1/30. Lung cancer, proptosis, and decreased vision.A 48-year-old man presented to the emergency department with a 3-day history of decreased vision in a painful proptotic right eye. The patient was being treated with chemotherapy and radiation for non-small cell lung carcinoma. Examination showed visual acuity of hand motions, decreased motility, and an afferent pupillary defect on the right, consistent with an orbital apex syndrome. neuroimaging revealed "dirty" orbital fat and no paranasal sinus disease. Orbital biopsy initially showed only fibrosis; however, on subsequent biopsies, nonseptate hyphae later identified as mucormycosis was recovered. The patient survived with exenteration and systemic amphotericin b.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
2/30. Providing timely and ongoing vision rehabilitation services for the diabetic patient with irreversible vision loss from diabetic retinopathy.BACKGROUND: diabetic retinopathy (DR) remains the leading contributor to severe vision loss in the united states among persons 20 to 70 years of age. Despite advances in disease management and treatment, patients with vision loss from DR continue to constitute a significant portion of patients served in vision rehabilitation service (VRS) settings. These patients present special challenges to VRS providers because of early onset, fluctuations in and the complex nature of vision loss, unique visual demands of disease management, and associated multi-system losses. case reports: After introductory epidemiologic review, a case presentation format is used to illustrate solutions a multidisciplinary VRS can offer the special visual challenges of the person with diabetes with vision loss from DR. Four patients are presented--ages 30 to 70 years--with varying degrees and types of vision loss, with different lifestyle demands and disease management needs. The cases address vocational issues, vision fluctuation, coordinating adaptive solutions to complex visual losses, and meeting diabetic needs to measure medication, insulin, and blood glucose levels, to maintain skin care, diet, exercise, transportation, family roles, and support systems. CONCLUSIONS: The unique and complex needs of people with diabetes who experience vision loss can be well addressed through timely and ongoing VRS consultations, in conjunction with medical/ocular disease management.- - - - - - - - - - ranking = 2.0708027165455keywords = ocular (Clic here for more details about this article) |
3/30. Chronic, traumatic intraconal hematic cyst of the orbit removed through the fronto-orbital approach--case report.A 22-year-old male presented with a chronic encapsulated intraorbital hematoma 3 months after blunt trauma to his left eyeball. Ophthalmological examination found the best corrected visual acuity was 4/20 in the left eye, and 20/20 in the right eye. The orbit exhibited exophthalmus and inability of the eye to move above the horizontal level. Orbital magnetic resonance imaging showed a fairly well-demarcated area in the medial aspect of the orbit appearing as hyperintense on T1-weighted images and isoto hyperintense on T2-weighted images. This area was believed to be hemorrhage. No other abnormalities were found. The diagnosis was hematic cyst. The cyst was approached through a left fronto-orbital route and its location identified within the periorbita and orbital fat. The cyst was removed partially. Histological examination demonstrated cystic accumulation of blood and breakdown products in a non-epithelium-lined fibrous capsule, compatible with hematic cyst. The presence of hemosiderin in the cyst wall suggested that the cyst was a chronically enlarging lesion. Hematic cysts of the orbit usually present as subperiosteal mass months to years after trauma. Surgical removal of the cyst wall rather than needle aspiration is recommended to prevent recurrence.- - - - - - - - - - ranking = 4keywords = eye (Clic here for more details about this article) |
4/30. Enhanced responsiveness of human extravisual areas to photic stimulation in patients with severely reduced vision.Lesions in the primary visual cortex induce severe loss of visual perception. Depending on the size of the lesion, the visual field might be affected by small scotomas, hemianopia, or complete loss of vision (cortical blindness). In many cases, the whole visual field of the patient is affected by the lesion, but diffuse light-dark discrimination remains (residual rudimentary vision, RRV). In other cases, a sparing of a few degrees can be found (severely reduced vision, SRV).In a follow-up study, we mapped visually induced cerebral activation of three subjects with SRV using functional magnetic resonance imaging. We were especially interested in the visual areas that would be activated if subjects could perceive the stimulus consciously although information flow from V1 to higher visual areas was strongly reduced or virtually absent. Because subjects were only able to discriminate strong light from darkness, we used goggles flashing intense red light at a frequency of 3 Hz for full visual field stimulation. Besides reduced activation in V1, we found activation in the parietal cortex, the frontal eye fields (FEF), and the supplementary eye fields (SEF). In all patients, FEF activation was pronounced in the right hemisphere. These patterns were never seen in healthy volunteers. In a patient who recovered completely, we observed that extrastriate activation disappeared in parallel with the visual field restitution. This result suggests that damage to the primary visual cortex changes the responsiveness of parietal and extravisual frontal areas in patients with SRV. This unexpected result might be explained by increased stimulus-related activation of attention-related networks.- - - - - - - - - - ranking = 2keywords = eye (Clic here for more details about this article) |
5/30. exercise-induced visual loss associated with advanced glaucoma in young adults.PURPOSE: To highlight the phenomenon of exercise-induced visual loss associated with advanced glaucoma and to discuss the possible underlying mechanisms. methods: Three young adult patients with congenital or juvenile-onset glaucoma presenting with visual loss which occurred during exercise underwent ophthalmic examination. In 2 cases, visual function parameters, including visual fields (Humphrey full threshold perimetry) were measured before and after exercise. RESULTS: All patients clearly described visual loss during exercise. In the 2 cases in which data were available, significant impairment in central visual acuity and reduced foveal sensitivity and mean deviation on visual field analysis occurred during exercise of mild to moderate intensity with complete or near complete recovery of visual function upon cessation of exercise. CONCLUSION: Young patients with advanced glaucomatous optic neuropathy should be questioned regarding exercise-induced visual disturbance. We hypothesise that a 'vascular steal' is the likely mechanism underlying this phenomenon. patients should be advised to limit activities which induce their symptoms, and therapeutic measures to promote ocular blood flow should be considered.- - - - - - - - - - ranking = 2.0708027165455keywords = ocular (Clic here for more details about this article) |
6/30. malignant atrophic papulosis. Report of a case with multiple ophthalmic findings.malignant atrophic papulosis is a rare and fatal condition with multiple organ involvement. We describe a patient with progressive ocular and dermatological findings.- - - - - - - - - - ranking = 2.0708027165455keywords = ocular (Clic here for more details about this article) |
7/30. Aggravation of proliferative diabetic retinopathy after laser in situ keratomileusis.We describe a patient with proliferative diabetic retinopathy who had laser in situ keratomileusis (LASIK). Rapid progression and pronounced aggravation of diabetic retinopathy occurred after LASIK, resulting in severe visual loss in both eyes.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
8/30. sphenoid sinus mucocele with recurrent visual disturbance.We present a case of sphenoid sinus mucocele with recurrent visual disturbance on the same side. A 22-year-old female showed two episodes of visual disturbance in the left eye for 3 months, and acute retrobulbar optic neuritis was diagnosed. With corticosteroid, visual disturbance improved in 1 week. MRI and CT scans showed mucocele in the left sphenoid sinus, and left optic nerve swelling with high intensity was observed in T2-weighted MRI. No destruction of the optic canal was found. The contiguous inflammation in the optic nerve rather than compression was considered as pathogenesis.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
9/30. cogan syndrome in children: early diagnosis and treatment is critical to prognosis.PURPOSE: To present two cases of pediatric cogan syndrome and to highlight the differences between the adult and pediatric forms of the disease, as well as the importance of early diagnosis and treatment. DESIGN: Interventional case report. methods: Institutional setting. RESULTS: Corneal lesions were much more diffuse than those observed in adult cogan syndrome. Immunosuppressive drug combination therapy successfully resolved systemic and ocular inflammation, but the involvement of the pupillary area caused permanent low vision in one case and amblyopia in the other. CONCLUSION: When chronic ocular inflammation is observed in association with sensory neural hearing loss and any systemic signs of autoimmune inflammation, a diagnosis of cogan syndrome should be suspected. If immunosuppressive treatment is not initiated as soon as possible, permanent low vision and deafness can result.- - - - - - - - - - ranking = 4.1416054330911keywords = ocular (Clic here for more details about this article) |
10/30. Free autologous buccal mucosal graft transplantation to treat ocular complications after toxic epidermal necrolysis: case report.BACKGROUND: Toxic epidermal necrolysis (TEN) can lead to ocular surface scarring associated with pain, dry eye symptoms, and decreased visual acuity that often are difficult to treat. history AND SIGNS: A 34-year-old woman was referred to our department two-years after TEN induced by lamotrigin (lamictal(R)). She was complaining of severe visual acuity loss, pain, and dry eye symptoms. visual acuity was reduced to light perception in the right eye (RE) and to 0.2 in left eye (LE). Basal Schirmer test was 2 mm in RE and 3 mm in LE. With or without therapeutic contact lenses, the patient was experiencing severe discomfort requiring tear supplementation up to 50 - 80 times/day in both eyes. THERAPY AND OUTCOME: A free autologous mucosal graft (3.5 x 2.0 cm) was transplanted from the lower lip into the upper RE fornix. Six months after surgery, with therapeutic contact lenses, the need for tear supplementation was markedly reduced to 3 - 4 times/day in RE while it remained unchanged in LE. In RE, slit-lamp examination revealed decreases in the corneal stromal edema and in the diameter of neo-vessels associated with an improvement of visual acuity (counting fingers at 30 cm). Basal Schirmer test values were unchanged. It has to be mentioned that the improvement observed after surgery was markedly dependent on wearing a therapeutic contact lens. CONCLUSIONS: Free autologous buccal graft transplantation (with its presumably accessory salivary glands) in association with the use of a therapeutic contact lens can be an efficient approach to treat ocular complication following drug-induced TEN (Lyell's syndrome).- - - - - - - - - - ranking = 17.424816299273keywords = ocular, eye (Clic here for more details about this article) |
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