1/8. Amniotic membrane transplantation for corneal perforation related to vitamin a deficiency.corneal perforation is one of the most vision-threatening consequences of vitamin a deficiency. Amniotic membrane transplantation was performed in a 36-year-old man who presented with bilateral corneal ulcers. There was a small, sharply demarcated superficial ulcer with crevices of surrounding keratinized epithelium converging on the ulcer and minimal infiltration at the inferior periphery of the right cornea. A 3-mm perforation on a 9 x 7-mm area of stromal melting was noticed in the left cornea. The serum vitamin A level was 14.0 microg/dL (normal, 24.57 to 105.71 microg/dL) at presentation. A biopsy of the right corneal epithelium was performed to confirm the diagnosis. Multilayered amniotic membrane transplantation with debridement of the necrotic corneal stroma was performed on the left cornea. In addition to systemic vitamin A replacement, topical antibiotics and lubricants were also administered. The cornea ulcers healed in 10 days along with the restoration of the serum vitamin A level. The visual acuity improved from 20/250 to 20/20 in the right eye and from light perception to hand movement in the left eye at 3 months. Amniotic membrane transplantation could save eyes with corneal perforation related to vitamin a deficiency before reconstructive surgeries, such as penetrating keratoplasty, are necessary.- - - - - - - - - - ranking = 1keywords = corneal ulcer, ulcer (Clic here for more details about this article) |
2/8. adult blindness secondary to vitamin a deficiency associated with an eating disorder.OBJECTIVE: We examined an adult patient who lost one eye due to severe keratomalacia secondary to self-induced vitamin a deficiency. methods: This case report provides a clinical, ophthalmologic, and laboratory description in addition to a review of the medical literature. RESULTS: A 33-y-old woman with a 17-y history of an eating disorder presented with bilateral conjunctival xerosis, an infected corneal ulcer in the right eye and a large descemetocele in the left eye. Laboratory and clinical findings were consistent with vitamin a deficiency. Despite a tectonic penetrating keratoplasty, her left eye perforated and had to be eviscerated. In parallel, vitamin A replacement improved her clinical status and the ocular findings in her right eye. CONCLUSIONS: The present report indicates that vitamin a deficiency secondary to eating disorders should be considered in the differential diagnosis of patients with severe dry eye and corneal ulceration.- - - - - - - - - - ranking = 1.9929355575879keywords = corneal ulcer, ulcer (Clic here for more details about this article) |
3/8. corneal perforation in patients with vitamin a deficiency in the united states.An emaciated alcoholic 52-year-old white woman presented with an old left corneal perforation and bilateral conjunctival and corneal xerosis. The serum vitamin A level was 0 mumol/L. Laboratory and radiologic findings were consistent with the diagnosis of a fat malabsorptive syndrome secondary to chronic alcoholic pancreatitis. Histopathologic evaluation of her enucleated globe revealed conjunctival epidermidalization, corneal perforation with prolapse and loss of intraocular contents, retinal detachment, and massive choroidal hemorrhage. A second patient presented with bilateral conjunctival xerosis, corneal ulcers, and a low serum vitamin A level. corneal perforation of one ulcer ensued during her hospitalization. Medical investigation revealed hepatic metastases of an unknown primary source. Causes of vitamin a deficiency and its ocular complications as well as medical and surgical management options are discussed.- - - - - - - - - - ranking = 0.99764518586264keywords = corneal ulcer, ulcer (Clic here for more details about this article) |
4/8. xerophthalmia and cystic fibrosis.We treated two infants with failure to thrive who presented with clinical evidence of conjunctival and corneal xerosis. One patient was referred with possible infectious corneal ulcer thought to exist because there were deep peripheral ulcerations of the cornea and associated hypopyon. The other patient was initially thought to have a nasolacrimal duct obstruction because of excessive tearing. xerophthalmia secondary to vitamin a deficiency was suspected and led to the diagnosis and treatment of cystic fibrosis in each case. Therapy with vitamin A promptly resolved the xerosis, but it also caused a transient rise in intracerebral pressure. xerophthalmia can still be a problem in developed countries when underlying disorders, such as cystic fibrosis, lead to vitamin A malabsorption.- - - - - - - - - - ranking = 0.99764518586264keywords = corneal ulcer, ulcer (Clic here for more details about this article) |
5/8. Corneal ulceration, measles, and childhood blindness in tanzania.One hundred and thirty Tanzanian children with corneal ulceration were clinically examined to determine the cause of the ulceration. 37% of the ulcers were associated with recent measles infection and 38% of the children had bilateral ulceration. herpes simplex virus infection was the commonest cause of ulceration in the series, but vitamin a deficiency was the major cause of bilateral ulceration, subsequent blindness, and mortality in this series. Other significant causes of childhood corneal ulceration were the use of traditional eye medicines, confluent measles keratitis, and ophthalmia neonatorum. We discuss the various mechanisms by which measles causes corneal ulceration, and the priorities in prevention and management of corneal ulceration in African children.- - - - - - - - - - ranking = 3.996467778794keywords = corneal ulcer, ulcer (Clic here for more details about this article) |
6/8. Clinicohistopathologic correlations in xerophthalmic ulceration and necrosis.Corneal tissue from five eyes of three children with active xerophthalmic keratopathy and stromal loss was studied histopathologically. Stromal dissolution was strikingly focal, sometimes occurring beneath an intact epithelium and often, though not always, accompanied by extensive inflammatory reaction and bacteria.- - - - - - - - - - ranking = 0.0047096282747189keywords = ulcer (Clic here for more details about this article) |
7/8. Conjunctival appearance in corneal xerophthalmia.We studied the appearance of conjunctiva in 50 consecutive cases of vitamin A-responsive conjunctival xerosis (X1) and 162 consecutive cases of nutritional keratopathy (corneal xerosis [X2] and stromal loss [X3]). conjunctival xerosis, most extensive at or shortly after the onset of frank corneal involvement, was present in 101 (95%) of 106 eyes of cases of X2 but in only 99 (64%) of 155 ulcerated/necrotic eyes (X3A and X3B). Forty-four percent of involved eyes were inflamed, the percentage increasing with the severity of corneal disease. In 20 patients with nutritional keratopathy, conjunctival xerosis was monocular: inflammation was more prevalent and corneal involvement more severe in the nonxerotic eyes. In patients with precipitous deterioration of vitamin A status, clinically recognizable alterations of the cornea sometimes developed before any changes appeared in the conjunctiva.- - - - - - - - - - ranking = 0.0011774070686797keywords = ulcer (Clic here for more details about this article) |
8/8. Bilateral corneal ulcers in primary vitamin a deficiency.PURPOSE: To report a case of bilateral corneal ulcers and perforations resulting from hypovitaminosis A in an alcoholic patient. methods: A 38-year-old cachetic man presented with bilateral corneal ulcerations and severe visual loss. He was hospitalized, developed bilateral corneal perforations, and was treated with bilateral corneal transplants. RESULTS: serum vitamin A level was 0.01 microg/dL (normal, 0.30-0.75). The electroretinogram was consistent with vitamin a deficiency. His clinical status improved after vitamin A replacement. CONCLUSIONS: Although rare in developed countries, the ophthalmologist must consider avitaminosis A in the differential diagnosis of corneal ulcerations in cachetic, alcoholic, or chronically ill patients. early diagnosis and treatment can prevent unwanted outcomes.- - - - - - - - - - ranking = 6.9752744515577keywords = corneal ulcer, ulcer (Clic here for more details about this article) |