1/15. Chronic dacryoadenitis misdiagnosed as eyelid edema and allergic conjunctivitis.PURPOSE: To report the case of a 53-year-old woman with a 2-year history of episodic upper eyelid swelling and nonspecific complaints, who was diagnosed as having allergic conjunctivitis. methods: A complete ocular examination, orbital computerized tomographic (CT) scans followed by complete physical and systemic examinations. RESULTS: The results of physical and systemic examinations were unremarkable for systemic lymphoma and a primary focus of cancer. The results of the ocular examination were normal. CT scans demonstrated well-defined lesions bilaterally with a homogeneous internal structure in the lacrimal gland fossa, which suggested a diagnosis of chronic dacryoadenitis. The differential diagnosis included lymphoma and orbital metastases. The patient refused a biopsy and was started on a tapering dose of 60 mg oral prednisolone daily. The follow-up CT scans 1 month after cessation of 6-week oral corticosteroid treatment showed near complete resolution of the orbital lesions. CONCLUSION: This case demonstrates that orbital inflammation can be misdiagnosed as refractory allergic conjunctivitis.- - - - - - - - - - ranking = 1keywords = edema (Clic here for more details about this article) |
2/15. Allergy to an occupational allergen (Sapelli wood) in a child.The case is presented of a child who developed rhinoconjunctivitis, angioedema and asthma by sensitization to Sapelli wood, which was used in his father's carpentry. Positive skin-prick test, high levels of specific immunoglobulin e by ELISA and a positive conjunctival challenge test suggest a type I hypersensitivity mechanism to this wood. This is the first case report of sensitization to Sapelli wood and it confirms that occupational allergen exposure as Sapelli wood may also cause sensitization in a child.- - - - - - - - - - ranking = 0.25keywords = edema (Clic here for more details about this article) |
3/15. Acute hydrops in the corneal ectasias: associated factors and outcomes.PURPOSE: To identify factors associated with the development of hydrops and affecting its clinical outcome. methods: Chart review of all patients with acute hydrops seen by a referral cornea service during a 2.5-year period between June 1996 and December 1998. RESULTS: Twenty-one patients (22 eyes) with acute hydrops were seen. Nineteen patients had keratoconus, 2 had pellucid marginal degeneration, and 1 had keratoglobus. Twenty-one of 22 (95%) eyes had seasonal allergies and 20 of 22 (91%) eyes had allergy-associated eye-rubbing behavior. Six of 22 (27%) had a diagnosis of Down's syndrome. Six patients were able to identify a traumatic inciting event: vigorous eye rubbing in 4 and traumatic contact lens insertion in 2. The affected area ranged from 7% to 100% of the corneal surface area and was related to disease duration and final visual acuity. Proximity of the area of edema to the corneal limbus ranged from 0 to 2.3 mm and was also related to prognosis. Three serious complications were observed: a leak, an infectious keratitis, and an infectious keratitis and coincidental neovascular glaucoma. Various medical therapies did not differ significantly in their effect on outcome, and ultimately 4 (18%) of 22 patients underwent penetrating keratoplasty. Best-corrected visual acuity was equal to or better than prehydrops visual acuity in 5 of the 6 patients in whom prehydrops visual acuity was known, without corneal transplantation. CONCLUSIONS: Allergy and eye-rubbing appear to be important risk factors in the development of hydrops. Visual results are acceptable in some patients without surgery. Close observation allows for the early detection and treatment of complications such as perforation and infection.- - - - - - - - - - ranking = 373.16440944773keywords = hydrops, edema (Clic here for more details about this article) |
4/15. Contact dermatitis.BACKGROUND: Anatomically, the eyelid can be divided microscopically into (1) skin, which is made up of epidermis and dermis; (2) submucosa (3) muscular layer; (4) submuscular layer (dense connective tissue); (5) fibrous layer; and (6) palpebral conjunctiva. The thin nature of the eyelid makes it susceptible to inflammation resulting from allergy. Minimum levels of irritants contacting the adnexal area can penetrate the skin to initiate the allergic cascade. Allergic reactions that involve the eye may begin via contact to the skin, but often involve the conjunctiva. eczema is the general term that describes the superficial inflammatory process involving the epidermis. Contact eczema is characterized by varying elements of epidermal erythema, papules, and vesicles. Allergic dermatoconjunctivitis connotes involvement of both the skin and conjunctiva. CASE REPORT: A 24-year-old man came to the clinic with a red, swollen left eye. Based on the history, the constellation of signs and symptoms (lack of diffuse or focal pain, presence of periorbital and conjunctival edema, absence of fever), and failed resolution after treatment with injectable antibiotics, the diagnosis of type IV delayed hypersensitivity reaction secondary to toxic/chemical exposure was made. Speedy resolution was accomplished using a sequenced therapy, which included oral antihistamines, topical cycloplegics, topical antibiotics, topical steroids, and palliative therapies. CONCLUSION: Optometrists should be familiar with the signs and symptoms of contact eczema and allergic dermatoconjunctivitis. Treatment includes management of the skin and adnexae, as well as the ocular manifestations.- - - - - - - - - - ranking = 0.25keywords = edema (Clic here for more details about this article) |
5/15. Allergic contact dermatitis to latanoprost.An 85-year-old male with glaucoma presented with a 1-1/2 year history of tearing; red eyes; and pruritic, edematous, eczematous eyelids. Treatment for presumed ocular rosacea and seborrhea was unhelpful. Patch testing to our standard 64 antigens yielded a positive reaction to Balsam of peru. Notably, benzalkonium chloride, thimerosal, and other preservatives elicited negative reactions. Repeat open application testing elicited positive results to Xalatan (latanoprost) 0.005% ophthalmic solution (Pharmacia & Upjohn, Kalamazoo, MI). A second session of patch tests to 10 personal products, in addition to Xalatan 0.005% solution and the Xalatan vehicle (provided by the manufacturer), elicited a strong positive reaction only to the full preparation of Xalatan 0.005% solution. This report describes the first known case of ACD to latanoprost, a new prostaglandin analog that is widely prescribed for treatment of glaucoma.- - - - - - - - - - ranking = 0.25keywords = edema (Clic here for more details about this article) |
6/15. Corneal hydrops associated with vernal conjunctivitis as a presenting sign of keratoconus in a Congolese child.PURPOSE: To report a case of unilateral corneal hydrops associated with vernal conjunctivitis as a presenting sign of keratoconus. METHOD: Case report. A 10-year-old girl with corneal hydrops of the left eye. RESULT: visual acuity in the affected eye was hand motions and slit-lamp examination revealed a left keratoconic, ectasis, edematous cornea with mild vernal conjunctivitis. CONCLUSION: Hereditary and environmental factors may contribute to the etiology of keratoconus and corneal hydrops.- - - - - - - - - - ranking = 261.29008661341keywords = hydrops, edema (Clic here for more details about this article) |
7/15. Erythrodermia to pseudoephedrine in a patient with contact allergy to phenylephrine.BACKGROUND: phenylephrine and pseudoephedrine are sympathomimetic drugs belonging to the phenylamine family. Adverse cutaneous effects associated with these drugs have been reported but, in view of their frequent use, appear to be rare. The very close chemical structures of these drugs could explain potential cross-reactions among them but the results reported in the literature are controversial. CASE REPORT: An 18-year-old woman developed blepharoconjunctivitis after application of phenylephrine and tropicamide eye drops. Four years after this reaction, she took 1 tablet of Narine (pseudoephedrine and loratadine) and 3-4 hours later developed a generalized erythrodermic reaction. Cutaneous biopsy revealed hydropic changes in the basal layer and, in the dermis, moderate edema with slight perivascular lymphocyte and eosinophil infiltrates. patch tests with European standard series, commercial eye drops, tropicamide, phenylephrine, pseudoephedrine and other sympathomimetic agents were applied to the patient's back. After 47 and 96 hours, only the patches with pseudoephedrine and phenylephrine were positive. CONCLUSIONS: We believe that our patient has presented two different reactions with different clinical outcome and histopathology, which are unlikely to be due to cross-reactivity between the drugs involved. We have found no similar coincidences reported int the literature.- - - - - - - - - - ranking = 0.25keywords = edema (Clic here for more details about this article) |
8/15. A case of anaphylaxis due to rose pollen ingestion.BACKGROUND: Recent publications have demonstrated that in Guneykent (turkey), a rose-cultivating area, some workers experience various allergic reactions due to contact with rose or its pollen. CASE REPORT: A 47-year-old man, originally from Guneykent although he no longer lived there, suffered perennial rhinitis, asthma and rhinoconjunctivitis in spring related to sensitization to dust mites and various pollens, respectively. On several occasions, he had presented oral and cutaneous symptoms and angioedema due to contact with rose or intake of honey or other products. Finally, he had an anaphylactic reaction on drinking dew collected in the tulips of a rose that possibly contained rose pollen. methods: Specific IgE was evaluated with Rosa rugosa extract and was 30.3 IU (class IV). Sensitization to other pollens and to mites was also confirmed. Oral provocation test was not deemed ethical. CONCLUSION: This may be the first reported case of anaphylactic reaction due to rose pollen ingestion.- - - - - - - - - - ranking = 0.25keywords = edema (Clic here for more details about this article) |
9/15. Acute conjunctival inflammation following contact with squashed spider contents.PURPOSE: To report the effects to the eye following contact with spider contents. DESIGN: Observational case report. methods: A 46-year-old man presented with a painful and inflamed eye after contents of a spider got into his right eye when he squashed the spider with a newspaper. He suffered immediate severe pain in the eye, which rapidly became red and swollen. He had conjunctival edema and periorbital swelling of the eye and severe photophobia, but his vision was normal. RESULTS: Topical local anesthetic was applied to the right eye, which was then flushed with normal saline for an hour. The redness and swelling began to resolve over 2 hours. CONCLUSIONS: Ocular exposure to the contents of a spider can cause severe pain, swelling, and redness associated with photophobia. The effects are short term, so reassurance, irrigation, and symptomatic treatment are sufficient.- - - - - - - - - - ranking = 0.25keywords = edema (Clic here for more details about this article) |
10/15. Severe allergic blepharoconjunctivitis induced by a dye for eyelashes and eyebrows.PURPOSE: To report a case of severe allergic blepharoconjunctivitis induced by a dye for eyebrows and eyelashes. methods: A 38-year-old healthy female was examined one day after dyeing her eyebrows and eyelashes with a black cream dye intended for this purpose (FDA-approved). The patient complained of severe eye itching, redness, and epiphora. RESULTS: Vision was 20/40 in both eyes; a moderate edema of the eyebrows and eyelid margins was noted. The conjunctiva was severely hyperemic with papillary reaction and chemosis. The corneas, anterior chambers, irides, lenses, and posterior segments were normal. The patient was treated with dexamethasone 0.1% and ocular lubrication. After five days of treatment, the ocular symptoms improved, her vision returned to 20/20 in both eyes, and the ocular examination was within normal limits. CONCLUSION: FDA-approved dyes for eyebrows and eyelashes can sometimes irritate the ocular surface.- - - - - - - - - - ranking = 0.25keywords = edema (Clic here for more details about this article) |
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