Cases reported "Vitreous Hemorrhage"

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1/9. Massive ocular hemorrhage resulting in blindness in a patient with the sickle cell trait who developed leptospirosis. Case report.

    This case report describes the findings of a 18 year-old black male from Bahia, a Northeastern state in brazil, with the sickle cell trait, who developed bilateral hyphema and vitreous hemorrhage with blindness in the course of leptospirosis. The patient started to complain of blurred vision four days after the start of fever and muscular pain and approximately twelve hours after the introduction of penicillin. The severity of the leptospirosis in conjunction with sickle cell trait was considered to be the most likely explanation for this ocular complication.
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2/9. A case of air-bag associated severe ocular injury.

    air-bags have received widespread support as an effective means of enhancing automotive safety, and they are becoming more common as standard automobile equipment on many cars. Although air-bag induced ocular injuries are rare, they present a serious concern because of the possibility of permanent damage or visual impairment. To date, most reports have investigated ocular injury from high velocity motor vehicle accidents and reports of ocular injury from low speed motor vehicle accidents have been rare. We describe a patient who sustained severe ocular injury, including periorbital fracture, hyphema, vitreous hemorrhage, and choroidal rupture of the macular area, due to an inflated air-bag in a low speed motor vehicle accident.
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3/9. Acute haptic-induced ciliary sulcus irritation associated with single-piece AcrySof intraocular lenses.

    We report an analysis of 3 single-piece hydrophobic acrylic intraocular lenses (IOLs) that were explanted because of complications related to the presence of their haptics in the ciliary sulcus. In 2 cases, the IOL was primarily implanted in the ciliary sulcus because of inadequate posterior capsule support. In the third case, postoperative displacement of 1 haptic in the sulcus was associated with hyphema and vitreous hemorrhage. Ultrasound biomicroscopy confirmed the contact between the haptic and iris. Areas of iris atrophy were observed in all cases. light microscopy and scanning electron microscopy of the explanted lenses revealed the presence of pigmentary dispersion on the anterior surfaces. In Case 3, the pigments were concentrated on the surface of the haptic that was displaced from the capsular bag and on the corresponding optic-haptic junction. Scanning electron microscopy also showed the IOL's squared edges and unpolished side walls. The flexibility and thickness of the single-piece hydrophobic acrylic haptics, as well as the square optic and haptic edges, may increase the risk for iris chafing when the haptics are in the sulcus. Therefore, sulcus fixation of this IOL design is not recommended.
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4/9. Blunt ocular trauma secondary to "war games".

    "war games" are gaining popularity in the western united states. These recreational contests involve members of one team attempting to shoot their opponents with high-velocity dye or paint pellets fired from air guns. Unfortunately, serious eye injuries occur when participants do not use protective eye wear. We report a case of severe blunt ocular trauma resulting in a hyphema, choroidal rupture, and retinal and vitreal hemorrhage secondary to a paint pellet striking an unprotected eye. This injury resulted in a significant visual defect in this patient.
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5/9. Intraocular hemorrhage from wound neovascularization years after anterior segment surgery (Swan syndrome).

    At the Mayo Clinic from 1972 to 1986, 15 patients (17 eyes) had intraocular hemorrhage due to neovascularization of the stromal wound years after anterior segment surgery (Swan syndrome). Months to years after surgery patients complained of low-grade blurring that was painless and transient. The hemorrhage was seen after intracapsular cataract extraction, and one third of the patients had had an intraocular lens implant. Of the 15 patients 14 were referred, 6 for vitreous hemorrhage, 5 for recurrent hyphema, 2 for amaurosis fugax and 1 for recurrent uveitis. The average time between surgery and presentation was 4 years. The initial visual acuity was better than 20/40 in 15 eyes (extremes 20/20 and hand movement), and intraocular pressure was elevated above 30 mm Hg in 2 eyes. Treatment included periodic observation (in 10 eyes), goniophotocoagulation (in 7) and limbal cryopexy (in 3). After a mean follow-up period of 3 years all 17 eyes showed normal acuity and intraocular pressure. No patient had intractable glaucoma or phthisis.
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6/9. Diffuse infiltrating retinoblastoma.

    A young child was examined for unilateral hyphema of 1 month duration with a questionable history of blunt trauma. ultrasonography was negative for tumefaction. Two months later the media cleared, revealing a diffusely abnormal retina. Computed tomography demonstrated a diffusely thickened posterior pole containing calcium. Histopathology of the enucleated globe was consistent with a diffuse infiltrating retinoblastoma. This is the first report of computed tomographic findings in diffuse infiltrating retinoblastoma.
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7/9. Incomplete posterior U.G.H. syndrome--different iatrogenic entity?

    U.G.H. syndrome is a known complication of IOL implantation associated with the use of anterior and rarely, posterior chamber intraocular lenses. It is due to mechanical excoriation of the angle or iris by the haptics or optic of an IOL and consists of uveitis, glaucoma and hyphema (U.G.H.). The advised therapeutic approach is explantation of the IOL. Following implantation of a posterior chamber IOL, three patients presented with bleeding into the posterior chamber, one associated with glaucoma. No patient had signs of uveitis. We decided to address the symptoms and not to explant the IOL. We believe that this constitutes a variant of the 'classical' U.G.H. syndrome, namely an incomplete posterior U.G.H. (I.P.U.G.H.) syndrome, in which explanation of the I.O.L. is not compulsory.
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8/9. Delayed hyphema and intravitreal blood following intrableb autologous blood injection after trabeculectomy.

    PURPOSE: To report delayed hyphema and intravitreal blood as complications following intrableb autologous blood injection after trabeculectomy. methods: Case report. A 44-year-old woman with hypotony and maculopathy after trabeculectomy with mitomycin C received an intrableb autologous blood injection. RESULTS: Three days after the blood injection, a hyphema formed and subsequently dispersed into the vitreous. CONCLUSIONS: Although immediate hyphema from autologous blood injection is common, hyphema may be delayed and associated with intravitreal blood.
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9/9. Bungee cord-associated ocular injuries.

    PURPOSE: To report ocular injuries associated with the use of bungee cords. METHOD: Four patients with bungee cord-associated ocular trauma are presented. RESULTS: Four eyes of four patients demonstrated severe contusion injuries associated with bungee cord trauma. Ocular injuries in the four eyes included a variable combination of corneal abrasion, hyphema, iridodialysis, anterior chamber angle recession, secondary glaucoma, lens subluxation, vitreous hemorrhage, and retinal detachment. Three of the four eyes required ophthalmic surgery. All eyes had anterior chamber angle recession and required continuing ophthalmic care. CONCLUSION: Bungee cords may be associated with severe ocular injury and should be used with caution.
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