1/10. Post-traumatic endophthalmitis: causative organisms and visual outcome.PURPOSE: Post-traumatic endophthalmitis makes up a distinct subset of intraocular infections. The purpose of the present study was to identify the causative organisms and record the visual outcome after infectious endophthalmitis in eyes with penetrating trauma. methods: We reviewed 18 consecutive cases of culture-positive endophthalmitis that developed after penetrating ocular trauma. All cases were treated with pars plana vitrectomy and intravenous and intraocular antibiotics. RESULTS: The 15 males and 3 females ranged in age from 4 to 43 years (mean 25.1 /- 11 years). Nine (50%) had intraocular foreign bodies. A single species was isolated in 16 cases, and multiple organisms in two. staphylococcus epidermidis and gram-negative organisms were the most frequent and were cultured either alone or in association with other organisms in respectively five (27.7%) and four cases (22.2%). clostridium perfringens was isolated in three cases (16.6%). Bacillus was not found as a cause of endophthalmitis. Final visual acuity was better than 20/400 in eight cases (44%). In five cases (27.7%), the eye was saved but visual acuity was counting fingers. Two eyes (11%) had no light perception. The remaining three eyes (16.6%) were enucleated or eviscerated. clostridium perfringens was isolated from two eyes and aspergillus niger from one. Postoperative retinal detachment developed in four eyes, which were successfully operated. CONCLUSIONS: Organisms isolated in this series were similar to those in previous reports of post-traumatic endophthalmitis from other parts of the world, except that the frequency of clostridium perfringens isolation was high and no Bacillus species were cultured. In view of its devastating outcome, post-traumatic endophthalmitis must be treated promptly with vitrectomy and intravitreal antibiotics.- - - - - - - - - - ranking = 1keywords = post-traumatic (Clic here for more details about this article) |
2/10. Post-traumatic endophthalmitis involving clostridium tetani and Bacillus spp.PURPOSE: To report a case of post-traumatic infectious endophthalmitis caused by clostridium tetani and Bacillus spp. methods: Case report. RESULTS: A 25-year-old man developed endophthalmitis after a traumatic corneoscleral laceration of his right eye by a concrete reinforcement bar. He underwent pars plana lensectomy and vitrectomy with aspiration of vitreous fluid and a conjunctival swab for cultures. Cultures from the conjunctival swab were negative for organisms. Cultures of the vitreous aspirate were positive for Bacillus species and C. tetani. He had received a tetanus toxoid booster at the emergency department. By the time the culture results became available, he had developed severe eye pain associated with marked orbital congestion, increased swelling and erythema of the lids, marked injection and chemosis of the conjunctiva, and subsequently underwent evisceration. The inflammation resolved after evisceration of the right eye, and he was discharged to home on doxycycline 100 mg orally two times daily for 10 days. CONCLUSION: We are unaware of previous reports of endophthalmitis involving C tetani and could find none in a computerized medline search. patients with penetrating eye injury should be assessed for tetanus immunization status, and early intervention with tetanus toxoid booster and/or tetanus immune globulin should be considered if cultures are positive.- - - - - - - - - - ranking = 0.5keywords = post-traumatic (Clic here for more details about this article) |
3/10. Post-traumatic scedosporium inflatum endophthalmitis.This is the first documented case of post-traumatic scedosporium inflatum endophthalmitis and only the second of S. inflatum endophthalmitis occurring in a non-immunocompromised individual, to the authors' knowledge. A case is reported of a 57-year-old woman who, while chopping wood, had a wood chip hit her in the right eye. This caused a penetrating corneal injury with uveal prolapse and damage to the crystalline lens. There were also vitreous and suprachoroidal haemorrhages. No detectable intraocular foreign material was retained. The clinical manifestation of infection was delayed, but once established, it was very destructive. The initially indolent endophthalmitis eventually led to loss of all light perception and panophthalmitis which required enucleation. The responsible strain of S. inflatum was found to be resistant to all antifungal medication in vitro.- - - - - - - - - - ranking = 0.5keywords = post-traumatic (Clic here for more details about this article) |
4/10. Post traumatic polymicrobial endophthalmitis, including neisseria subflava.DESIGN: To report the second known case of post-traumatic endophthalmitis caused by neisseria subflava. DESIGN: Interventional case report. methods: A two-year-old child with post-traumatic corneal laceration and uveal prolapse required medical and surgical therapy for endophthalmitis caused by multiple organisms including N. subflava. RESULTS: After aggressive therapy, patient had a favorable outcome without vision compromise. CONCLUSIONS: As there is still not a standard protocol for therapy for post-traumatic endopthalmitis, we recommend the use of broad-spectrum antibiotics via intravitreal, intravenous, and topical routes. Consideration of typical and unusual bacteria that have been reported to cause endopthalmitis, as well as the source of injury, should guide antibiotic choice.- - - - - - - - - - ranking = 1.5keywords = post-traumatic (Clic here for more details about this article) |
5/10. pseudallescheria boydii keratitis.We treated a case of post-traumatic keratitis caused by the soil saprophyte, pseudallescheria boydii. The injury was caused by a wood splinter which produced a perforating corneal laceration that was primarily repaired. Signs of corneal infection were not evident until the fourth postoperative week. The organism was eradicated by topical miconazole and natamycin. Subsequent penetrating keratoplasty combined with cataract extraction and intraocular lens implantation has achieved a good visual outcome.- - - - - - - - - - ranking = 0.5keywords = post-traumatic (Clic here for more details about this article) |
6/10. Three cases of post-traumatic endophthalmitis caused by unusual bacteria.Three cases of post-traumatic endophthalmitis caused by unusual bacteria are presented. The pathogens identified were: (i) bacillus cereus and citrobacter freundii; (ii) pseudomonas fluorescens; and (iii) chryseobacterium meningosepticum and stenotrophomonas maltophilia. Two of these pathogens have not previously been reported to cause endophthalmitis. The available literature regarding the individual cases is summarized and a brief discussion of post-traumatic endophthalmitis is presented, with reference to a recently published large series at the authors' institution.- - - - - - - - - - ranking = 3keywords = post-traumatic (Clic here for more details about this article) |
7/10. Posterior keratoconus due to iron nail injury--a case report.A case of post-traumatic keratoconus is presented. This is an unusual variant of an uncommon disorder. Posterior keratoconus is a very rare ectatic dystrophy of the cornea. Since its first description in 1927, only a few cases have been described in the literature. Posttraumatic posterior keratoconus is a much rarer entity. We are reporting a case of posterior keratoconus caused by iron nail injury.- - - - - - - - - - ranking = 0.5keywords = post-traumatic (Clic here for more details about this article) |
8/10. Calcific phacolysis.BACKGROUND AND methods: The authors report the clinical and ocular histopathologic findings in three patients with longstanding unilateral post-traumatic blindness. After one or more decades, acute pain associated with conjunctival hyperemia and apparent keratoprecipitates or a hypopyon developed in the affected eye of each individual. Phacoanaphylaxis was diagnosed preoperatively in two patients. RESULTS: Calcified granular lens fragments were dispersed throughout all three eyes. The anterior chamber in all patients contained extracellular calcified lens particles, but only one eye contained conspicuous macrophages. Two eyes showed elevated intraocular pressure (IOP), and in one patient calcified particles extended into a glaucomatous optic nerve head. CONCLUSION: To the authors' knowledge, this is the first report describing a rare condition involving the intraocular dispersal of calcified lens particles after disruption of the lens capsule. The authors have designated this entity as calcific phacolysis.- - - - - - - - - - ranking = 0.5keywords = post-traumatic (Clic here for more details about this article) |
9/10. Useful visual outcomes after treatment of bacillus cereus endophthalmitis.PURPOSE: bacillus cereus endophthalmitis occurring after penetrating ocular trauma has been almost always associated with a poor visual outcome. The purpose of our study was to review and report patients who had useful visual acuity outcomes. methods: The study group consisted of five patients from a single medical center with penetrating ocular trauma and endophthalmitis caused by B. cereus. The study population was derived from a review of the microbiology records, clinical records, and operative reports of patients with culture-proven, post-traumatic endophthalmitis over a 15-year period. patients were only included if the final visual acuity outcomes were 20/200 or better. RESULTS: All five patients had penetrating ocular injuries, and four patients had a retained intraocular foreign body. endophthalmitis was diagnosed preoperatively in three patients and intraoperatively in two patients. All patients underwent pars plana vitrectomy and injection of intravitreal and periocular antibiotics. Postoperatively, a rhegmatogenous retinal detachment developed in three patients between 4 weeks and 12 months after the injury (average, 19 weeks); all retinal detachments were reattached with additional vitreoretinal surgery. Final postoperative visual acuities were 20/200 (two patients), 20/30 (one patient), and 20/25 (two patients). The postoperative follow-up time interval ranged from 12 months to 30 months (average, 19.2 months). CONCLUSION: The current series adds further support to the observation that certain eyes with post-traumatic B. cereus endophthalmitis may be associated with preservation of anatomic integrity and restoration of useful visual acuity.- - - - - - - - - - ranking = 1keywords = post-traumatic (Clic here for more details about this article) |
10/10. The use of tissue plasminogen activator in post-traumatic total hyphaema.BACKGROUND: We wanted to evaluate whether intracameral injection of tissue plasminogen activator (tPA) is useful in managing traumatic hyphaema. methods: Two eyes with total hyphaema after a severe penetrating injury were treated with a single intracameral injection of 25 micrograms of tPA 5 and 14 days after the injury, respectively. RESULTS: Most of the blood coagulum dissolved within 24 h, and in one of the two eyes the intraocular pressure decreased from 45 to 8 mmHg. The other eye was hypotonic. No re-bleeding or complications related to the use of tPA were noticed. CONCLUSION: The results in these two cases suggest that tPA is a useful adjunct in managing total hyphaema.- - - - - - - - - - ranking = 2keywords = post-traumatic (Clic here for more details about this article) |
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