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Glaucoma
Published in Mary E. Shaw, Agnes Lee, Ophthalmic Nursing, 2018
Blind, painful eyes which occur at this stage are best treated by enucleation. Alternatively, periodic retrobulbar or facial nerve injections can be administered. Phthisis bulbi, or shrinkage of the eye, occurs as it atrophies when enucleation is the most appropriate course of action.
Uveitis and allied disorders
Published in Thomas H. Williamson, Vitreoretinal Disorders in Primary Care, 2017
Vitreous opacity occurs from white cells, cellular deposits, proteinaceous infiltration and degeneration of the gel structure. The inflammatory process can cause shrinkage of the gel, which, in the presence of vitreoretinal adhesion, will produce secondary TRD or RRD if a tear is created.1,4,5 In patients with intermediate uveitis, CMO is a common complication seen in 40% of all eyes. Sixty per cent of eyes with poor vision have CMO.6,7 Hypotony is a risk from the destruction of the ciliary body or traction on the ciliary body from the anterior membrane formation. Ultimately, phthisis bulbi,8 severe shrinkage of the low-pressure eye, will be associated with complete loss of vision. The phthisical eye may be a cosmetically unacceptable eye.
Aqueous Shunts
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Brian J. Song, JoAnn A. Giaconi, Anne L. Coleman
Complications associated with aqueous shunts can be categorized as those associated with the reduction of intraocular pressure, with the functioning and placement of the tube, with the episcleral plate and the response of surrounding tissues to it, and with intraocular surgery per se. A complete list of complications is provided in Table 18.4. Information about the steps of the surgery and potential associated complications are illustrated by Figures 18.1 through 18.38. Suprachoroidal hemorrhage is a complication that can occur in any eye predisposed to develop it regardless of the presence of a device to restrict flow. Ocular hypotony with or without consequent serous choroidal effusion may occur with both valved and nonvalved devices with which flow is restricted. Ocular hypotony can have many etiologies, including inadequate restriction of aqueous flow, leakage of aqueous around the tube, or the decreased production of aqueous humor by the ciliary body. Phthisis bulbi has been reported in 2%–18% of eyes following shunt placement with neovascular glaucoma having a greater risk.5,28 Complications associated with intraocular surgery per se also occur with glaucoma drainage devices. The incidence of retinal detachment has been reported as 0%–14% and that of vitreous hemorrhage is 0%–11% (although vitreous hemorrhages may be secondary to underlying disease, such as proliferative diabetic retinopathy).29–32 The incidence of epiretinal membranes and/or cystoid macular edema have been reported in 0%–14% of eyes, and that of endophthalmitis after aqueous shunt implantation is 0%–3%.20,32–36
Novel Histopathologic and Immunohistochemical Observations in Explanted Orbital Peri-implant Capsules
Published in Current Eye Research, 2021
Tarjani Vivek Dave, Dilip Kumar Mishra, Vivek Singh, Sonali Kumar, Noopur Mitragotri, B Sridhar Rao
The study included 13 peri-implant capsules from 13 patients. Of these, seven were harvested from around extruded implants (implant extrusion group, group 1) and six at the time of implant exchange (implant non-extrusion group, group 2). In the implant extrusion group, three patients had staphyloma and three had a history of surgery for a prior open globe injury that culminated into a painful blind eye. In one patient the etiology was not known. In the other group, three patients had phthisis bulbi following surgery for open globe injury and three patients had painful blind eye following end-stage eye disease. The mean age of the patients in the implant extrusion group was greater as compared to those in the implant non-extrusion group (41 ± 6 years vs 20 ± 10 years, p = .002) (Table 1). The implant extrusion group also received implant with a greater diameter (19 ± 1 mm vs 17 ± 1 mm, p = .02).
How to best manage a patient with Bacillus endophthalmitis: current insights
Published in Expert Review of Ophthalmology, 2021
Amin Ahmadi, Mohammad Soleimani, Ali A. Haydar, Shima Moslemi Haghighi
Bacillus endophthalmitis commonly results in partial or complete vision loss within 24–48 hours [19]. Decreased visual acuity is the most common presenting sign [19]. Vision is preserved in only very few patients. Bacillus endophthalmitis has a rapid manifestation and presents with severe ocular pain, periocular swelling and redness, proptosis, ocular discharge, blurring, and corneal ring infiltration and abscess (Figure 1) [19]. The slit-lamp examination reveals conjunctival/corneal edema, anterior chamber cells and fibrins, hypopyon, blunting of red reflex, and vitreous inflammation [19]. Patients with severe and prolonged symptoms may develop phthisis bulbi in which the eye globe and intraocular contents become atrophic and shrunken [19].
Phthisis Bulbi—a Clinicopathological Perspective
Published in Seminars in Ophthalmology, 2018
Koushik Tripathy, Rohan Chawla, Shreyas Temkar, Pradeep Sagar, Seema Kashyap, Neelam Pushker, Yog Raj Sharma
“Phthisis bulbi” is a histopathological diagnosis of end-stage ocular disease showing atrophy, shrinkage, and disorganization of the eye and intraocular contents.1 The name comes from Greek word phthiein or phthinein which means “to waste away,” “shrinkage,” or “consuming.”2 “Phthisical eye” is often a clinical diagnosis used to refer to a nonfunctional (inaccurate projection of rays or absent perception of light), sunken, hypotonous, and disfigured eye. Atrophic bulbi is the earlier stage of terminal eye disease with intraocular atrophy and shrinkage without disorganization of ocular structures.3