China
Africa
Explore chapters and articles related to this topic
Corneal Disorders
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Darren S. J. Ting, Rashmi Deshmukh, Daniel S. W. Ting, Marcus Ang
Conjunctivitis in a newborn is termed ophthalmia neonatorum (ON) or neonatal conjunctivitis. The incidence ranges from 2% to 12%.65 Although ON is less common, it remains an important cause of childhood corneal blindness in developed countries, and even of mortality in developing regions of the world.65,66 It is seen in babies of mothers affected by sexually transmitted diseases (STDs) caused by C. trachomatis (serotypes D–K) and Neisseria gonorrhoeae.67 Chemical substances like erythromycin, tetracycline, or silver nitrate are also known to cause ON. Chemical conjunctivitis presents within 24 hours and is self-limiting. The bacterial causes of ON however need antibiotic treatment.67 Affected babies present with congested, swollen eyes and sticky discharge usually within 2–14 days of birth. Chlamydial ON is more common than gonococcal ON. Most cases of chlamydial ON are mild to moderate in nature whereas gonococcal ON tends to be more severe.66
Management of Ophthalmic Injuries by the Forward Surgical Team
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Richard J. Blanch, Johno Breeze, William G. Gensheimer
Aside from the detrimental effect on visual outcome in the eye affected, the main risk of very delayed, absent, or incompetent repair is sympathetic ophthalmia. Sympathetic ophthalmia is an autoimmune granulomatous inflammatory disorder that occurs after open globe injury or intraocular surgery and affects the uninjured (as well as the injured or operated) eye. The risk of sympathetic ophthalmia after intraocular surgery is low, at between 1/1,000 and 1/10,000, but is higher after open globe injury. In a large series of 1,392 patients with open globe injury, 1,283 underwent primary repair (889 patients), evisceration (491 patients), or enucleation (3 patients) of whom none developed sympathetic ophthalmia. 109 patients did not have primary surgical management, and of these patients, two developed sympathetic ophthalmia (1.83%), suggesting that this risk is low except when primary repair or eye removal is not performed.
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Neisseria gonorrhoea:Gram-negative diplococcus bacterium.Infects the baby during childbirth.Causes ophthalmia neonatorum.Causes urethritis.Can cause perihepatitis.
Changing Trends in Uveitis in the United Kingdom: 5000 Consecutive Referrals to a Tertiary Referral Centre
Published in Ocular Immunology and Inflammation, 2023
N. P. Jones, S. Pockar, L. R. Steeples
Sympathetic ophthalmia has significantly fallen in this study both in incidence and as a proportion of patients seen. In 2000, a UK surveillance study17 prospectively identified a minimum incidence of 0.03/100 000 per annum. The study was reliant upon active reporting and there may have been a significant underestimation of incidence nationwide. As the single uveitis centre in the GM and Lancashire/Cumbria area dealing with this disease, we can say with some confidence that the incidence was approximately 0.31/100 000 pa during quartile 1 and 0.23/100 000 pa in quartile 4. For trauma-induced SO, those figures were 0.20 and 0.08 and for surgery-induced, 0.03 and 0.15. Clearly, the main precipitator of SO has changed during the study period from trauma to intraocular surgery. A recent study18 identified a very low risk of SO following a single vitreoretinal procedure (0.008%) but rising exponentially to as high as 6.67% after 7 procedures. The modern tendency towards multiple vitreoretinal surgery should be tempered by knowledge of this risk.
Recurrent Sympathetic Ophthalmia with Annular Choroidal Detachment after Pembrolizumab Treatment: A Case Report
Published in Ocular Immunology and Inflammation, 2020
Junwon Lee, Joo Youn Shin, Jihei Sara Lee, Sung Chul Lee, Min Hee Hong, Christopher Seungkyu Lee
Sympathetic ophthalmia is a bilateral, granulomatous uveitis due to trauma or surgery in one eye. It is thought to occur secondary to the development of an autoimmune reaction to ocular antigens exposed during the traumatic or surgical event. Typically, T-cell predominance is seen in the choroidal infiltrate, which suggests the role of T-cells in the pathophysiology of this condition.12 In theory, eyes with previous sympathetic ophthalmia may be predisposed to aggravation/recurrence or an autoimmune reaction after anti-PD-1 therapy, which enhances the T-cell response. Posterior segment inflammation after pembrolizumab in the present case may be regarded as an unrelated autoimmune inflammation, rather than the recurrence of sympathetic ophthalmia, because severe annular choroidal detachment is a rare feature of sympathetic ophthalmia. However, annular choroidal detachment resembling uveal effusion syndrome can develop in a severe case of sympathetic ophthalmia.13 Further studies should evaluate the risk of ocular inflammation after immune checkpoint inhibitor treatment in patients with a history of uveitis.
Intravitreal Bevacizumab for Inflammatory Neovascularization of the Lens after Traumatic Open Globe Injury
Published in Ocular Immunology and Inflammation, 2020
Je Hyung Hwang, Kyeong Do Jeong, Kyu Ho Chung, Jung Hyun Park, Jin Choi, Won Hyuk Oh, Jae Suk Kim
To our knowledge, only two case reports of intralenticular neovascularisation after trauma have been reported to date.3,6 Hwang et al. reported the presence of blood vessels in the crystalline lens 20 years after trauma.3 Eren et al. described complete resolution of neovascularization on the posterior capsule surface after intravitreal bevacizumab injection.1 We also administered intravitreal bevacizumab injection to regress new vessels in our case. The molecular weight of bevacizumab is 149 kDa;7 thus, bevacizumab can penetrate the lens capsule because the permeability cutoff of the lens capsule is 166 kDa.8–10 However, intravitreal bevacizumab injection was ineffective for intralenticular neovascularization in our case, in which intralenticular neovascularization occurred after severe inflammation. Six weeks after primary repair, when hypopyon observed, we could not rule out endophthalmitis; hence, we did not use corticosteroid initially. However, after hypopyon resolved, mutton-fat KP was observed, and vitreous tap culture was negative for the anterior chamber. Therefore, uveitis was more likely than endophthalmitis. Although there is no sign of inflammation in the other eye, sympathetic ophthalmia cannot be ruled out. If we had used corticosteroid initially, it is less likely that neovascularization would have occurred.