scholarly journals Achondroplasia Associated with Bilateral Keratoconus

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Ammar M. Al Mahmood ◽  
Hind M. Al Katan ◽  
Ghada Y. Al Bin Ali ◽  
Samar A. Al-Swailem

We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE). Right eye (RE) improved to 20/25. The patient underwent penetrating keratoplasty (PKP) in his LE. Twenty-seven months postoperatively, uncorrected visual acuity (UCVA) was 20/30. Ophthalmologists should be aware that patients with achondroplasia who complain of poor vision should be suspected of having keratoconus once other more common conditions are ruled out.

2009 ◽  
Vol 19 (4) ◽  
pp. 675-678 ◽  
Author(s):  
Eszter Fodor ◽  
Éva Fok ◽  
Erika Maka ◽  
Olga Lukáts ◽  
Jeanette Tóth*

Purpose To report four cases of zoonotic ophthalmodirofilariasis infection caused by Dirofilaria repens in Hungary. Methods Four cases of ophthalmofilariasis have been treated at our department during the last 14 months. A subconjunctival moving worm was observed by slit lamp biomicroscopy in two cases. In one of these a living filaria was surgically removed, but the other disappeared. Red eye and migrating edema were the presenting signs in two cases. A biopsy taken from the subcutaneous masses disclosed D repens. Results Histopathologic or parasitologic examination identified a female D repens in every case. Laboratory alterations were not found. Symptoms subsided after treatment. Conclusions The clinical presentation of filariasis is not always straightforward, and a high index of suspicion is necessary in cases presenting with orbital or periorbital inflammation. During the past 10 years the identification of locally acquired infections by D repens has increased in Hungary.


2009 ◽  
Vol 19 (4) ◽  
pp. 535-543 ◽  
Author(s):  
Leopoldo Spadea ◽  
Massimo Saviano ◽  
Angela Di Gregorio ◽  
Domenico Di Lodovico ◽  
Fabio De Sanctis

Purpose To evaluate in a long-term period the effectiveness and safety of topographically guided two-step laser in situ keratomileusis (LASIK) and standard LASIK technique in the correction of refractive errors after successful penetrating keratoplasty (PKP) for keratoconus. Methods At least 2 years after PKP and 6 months after removal of all sutures, 15 eyes of 15 patients (Group 1; mean manifest refraction spherical equivalent (MRSE) −7.23 D ± 3.42 SD) were submitted to standard LASIK and 15 eyes of 15 patients (Group 2; mean MRSE −4.37 D ± 1.97 SD) to a topographically guided two-step LASIK procedure (first the flap and at least 2 weeks later the laser ablation). In all cases, a superior hinged corneal flap (160 μm/9.5 mm) was created. Results After a follow-up of 36 months, in Group 1 the mean uncorrected visual acuity (UCVA) was 0.51 logarithm of the minimum angle of resolution (logMAR) ± 0.41 SD and the mean best-corrected visual acuity (BCVA) was 0.03 logMAR ± 0.05 SD, with a mean MRSE of −1.57 D ± 2.65 SD. In Group 2, the mean UCVA was 0.28 logMAR ± 0.24 SD and the mean BCVA was 0.01 logMAR ± 0.03 SD, with a mean MRSE of −0.07 D ± 1.00 SD. In both groups, no complications were observed. Conclusions After a long follow-up period, both topographically guided two-step LASIK and standard LASIK could be considered effective and safe tools in the correction of refractive errors after successful PKP for keratoconus.


2021 ◽  
Vol 6 (6-1) ◽  
pp. 48-55
Author(s):  
N. A. Pozdeyeva ◽  
M. V. Sinitsyn ◽  
A. E. Terentieva ◽  
O. V. Shlenskaya

Background. After penetrating keratoplasty, mild to high induced corneal astigmatism was observed in each case. The existing choice of correction of postkeratoplastic astigmatism is aimed at fi nding an individual approach in order to compensate for it and not weaken the biomechanical properties of the corneal graft.The aim: to analyze the clinical, functional, and morphological results of postkeratoplastic astigmatism correction by implantation of intrastromal corneal segments using a femtosecond laser.Methods. 22 patients were examined before and 1 year after surgery. The operation was performed under local anesthesia: stage I – an intrastromal tunnel was formed using a femtosecond laser “Femto Visum” 1 MHz (Optosystems, Russia); stage II – the intrastromal corneal segments were implanted. The results were assessed using standard and special research methods using optical coherence tomography Visante OCT (Zeiss, Germany), keratotopography (Tomey-5, Japan), optical corneal analyzer ORA (Reichert, USA), laser tindalemetry FC-2000 (Kowa, Japan) and confocal microscope Confoscan-4 (Nidek, Japan).Results. Before the operation, uncorrected visual acuity averaged 0.09 ± 0.05, after a year – 0.50 ± 0.16; best corrected visual acuity – 0.30 ± 0.12 and 0.60 ± 0.05 respectively; cylindrical component of refraction – –10.29 ± 3.12 and –2.20 ± 0.64 D respectively; mean keratometry value – 43.59 ± 2.14 and 38.56 ± 1.75 D respectively; corneal hysteresis – 7.92 ± 1.22 and 8.95 ± 1.05 mm Hg respectively; corneal resistance factor – 7.01 ± 1.81 and 8.44 ± 1.44 mm Hg respectively; protein fl ux in the moisture of the anterior chamber – 2.97 ± 0.28 and 3.04 ± 0.24 f/ms respectively; endothelial cell density – 1521 ± 327 and 1475 ± 419 cells/mm2 respectively.Conclusion. Intrastromal corneal segments implantation into a corneal graft using a femtosecond laser has efficiency and safety method in correcting postkeratoplastic astigmatism.


2019 ◽  
Vol 48 ◽  
Author(s):  
Rebeca Dos Santos Costa ◽  
Nina Gabriela Gualberto ◽  
Jéssica Fontes Valência ◽  
Renata Santiago Alberto Carlos

Background:Pupillary membrane persistence (PMP) is a congenital abnormality, which is not usually reported in felines. It is characterized by remnants of the fetal membrane that persist as filamentous tissue across the pupil. In general, this change does not cause any clinical symptoms. However, the filaments may either attach to the cornea and cause small opacities in it or attach to the lens and cause cataracts. In most cases, there is no visual impairment, so treatment is not prescribed. This report aims to describe a case of PMP in a domestic cat diagnosed at the Veterinary Hospital of the State University of Santa Cruz (HV-UESC). Case: A two-and-a-half-year-old mixed-breed castrated male cat was brought to the HV-UESC with dermatological complaints. Upon physical examination, the animal was alert with a body temperature, heart, and respiratory rate within the normal parameters for the feline species. The lymph nodes were non-reactive, and the coloration of the oral mucosa was normal. There was no ophthalmic complaint from the owner, nor any loss of visual acuity. In addition, the animal had moderate pruritus, redness, and alopecia in the region of the ears, head, neck, chest, and back. Bristle samples were collected for an optical microscope analysis and an infestation with lice (Felicola subrostratus) was confirmed. An endectocide containing selamectin (15 mg; single application every 30 days) was prescribed. During physical examination, filamentous tissue crossing from iris to iris through pupil was observed in both eyes. The eyelid, corneal, and pupillary reflexes were within normal ranges. An ophthalmic evaluation did not identify conjunctival hyperemia or episcleral vessel congestion, and the eyelid, corneal, and pupillary reflexes were determined to be within the normal range. A slit-lamp biomicroscopy did not detect any anterior chamber alteration besides the filamentous tissue previously mentioned. An examination of the fundus of the eye by direct ophthalmoscopy revealed that the crystalline lens, retina, optic nerve, and retinal vessels all looked normal with no other ophthalmic alteration. Thus, the diagnosis was PMP, and because of the absence of visual impairment or any other ophthalmic abnormality, no treatment was initiated. Discussion: Feline PMP is a rare condition. Since the present case, a few studies about this alterations in cats were found in the literature about. As in cats, this ophthalmopathy is uncommon in horses and cattle. The present report describes a case of PMP, a poorly described alteration in veterinary medicine, which was diagnosed by ophthalmic examination and slit-lamp biomicroscopy. As reported previously, PMP was an incidental finding during physical examination, since most animals with this alteration present little impairment of visual acuity. However, in some cases, membranous filaments may attach to the cornea and/or lens causing opacities and/or cataracts that may result in vision defects. This did not occur in the present case. In previous studies too, other ophthalmic alterations beyond PMP were not observed, thus corroborating the findings of our case. In the present case, as there were no other ophthalmic changes, it was not necessary to initiate any type of treatment. In conclusion, the lack of information regarding the epidemiology of PMP in cats warrants further studies of this alteration. Although infrequent in cats, this condition can easily be diagnosed in the routine examinations of this species.


1983 ◽  
Vol 221 (2) ◽  
pp. 73-77 ◽  
Author(s):  
A. J. P. Rouwen ◽  
A. J. L. G. Pinckers ◽  
A. A. I. v't Pad Bosch ◽  
H. Punt ◽  
W. H. Doesburg ◽  
...  

2019 ◽  
Vol 12 (11) ◽  
pp. e232473 ◽  
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon ◽  
Praveen Subudhi ◽  
Neha Mithal

A 21-year-old patient presents to us with complaints of blurred vision and photophobia in the left eye, with an uncorrected visual acuity of 20/100 improving to 20/30 with pinhole and diagnostic rigid gas permeable lens trial. He had a history of trauma with subsequent cataract extraction, with residual irregular astigmatism and traumatic mydriasis. XtraFocus Pinhole intraocular lens (Morcher) was implanted in the left eye. One week postoperatively, the left eye uncorrected visual acuity improved to 20/30, uncorrected intermediate visual acuity improved to 20/40, and uncorrected near visual acuity improved to J4. The glare and photophobia resolved completely. Surprisingly, the patient complained of severely poor vision in dim illumination. His vision was limited to bare perception of objects and hand movements close to the face. He started facing difficulties in major activities such as driving at night and in dark ambient surroundings such as movie theatres, which persisted to the extent of necessitating explantation of the implant.


2019 ◽  
Vol 7 (24) ◽  
pp. 4287-4291
Author(s):  
Le Xuan Cung ◽  
Duong Mai Nga ◽  
Nguyen Dinh Ngan ◽  
Nguyen Xuan Hiep ◽  
Do Quyet ◽  
...  

BACKGROUND: Keratoconus is an ectatic corneal disorder that can impair the visual acuity. Up to now, penetrating keratoplasty (PK) remains the most common surgical procedure to treat severe keratoconus. In Vietnam, most keratoconus patients come to visit doctor at severe stage and were treated by PK, so we conduct this study. AIM: To evaluate the results of PK for keratoconus in Vietnamese patients. METHODS: This was a retrospective study of 31 eyes with keratoconus who underwent PK in VNIO from January 2005 to December 2014. RESULTS: The average visual acuity was 0.86 ± 0.37 logMAR (20/145). In the group of patients without amblyopia, best spectacle-corrected visual acuity of 20/60 or better was recorded in 75.9% of eyes and 93.1% of eyes achieved a best corrected visual acuity with hard contact lenses of 20/40 or better. Mean postoperative corneal power was 43.8 ± 4.5D. Mean corneal astigmatism was 5.9 ± 2.7D. 94.6% of grafts remained clear. Posterior subcapsular cataract developed in 22.6% of eyes. Graft rejection was recognized in 12.9% of eyes. CONCLUSION: PK is an effective procedure with high rate of graft survival for keratoconus patients. However, patients should be aware of the necessary of optical correction to gain the best VA after surgery.


2015 ◽  
Vol 09 (01) ◽  
pp. 19
Author(s):  
Ebru Toker ◽  

Over the past decade the management of keratoconus has changed from the traditional model limited only to rigid gas permeable lenses or penetrating keratoplasty to an array of newer medical and surgical treatment modalities that focus on both prevention of disease progression and improvement of functional visual acuity. New design contact lenses such as keratoconus design rigid gas permeable lenses, soft lenses, hybrid and scleral lenses offer the advantage of better comfort together with improved vision. Fitting of these contemporary contact lenses may postpone or avoid the need for keratoplasty in most of the patients with keratoconus.


2020 ◽  
Vol 17 (3) ◽  
pp. 95
Author(s):  
Muhammad Marwat

A 40 years old man presented with bilateral mild dimness of vision and mild glare. Diffuse and focal illumination on slit lamp biomicroscopy did not reveal any pathology. Retro-illumination on slit lamp showed faint bilateral spokes like cortical lens opacities. Retro-illumination mode on Auto-Ref/Keratometer (HRK 7000A, Huvitz, Anyang-si, Gyeonggi-do, Republic of Korea) prominently revealed these insignificant bilateral spokes like cortical opacities (cataracts). Visual acuity was 6/9 in both eyes. No intervention was advisable and the patient was reassured.


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