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Exophthalmos (Proptosis)
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Medical and surgical measures are available: Medical measures include: Sunglasses to protect eyes from dust and foreign bodies.Methyl cellulose eye drops to prevent corneal dryness.Diuretics to reduce orbital oedema.Steroids in high doses.Surgical measures: Tarsorrhaphy.Orbital decompression.
Membrane dissection in proliferative diabetic retinopathy
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Michael S L.e.e, Gary W Abrams
Another common early postoperative complication is corneal erosion. The reported incidence of postvitrectomy corneal problems in diabetics is 28–52%.18,28 Corneal complications, especially persistent epithelial defects, may be very frequent in these cases, because diabetic eyes have abnormal epithelial basement membranes and attachments.38 Erosion will often heal when treated with emollients and patching. If the erosion is persistent, it should be treated with a bandage contact lens. Rarely, a tarsorrhaphy will be necessary to allow a chronic, nonhealing corneal erosion to re-epithelialize.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Parotid Benign or low-grade tumours: Superficial lobe – superficial parotidectomy (lobectomy), e.g. PA, mucoepidermoid.Deep lobe – facial nerve-sparing total parotidectomyHigh-grade malignancy: Radical parotidectomy sacrificing the facial nerve and surrounding involved structures including masseter, medial pterygoid, styloid process and associated muscles and the PBD. Overlying skin may also need to be sacrificed. Immediate nerve grafting and temporary lateral tarsorrhaphy are recommended under such circumstances.
Beneficial Effects of Plasma Rich in Growth Factors (PRGF) Versus Autologous Serum and Topical Insulin in Ocular Surface Cells
Published in Current Eye Research, 2023
Eduardo Anitua, María de la Fuente, Ronald M. Sánchez-Ávila, Borja de la Sen-Corcuera, Jesús Merayo-Lloves, Francisco Muruzábal
Topical lubrication is typically first line treatment with high frequency application every 1–2 h; if the patient is concurrently using medications such as antibiotics, antivirals that may alter the corneal epithelium, withdrawal of these offending agents may allow re-epithelialization. The application of therapeutic soft contact lenses serves to protect the corneal surface from mechanical trauma to the eyelids, and the use of punctal plugs should increase the retention of natural tears that aid the healing process. Surgical interventions, such as debridement and tarsorrhaphy, are other effective treatments in most cases of ocular surface disorders refractory to medical treatment, along with amniotic membrane transplantation, which has yielded satisfactory results.3–5 However, these treatments have some drawbacks such as the risk of disease transmission and the limited availability of donor tissues.
A Rare Case of Rhizopus Oryzae Keratitis following Orbital Cellulitis in a Diabetic Patient
Published in Ocular Immunology and Inflammation, 2022
Rama Rajagopal, Nikhil Navneet Toshniwal, Kirthi Koka, Janani Madhuravasal Krishnan, Sumathi Veluswamy
The patient underwent corneal scraping and nasal endoscopic biopsy from the middle meatus, both of which revealed aseptate fungal filaments in both KOH and Calcofluor staining (Figure 1C,D). There was no fungal growth in culture from both specimens. PCR targeting the Internal transcribed region (ITS) of the pan fungal genome was carried out directly on both the clinical specimens. PCR of both the samples revealed similar results suggestive of fungus (Figure 1E). Further processing of the PCR amplified products for DNA sequencing in ABI 3130 genetic analyser identified the organism as Rhizopus Oryzae showing 99% homology match with the NCBI database in both specimens. Patient was started on topical Amphotericin B 0.15% 2 hourly for the keratitis. A lateral tarsorrhaphy was done to protect the cornea. She was advised to have a maxillectomy. However, surgery was delayed due to deranged blood thyroid parameters. She was started on oral Posaconazole 400 mg BD as a prophylactic antifungal treatment until planned surgery but she discontinued it after 2 weeks as she was unable to tolerate it. The epithelial defect healed in a week and the infiltrate scarred completely in a month (Figure 1F). She tested negative for SARS-CoV-2 virus infection both at the time of initial presentation of orbital cellulitis and currently.
Clinical Outcomes of Minimally Invasive Corneal Neurotization After Cerebellopontine Angle Neurosurgical Procedures
Published in Current Eye Research, 2022
Yue Wu, Jiaying Zhang, Wei Ding, Gang Chen, Chunyi Shao, Jin Li, Wenjin Wang, Wei Wang
Demographic and clinical characteristics of patients underwent MICN were listed in Table 1. The mean age at the time of surgery was 32.5 ± 8.5 years. All the 12 patients had cranial tumor, and the most common type of intracranial tumor was acoustic neuroma (9 cases), cerebellar hemangioblastoma (2 cases), and meningiomas (1 case). All of them underwent cerebellopontine angle neurosurgical procedures and developed NK afterwards. The duration of all the 12 patients that had been diagnosed with NK was 3.7 ± 5.0 years at the time of MICN. All the patients suffered from facial paralysis, and therefore a tarsorrhaphy was necessary to handle eyelid retractions. According to the Mackie classification of NK, three (25%), four (33.3%), and five (41.7%) patients were respectively diagnosed with Stage I, II, and III NK.