1/7. Open-sky pupilloplasty during phakic penetrating keratoplasty to treat a fixed, dilated pupil.We report a technique in which penetrating keratoplasty is performed in conjunction with open-sky pupilloplasty in a phakic patient. The technique was used in a 27-year-old man with poor vision and severe light sensitivity in the left eye dating back to an episode of presumed herpes simplex keratouveitis 13 years previously. Examination showed a best corrected visual acuity of 20/40, a paracentral midstromal corneal scar, a fixed dilated pupil, and a clear lens. Postoperatively, the pupil was relatively round with a diameter of approximately 4.0 mm, the cosmetic result was favorable, the photophobia had resolved, and the lens and corneal transplant were clear.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
2/7. Accidental mydriasis from exposure to Angel's trumpet (Datura suaveolens).PURPOSE: To report clinical findings after accidental instillation into the eye of sap from Angel's trumpet (Datura suaveolens). methods: We report findings on seven patients who developed sudden onset of unilateral mydriasis. At least three of them also had ipsilateral cycloplegia and one developed transient tachycardia. RESULTS: The symptoms evolved after ocular exposure to sap from Angel's trumpet, a plant containing natural alkaloids with parasympatholytic properties. Six patients were initially unaware of the cause of their symptoms. In these cases, patient history revealed recent contact with Angel's trumpet. CONCLUSION: Accidental ocular instillation of sap from Angel's trumpet should be noted as a cause of sudden onset of mydriasis in otherwise unaffected patients and also of general symptoms like tachycardia.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
3/7. Angel's trumpet (Brugmansia arborea) and mydriasis in a child--a case report.We report a case of anisocoria in a 6-year old child who felt out of an inflatable swimming pool in the garden. After instillation of pilocarpine 1% the dilated pupil constricted, which is an important clinical sign associated with intracranial trauma. There was evidence of exposure to angel's trumpet (Brugmansia arborea), a plant known to contain anticholinergic substances. As the results of further neurological examination turned out to be normal, we believe the mydriasis was due to an accidental exposure to angel's trumpet. The time lag between exposure and presentation at the emergency room, the probably low volume of the plant extract in the eye and the unpredictable concentration of alkaloids in the plant, can influence and question the reliability of the pilocarpine test in this case.- - - - - - - - - - ranking = 3keywords = plant (Clic here for more details about this article) |
4/7. mydriasis due to Datura inoxia.Unilateral, dilated unresponsive pupil may be secondary to a wide range of ocular and neurological disorders. "Gardener's pupil" is a pharmacological mydriasis caused by exposure to plants containing alkaloids. We report a case of mydriasis related to Datura inoxia, and detail a number of plants that have toxic effects. This report emphasises the importance of accurate history taking when evaluating fixed dilated pupil. We recommend that labelling of such poisonous plants should detail the local and systemic effects of accidental exposure, rather than merely the fact that they are poisonous.- - - - - - - - - - ranking = 3keywords = plant (Clic here for more details about this article) |
5/7. Fixed, dilated pupil after phakic intraocular lens implantation.A 26-year-old man with degenerative high myopia had bilateral anterior chamber phakic intraocular lens (IOL) implantation under general anesthesia. The preoperative slitlamp examination was normal. No mydriatic drops were used before, during, or after the procedure. Postoperatively, the intraocular pressure (IOP) in the right globe increased to 60 mm Hg. After the IOP was controlled, the pupil became fixed and dilated. iris fluorescein angiography was obtained and delayed filling of the iris capillary plexus with large areas of no perfusion was observed in the right eye. Based on these findings, a diagnosis of Urrets-Zavalia syndrome was made. To our knowledge, this is the first report of Urrets-Zavalia syndrome after phakic IOL implantation.- - - - - - - - - - ranking = 6keywords = plant (Clic here for more details about this article) |
6/7. Cataractous changes due to posterior chamber flattening with a posterior chamber phakic intraocular lens secondary to the administration of pilocarpine.OBJECTIVE: To present the first reported case of cataract formation as a consequence of instillation of pilocarpine in an eye with a posterior chamber phakic intraocular lens (IOL). DESIGN: Interventional case report. INTERVENTION: A 46-year-old man received a hyperopic implantable collamer lens (ICL) bilaterally. MAIN OUTCOME MEASURES: Determination of best-corrected visual acuity (BCVA); contrast sensitivity testing with and without glare; and intraocular pressure (IOP), specular endothelial cell, and slit-lamp examinations were performed serially. In addition, the distance between the ICL and crystalline lens was measured with optical coherence tomography. RESULTS: Both eyes underwent uneventful ICL implantation for the correction of a manifest spherical equivalent of 7 diopters (D) in the right eye and 7.1 D in the left eye. The left eye was followed for 2 years without developing complications. The right eye, however, showed on the first postoperative day a fleckenlike opacification on the anterior pole of the crystalline lens after instillation on the operative day of 2% pilocarpine in an attempt to accelerate recovery from unwanted pupil dilation causing patient complaints of glare disability after surgery. Optical coherence tomography demonstrated complete contact of the ICL with the natural lens 24 hours postoperatively. Serial IOP measurements were always within the normal limits. The instillation of 1% cyclopentolate resulted in an increase in the ICL vault that measured 132 mum 24 hours later. Three days after the completion of a 3-day course of topical 1% cyclopentolate, the opacification was less dense and demarcated, and a 124-mum vault was measured. Three months postoperatively, the cataract was associated with a 3-line loss of BCVA and considerable degradation of the contrast sensitivity, especially at higher spatial frequencies and with a glare source, and corneal endothelial cell changes were within normal limits. One year after ICL implantation, the right eye had to undergo phacoemulsification and IOL implantation, which were uneventful. CONCLUSIONS: Posterior chamber flattening with resulting crystalline lens opacification can occur immediately after the instillation of pilocarpine in an eye with a hyperopic ICL. Therefore, caution should be taken with the administration of cholinergic agonists such as pilocarpine in patients with phakic IOLs, at least if they are hyperopic ICLs.- - - - - - - - - - ranking = 4keywords = plant (Clic here for more details about this article) |
7/7. atropine intoxication from the ingestion and smoking of jimson weed (datura stramonium).Anticholinergic effects occur due to jimson weed intoxication. The most common intoxication involves teenagers desiring mind-altering properties from the plant. We report 4 cases of jimson weed intoxication due to ingestion and inhalation (smoking) of jimson weed. Clinicians should be aware of the potential abuse of botanicals such as jimson weed.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |