1/193. Rotoextractor evacuation of total hyphema. hyphema was created in ten albino rabbits and removed within an hour by the Douvas Rotoextractor. All the blood was gone from each eye within 48 hours and there was no evidence of damage to iris, cornea or lens after six weeks. One patient underwent Douvas Rotoextractor removal of a hyphema that was causing increased intraocular pressure and corneal staining. Three months postoperatively, vision was 6/7.5 and intraocular pressure was controlled. ( info) |
2/193. Endocapsular hematoma: report of a case following glaucoma surgery in a pseudophakic eye. The authors describe a case of an endocapsular hematoma that occurred in a 69-year-old pseudophakic diabetic male following mitomycin C (MMC) augmented trabeculectomy for neovascular glaucoma (NVG). The clinical course of the patient is described, and the unique features of this case are presented and discussed. The endocapsular hematoma absorbed in 6 weeks with conservative management. The patient regained the preoperative visual acuity of 20/30, and his intraocular pressure was controlled without any glaucoma medication. The iris neovascularization regressed. This case is the first report of an endocapsular hematoma following glaucoma filtering surgery in a pseudophakic eye with neovascular glaucoma. ( info) |
3/193. Photocoagulation of iris nevus to control recurrent hyphema. PURPOSE: To report a case of recurrent hyphema caused by an iris nevus that was successfully treated with photocoagulation. METHOD: Case report. In a 30-year-old woman with recurrent hyphema secondary to an iris nevus, photocoagulation was applied to the iris nevus. RESULTS: Before photocoagulation of the iris nevus, the patient had increasing frequency of hyphema episodes. After treatment, no hyphema episodes occurred during 13 months of observation. CONCLUSION: Photocoagulation of the surface of an iris nevus may prevent recurrent hyphema. ( info) |
4/193. hyphema associated with pupillary dilation in a patient with exfoliation glaucoma and warfarin therapy. PURPOSE: To describe an unusual hemorrhagic complication associated with pupillary dilation in a patient with exfoliation glaucoma taking anticoagulation therapy. methods: A 78-year-old woman with bilateral exfoliation glaucoma who was receiving warfarin, 2 mg daily, for systemic anticoagulation developed acute visual loss in the right eye several hours after pupillary dilation. RESULT: Examination disclosed bilateral advanced exfoliation glaucoma, localized vascularized iridolenticular adhesions in the right eye, and a 4-mm layered hyphema in the right eye. CONCLUSION: patients with exfoliation glaucoma and vascularized posterior synechiae who are receiving anticoagulation therapy are at increased risk for visually significant spontaneous hyphema after pupillary dilation. ( info) |
5/193. Transpupillary argon laser cyclophotocoagulation in the treatment of traumatic glaucoma. PURPOSE: A patient with traumatic glaucoma who underwent transpupillary argon laser cyclophotocoagulation for management of uncontrolled intraocular pressure (IOP) despite maximally tolerated medical therapy is discussed. methods: In this patient, pars plana vitrectomy, lensectomy, and removal of 180 degrees of necrotic iris had been performed after a blunt trauma with a bungee cord. Six weeks after surgery, the patient presented with an IOP of 40 mmHg despite therapy with three aqueous suppressants. The patient refused further surgical intervention and opted for transpupillary argon laser cyclophotocoagulation (talc). The laser setting was 1,000 mW, with a 50-micron spot size for 0.1 second. A total of 293 laser exposures through a Goldmann contact lens was administered to all visible ciliary processes over 180 degrees where iris structures were absent. RESULTS: Ten weeks after talc, the patient's IOP remained controlled with medications at 16 mmHg, and visual acuity had improved to 20/25 with an aphakic contact lens. CONCLUSION: In selected patients whose ciliary processes are visible with indirect gonioscopy due to the defect in the iris, talc may be an effective alternative cyclodestructive procedure to lower IOP when conventional medical or laser treatments are not successful. ( info) |
6/193. eye injuries associated with paintball guns. AIMS: This study identifies the various types of ocular injuries sustained after blunt trauma with a paintball fired from a paintball gun. methods: We report two patients who sustained injury to an eye after being shot with a paintball and review similar cases presented in the world literature. The type of injury sustained and the final visual acuity obtained after a paintball hit to the eye are examined. RESULTS: The two boys presented were hit in the eye with a paintball resulting in lens subluxation, hyphema formation, and angle recession. cataract extraction was required in both cases. One boy also had an optic neuropathy and a choroidal rupture. A review of the literature reveals a variety of injuries occur after a paintball hit to the eye. In some of the cases, the damage to the eye has led to loss of vision and at times loss of the eye. CONCLUSIONS: Paintball guns can cause devastating ocular injuries. Wearing protective eye and face gear during this game is essential. We recommend that an anti-fog face mask with a one-piece polycarbonate eye shield be worn by those participating in paintball games. ( info) |
| PURPOSE: To report a 63-year-old man with a retained intraocular foreign body who developed a hyphema during magnetic resonance imaging (MRI) of the brain. methods: Case report and review of the current literature on ocular injury caused by intraocular foreign bodies when subjected to an electromagnetic field. RESULTS: Our patient underwent a brain MRI, and the intraocular foreign body caused a hyphema and increased intraocular pressure. The presence and location of the intraocular foreign body were determined by computed tomography (CT). CONCLUSION: magnetic resonance imaging can cause serious ocular injury in patients with ferromagnetic intraocular foreign bodies. This case demonstrates the importance of obtaining an occupational history, and, when indicated, a skull x-ray or CT to rule out intraocular foreign body before an MRI study. ( info) |
8/193. Pitfalls in the management of a child with mild haemophilia A and a traumatic hyphaema. A 12-year-old boy presented with a traumatic hyphaema that failed to settle with the standard treatment. Subsequent investigation showed that despite a normal APTT, he had a low factor viii:C. Treatment with DDAVP precipitated further bleeding despite correction of the fVIII:C to normal, possibly caused by the vasodilation induced by the therapy. Bleeding was effectively treated with recombinant fVIII concentrate. DDAVP may be contraindicated in mild Haemophilia and von Willebrand patients for treatment of traumatic hyphaema. ( info) |
| iris varix is rare and little is known about its clinical characteristics. We treated a thrombosed iris varix that simulated an iris melanoma. A 53-year-old man developed a dark brown iris mass and hyphema in his left eye. Ultrasound biomicroscopy revealed a circumscribed mass of the iris stroma. Because of suspicion for melanoma, it was removed by sector iridectomy. Histopathologic examination disclosed an extensive focus of stromal hemorrhage, partially surrounded by endothelial cells that showed immunoreactivity to vascular markers. The histopathologic diagnosis was thrombosed iris varix. iris varix is a rare condition that should be included in the differential diagnosis of iris melanoma. ( info) |
10/193. Partial dislocation of laser in situ keratomileusis flap by air bag injury. PURPOSE: A patient developed significant corneal complications from air bag deployment, 17 months after laser in situ keratomileusis (LASIK). methods: Case report, slit-lamp microscopy, and review of the medical literature. RESULTS: A 37-year-old woman underwent bilateral LASIK with resultant 20/20 uncorrected visual acuity. Seventeen months later, she sustained facial and ocular injuries from air bag deployment during a motor vehicle accident. Examination revealed bilateral corneal abrasions, partial dislocation of the right corneal LASIK flap, and a hyphema in the right eye. The LASIK flap was realigned, but recovery was complicated by a slowly healing epithelial defect and flap edema. One month following the injury, epithelial ingrowth beneath the LASIK flap was noted. Surgical elevation of the flap and removal of the epithelial ingrowth was performed. Eight months later, epithelial ingrowth was absent and the visual acuity was 20/40. Residual irregular astigmatism necessitated rigid gas permeable contact lens fitting to achieve 20/20 visual acuity. CONCLUSIONS: air bags may cause significant ocular trauma. The wound healing response of LASIK allows corneal flap separation from its stromal bed for an indeterminate time after surgery. Discussion of the possible risk of corneal trauma as part of informed consent prior to LASIK may be appropriate. ( info) |