Cases reported "Blindness"

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1/10. Sudden blindness secondary to injections of common drugs in the head and neck: I. Clinical experiences.

    Several cases of sudden, irreversible blindness have been reported in the world literature following injections of various drug combinations in the head and neck. The common feature these drugs have is their capacity to either produce direct neurotoxic effects or embolic phenomena. Two new cases which resulted from injection of the combination of a depo or long-acting corticosteroid (methylprednisolone acetate, 40 mg) and a local anesthetic and epinephrine or penicillin were added to the growing world literature. The ocular and systemic pathologic findings are described and important questions are raised as to the pathophysiology. The need for an animal model experiment to answer as many of these questions as possible is emphasized.
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2/10. Visual hallucinations after acute visual loss in a young child.

    A four-year-old boy developed complex visual hallucinations consisting of moving figures, animals and other familiar objects one week after becoming totally blind. This followed a six-month period of gradually deteriorating vision and was precipitated by the debulking of a large optic nerve glioma. Although visual hallucinations are well recognised in adults with visual loss, secondary to both ophthalmological and neurological causes, they have not been reported in young children.
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3/10. Optokinetic response and adaptation of the vestibulo-ocular reflex (VOR) in a patient with chronic cortical blindness.

    Optokinetic response and adaptation of the VOR were investigated in a patient with chronic cortical blindness. Our results suggest that: 1) optokinetic response was present in a patient with cortical blindness. This optokinetic response may relate to the extrastriate pathways: 2) the occurrence of VOR adaptation was shown in a patient with cortical blindness, which may indicate preservation of the pathways of the visual-vestibular interaction in the brain stem and cerebellum. The result is in agreement with previous reports in experimental animals; 3) less adaptation of the VOR in this patient than in normal adults may relate to a chronic loss of visual feed back. To the best of our knowledge, this is the first report of adaptation of the VOR in a patient with cortical blindness.
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4/10. melatonin stabilises sleep onset time in a blind man without entrainment of cortisol or temperature rhythms.

    The pineal hormone melatonin (N-acetyl-5-methoxytryptamine) is normally secreted at night: in animals it serves to transmit information about light-dark cycles to body physiology Suitable timed administration will alleviate 'jet-lag' severity ratings in humans, the major effect being to improve sleep. It has been suggested that this may be mediated by melatonin re-entraining the endogenous circadian oscillator. We have examined this possibility by feeding melatonin to a blind individual (HK) with a free-running temperature rhythm and a pronounced 35-day cycle in his ability to fall asleep at 'normal' times. Our results show a clear stabilizing effect of melatonin on sleep onset time with elimination of day time sleep, but no entrainment of rectal temperature or urinary cortisol rhythms. Thus melatonin may act on the timing mechanism of sleep onset, rather than as a entrainer of all circadian rhythms. It may well help shiftworkers to sleep at inappropriate phases of their circadian oscillators.
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5/10. Cerebral artery spasm--a possible mechanism of TIA?

    The pathogenetic transitory ischemic attacks (TIA) is usually ascribed to emboli although in some 25% of TIA patients there is no source of embolism to be found in either the heart or neck vessels and angiographically visible carotid lesions are present only in about half the patients with carotid distribution TIA. A case is reported with repeated attacks of amaurosis fugax without remaining neurological symptoms in this very sensitive area. This and similar case histories raise the possibility of spasm in the cerebral arteries as the underlying cause of certain forms of TIA. As certain Ca-blocking agents, such as nifedipine and especially nimodipine, can relieve spasm, there are reasons to conduct a controlled study in man to find out if and to what extent a Ca-blocker with a verified effect on cerebral artery spasm in animal experiments has a beneficial effect on TIA in man.
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6/10. Persistent behavioural blindness after early visual deprivation and active visual rehabilitation: a case report.

    Early long lasting binocular deprivation results in behavioural blindness in both man and experimental animals. However, few reported cases show that visual rehabilitation may improve visual behaviour. A 34-year-old man who had experienced 30 years of binocular deprivation due to bilateral cataracts received visual rehabilitation for one year. The rehabilitation included training in eye-hand co-ordination, recognition of objects, evaluation of distance and size, and mobility training. Despite signs of recovery of visual functions the patient never started to use vision in his normal life. The negative outcome of the rehabilitation is partly attributed to the patient's motivational problems and to the relatively short rehabilitation time. Visual rehabilitation may be successful when started immediately after the corrective operation on the eyes when the level of motivation is also high.
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7/10. Visual rehabilitation after long lasting early blindness.

    A 23-year-old woman, blinded at an early age due to retinopathy of prematurity and cataract was successfully operated. After the operation the patient was behaviourally blind. Visual rehabilitation was started 9 months later and lasted 1 1/2 years. During this time the visual behaviour of the patient improved. Quantitative tests were designed to depict the progress. The functional improvement of the patient is in agreement with the findings of animal studies; binocular deprivation during the critical period of development causes behavioural blindness, which is partially recoverable. The result of this study indicates that the visual rehabilitation facilitates the process of recovery. The progress in visual behaviour is likely to reflect an improvement of the function of the associative systems of the brain.
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8/10. Complex visual hallucinations in partial blindness due to eye disease.

    Three patients experienced complex formed hallucinations during progressive visual failure from eye disease. The hallucinations began abruptly, were brightly coloured stereotyped figures, animals or objects, and appeared to be provoked by light. As blindness progressed the clarity, frequency and duration of the hallucinations faded. The patients had no abnormalities other than their eye disease, which in two cases was macula degeneration, and choroideraemia in the third.
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9/10. Retinal toxicity of high dose intravitreal ganciclovir.

    BACKGROUND: Intravitreal administration of ganciclovir has been used to treat cytomegalovirus (CMV) retinitis in patients with acquired immune deficiency syndrome (AIDS) who are unable to tolerate systemic antiviral therapy. Although retinal toxicity from intravitreal ganciclovir has been observed in animal experiments, to our knowledge, retinal toxicity from intravitreal ganciclovir has not been reported in humans. methods: A case of inadvertent intravitreous injection of a high dose of ganciclovir (40 mg/0.1 ml) for CMV retinitis in a patient with AIDS is presented. RESULTS: Despite immediate intervention with vitreous surgery, permanent retinal damage and visual loss developed. Clinical observations and photographic documentation are provided. CONCLUSION: Retinal toxicity can occur from a high-dose intravitreal ganciclovir injection. This toxicity may result from the high alkaline nature of this preparation, from osmotic damage, or from a direct effect of the concentrated ganciclovir.
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10/10. "Blow-in" fracture of the orbit with partial visual loss and choroidal folds.

    Choroidal fold formation caused by "blow-in" fracture of the orbit is described. Rapid and almost complete recovery of vision followed removal of the bone fragments compressing the globe. The findings in this case support the conclusions of recent animal experiments on the pathogenesis of choroidal folds. Congestion of the choroid and adhesions to Bruch's membrane are probably prerequisites for folds to form, and folds are aligned perpendicular to a force applied to the eye.
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