Cases reported "Blindness"

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1/35. blindness following gastrointestinal haemorrhage.

    Loss of vision is a rare but well known complication of distant and recurrent haemorrhage. It shares a poor prognosis, with only 10-14% of cases likely to make a complete recovery. Visual symptoms, due to ischaemic anterior optic neuropathy, vary from blurred vision to complete loss of vision in one or both eyes. The pathogenesis of such ischaemia remains unclear. Gastrointestinal bleeding seems to be the leading cause of loss of vision secondary to haemorrhage. However, complete and permanent blindness following gastrointestinal bleeding has rarely been reported. We report the case of a 51 -year-old woman who complained of complete blindness following blood loss, secondary to peptic ulcer, and discuss the pathogenesis of such a complication.
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keywords = blood loss, haemorrhage
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2/35. Upside-down orbitopathy: unilateral orbital dependent-tissue oedema causing total visual loss.

    The case is reported of a 24-year-old man who was involved in a road traffic accident and became trapped upside down with the right side of his face being the most dependent part of his body. Marked hemifacial tissue oedema was associated with right acute compressive orbitopathy and vascular compromise. Acute dysfunction of al orbital nerves was found on examination. Such neuropathy is usually related to the consequences of direct trauma, fractures or haemorrhage; however, computed tomography scanning demonstrated no evidence of orbital fracture or haemorrhage. Immediate anterior surgical orbital decompression was performed in the emergency room in addition to high dose intravenous steroids. Dependent orbtal tissue oedema is proposed as a mechanism of compressive orbitopathy with consequent ischaemic damage to all orbital nerves, total visual loss and complete ophthalmoparesis. Good recovery of other orbital nerves has occurred and the globe has reperfused. Despite intervention, no visual function has returned.
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ranking = 0.14667215450405
keywords = haemorrhage
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3/35. Post-traumatic scedosporium inflatum endophthalmitis.

    This is the first documented case of post-traumatic scedosporium inflatum endophthalmitis and only the second of S. inflatum endophthalmitis occurring in a non-immunocompromised individual, to the authors' knowledge. A case is reported of a 57-year-old woman who, while chopping wood, had a wood chip hit her in the right eye. This caused a penetrating corneal injury with uveal prolapse and damage to the crystalline lens. There were also vitreous and suprachoroidal haemorrhages. No detectable intraocular foreign material was retained. The clinical manifestation of infection was delayed, but once established, it was very destructive. The initially indolent endophthalmitis eventually led to loss of all light perception and panophthalmitis which required enucleation. The responsible strain of S. inflatum was found to be resistant to all antifungal medication in vitro.
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ranking = 0.073336077252027
keywords = haemorrhage
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4/35. Acute visual loss in a child with autosomal recessive polycystic kidney disease: case report and review of the literature.

    Acute visual loss secondary to ischemic optic neuropathy in children is extremely rare. The causes are usually hypotension or anemia. We describe the clinical course of a 9-year-old boy with a functional renal transplant who presented to the emergency room hemodynamically stable after waking up with complete bilateral loss of vision (no light perception). Examination showed that he had suffered massive nocturnal blood loss from esophageal varices secondary to portal hypertension. The patient's end-stage renal disease was secondary to autosomal recessive polycystic kidney disease (ARPKD), an entity comprised of renal cysts and hepatic fibrosis. Ophthalmologic findings in ARPKD are rarely cited in the literature. A literature search revealed 3 other cases of sudden visual loss reported in nonophthalmologic journals in patients with ARPKD. Funduscopic examination showed bilateral optic nerve head pallor and swelling with associated flame hemorrhages. The fact that this patient already had mildly pale nerves on presentation, along with hemodynamically compensated blood pressure and pulse, suggested chronic as well as acute ischemia. Based on our findings and other reported cases in the literature, ophthalmologic examinations may be indicated in all patients with ARPKD.
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ranking = 0.55998353648784
keywords = blood loss
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5/35. blindness following paranasal sinus surgery: a report of two cases.

    Two cases of blindness following paranasal sinus surgery are presented. The first patient, a 38-year old man, developed a delayed massive haemorrhage, after bilateral sphenoethmoidectomy. This hemorrhage could be stopped by electric cauterisation under endoscopical control. During this reintervention the patient developed total blindness of his right eye, and a restriction of the inferotemporal left visual field. The second patient, a 10-year old girl, developed, after bilateral spheno-ethmoidectomy for isolated sphenoiditis, total blindness of the left eye and paralysis of the ipsilateral extraocular muscles. According to the literature, blindness secondary to paranasal surgery is mainly due to retrobulbar hemorrhage. In the first case blindness was due to a direct cauterisation of the optic nerve, after perforation of the lamina papyracea. In the second case, blindness was probably due to a hemorrhage in the orbital apex.
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ranking = 0.073336077252027
keywords = haemorrhage
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6/35. Posterior ischemic optic neuropathy: case report of a rare complication after general surgery.

    BACKGROUND: Posterior ischemic optic neuropathy (PION) is a rare cause of bilateral severe and bilateral visual loss. Three mechanisms for posterior ischemic optic neuropathy are recognized: arteritic, non-arteritic, and peri- or postoperative. We report a case of bilateral postoperative posterior ischemic optic neuropathy. history AND SIGNS: A previously healthy 51-year-old man complained of the sudden onset of visual loss and unformed visual hallucinations in both eyes, 24 hours after an uneventful lumbar spine surgery. Duration of surgery was 12 hours with 2.5 liters of blood loss. At the time of visual loss, anemia was 74 g/L. Ophthalmic examination revealed decreased visual acuity to count fingers and normal optic disc without swelling or hemorrhages in both eyes. THERAPY AND OUTCOME: Despite blood transfusion 2 days after visual loss, evolution was stable. One month later, visual acuity was 0.15 RE and 0.2 LE with severe dyschromatopsia. Pupils reacted sluggishly to light but briskly to convergence. Optic discs were diffusely pale. DISCUSSION: Peri- and postoperative posterior ischemic optic neuropathy is a rare but devastating complication of surgery performed at distance from the visual pathways and its vascularization. risk factors include: spine surgery, peri-operative hypotension, anemia, facial edema. Early recognition of posterior ischemic optic neuropathy and rapid correction of hypotension and/or anemia might improve outcome of posterior ischemic optic neuropathy, which usually is poor.
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ranking = 0.55998353648784
keywords = blood loss
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7/35. Orbital haemorrhage with loss of vision in a patient with disseminated intravascular coagulation and prostatic carcinoma.

    A 65-year-old man with sudden profound loss of vision in his right eye due to sub-periosteal orbital haemorrhage was found to have disseminated intravascular coagulation (DIC) secondary to metastatic prostatic carcinoma. CT-scan did not reveal any orbital metastases. A lateral canthotomy did not help to restore the vision. Orbital haemorrhage is known to occur with DIC due to different causes. To the best of our knowledge this is the first report of orbital haemorrhage with DIC related to prostatic carcinoma. This case emphasises the importance of considering systemic factors in cases of non-traumatic haemorrhage, along with imaging studies to rule out any co-existing vascular anomaly.
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ranking = 0.58668861801622
keywords = haemorrhage
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8/35. Clinical and electrophysiological course of acute syphilitic posterior placoid chorioretinitis.

    BACKGROUND: syphilis can affect the anterior as well as the posterior segment of the eye at any stage. history AND SIGNS: A 52-year-old man was referred to our clinic because of acute loss of his vision and hearing. Best corrected visual acuity (BCVA) was counting fingers (CF) right and 0.05 left eye, respectively. Fundoscopy revealed bilateral intraretinal macular haemorrhages and a large yellowish edematous lesion involving macula and midperipheral retina. fluorescein angiography showed diffuse late edema. The visual field showed a defect corresponding to the edematous lesion. The "Ganzfeld" electroretinogram (ERG) was markedly reduced and the multifocal ERG in the affected area was not recordable. THERAPY AND OUTCOME: VDRL, FTA-Abs and TPHA tests in serum and cerebrospinal fluid were positive. Intravenous penicillin therapy was initiated. BCVA, visual field and ERG eventually recovered completely. CONCLUSIONS: syphilis should be considered as a differential diagnosis in any unclear inflammatory ocular condition. awareness of syphilitic posterior placoid chorioretinitis allows rapid diagnosis and therapy.
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ranking = 0.073336077252027
keywords = haemorrhage
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9/35. Anterior ischemic optic neuropathy complicating cranial vault reconstruction for sagittal synostosis in a child.

    The authors report a case of postoperative visual loss in a pediatric patient who underwent an uneventful cranial vault reconstruction. A 5-year-old boy underwent total cranial vault reconstruction for nonsyndromic sagittal synostosis. He was positioned prone for 6 hours and then supine for the final 2 hours of surgery. Controlled hypotension was used to maintain the systolic arterial pressure at 80 mmHg to 90 mmHg. The intraoperative hematocrit was 23% to 31%. In the immediate postoperative period, both pupils were noted to be reactive to light. After an uneventful night in the intensive care unit, he was transferred to the ward. The eyelids were edematous on postoperative day 1, and visual examination was no longer possible. He was discharged home on postoperative day 4, and readmitted 2 days later with bilateral blindness. The pupils were nonreactive, and the optic discs were pale and edematous. Computed tomography and magnetic resonance imaging of the head revealed no abnormality. Intravenous steroid therapy was initiated, and the patient was taken to the operating room for re-exploration; the intracranial pressure was found to be normal. The presumed diagnosis was bilateral infarctions of the anterior optic nerves. visual acuity 14 months after surgery was less than 3/200 in the right eye and 20/20-2 in the left, indicating significant recovery. Pediatric patients undergoing cranial vault reconstruction are at risk for postoperative visual loss because of ischemic optic nerve injury. Prolonged duration in the prone position and significant blood loss may be risk factors.
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ranking = 0.55998353648784
keywords = blood loss
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10/35. Recovery of postoperative visual loss following treatment of severe anaemia.

    A 29-year-old pregnant woman noted acute visual loss following emergent Caesarean section complicated by excessive uterine bleeding. Postoperative visual acuity was count fingers in both eyes. Funduscopic changes were consistent with a diagnosis of anaemia-associated ischaemic optic neuropathy and retinopathy. One month later, because of persistent anaemia and poor visual recovery, blood transfusion was given. Following transfusion, the patient's vision improved over the next 6 months. In an otherwise healthy patient, visual loss associated with postoperative blood loss may still be partially reversible with correction of the anaemia, even after a delayed period of time.
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ranking = 0.55998353648784
keywords = blood loss
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