1/11. Phototherapeutic keratectomy for Schnyder's crystalline corneal dystrophy.PURPOSE: To describe the treatment of Schnyder's crystalline dystrophy (SCD) with excimer laser phototherapeutic keratectomy (PTK). methods: Chart review of three patients (four eyes) with SCD treated with PTK between March 1992 and December 1998. Pre- and posttreatment visual acuity, subjective glare, photophobia, manifest refraction, ultrasound pachymetry, hyperopic shift, and biomicroscopic findings were studied. Brightness acuity testing (BAT) was evaluated in two eyes. RESULTS: Four eyes were treated during the study period. The average best corrected visual acuity (BCVA) improved from 20/175 to 20/40 under bright conditions. All patients reported subjective improvement in glare and photophobia. No visually significant recurrence was observed during the follow-up period which ranged from seven months to three years. The mean spherical equivalent refractive shift was 3.28 diopter (D). One patient developed irregular astigmatism from an eccentric ablation. No vision threatening complications were observed. CONCLUSION: PTK can be effective at improving visual symptoms in patients with SCD. It can be a useful therapeutic alternative to lamellar or penetrating keratoplasty in these patients.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
2/11. Successful cognitive-behavioral habituation training toward photophobia in photogenic partial seizures.We report on the cognitive-behavioral treatment of a 12-year-old boy with photogenic partial seizures with secondary generalization who had developed phobic avoidant behavior toward all kinds of situations with potential photostimulation, leading to serious impairments of life quality. Based on a behavioral analysis of seizure and anxiety reaction, a habituation training (systematic desensitization procedure) was developed and performed, while maintaining protection against seizures with antiepileptic pharmacotherapy. The treatment was to gradually increase exposure to computer monitor and television screen photostimulation, closely adjusted to the level of subjective distress and tolerance. In addition to exercising control of photogenic input by regulating the monitor control button, rapid relaxation and imagery techniques were taught and applied as countermeasures at the onset of seizure precipitants. The treatment resulted in complete remission of phobic anxieties and responses and may also have facilitated ongoing seizure control after termination of antiepileptic medication.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
3/11. 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 = vision (Clic here for more details about this article) |
4/11. Bilateral panuveitis in a child with hypohidrotic ectodermal dysplasia.PURPOSE: To report a case of bilateral panuveitis in a patient with hypohidrotic ectodermal dysplasia. DESIGN: Interventional case report. methods: A 6-year-old African-American boy with hypohidrotic ectodermal dysplasia presented with pain, photophobia, and decreased vision in both eyes. RESULTS: Findings included severe bilateral panuveitis with optic disk edema, macular epiretinal membrane, peripheral retinal vasculitis, and retinitis. All other known causes of panuveitis were explored and ruled out. CONCLUSIONS: The abnormal development of tissues of ectodermal origin evident in hypohidrotic ectodermal dysplasia may include a predisposition to panuveitis.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
5/11. Idiopathic limbal stem cell deficiency.PURPOSE: To describe and to characterize the clinical findings and prognosis of patients with idiopathic limbal stem cell deficiency (LSCD). DESIGN: Retrospective case series. PARTICIPANTS/methods: We reviewed records from seven patients whose LSCD had been diagnosed clinically and confirmed by impression cytology and in whom the cause of LSCD was never identified. A detailed history, clinical records, and results of slit-lamp biomicroscopy, photography, vital staining, and impression cytology were evaluated. RESULTS: Six of seven patients (86%) were women, indicating a female predominance. Two patients were from the same family, whereas one other had a positive family history. Severe photophobia was noted in all patients and reduced vision in three patients. The main clinical findings included superficial vascularization, worse in the superior followed by the inferior and nasal cornea. The limbal regions showed a loss of limbal palisades of Vogt, and the adjacent peripheral cornea revealed an irregular and hazy epithelium with positive late fluorescein staining and the presence of conjunctival goblet cells by impression cytology. LSCD was bilateral in all patients but asymmetric in four. During a mean follow-up of 6.1 /- 3.8 years, the visual acuity decreased in both eyes of one patient after cataract extraction and in both eyes of two other patients without surgery. The process of conjunctivalization advanced in four patients (57%) and remained stable in three (43%) without surgical intervention. CONCLUSIONS: Idiopathic LSCD is a rare and as yet poorly recognized clinical entity, and the findings reported herein may help explore how progressive loss of limbal stem cells occurs. Correct diagnosis of idiopathic LSCD is important so that the patient will not be subjected to unnecessary surgeries, which may actually severely worsen the clinical course.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
6/11. Acute conjunctival inflammation following contact with squashed spider contents.PURPOSE: To report the effects to the eye following contact with spider contents. DESIGN: Observational case report. methods: A 46-year-old man presented with a painful and inflamed eye after contents of a spider got into his right eye when he squashed the spider with a newspaper. He suffered immediate severe pain in the eye, which rapidly became red and swollen. He had conjunctival edema and periorbital swelling of the eye and severe photophobia, but his vision was normal. RESULTS: Topical local anesthetic was applied to the right eye, which was then flushed with normal saline for an hour. The redness and swelling began to resolve over 2 hours. CONCLUSIONS: Ocular exposure to the contents of a spider can cause severe pain, swelling, and redness associated with photophobia. The effects are short term, so reassurance, irrigation, and symptomatic treatment are sufficient.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
7/11. Multiple evanescent white dot syndrome and acute zonal occult outer retinopathies.BACKGROUND: Multiple evanescent white dot syndrome (MEWDS) is a rare, acute, multifocal retinitis located in the posterior pole. patients with MEWDS may report photopsia, central scotoma, or decreased vision. Prodromal viral-like symptoms may be associated with this syndrome, but its etiology remains unknown. The condition is self limiting with a favorable prognosis for visual recovery within several weeks. CASE REPORT: A young, myopic, female patient presented with painless photopsia, scotoma, and subsequent vision loss secondary to MEWDS. The clinical appearance, differential diagnosis, and management of MEWDS are discussed. DISCUSSION: Careful ophthalmoscopic and angiographic interpretation along with complete history taking are the keys to diagnosing MEWDS. Ancillary testing including electroretinogram, early receptor potential, and visual fields aid in the differential diagnosis. Once the diagnosis has been established, patient reassurance is appropriate in the management of this condition.- - - - - - - - - - ranking = 2keywords = vision (Clic here for more details about this article) |
8/11. Ocular findings in ichthyosis follicularis-alopecia-photophobia (IFAP) syndrome.PURPOSE: To report the ocular findings in two siblings with IFAP and their mother and to review the natural course of the keratopathy of this disease. methods: Clinical ophthalmological examination of all patients and fundus photography of the carrier mother were performed. RESULTS: Both affected male children had severe photophobia, total superficial and deep corneal vascularization, and reduction of vision to counting fingers.The mother had tortuous retinal vessels. CONCLUSIONS: Males with IFAP have an inexorable progression of corneal vascularization and loss of vision. Retinal vascular tortuosity may be another clinical sign of carrier status in females.- - - - - - - - - - ranking = 2keywords = vision (Clic here for more details about this article) |
9/11. Progressive cone dystrophy and sensorineural hearing loss.A 39-year old man presented 13 years ago with a history of progressive loss of vision and photophobia. A full ophthalmological and ENT work-up during several years of follow-up, including psychophysical as well as electrophysiological tests, revealed a progressive cone dystrophy in combination with sensorineural hearing loss. His younger sister presented with very similar features and underwent the same work-up. A novel syndrome of progressive cone dystrophy and sensorineural hearing loss is described in both siblings. Both also suffered from non-ocular disease possibly related to ciliary dysfunction. The condition is likely to be inherited as an autosomal recessive trait.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
10/11. corneal perforation during laser blepharoplasty.A 61-year-old woman presented with photophobia, pain, epiphora, and decreased vision as a result of two iatrogenic corneal perforations sustained during carbon dioxide laser blepharoplasty. The management and course of the case are outlined. Laser blepharoplasty complications are reviewed. This case highlights the potential occurrence of corneal penetration with laser blepharoplasty. Meticulous awareness of the laser effects on periocular tissue must be kept in mind at all times during laser blepharoplasty to avoid unnecessary intraocular side effects and undesirable postoperative outcomes.- - - - - - - - - - ranking = 1keywords = vision (Clic here for more details about this article) |
| | Next -> |