China
Africa
Explore chapters and articles related to this topic
Trauma to the Eyelids and Periorbital Region
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
The history will allow you to determine the potential site of injury and more importantly the likelihood of foreign body or ocular penetration. These patients often present with sharp pain, increased lacrimation, and a foreign body sensation with severe irritation. Although for the vast majority of these cases the clinician will be able to locate the culprit, it is nonetheless vital to rule out an intraocular foreign body (IOFB), especially with a history of explosion or when hammering and chiselling. Simple foreign bodies located within the ocular surface should be suspected when punctate epithelial erosions or linear vertical corneal abrasions are seen on the cornea. Quite often a subtarsal perpetrator is found embedded on lid eversion. When a conjunctival laceration is identified it is important to be suspicious of an injury affecting the deeper structures. Quite often this can mask an open globe injury and sometimes even an IOFB. The conjunctiva may appear to be folded within itself with surrounding chemosis and subconjunctival haemorrhage. When confronted with these cases, the wound should be imaged and explored appropriately to ensure an accurate diagnosis to guide subsequent management. Signs that suggest an IOFB include an irregular shaped (peaked) pupil (see Figure 4.1), reduced IOP, vitreous haemorrhage, and intraocular inflammation. All structures of the eye should be examined systematically, with emphasis on the position and integrity of the lens and drainage angle.
Ophthalmologic Side Effects
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Punctate epithelial erosions or superficial punctate keratitis (Figure 12.2) is a finding associated with dry eye disease, reflecting the damaged ocular surface with dryness on the corneal epithelium. Although the association of keratitis with isotretinoin use was previously listed as certain (4), these older reports probably represented dryeye disease–associated punctate epithelial erosions, not the full-blown clinical picture of keratitis (24). There is no detailed study describing the association of these corneal findings with other retinoids; however, the package inserts of other retinoid compounds (acitretin, bexarotene, and alitretinoin) also describe corneal involvement and visual disturbances among rare side events (21,22,25).
Palytoxin
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Jiri Patocka, Qinghua Wu, Kamil Kuca
A 45-year-old Caucasian female coral farmer presented to the emergency eye department with ocular pain, redness, and eyelid swelling [49]. She denied any ophthalmic history. One day earlier, a coral she was holding (Palythoa sp.) expressed a toxin directly into her left eye from the distance of around 20 cm causing immediate pain. She performed immediate eye irrigation. On examination, visual acuity was 6/5 in the affected eye. Slit lamp examination showed eyelid swelling, conjunctival chemosis and injection, diffuse punctate epithelial erosions, and a circumferential marginal ulcer. There was no limbal ischaemia or anterior chamber inflammation. The pH level of her tears was neutral (pH = 7), and no foreign bodies were detected.
Pembrolizumab-induced Stevens–Johnson Syndrome with Severe Ocular Complications
Published in Ocular Immunology and Inflammation, 2022
Soyoung Ryu, Ikhyun Jun, Tae-Im Kim, Kyoung Yul Seo, Eung Kweon Kim
The patient was admitted to the oncology division of our hospital, and the dermatologist and ophthalmologist continued to monitor the progress. Along with 12 mg oral methylprednisolone and 125 mg intravenous methylprednisolone per day, the patient was treated aggressively with topical steroids (dexamethasone ointment 4 times/day), lubrication (0.1% hyaluronic acid every hour), and prophylactic topical antibiotics (0.5% moxifloxacin 4 times/day). The pseudo-membrane was removed in the first two visits (second visit was scheduled one day after the first visit). Therapeutic contact lenses were prescribed and all four lacrimal puncta were plugged in both eyes. After 2 weeks of treatment, corneal epithelial defects and pseudo-membranes disappeared, minimal punctate epithelial erosions remained in the inferior part of both cornea, and skin lesions had improved. No definite sign of acute stage ocular SJS pathology was noted, and intravenous methylprednisolone was stopped. Oral steroid dose was gradually tapered from 2 weeks after the first administration, and completely tapered off after 3 months. In addition, topical steroid was altered from dexamethasone ointment 4 times/day to prednisolone 4 times/day after a week of treatment and subsequently tapered off.
Ocular Manifestations in Patients of HIV(Human Immunodeficiency Virus) Infection on Combined Anti-Retroviral Therapy (CART)
Published in Ocular Immunology and Inflammation, 2022
Ritu Arora, Neha Sandhu, Pallavi Dokania, Anuradha Subramanian
The ophthalmic evaluation included measurement of best-corrected visual acuity (BCVA) using Snellen chart and Logarithm of the Minimum Angle of Resolution (LogMAR) visual acuity charts, Intraocular pressure by Goldmann Applanation Tonometer and evaluation of pupillary reflexes. Detailed ocular examination was carried out by slit-lamp biomicroscopy for the evaluation of anterior segment and dilated indirect ophthalmoscopy for the posterior segment. Tear film status was assessed using Schirmer’s test, TFBUT (Tear film breakup time). Patients were also evaluated by the Dry Eye Questionnaire (DEQ).13 The dry eye diagnosis criteria included both subjective discomfort and clinical signs of ocular surface disorder such as punctate epithelial erosion or TFBUT less than 10 seconds. Patients were classified as having mild, moderate, and severe dry eye.14 Moderate dry eye was defined clinically as in addition to symptoms of dryness, the patient had reversible slit lamp signs such as epithelial erosion, punctuate keratopathy, filamentary keratitis, short TFBUT, etc.14
Congenital alacrima
Published in Orbit, 2022
Zhenyang Zhao, Richard C. Allen
Classic ocular findings of HSAN3 includes (1) the absence of both emotional and reflex tear production and (2) corneal hypoesthesia, both of which contribute to keratoconjunctivitis sicca. The subsequent corneal damage can range from punctate epithelial erosion to bilateral corneal ulcers with perforation.14–16 The lacrimal gland structure remains grossly normal on biopsy.15 Profound tear deficiency is observed in both basal and reflex secretion, however, topical or subcutaneous installation of parasympathomimetics can temporarily induce tear production.14 Collectively, impairment in both the sensory afferent arm and parasympathetic efferent arm may contribute to alacrima in these patients. Optic neuropathy is observed in almost all patients, manifesting as optic nerve pallor, red-green dyschromatopsia, central-cecocentral scotoma and progressive vision loss.17