Uveitis and allied disorders
Thomas H. Williamson in Vitreoretinal Disorders in Primary Care, 2017
There are a variety of possible presentations of uveitis of the posterior segment which can be diagnosed on clinical features or systemic investigations. 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 tractional retinal detachment (TRD) or rhegmatogenous retinal detachments (RRDs) if a tear is created. Vitrectomy may restore vision in patients with vitreous opacification from panuveitis. Visual recovery may not be complete because of the presence of optic atrophy, retinal atrophy, retinal ischaemia or cystoid macular oedema (CMO). The removal of the gel may reduce the ability of the eye to hold inflammatory mediators and, thereby, reduce the recurrence of inflammation in the long term. Low intraocular pressure occurs because the uveitic process damages the ciliary body or because the traction from epiretinal membranes (ERM) separates the ciliary processes from the choroid.
Eye
A. Sahib El-Radhi in Paediatric Symptom and Sign Sorter, 2019
Acute red eye is common and caused by a variety of conditions including trauma such as a foreign body, diseases of the conjunctiva, cornea, iris, ciliary body and choroid, aqueous humour and sclera. Clinicians should be able to diagnose most common eye diseases, which include allergic conjunctivitis, and viral conjunctivitis. Visual loss within the eyes is easy to detect, example corneal opacity, cataract or optic atrophy. Eye examination is an essential part of neonatal examination, including using an ophthalmoscope at a distance of 20–25 cm to look for the red reflex. Children with eye problems are often referred to an ophthalmologist, clinicians should be able to perform certain eye examinations. Eyelid disorders are exceedingly common in children and range from benign and self-resolving to serious malignant or metastatic processes. Eyelid elevation is primarily provided by levator palpebrae superioris muscle with its function to lift the upper eyelid by 5 mm or greater.
Ophthalmology
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan in Essential Notes for Medical and Surgical Finals, 2021
Beware that eyesight may be threatened and action may be required immediately. Causes include conjunctivitis, keratitis, episcleritis, scleritis, anterior uveitis and acute glaucoma. It is important to distinguish between painless versus painful (identified in brackets) causes. Inflammation of the uveal tract, i.e. the iris, ciliary body and choroid. A hypopyon may be present and there may be keratic precipitates (clumps of inflammatory cells) and synechiae (adhesions of the iris to the lens). Damage to the optic nerve secondary to raised intraocular pressure. Classified as primary or secondary (associated with ocular disease); acute or chronic; and closed-angle (iris in contact with the trabecular meshwork) or open-angle (iris not in contact with the trabecular meshwork): Chronic and acute closed angle. Hereditary condition with clinical features of night blindness, tunnel vision and classical fundus appearance.
Circumferential Ciliary Body Cysts Presenting as Acute Pigment Dispersion and Ocular Hypertension
Published in Ocular Immunology and Inflammation, 2018
Almila Sarıgül Sezenöz, Sirel Gür Güngör, Hayyam Kıratlı, Ahmet Akman
Purpose: To report a case of circumferential neuroepithelial cyst of the ciliary body presenting with pigment dispersion (PD) and ocular hypertension. Case report: 48-year-old female patient presented with a complaint of pain in the left eye. On examination, visual acuity of the left eye was 0.9, and the intraocular pressure was 48 mmHg. Biomicroscopic anterior segment examination of the left eye revealed 4+ pigmented cells in the anterior chamber. Active PD from the pupillary region at 11 o’clock was noticed at the time of the examination. Ultrasound biomicroscopy demonstrated 360º cystic lesions of the ciliary body in the left eye. The patient was diagnosed as neuroepithelial cyst of the ciliary body. Conclusion: Our case is unique as it is the first case of circumferential neuroepithelial ciliary body cyst presenting with acute PD and ocular hypertension.
Primary Diffuse Large B-Cell Lymphoma of the Ciliary Body
Published in Ocular Immunology and Inflammation, 2019
Hayyam Kiratli, Abdullah Ağın, Berrin Büyükeren, Figen Söylemezoğlu
Purpose: To report an unusual case of an eye with primary ciliary body lymphoma which came to enucleation allowing detailed histopathological examination. Methods: A 50-year-old man presented with a painful loss of vision in the left eye. The clinical, imaging, and immunohistopathological features of this case were reviewed. Results: The vision in the left eye was light perception. There were keratic precipitates, an irregular and thickened iris with neovascularization. Imaging studies disclosed a ciliary body mass extending into the anterior chamber. The eye was enucleated and immunohistopathological examination showed positive staining with CD20, BCL-2, MUM1, and CD10. Staining with BCL-6 was weak and S100 and HMB45 expressions were negative. Occasional CD3+ reactive T cells were present. The Ki-67 index was 80–90%. All these results suggested diffuse large B-cell lymphoma. Conclusions: Diffuse large B-cell lymphoma may primarily arise from the ciliary body and can develop without systemic or central nervous system disease.
Ciliary body toxicities of systemic oxcarbazepine and valproic acid treatments: electron microscopic study
Published in Cutaneous and Ocular Toxicology, 2015
Güleser Göktaş, Zeynep Aktaş, Deniz Erdoğan, Cemile Merve Seymen, Emine Esra Karaca, Ali Cansu, Ayşe Serdaroğlu, Gülnur Take Kaplanoğlu
Ciliary body is responsible for humour aqueous production in posterior chamber. Valproic acid (VPA) has been widely used for the treatment of epilepsy and other neuropsychiatric diseases such as bipolar disease and major depression. Oxcarbazepine (OXC) is a new anti-epileptic agent that has been used recently for childhood epilepsies such as VPA. In this study, we aimed to investigate the effects of VPA and OXC treatments used as antiepileptic in ciliary body by electron microscopy. In our study, 40 Wistar rats (21 days old) were divided equally into four groups which were applied saline (group 1), VPA (group 2), OXC (group 3) and VPA + OXC (group 4). The as-prepared ocular tissues were characterized by transmission electron microscopy (TEM) technique in scanning and transmission electron microscopy (SEM-TEM) (Carl Zeiss EVO LS10). The results confirmed that VPA caused dense ciliary body degeneration. Additionally, ciliary body degeneration in group 4 was supposed to be due to VPA treatment. Ciliary body damage and secondary outcomes should be considered in patients with long-term VPA therapy.