1/349. Infectious crystalline keratopathy and endophthalmitis secondary to mycobacterium abscessus in a monocular patient with stevens-johnson syndrome.PURPOSE: To describe the clinical and laboratory features of infectious crystalline keratopathy and endophthalmitis secondary to mycobacterium abscessus in a patient with stevens-johnson syndrome. METHOD: Case report. A 19-year-old man with a history of stevens-johnson syndrome and multiple corneal transplants developed white crystalline corneal infiltrates. RESULTS: anterior chamber aspirate disclosed acid-fast bacilli. A repeat corneal transplant was performed and antibiotic therapy begun. Histopathology showed focal acute inflammation surrounding collections of acid-fast bacilli, which were speciated as M. abscessus. CONCLUSIONS: M. abscessus is a cause of infectious crystalline keratopathy and endophthalmitis. risk factors include ocular surface disease, corneal transplantation, and immunosuppressive therapy.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
2/349. Late bleb-related endophthalmitis after trabeculectomy with mitomycin C.To present two cases of delayed-onset postoperative endophthalmitis following trabeculectomy combined with mitomycin C for secondary glaucoma after penetrating keratoplasty. We retrospectively evaluated two patients with late endophthalmitis after trabeculectomy combined with intraoperative mitomycin C application. Both patients underwent trabeculectomy for uncontrolled glaucoma following penetrating keratoplasty and they developed thin-walled cystic blebs. intraocular pressure was normal, and grafts remained clear postoperatively. Severe endophthalmitis with hypopyon developed at 3 and 7 months postoperatively. Both patients had concomitant bleb infection. They underwent vitreous sampling and intravitreal injection of vancomycin and amikacin and were given topical fortified and systemic antibiotic therapy. Intravitreal injection was repeated once in both patients. Cultures grew streptococcus pneumonias in one and staphylococcus aureus in the other. Although the treatment of endophthalmitis was successful in both patients, only one of them achieved useful vision (20/40). For the other patient who had been infected with S. pneumoniae, vision was light perception. Delayed-onset endophthalmitis following trabeculectomy with mitomycin C application is a severe and vision threatening complication. It seems that the development of thin cystic filtering blebs secondary to intraoperative mitomycin C application may be a predisposing factor for bleb-related late endophthalmitis.- - - - - - - - - - ranking = 0.2keywords = ocular (Clic here for more details about this article) |
3/349. alcaligenes xylosoxidans endophthalmitis 8 months after cataract extraction.PURPOSE: To report a case of alcaligenes xylosoxidans endophthalmitis and to increase awareness of its potential as an intraocular pathogen. methods: An 80-year-old woman in good general health developed A. xylosoxidans endophthalmitis 8 months after an uncomplicated cataract extraction performed at another institution. Eventually, vitrectomy with removal of the intraocular lens and capsule was performed because of recurrent disease after intravitreal antibiotic injections. RESULTS: Microbiologic examination of the vitreous biopsies and capsule disclosed A. xylosoxidans, a motile, gram-negative rod resistant to many antibiotics. CONCLUSION: A. xylosoxidans should be considered as a cause of low-grade endophthalmitis after cataract surgery.- - - - - - - - - - ranking = 0.4keywords = ocular (Clic here for more details about this article) |
4/349. A case of an intraocular foreign body due to graphite pencil lead complicated by endophthalmitis.We report a case of an 8-year-old boy who presented with an intraocular foreign body composed of graphite pencil lead. The patient had been accidentally poked in the right eye with a graphite pencil. Primary care consisted of corneal suturing and lens extraction. Two pieces of the pencil lead remained in the vitreous cavity following surgery, and 2 days later the patient developed endophthalmitis. Pars plana vitrectomy was performed immediately and the intraocular foreign bodies were removed through the scleral wound. Cultures of the vitreous fluid revealed no bacterial organisms. X-ray fluoroscopic analysis of the vitreous detected 1 ppm of aluminum (a constituent of the pencil lead). Although the clinical presentation indicated probable bacterial endophthalmitis, the detection of elemental aluminum within the vitreous cavity also suggested the possibility of further retinal toxicity due to some dissolving of the pencil lead.- - - - - - - - - - ranking = 1.2keywords = ocular (Clic here for more details about this article) |
5/349. Streptococcal keratitis after myopic laser in situ keratomileusis.A 24-year-old healthy male underwent uncomplicated laser in situ keratomileusis (LASIK) in left eye. One day after the surgery, he complained of ocular pain and multiple corneal stromal infiltrates had developed in left eye. Immediately, the corneal interface and stromal bed were cleared, and maximal antibiotic treatments with fortified tobramycin (1.2%) and cefazolin (5%) were given topically. The causative organism was identified as 'streptococcus viridans' both on smear and culture. Two days after antibiotic therapy was initiated, the ocular inflammation and corneal infiltrates had regressed and ocular pain was relieved. One month later, the patient's best corrected visual acuity had returned to 20/20 with -0.75 -1.00 x 10 degrees, however minimal stromal scarring still remained. This case demonstrates that microbial keratitis after LASIK, if treated promptly, does not lead to a permanent reduction in visual acuity.- - - - - - - - - - ranking = 1026.0623865653keywords = keratitis, ocular (Clic here for more details about this article) |
6/349. Bacterial keratitis following laser in situ keratomileusis for hyperopia.A 42-year-old Bahraini man had uneventful laser in situ keratomileusis for hyperopia (OD: 3.00 0.75 x 155 degrees; OS: 2.00 0.50 x 155 degrees). Three weeks later, he presented with localized keratitis in his right eye, with localized keratitis at the flap margin with stromal edema. Uncorrected visual acuity was 20/80 OD with no improvement with pinhole, and was 20/20 OS. Corneal smear culture showed a positive growth of staphylococcus aureus. The patient was immediately treated with subconjunctival gentamicin and intensive topical ofloxacin 0.3% with systemic cephalosporin. The patient recovered from keratitis within 2 weeks and his uncorrected visual acuity OD improved to 20/20. keratitis following LASIK should be treated promptly so that it does not lead to permanent reduction in visual acuity.- - - - - - - - - - ranking = 1435.6473411914keywords = keratitis (Clic here for more details about this article) |
7/349. A case of bacterial endophthalmitis following perforating injury caused by a cat claw.A case of bacterial endophthalmitis following a perforating ocular injury caused by a cat claw is reported. The scleral wound was sutured immediately following the injury and systemic antibiotics were administered. Despite this treatment, endophthalmitis occurred 3 days after the injury. The endophthalmitis was resolved by pars plana vitrectomy, however preretinal reproliferation and retinal detachment subsequently occurred. After reoperation the retina was reattached and the corrected visual acuity improved from 10 cm/HM to 20/200. pseudomonas aeruginosa was detected in cultured vitreous humor that was collected during surgery. This case illustrates the possibility of endophthalmitis being caused by gram negative bacillus in cases of perforating injuries caused by animal claws. Perforating ocular injuries caused by animal claws are relatively rare. Here we report a case of endophthalmitis due to pseudomonas aeruginosa that occurred after a perforating injury caused by a cat claw. The eye was treated by pars plana vitrectomy.- - - - - - - - - - ranking = 0.4keywords = ocular (Clic here for more details about this article) |
8/349. listeria monocytogenes-induced endogenous endophthalmitis in an otherwise healthy individual: rapid PCR-diagnosis as the basis for effective treatment.PURPOSE: listeria monocytogenes is a rare cause of endogenous endophthalmitis. To date 15 cases have been published in the literature. All eyes showed similar clinical features and profound visual loss mainly due to delayed diagnosis. methods: An additional case of an otherwise healthy 73 year-old male, who was referred to our hospital because of acute iridocyclitis with secondary glaucoma, is reported. Within a few days the severity of the intraocular infection increased dramatically, resulting in the clinical picture of acute endophthalmitis. RESULTS: In contrast to most published cases, early identification of the causative pathogen in the aqueous humor after anterior chamber puncture using polymerase chain reaction (PCR) and the initiation of a specific, systemic antibiotic medication, resulted in-complete recovery of visual acuity. CONCLUSIONS: PCR is very useful for the identification of the pathogen in intraocular infections.- - - - - - - - - - ranking = 0.4keywords = ocular (Clic here for more details about this article) |
9/349. Cyanoacrylate tissue adhesive augmented tenoplasty: a new surgical procedure for bilateral severe chemical eye burns.PURPOSE: To report on cyanoacrylate tissue adhesive augmented tenoplasty, a new surgical procedure for bilateral severe chemical eye injuries. methods: A 26-year-old man presented with bilateral severe (grade IV) chemical burns involving the eye, periorbital tissues, face, and neck. Despite adequate medical therapy, corneal, limbal, and scleral ulceration progressed in both eyes. Secondary Pseudomonas keratitis necessitated therapeutic penetrating keratoplasty in the right eye. Tenoplasty and glued-on rigid gas permeable contact lens were unsuccessful to arrest progression of corneolimboscleral ulceration in the left eye. We applied n-butyl cyanoacrylate tissue adhesive directly on the ulcerating corneal, limbal, and scleral surface to augment tenoplasty. RESULTS: The left ocular surface healed with resultant massive fibrous tissue proliferation and symblepharon on the nasal side. Ocular surface rehabilitation resulted in a vascularized leukomatous corneal opacity with upper temporal clear cornea. The patient achieved visual acuity of 6/36 in the left eye. CONCLUSION: We suggest that cyanoacrylate tissue adhesive-augmented tenoplasty can be undertaken to preserve ocular integrity and retain visual potential in a severe chemical eye injury.- - - - - - - - - - ranking = 205.49247731306keywords = keratitis, ocular (Clic here for more details about this article) |
10/349. Bilateral Pseudomonas corneal ulcer in a disposable contact lens wearer.PURPOSE: To describe a case of bilateral corneal ulcers caused by Pseudomonas in a disposable soft contact lens wearer. This case study discusses the role of patient examination, contact lens care instruction, and adequate patient supervision in reducing the risk of serious potential complications. methods AND RESULTS: A 17 year old student who had been using disposable soft contact lenses on an extended wear basis for 6 months presented complaining of pain in the left eye. When he was examined, a corneal ulcer with surrounding infiltrate was observed in the superior middle periphery of the left eye. Samples were collected for culture, and treatment with fortified cefalotin and gentamicin was started. After 8 hours the patient returned, now complaining of pain in the right eye. Examination of the right eye revealed a diffused keratitis with a mucopurulent discharge. A culture was taken, and the same treatment was instituted. The laboratory tests revealed Pseudomonas in both eyes. The bilateral corneal ulcers responded to therapy after 1 week of treatment. CONCLUSIONS: We discuss the factors involved in the occurrence of infectious keratitis in contact lens wearers, and stress that even disposable contact lens wear can be associated with serious complications. This case also highlights extended wear as one of the main risk factors for complications in disposable soft contact lens wear.- - - - - - - - - - ranking = 410.18495462611keywords = keratitis (Clic here for more details about this article) |
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