scholarly journals Ocular Toxicity Secondary toAsclepias physocarpa: The Balloon Plant

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Susana Pina ◽  
Catarina Pedrosa ◽  
Cristina Santos ◽  
Bernardo Feijóo ◽  
Peter Pego ◽  
...  

We report a case of a 65-year-old woman with symptoms of blurred vision and ocular irritation a few hours after accidental contact of the right eye withAsclepias physocarpamilky latex. Observation showed a diffuse conjunctival hyperemia and stromal corneal edema with Descemet’s membrane folds. Recovery was fast and apparently complete in less than one month. However, specular microscopy at 6-months follow-up showed an abnormal endothelial morphology as sequelae, suggesting this condition is not as innocuous as it has been suggested.

Author(s):  
Benchakroun S ◽  
◽  
Taouri N ◽  
Tagmouti A ◽  
Cherkaoui LO ◽  
...  

We report a case of a 42-year-old-woman, who presented to the ophthalmic consultation for decreased visual acuity complaints of blurred vision, altered pupillary shape since few months of her right eye. The clinical examination found a reduced visual acuity to counting fingers in the right eye and 20/20 in the left eye. intraocular pressures was 38 mm Hg OD and 14 mm Hg OS. Slit lamp examination of the right eye found: Corneal edema, iris atrophy with a deformation of the iris architecture and pupillary anomalies, with polycoria (Figure 1). The evaluation of the angle by gonioscopy found areas of broad synechiae anterior to Schwalbe’s line (Figure 2). While the examination of the left eye was normal (Figure 1B). The posterior segment examination was normal in both eyes. Specular microscopy confirmed the presence of unilateral endothelial pleomorphism and polymegathism. In our case of the retained diagnosis was iridocorneal endothelial syndrome


2021 ◽  
pp. 611-615
Author(s):  
Ayaka Doi ◽  
Tadamichi Akagi ◽  
Akitaka Tsujikawa

Descemet’s membrane detachment (DMD) is a rare but serious complication of phacoemulsification surgery. A small DMD may resolve spontaneously, but extensive DMD often requires intracameral injection of air, nonexpansile gases, or expansile gases. A 92-year-old man who underwent phacoemulsification and aspiration with intraocular lens placement in the right eye had significantly reduced visual acuity, with a hazy cornea after surgery. Anterior segment optical coherence tomography (AS-OCT) examination revealed extensive DMD throughout the cornea. He was treated with intracameral injection of 20% sulfur hexafluoride. As a result, the Descemet membrane was successfully reattached, and the corneal edema resolved. AS-OCT was helpful in confirming the presence and extent of DMD, provided useful information to determine the appropriate treatment, and was useful for monitoring DMD.


2018 ◽  
Vol 10 (2) ◽  
pp. 188-192
Author(s):  
Sanjay Kumar Singh ◽  
Reena Yadav ◽  
Ashmita Sharma

Background: Descemet’s membrane endothelial keratoplasty (DMEK) is an evolving option for failed penetrating keratoplasty (PK) as it has shown promising results compared to repeat PK. Case description: A 22 years young gentleman presented with gradual diminution of vision in the left eye (LE) for six months following therapeutic PK for a perforated fungal corneal ulcer. His best spectacle corrected visual acuity (BSCVA) was 6/60 in LE. Slit-lamp examination of LE revealed circumcorneal congestion with full thickness corneal graft with micro and macrobullae, diffuse stromal edema, DM folds and seven well-buried sutures. Intraocular pressure was 20 mmHg in the right eye whereas it could not be assessed in the left eye. The diagnosis of LE failed PK was made and the patient underwent DMEK. At four months postoperative follow up visit, BSCVA improved to 6/9. This is the first reported case of DMEK after a failed PK in a  young patient from Nepal which was successfully treated without any complications. Conclusion: DMEK has a higher potential for better visual rehabilitation compared to DSEK and PK. It has also proved its efficacy in the treatment of endothelial graft failure following PK as it is a less invasive procedure.


Author(s):  
Malik Y. Kahook

Corneal injury resulting from glaucoma surgery has been well described. Causes of injury can range from direct mechanical manipulation to the often more subtle pharmacologically induced injuries that occur with use of antifibrotic medications. Descemet’s membrane detachment (DMD) occurs uncommonly during or after intraocular surgery and has been linked with a variety of procedures ranging from simple clear cornea cataract extraction to deep lamellar keratoplasty. The corneal endothelium, which rests upon Descemet’s membrane, functions as a pump to keep the stroma from becoming swollen. Therefore, DMD results in focal corneal edema and possibly bullous keratopathy. If detachment of Descemet’s membrane extends far enough centrally, visual acuity may become sufficiently compromised to necessitate corneal transplantation surgery (either full-thickness penetrating keratoplasty [PKP] or Descemet’s stripping with automated endothelial keratoplasty [DSAEK]). In glaucoma surgery, DMD often results from the mechanical manipulation that occurs with creation of the cornealtrabecular meshwork opening. Knowing how to accurately diagnose and treat DMD can prevent disastrous consequences and preserve vision. Mackool and Holtz proposed separating DMD into 2 categories, planar and nonplanar, depending on the distance of separation between Descemet’s membrane and the posterior corneal stroma. Planar DMD involves less than 1 mm separation of Descemet’s membrane from the corneal stroma and may be limited to the periphery or extend from the periphery to central regions. Nonplanar DMD involves greater than 1 mm separation of Descemet’s membrane from the corneal stroma and may also be categorized as limited to the periphery or extending to central regions. The significance of this classification was the belief that planar DMD was more likely to spontaneously resolve while nonplanar DMD required surgical intervention. Assia and colleagues also split DMD into 2 categories: DMD with scrolling of tissue and DMD without scrolling of tissue. They believed this classification more accurately described potential for spontaneous resolution in that nonscrolled DMD was more likely to resolve without surgical intervention, even if its location was >1mm from the posterior corneal stroma. While useful as a general guide, these classification systems are not foolproof, and each case of DMD should be viewed independently.


2014 ◽  
Vol 73 (5) ◽  
Author(s):  
Karine Feitosa Ximenes ◽  
Jailton Vieira Silva ◽  
Karla Feitosa Ximenes Vasconcelos ◽  
Fernando Queiroz Monte

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Hung-Ta Chen ◽  
Kuan-Jen Chen ◽  
Yi-Jen Hsueh ◽  
Yaa-Jyuhn James Meir ◽  
...  

Abstract Background Generally, the loss rate of human endothelial cells (HCEC) in routine cataract surgery is 8.5%. When the corneal endothelial cells density (ECD) drops, the HCEC may decompensate to keep cornea dehydration which leads to corneal edema. Granulomatosis with polyangiitis (GPA) is an uncommon autoimmune disease involving multiple organs including eyes such as conjunctivitis, scleritis, uveitis, and corneal ulcer. In this study, we report two cases of GPA whose corneal ECD decreased significantly after phacoemulsification cataract surgery. Case presentation In the first case of 69-year-old male with GPA, the ECD dropped 39.6% (OD) four months after phacoemulsification and 38.1% (OS) six months postoperatively respectively. At the final follow-up, the residual ECD was only 55% in the right eye in the 49th month, and 56% remained in the left eye in the 39th month. In the second case of 54-year old female, left ECD dropped 63.9% at the 4th month after surgery and 69.6% ECD remained at the 15th month postoperatively while similar ECD of right eye before and after left eye surgery. Conclusion Extensive preoperative ophthalmic evaluation and meticulous postoperative inflammation control should be applied to prevent severe loss of HCEC in GPA patients.


2020 ◽  
pp. 112067212095759
Author(s):  
Meriem Ouederni ◽  
Hela Sassi ◽  
Zied Chelly ◽  
Fehmy Nefaa ◽  
Monia Cheour

Purpose: Since its first description by Chang et al. in 1995, the diagnosis of Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome has been based on the findings of Fundus Fluorescein Angiography (FFA). Our purpose was to describe the utility of optical coherence tomography angiography (OCT-A) in its diagnosis and management. Case description: A 40-year-old female presented with bilateral blurred vision. Her best corrected visual acuity was at 8/10. Fundus examination revealed blurred disc margins, perivascular exudates, arterial sheaths and retinal hemorrhages bilaterally. FFA showed staining of the optic disc with dye leakage in the right eye, a punctuate hyperfluorescence of the temporosuperior artery in the left eye, bilateral vascular sheathing and capillary dropout. OCT-A showed simultaneous presence of papillary aneurysm and neovascularization of the optic nerve head in the right eye, a papillary aneurysm in the left eye and bilateral capillary non-perfusion. Our patient was diagnosed with IRVAN syndrome. Oral steroids associated with panretinal laser photocoagulation and intravitreal injection of bevacizumab in the right eye resulted in vanishing of the papillary neovascularization with no recurrence on OCT-A at 10-month follow-up. Conclusions: OCT-A is an additional tool to FFA for visualization of arterial macroaneurysms and retinal neovascularization without the interference of dye leakage. It well demarcates nonperfused areas and ensures follow-up of retinal neovascularization. Its limitations are the limited field of view and the low sensitivity in detecting arteriolar dilations. Thus, OCT-A is unable to outplace FFA but should be considered alternately with it for non-invasive follow-up of IRVAN syndrome.


2021 ◽  
Vol 8 (3) ◽  
pp. 1-3
Author(s):  
Anirudh Duhan ◽  
◽  
Eswar Sakare ◽  
Sudhakar Potti ◽  
Madhuri Venigalla ◽  
...  

We report a case of bilateral Terrien’s Marginal Degeneration with Hydrops. A 59 year old man presented with dimunition of vision in both eyes since 3 years. On examination both eyes had superior ectatic changes with right eye having scarred Descemet’s membrane indicating a healed hydrops and left eye showing superior corneal edema indicating resolving hydrops.


2020 ◽  
Vol 26 (3) ◽  
pp. 232-236
Author(s):  
Izumi Yamaguchi ◽  
Kyong-Hon Pooh ◽  
Mai Azumi ◽  
Yasushi Takagi

Temporal crescent syndrome is a monocular visual field defect involving the temporal crescent of one eye caused by a retrochiasmal lesion. The most anterior portion of the striate cortex is the only area where the retrochiasmal lesion produces a monocular visual field defect. The authors present the case of a 9-year-old boy who presented with mild headache. MRI revealed a cyst with cerebrospinal fluid signal intensity, occupying the body and trigone of the right lateral ventricle. Conservative treatment with regular clinical and radiological follow-up was chosen because neurological examination findings were normal. Three years later, the patient experienced blurred vision with a temporal crescent defect in the left eye. Endoscopic cyst fenestration was performed, and the pathological findings indicated a glioependymal cyst. After surgery, the monocular temporal crescent disorder was resolved. MRI indicated shrinkage of the cyst and improvement in the narrowing of the anterior calcarine sulcus. These findings suggested that the temporal crescent syndrome was caused by a lateral ventricular glioependymal cyst. This is the first known report of temporal crescent syndrome caused by a lateral ventricular glioependymal cyst. In patients with monocular temporal crescent disorder without intraocular disease, a retrochiasmal lesion in the most anterior portion of the striate cortex should be considered.


2018 ◽  
Vol 29 (3) ◽  
pp. 278-286
Author(s):  
Sergio Jacobovitz ◽  
José Aloísio Massote ◽  
Sebastião Cronemberger

Objective: To assess the feasibility of a novel surgical technique in painful blind eyes. Design: A prospective safety study conducted at the Federal University of Minas Gerais, Brazil. Participants/samples: A total of 15 end-stage glaucomatous eyes without light perception vision. Methods: After implantation, conjunctival hyperemia, discharge, erosion, aqueous humor leakage, corneal edema, hyphema, anterior chamber cells and depth, dislocation of the implant, and filtering bleb height were assessed by slit-lamp biomicroscopy. Intraocular pressure was measured preoperatively and 24 months following surgery. A numerical rating scale was used to evaluate pain. Anterior segment optical coherence tomography was also assessed. Results: Laminar drainage implant surgery was performed in all patients without major complications. Mean intraocular pressure was significantly reduced after surgery without hypotensive medication (preoperatively 54.5 ± 5.1 mmHg vs 24 months after surgery 37.0 ± 15.4 mmHg, p = 0.003). Subjective ocular pain intensity also reduced (preoperatively 10 vs at 24-month follow-up visits 0). Corneal edema incidence reduced from 85.7% (95% confidence interval: 57.2%–98.2%) to 16.7% (95% confidence interval: 2.1%–48.4%) at the 24-month follow-up. No patients experienced a prolonged flat anterior chamber or erosion of overlying tissues. Conclusion: The surgery was feasible and safe in painful blind eyes.


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