rate of RRT of normal newborns. China 3 of newborns born in the Kunming Maternal and Child Further, this age group has not been studied exten- Shanghai Xinhua Hospital, Healthcare Hospital, China, between May 2010 and sively and the actual prevalence of ocular abnor- Shanghai, China 4Shenzhen Eye Hospital, Jinan June 2011. Infants underwent ocular examination within malities, transient and permanent, is largely University, Shenzhen, China 42 days after birth using a flashlight, retinoscope, hand- unknown. There are few previous studies looking 5Eye Hospital of Wenzhou held slit lamp microscope and wide-angle digital retinal at the incidence of retinal haemorrhages in healthy Medical College, Wenzhou, image acquisition system.
    [Show full text]
  • N Dhingra, Department of Ophthalmology, Bridend
    Correspondence 679 Correspondence: N Dhingra, Table 1 Clinical characteristics in infants who received Department of Ophthalmology, cryotherapy for retinopathy of prematurity (1996–2001) or laser Bridend Eye Unit, treatment (2001–2005) Princess of Wales Hospital, 1996–2001 2001–2005 Coity Road, Bridgend CF 31 1RQ, UK Number of infants 42 19 Gestational age at birth (weeks) 26.3 (1.5) 25.8 (1.2) Tel: þ 44 29 20614850; Weight at birth (g) 764 (188) 689 (135) Fax: þ 44 1656 7524156. Postnatal age at surgery (days) 62.5 (14.5) 63 (13.5) E-mail: [email protected] Weight at surgery (g) 1705 (340) 1488 (256) Results reported by mean and SD. Financial interests: None Eye (2007) 21, 678–679. doi:10.1038/sj.eye.6702680; duration of postoperative ventilation, in postoperative published online 23 February 2007 administration of analgesics, and in time until regain of full enteral feeding, was documented in infants who received laser photocoagulation compared with cryo- Sir, treated neonates.4,5 Variation in management during and after retinal Neonatal care has also changed. Since the 1980s, survival surgery for retinopathy of prematurity rates at threshold of viability have increased dramatically, resultinginanevenmorevulnerablegroupofpreterm We read with great interest the paper of Chen et al1 on the neonates who need laser treatment, as illustrated by the considerable variation in practice among decrease in weight at surgery in our unit over the last 10 ophthalmologists regarding the anaesthetic methods years (Table 1).3–5 There is a trend to treat retinopathy in an employed in the treatment of retinopathy of prematurity earlier phase in an attempt to ameliorate long-term visual (ROP) in the UK.
    [Show full text]
  • Eye, Iris – Synechia
    Eye, Iris – Synechia 1 Eye, Iris – Synechia Figure Legend: Figure 1 Eye, Iris - Synechia, Anterior in a female F344/N rat from a chronic study. There is adhesion of the iris to the posterior cornea (arrow). Figure 2 Eye, Iris - Synechia, Anterior in a female F344/N rat from a chronic study (higher magnification of Figure 1). There is adhesion of the iris to the posterior cornea (arrow) due to abnormal fibrovascular tissue formation. Figure 3 Eye, Iris - Synechia in a male F344/NTac rat from a subchronic study. There are concurrent anterior (A) and posterior (P) iridial synechiae, partial protrusion of the iris into the corneal stroma (staphyloma) (S), and a cataractous lens (L). Figure 4 Eye, Iris - Synechia in a male F344/NTac rat from a subchronic study (higher magnification of Figure 3). There is concurrent anterior (A) and posterior (P) iridial synechiae, as well as partial protrusion of the iris in the corneal stroma (staphyloma) (S), and a cataractous lens (L). Figure 5 Eye, Iris - Synechia, Posterior in a female F344/N rat from a chronic study. There is adhesion of the iris to the lens capsule (arrow). Figure 6 Eye, Iris - Synechia, Posterior in a female F344/N rat from a chronic study (higher magnification of Figure 5). There is adhesion of the iris to the lens capsule (arrow) due to abnormal fibrovascular tissue formation is present in the eye, as well as entropion uveae (arrowhead). Comment: Ocular synechiae are abnormal adhesions of the iris to other ocular structures. Causes include intraocular inflammation, especially of the iris and ciliary body.
    [Show full text]
  • ROP Mexico Libro.Pdf
    GRUPO ROP MÉXICO Retinopathy of Prematurity Authors Foreword Dr. Humberto Ruíz Orozco Ophthalmologist Surgeon President of the Mexican Society of Ophthalmology Chapter 1 Dr. Marco Antonio de la Fuente Torres Master in Medical Sciences Definition and Ophthalmologist Surgeon Specialty in Retina national reality Former president of the Mexican Retina Association Director General of the Regional Hospital of Specialty in the Yucatan Peninsula [email protected] Chapter 2 Dr. Cecilia Castillo Ortiz Surgeon Ophthalmologist with Specialty in Retina Pathophysiology Physician Assigned to the Ophthalmology Service of the High Specialty Regional Hospital in the Yucatan Peninsula [email protected] Chapter 3 Dr. Mónica Villa Guillén Pediatrician Perinatal triggering Specialty in Neonatology Deputy Director of Medical Assistance factors Children’s Hospital of Mexico “Federico Gómez” [email protected] Chapter 4 Dr. María Verónica Morales Cruz Pediatrician Rational Specialty in Neonatology Head of Neonatology at the National Medical Center “20 de Noviembre” management of 02 ISSSTE [email protected] Chapter 5 Dr. Marco Antonio Ramírez Ortiz Ophthalmologist Surgeon Current classification Doctor of Medicine (MD) Master of Public Health (MSP) Children’s Hospital of Mexico “Federico Gómez” [email protected] Chapter 6 Dr. Gabriel Ochoa Máynez Senior Medical Ophthalmologist Surgeon Screening criteria Head of the Retinal Subsection of the Central Military Hospital [email protected] Chapter 7 Dr. Juan Carlos Bravo Ortiz Ophthalmologist Surgeon Cryoagulation Former president of the Mexican Retina Association Former head of the Hospital of Pediatrics CMN Siglo XXI IMSS Treatment [email protected]. Chapter 8 Dr. Leonor Hernández Salazar Ophthalmologist Surgeon Transpupillary Laser Specialty in Retina and Vitreous Head of the Retinal Department of the Ophthalmology Service Treatment National Medical Center “20 de Noviembre” ISSSTE [email protected] Retinopathy of Prematurity 4 Chapter 9 Dr.
    [Show full text]
  • Title: Neurotrophic Corneal Ulcer with Herpetic Keratouveitis Masquerading As Posner-Schlossman Syndrome
    Title: Neurotrophic Corneal Ulcer with Herpetic Keratouveitis masquerading as Posner-Schlossman Syndrome. Author: Justin Obana, O.D., Joseph Gallagher, O.D., FAAO, Dorothy L. Hitchmoth OD, FAAO, ABO Diplomate Abstract: A patient presents with ipsilateral neurotrophic corneal ulcer a few weeks after treatment and improvement of Herpes Keratouveitis masquerading as Posner-Schlossman Syndrome. Case History The patient is a 96 year old white male who presents with worsening symptoms of blurred vision, and redness in his right eye that previously improved with Pred-Forte 1% and timoptic .5% ophthalmic solutions. The patient’s ocular history consists of a working diagnosis of Posner Schlossman Syndrome Other ocular diagnoses include epiretinal membrane, normal tension glaucoma, pseudophakia and mild dry age related macular degeneration. His medical history consists of hypertension, pulmonary embolism, GERD, enlarged prostate, spondylosis, and seborrheic keratosis. Patient’s medications include acetaminophen, albuterol, finasteride, fluorouracil, furosemide, lisinopril, metoprolol, tamsulosin, triamcinolone acetonide, and warfarin. Pertinent Findings Best correct vision is 20/400 right eye, 20/50 left eye. Right eye is notable for diffuse injection, stromal edema, diffuse keratic precipitates, there is a new midperipheral corneal ulcer, which appears to have heaped up smooth margins, slight peripheral staining. There is some central pooling with fluorescein, and no dendrites or end bulbs with Rose Bengal. A gram stain and corneal swab culture was positive for staphylococcus aureus. Pupil is round and reactive in the right eye and surgical in the left, equal in size for both. New cells with no flare present in the anterior chamber in the right eye. Normal iris with no rubeosis in both eyes.
    [Show full text]
  • Twelfth Edition
    SUPPLEMENT TO April 15, 2010 www.revoptom.com Twelfth Edition Joseph W. Sowka, O.D., FAAO, Dipl. Andrew S. Gurwood, O.D., FAAO, Dipl. Alan G. Kabat, O.D., FAAO 001_ro0410_hndbkv7.indd 1 4/5/10 8:47 AM TABLE OF CONTENTS Eyelids & Adnexa Conjunctiva & Sclera Cornea Uvea & Glaucoma Vitreous & Retina Neuro-Ophthalmic Disease Oculosystemic Disease EYELIDS & ADNEXA VITREOUS & RETINA Floppy Eyelid Syndrome ...................................... 6 Macular Hole .................................................... 35 Herpes Zoster Ophthalmicus ................................ 7 Branch Retinal Vein Occlusion .............................37 Canaliculitis ........................................................ 9 Central Retinal Vein Occlusion............................. 40 Dacryocystitis .................................................... 11 Acquired Retinoschisis ........................................ 43 CONJUNCTIVA & SCLERA NEURO-OPHTHALMIC DISEASE Acute Allergic Conjunctivitis ................................ 13 Melanocytoma of the Optic Disc ..........................45 Pterygium .......................................................... 16 Demyelinating Optic Neuropathy (Optic Neuritis, Subconjunctival Hemmorrhage ............................ 18 Retrobulbar Optic Neuritis) ................................. 47 Traumatic Optic Neuropathy ...............................50 CORNEA Pseudotumor Cerebri .......................................... 52 Corneal Abrasion and Recurrent Corneal Erosion ..20 Craniopharyngioma ..........................................
    [Show full text]
  • Iris Rubeosis, Severe Respiratory Failure and Retinopathy of Prematurity – Case Report
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE +MRIOSP4SPprovided by Via Medica Journals 46%')/%>9-78='>2) neonatologia Iris rubeosis, severe respiratory failure and retinopathy of prematurity – case report Rubeoza tęczówki, ciężka niewydolność oddechowa i retinopatia wcześniaków – opis przypadku 0RQLND0RGU]HMHZVND8UV]XOD.XOLN:RMFLHFK/XELĔVNL Department of Ophthalmology, Pomeranian Medical University, Szczecin, Poland Abstract The aim: Case study reports for the first time about development of massive iris neovascular complication in co- urse of retinopathy of prematurity related to systemic and ocular ischemic syndrome due to tracheostomy-requiring extremely severe premature respiratory failure. Material and method: Premature female, 950 grams birth weight, born from 17-year-old gravida 1, at 28 weeks’ gestation by cesarean section due to premature placental abruption with threatening hemorrhages, with 1 to 5 Apgar score. The baby developed severe respiratory failure which required tracheostomy, advanced bronchopulmo- nary dysplasia treated with steroids (BPD) and respiratory distress syndrome (RDS) with failure to extubate together with secondary ocular ischemia. All the mentioned with multifactorial organs complications (NEC, leucopenia, ane- mia, pneumonia, periventricular leucomalacia, electrolyte abnormalities and metabolic acidosis) resulted in massive peripupillary iris neovascularization (NVI) in both eyes coexisting with retinopathy of prematurity (ROP) in 38 weeks’ PMA infant. Ultrasonography-B, slit-lamp and indirect fundus examinations with photography were used to document focusing ocular diagnosis. The previous retinopathy of prematurity screening examinations performed at standard intervals of time starting from four weeks of life, that is 32 weeks’ PMA continuing every two weeks did not present typical lesions seen in retinopathy, however in the second zone of retina slightly marked “plus sign” was visible.
    [Show full text]
  • Treatment of Acute Bacterial Endophthalmitis After Cataract Surgery Without Vitrectomy
    Chapter 6 Treatment of Acute Bacterial Endophthalmitis 6 After Cataract Surgery Without Vitrectomy Thomas Theelen, Maurits A.D. Tilanus Core Messages ■ Exogenous endophthalmitis due to ■ A pretreatment vitreous tap for microbi- cataract surgery is rare and occurs in al analysis is always required and should approximately 0.05% of all cases with a begainedbyavitreouscutter. growing incidence since the routine use ■ Inject 1 mg (0.1 cc) of vancomycin, of no-stitch cataract surgery began. 2.5 mg (0.1 cc) of ceftazidime, and 25 mg ■ Most of the patients with acute endo- (0.1 cc) of prednisolone into the vitreous phthalmitis after cataract surgery be- cavity with a 23-gauge needle. come symptomatic between 1 day and ■ If there is no significant improvement 2 weeks after surgery. in the clinical aspect of the eye a second ■ When the diagnosis endophthalmitis has intravitreal injection is administered on been made a medical emergency is pres- thethirdday. ent and the next diagnostic and thera- ■ The causal bacteria seem to be the most peutic steps do not permit any delays. important prognostic factor in endo- We strongly advise carrying out a vitre- phthalmitis after cataract surgery. ous tap and injecting antibiotics into the ■ The production of bacterial exotoxins vitreous cavity within less than an hour and increased microbial motility may after the clinical diagnosis. lead to very early and severe functional ■ Vitreoretinal specialists all over the world damageeveninthepresenceofonly are divided into two camps: those who mild inflammation with a relatively avoid early vitrectomy and those who small amount of bacteria. In such cases, claim the obligation of immediate com- any therapeutical intervention may be pleteparsplanavitrectomy.Eventhough unsatisfactory and the visual outcome recent peer-reviewed literature includes maycommonlybepoor.
    [Show full text]