Cases reported "Hyphema"

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11/193. Air bag-associated ocular trauma in children.

    OBJECTIVE: To describe a series of children with ocular injuries related to air bag deployment. DESIGN: Retrospective, observational case series. PARTICIPANTS: Seven patients with ocular injuries sustained in motor vehicle accidents in which air bags were deployed. methods: review of medical records. RESULTS: All patients had periocular contusions. Minor injuries included corneal abrasions (n = 5), superficial eyelid laceration (n = 1), and traumatic iritis (n = 2). Serious injuries included corneal edema (n = 1) and a traumatic hyphema with secondary glaucoma and cataract (n = 1). The latter patient required surgery. All other injuries resolved with medical therapy. All patients recovered normal visual acuity. CONCLUSIONS: Serious ocular injuries in children may result from air bag deployment. Most such injuries are minor and resolve without sequela. It is recommended that infants and children travel in the rear seat of automobiles to minimize their risk of injury. ( info)

12/193. Cyclodialysis cleft diagnosed by conventional ultrasonography.

    This case report describes the diagnosis and management of a traumatic cyclodialysis cleft, in the absence of newer investigating modalities like ultrasonic biomicroscopy (UBM). This entity is frequently difficult to recognize clinically owing to the extreme hypotony and media haze that these patients usually present with, which makes gonioscopy particularly taxing. Adding to the diagnostic dilemma is the difficulty in delineating the lesion ultrasonically due to the extreme anterior location of the cleft. In these situations, high frequency ultrasound has been found to be extremely helpful, but the availability of such sophistication is difficult. Presented here is demonstration of the cleft with a microconvex ultrasound probe of 9 MHz frequency. The patient was successfully managed conservatively. This modality could prove to be a valuable adjunct to the diagnosis of such cases even in the situations of nonavailability of high frequency ultrasonography. ( info)

13/193. Late traumatic wound dehiscence after phacoemulsification.

    Scars from scleral tunnel or clear corneal incisions for phacoemulsification should theoretically be stronger than the larger incisions of planned extracapsular cataract extraction. They should also be more resistant to blunt trauma. We present a case of scleral tunnel wound dehiscence and expulsion of a posterior chamber silicone intraocular lens after blunt trauma. ( info)

14/193. Herpes zoster sine herpete presenting with hyphema.

    PURPOSE: To report a case of herpes zoster sine herpete presenting with hyphema. methods: A 69-year-old man was referred for traumatic hyphema and corneal edema in his left eye after a sandblast exposure three weeks previously. Slit-lamp examination demonstrated hyphema, anterior chamber inflammation, mid-dilated pupil, impaired corneal sensation, and high intraocular pressure, without any facial skin lesions. iris fluorescein angiography revealed tortuosity and extensive occlusion of iris vessels. The patient was treated with oral acyclovir and intensive topical steroids with a presumed diagnosis of severe herpes zoster uveitis. RESULTS: Clinical findings improved dramatically within several days. Typical sectorial iris atrophy with pupillary sphincter dysfunction and complete loss of corneal sensation developed after the resolution of intraocular inflammation. CONCLUSION: Herpes zoster should be considered in patients with uveitis and hyphema even in the absence of typical skin rash. ( info)

15/193. Transcorneal oxygen therapy for glaucoma associated with sickle cell hyphema.

    PURPOSE: To study three patients with glaucoma caused by sickle cell hyphema who were successfully treated with transcorneal oxygen therapy. methods: case reports. Three patients with increased intraocular pressure caused by sickle cell hyphema were administered transcorneal oxygen therapy using humidified oxygen at a flow rate that ranged from 1 to 3 l/minute. RESULTS: All three patients had a dramatic reduction in their intraocular pressure within hours of receiving oxygen therapy. No complications were associated with the oxygen therapy. CONCLUSION: Transcorneal oxygen therapy can reduce intraocular pressure in patients with glaucoma from sickle cell hyphema. Further study is warranted to evaluate this new therapy. ( info)

16/193. Triangular transchamber suture.

    A 64-year-old woman with a fibrous membrane at the lens plane after traumatic loss of all the iris and massive intraocular hemorrhage had posterior chamber intraocular lens (PCIOL) implantation anterior to the fibrous membrane with a triangular transchamber suture to prevent possible PCIOL-corneal touch and enhance the stability of the PCIOL. After 3 years, the PCIOL remained in a good position and visual rehabilitation was satisfactory and without complications. ( info)

17/193. Recurrent hyphema in an aphakic child: Swan syndrome.

    In 1973, Swan described 3 patients who developed hyphema months to years after uncomplicated cataract surgery. He noted focal vascularization from an ingrowth of episcleral vessels at the cataract wound site, resulting in recurrent intraocular bleeding. Swan syndrome has been reported following intracapsular cataract extraction, extracapsular cataract extraction (including clear corneal incisions), iridocyclectomy, and glaucoma filtering procedures. patients typically present with sudden painless blurred vision, often upon awakening, which may or may not be preceded by physical strain or trauma. Other patients are asymptomatic and diagnosed with hyphema or anterior chamber red blood cells on routine examination. The hyphema often resolve spontaneously, making later diagnosis difficult. Gonioscopic visualization of the abnormal wound vessels is necessary for diagnosis. Without active bleeding, however, the fibrovascular tuft may be easily overlooked. We report a case of Swan syndrome in a 16-month-old boy after cataract extraction was performed. To our knowledge, Swan syndrome has not been reported in the pediatric population. Children represent a significant proportion of patients undergoing anterior segment surgery and Swan syndrome should be considered in the differential diagnosis of hyphema in this population. ( info)

18/193. Acute panuveitis with haemorrhagic hypopyon as a presenting feature of acquired immunodeficiency syndrome (AIDS).

    Anterior uveitis is a known clinical entity in herpes zoster ophthalmicus associated with AIDS. However, reports of acute haemorrhagic hypopyon uveitis in such cases are lacking. Herein we describe a young male patient presenting with acute panuveitis with haemorrhagic hypopyon, who was found hiv positive on investigation. ( info)

19/193. Immune recovery vitritis presenting as panuveitis following therapy with protease inhibitors.

    Immune reconstitution in acquired immunodeficiency syndrome (AIDS) patients on highly active anti-retroviral therapy (HAART) with cytomegalovirus (CMV) retinitis manifested as posterior segment intraocular inflammation has been reported. We report an adult hiv-positive Indian male with clinically inactive CMV retinitis who developed panuveitis with hypopyon. This was related to immune recovery mediated by combination anti-retroviral treatment, including protease inhibitors. ( info)

20/193. Transient intraocular pressure elevation after trabeculotomy and its occurrence with phacoemulsification and intraocular lens implantation.

    PURPOSE: To elucidate the characterization of intraocular pressure (IOP) spike after trabeculotomy, and after the combined procedure of phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. methods: Included in this study were 39 patients (53 eyes) with primary open-angle glaucoma with IOPs uncontrolled even with anti-glaucoma medication. We conducted a retrospective study for the following two groups: patients who underwent trabeculotomy alone (25 eyes) and patients undergoing trabeculotomy combined with PEA and implantation of an IOL (28 eyes). RESULTS: In 7 (28%) of the 25 eyes after trabeculotomy alone and 7 (25%) of the 28 eyes after the combined procedure, transient IOP elevation was found postoperatively. The incidence of hyphema-related IOP spike was significantly higher in eyes after trabeculotomy alone (16%) than after the combined procedure (0%). After removal of the blood present in the anterior chamber in eyes with hyphema-related IOP spikes, the IOP levels were well controlled. CONCLUSIONS: hyphema-related IOP spike is one of the common complications in eyes after trabeculotomy alone, and the combined procedure decreases the incidence of this complication. It is thought that removal of prolonged massive hyphema is effective as treatment for hyphema-related IOP spike. ( info)
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