1/18. Ocular jellyfish stings.BACKGROUND: Corneal stings from the sea nettle (Chrysaora quinquecirrha) indigenous to the Chesapeake Bay are usually painful but self-limited injuries, with resolution in 24 to 48 hours. methods: Five patients who developed unusually severe and prolonged iritis and intraocular pressure elevation after receiving corneal sea nettle stings were followed for 2 to 4 years. RESULTS: Decreased visual acuity, iritis, and increased intraocular pressure (32 to 48 mmHg) were noted in all cases. iritis responded to topical corticosteroids and resolved within 8 weeks. Elevated intraocular pressure responded to topical beta blockers and oral carbonic anhydrase inhibitors. mydriasis (4 of 5 cases), decreased accommodation (2 of 5 cases), peripheral anterior synechiae (2 of 5 cases), and iris transillumination defects (3 of 5 cases) also were noted. mydriasis and decreased accommodation persisted for 5 months in 1 case and for more than 2 years in another. One patient has chronic unilateral glaucoma. visual acuity returned to normal in all cases. CONCLUSIONS: The precise relationship between sea nettle venom and the observed clinical responses is not known. Corneal jellyfish stings usually produce a brief and self-limited reaction, but they do have the potential for long-term sequelae.- - - - - - - - - - ranking = 1keywords = iris (Clic here for more details about this article) |
2/18. Ocular manifestations in Blau syndrome associated with a CARD15/Nod2 mutation.PURPOSE: To report cases of Blau syndrome with a CARD15/Nod2 mutation. DESIGN: Observational and interventional case report. PARTICIPANTS: A 10-year-old Japanese boy (proband) was seen with secondary angle-closure glaucoma (iris bombe), uveitis, skin rashes, and camptodactyly. His sister had posterior synechia and camptodactyly. She had iritis in both eyes during the follow-up period. Both eyes of the father were phthisical because of granulomatous uveitis and secondary glaucoma. The father also had camptodactyly. methods: Surgery was performed to release the iris bombe. Ocular inflammation was treated by topical and systemic steroids. biopsy specimens from the skin rash and from the iris (from iridectomy) were obtained from the proband. Genetic analyses were performed on the proband, his sister, and their mother for a CARD15/Nod2 mutation. MAIN OUTCOME MEASURES: Clinical features, pathologic findings of the skin and iris specimens, and genetic analysis of the CARD15/Nod2 gene. RESULTS: phacoemulsification, intraocular lens implantation, and peripheral iridectomy released the iris bombe. The biopsy specimen from the skin rash showed noncaseating, granulomatous infiltration with epithelioid cells and lymphocytes. The iridectomy specimen showed nonspecific inflammation. Systemic and topical steroid therapy partly reduced the ocular inflammation. Genetic analyses showed that the proband and his sister had an R334W mutation in the CARD15/Nod2 gene, but their mother was of the wild type. CONCLUSIONS: Blau syndrome should be considered in the differential diagnosis of childhood uveitis. Genetic analysis of the CARD15/Nod2 gene is helpful in the diagnosis.- - - - - - - - - - ranking = 5keywords = iris (Clic here for more details about this article) |
3/18. Acquired heterochromia with horner syndrome in two adults.BACKGROUND: Heterochromia iridis, asymmetry of iris pigmentation, has been well described with congenital horner syndrome. Acquired heterochromia associated with lesions in the ocular sympathetic pathways in adulthood, however, is rare. methods: Two cases are reported in which sympathectomy in adults resulted in ipsilateral horner syndrome with heterochromia. In each case, pharmacologic testing with cocaine and hydroxyamphetamine was performed. RESULTS: In both cases, sympathectomy occurred at the level of the second order neuron, but hydroxyamphetamine testing suggested at least partial third order neuron involvement. CONCLUSION: Acquired heterochromia can occur in adults. The partial response to hydroxyamphetamine in the two cases presented may reflect trans-synaptic degeneration of the postganglionic neuron. A reduction in trophic influences on iris melanocytes may have contributed to the observed heterochromia.- - - - - - - - - - ranking = 2keywords = iris (Clic here for more details about this article) |
4/18. Recurrent iritis after implantation of an iris-fixated phakic intraocular lens for the correction of myopia Case report and clinicopathologic correlation.The iris-claw intraocular lens (IOL) was recently approved by the U.S. food and Drug Administration for the correction of refractive disorders. Previous reports are not uniform regarding its potential to induce inflammatory reaction. We report the case of a young healthy patient who experienced persistent and intolerable iritis after implantation of an iris-claw IOL. The iritis was resolved only after explantation of the IOL.- - - - - - - - - - ranking = 6keywords = iris (Clic here for more details about this article) |
5/18. histoplasma capsulatum endophthalmitis after cataract extraction.A 60-year-old white man from an area endemic for histoplasma capsulatum presented with a vitreous wick, hypopyon iritis, and dense vitreitis 2 months after removal of an anterior chamber intraocular lens (IOL) for chronic iritis. A diagnostic vitrectomy was performed and H. capsulatum was cultured and identified 2 weeks later. Despite intravitreal and intravenous amphotericin as well as repeat vitrectomies, the inflammation worsened and the eye was removed. Results of histopathologic examination showed histoplasma organisms along the vitreous wick, over the surface of the iris and ciliary body, and over the retina. No organisms were found in the choroid. Dalen-Fuchs-type nodules similar to those of sarcoid also were noted, but there was no evidence of granulomatous inflammation in the uvea. Because of his unilateral disease with histoplasma in the vitreous wick, negative serology, and an absence of systemic infection, the authors believe that this patient had a previously unreported form of ocular histoplasma, exogenous postoperative histoplasma endophthalmitis.- - - - - - - - - - ranking = 1keywords = iris (Clic here for more details about this article) |
6/18. Leukemic iritis with hypopyon.A patient with acute lymphoblastic leukemia who had received CNS sanctuary treatment with cranial X-irradiation and intrathecal methotrexate displayed his first sign of relapse as iritis with malignant hypopyon. Treatment included topical and subconjunctival corticosteroids and local X-irradiation. leukemic infiltration of the iris may be the first sign of leukemic relapse. Slit-lamp examination should be performed in all leukemic patients with ocular symptoms.- - - - - - - - - - ranking = 1keywords = iris (Clic here for more details about this article) |
7/18. Pseudophakic posterior iris chafing syndrome.Posterior iris chafing by the loop or the optic portion of sulcusfixated posterior chamber lens implants may cause a spectrum of disorders that include iris-pigment epithelial "window defects," pigment dispersion with or without elevation of intraocular pressure, intermittent microhyphemas with transient visual obscurations, and the UGH syndrome. It appears that secondary pigmentary glaucoma is more likely with planar loop design than with angulated loops. Optic and loop materials may play a role in the development of the disorder. Implantation of both supporting loops of the implant within the capsular bag is suggested to prevent posterior iris chafing.- - - - - - - - - - ranking = 7keywords = iris (Clic here for more details about this article) |
8/18. Pseudomelanoma of the iris in herpes simplex keratoiritis.A 37-year-old white man with a long history of recurrent herpetic keratitis presented with a rapidly enlarging pigmented iris lesion. The primary diagnostic concern was that the lesion might be a malignant melanoma. A biopsy of the mass was done and proved it to be a granuloma with granulomatous arteritis and infarction of the iris. In a patient with a history of recurrent ocular inflammation, such a hypersensitivity granuloma should be considered in the differential diagnosis of iris melanoma.- - - - - - - - - - ranking = 7keywords = iris (Clic here for more details about this article) |
9/18. Metastatic tapioca iris melanoma.A case of metastatic tapioca melanoma of the iris in a 12-year-old girl is reported. The patient had heterochromia, a red painful eye, and was treated for iritis with secondary glaucoma. In the course of 5 months iris lesions with the clinical appearance of tapioca pudding developed, and biopsy disclosed a melanoma. The eye was immediately enucleated, and pathological examination showed a melanoma with predominantly epithelioid-type cells which had infiltrated the angle, the posterior chamber, and the surgical wounds. Conjunctival extension was noted 10 months after enucleation, and regional lymph node metastases were found 4 months later. Previously reported cases are reviewed and compared with the present case.- - - - - - - - - - ranking = 6keywords = iris (Clic here for more details about this article) |
10/18. association of foveomacular retinitis, ankylosing spondylitis, iritis, and acquired iris atrophy.A case of foveomacular retinitis, ankylosing spondylitis, iritis, and iris dissociation is described. Only ankylosing spondylitis was present in other family members. The differential diagnosis is discussed. The iritis of ankylosing spondylitis must be considered in cases of developmental full-thickness iris holes.- - - - - - - - - - ranking = 6keywords = iris (Clic here for more details about this article) |
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