Complete Vision Loss after Laparoscopic Hysterectomy

Postoperative vision loss (POVL) is a rare but devastating complication that has only recently been reported following laparoscopic surgery. We present the case of a 34-year-old gravida 6 para 4 female who experienced POVL following an uncomplicated laparoscopic hysterectomy. Operating time was 174 minutes, and EBL was 75 mL. After surgery, she complained of complete vision loss with no light perception. No cerebral hemorrhage or ischemia was detected on imaging. Funduscopic exam revealed no structural abnormalities. On postoperative day 7, she received an IV methylprednisolone taper. The following morning, she reported mild light perception. Later that night, she reported a partial return of visual acuity and was discharged home. At her 2-week postoperative visit, her vision had returned to baseline. POVL is an emergency and prompt evaluation should be initiated to optimize outcome.

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Streptococcus pneumoniae endophthalmitis: clinical settings, antibiotic susceptibility, and visual outcomes

Scientific Reports ◽

10.1038/s41598-021-85456-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kuan-Jen Chen ◽

Ying-Jiun Chong ◽

Ming-Hui Sun ◽

Hung-Chi Chen ◽

Laura Liu ◽

...

Keyword(s):

Visual Acuity ◽

Streptococcus Pneumoniae ◽

Antibiotic Susceptibility ◽

Vision Loss ◽

Clinical Settings ◽

Light Perception ◽

Tertiary Referral Center ◽

Visual Outcomes ◽

Pars Plana ◽

Better Than

AbstractStreptococcus pneumoniae endophthalmitis is clinically more severe, more difficult to treat, and carry a higher risk of vision loss, evisceration, or enucleation. This study is to investigate the clinical settings, antibiotic susceptibility, and visual outcomes of S. pneumoniae endophthalmitis at a tertiary referral center in Taiwan. S. pneumoniae endophthalmitis was diagnosed in 38 eyes of 38 patients. The main clinical features were postcataract endophthalmitis (n = 13, 34%) and endophthalmitis associated with corneal ulcer (n = 12, 32%), trauma (n = 6, 16%), endogenous etiology (n = 4, 11%), trabeculectomy (n = 2, 5%), and pterygium excision-related scleral ulcer (n = 1, 3%). Presenting visual acuity ranged from counting fingers to no light perception. Pars plana vitrectomy with intravitreal antibiotics was performed in 17 eyes (39%) in primary or secondary treatments. S. pneumoniae isolates were susceptible to vancomycin (38/38, 100%), penicillin (37/38, 97%), ceftriaxone (37/38, 97%), cefuroxime (12/15, 80%), levofloxacin (13/15 ,87%), and moxifloxacin (15/17, 88%). Final visual acuity was better than 20/400 in 3 of 38 eyes (8%), 5/200 to hand motions in 3 eyes (8%), and light perception to no light perception in 32 eyes (84%). Ten eyes (26%) underwent evisceration or enucleation. Although S. pneumoniae isolates were susceptible to vancomycin, S. pneumoniae endophthalmitis had a very poor visual prognosis.

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Complete Vision Loss following Orbital Cellulitis Secondary to Acute Dacryocystitis

Case Reports in Ophthalmological Medicine ◽

10.1155/2016/9630698 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Margaret L. Pfeiffer ◽

Alexander Hacopian ◽

Helen Merritt ◽

Margaret E. Phillips ◽

Karina Richani

Keyword(s):

Visual Acuity ◽

Vision Loss ◽

Orbital Cellulitis ◽

Close Monitoring ◽

Light Perception ◽

Lacrimal Sac ◽

Surgical Incision ◽

Incision And Drainage ◽

Severe Vision Loss ◽

Prompt Diagnosis

We present a case of a 50-year-old woman with acute dacryocystitis that was complicated by posterior rupture of the lacrimal sac causing an orbital cellulitis with subsequent visual acuity of no light perception. Upon presentation, she was immediately started on broad-spectrum antibiotics and underwent surgical incision and drainage of the lacrimal sac abscess but never regained vision. There are 4 cases in the literature of permanent severe vision loss from acute dacryocystitis. Prompt diagnosis and close monitoring of acute dacryocystitis are therefore essential to prevent extension into the orbit and possible optic nerve compromise.

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Laparoscopic hysterectomy for endometrial carcinoma in obese patients

Journal of obstetrics and women s diseases ◽

10.17816/jowd63621-31 ◽

2014 ◽

Vol 63 (6) ◽

pp. 21-31 ◽

Cited By ~ 3

Author(s):

Igor’ Viktorovich Berlev ◽

Elena Aleksandrovna Ul’rikh ◽

Bakhtierovich Saparov Aminzhon ◽

Ekaterina Aleksandrovna Nekrasova ◽

Nikolay Aleksandrovich Mikaya ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Surgical Treatment ◽

Endometrial Carcinoma ◽

Operating Time ◽

Laparoscopic Hysterectomy ◽

Laparoscopic Technique ◽

Obese Patients ◽

Treatment Results ◽

Effective Option ◽

Complications Rate

Background. Up to date the coincidence of endometrial carcinoma and obesity is widespread. Obesity has unfavorable action on surgical treatment results. Objective. To evaluate the effectiveness of laparoscopic technique for surgical treatment of endometrial carcinoma in obese patients. Methods. We have prospectively evaluated the results of surgical treatment from 97 obese patients with low metastasis risk endometrial carcinoma from 2010 to 2014 years. Results. Laparoscopic surgery associated with low intraoperative blood loss (26.4 ± 7.1 ml vs 267.2 ± 45.0 ml, p < 0.0001), on the other hand laparoscopic surgery not prolongs operating time (108.8 ± 7.5 min vs 104.3 ± 13.5 min, p = 0.38). Obese patients after laparoscopic surgery have low complications rate (1.5 % vs. 48.3 %, p = 0.002). Conclusions. Laparoscopy is effective option for surgical treatment of low metastasis risk endometrial cancer patients with obesity.

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Older woman with abdominal pain and bilateral sequential vision loss due to syphilis

BMJ Case Reports ◽

10.1136/bcr-2021-243847 ◽

2021 ◽

Vol 14 (6) ◽

pp. e243847

Author(s):

Anna Kabanovski ◽

Trishal Jeeva-Patel ◽

Alexander Kaplan ◽

Esther Bui ◽

Edward A Margolin

Keyword(s):

Visual Acuity ◽

Abdominal Pain ◽

Visual Loss ◽

Vision Loss ◽

Treponema Pallidum ◽

Light Perception ◽

Older Woman ◽

Syphilis Infection ◽

Elevated Alkaline Phosphatase ◽

Systemic Symptoms

A 62-year-old woman presented with non-specific abdominal pain, elevated alkaline phosphatase levels and bilateral sequential visual loss. Visual acuity was counting fingers in right eye (RE) and 20/400 in left eye (LE). She was noted to have optic nerve pallor in RE and mildly elevated optic disc with signs of ocular inflammation in LE. After 2 weeks, vision deteriorated to light perception bilaterally with now extensive vitreal inflammation present in both eyes. Positive rapid plasma reagen and Treponema pallidum’s antibody tites confirmed syphilis infection. Unfortunately, as the diagnosis was delayed by many months, her visual acuity remained poor (hand motions in RE and 20/50 in LE) despite treatment with intravenous penicillin. This case reminds us of the re-emergence of this ‘great masquerader’ and highlights the importance of maintaining high suspicion for syphilis in patients with unexplained visual loss and systemic symptoms, even in older adults without identifiable risk factors.

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Intraorbital Wooden Foreign Body with Intracranial Extension : A Case Report

Ophthalmologica Indonesiana ◽

10.35749/journal.v44i1.155 ◽

2018 ◽

Vol 44 (1) ◽

pp. 4

Author(s):

Amanda N Shinta ◽

Purjanto Tepo Utomo ◽

Agus Supartoto

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Frontal Lobe ◽

Vital Sign ◽

Intracranial Extension ◽

Ocular Motility ◽

Light Perception ◽

Bone Segment ◽

Wooden Foreign Body ◽

Wooden Stick

Purpose : The aim of this study is to report a case of intraorbital wooden foreign body with intracranial extension to the frontal lobe and its management. Method : This is a descriptive study: A 53 year-old male referred due to wooden stick stucked in the orbital cavity causing protruding eyeball and vital sign instability. Result : Right eye examination revealed light perception visual acuity, with bad light projection and bad color perception, inwardly folded upper eyelid, proptosis, conjunctival chemosis, corneal erosion and edema, dilated pupil with sluggish pupillary light reflex and limited ocular movement in all direction. Vital sign was unstable with decreasing blood pressure, increasing temperature and heart rate. CT Scan showed complete fracture of the orbital roof due to penetration of the wooden stick, pneumoencephalus, cerebral edema and hematoma. Emergency craniotomy was performed to remove the penetrating wooden stick and bone segment in the frontal lobe and fracture repair. Ophthalmologist pulled the remaining stick, released the superior rectus muscle and repaired the lacerated eyelid. Outcome visual acuity was no light perception with lagophthalmos and limited ocular motility. Patient was admitted to Intensive Care Unit one day post-operatively and treated with systemic and topical antibiotic. Conclusion : Any case presenting with intraorbital foreign body must undergo immediate neuroimaging to exclude any intracranial extension, especially in patients with worsening general condition.

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Valsalva Retinopathy Associated with Sexual Activity

Case Reports in Medicine ◽

10.1155/2014/524286 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Khalid Al Rubaie ◽

J. Fernando Arevalo

Keyword(s):

Visual Acuity ◽

Sexual Activity ◽

Vision Loss ◽

Internal Limiting Membrane ◽

Internal Limiting Membrane Peeling ◽

Sudden Loss ◽

Initial Visual Acuity ◽

Pars Plana ◽

23 Gauge ◽

The Right

A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

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Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study

Journal of Ophthalmology ◽

10.1155/2015/821864 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Salvatore Di Lauro ◽

Melissa Castrejón ◽

Itziar Fernández ◽

Jimena Rojas ◽

Rosa M. Coco ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Visual Loss ◽

Vision Loss ◽

Multicentric Study ◽

Prospective Multicentre Study ◽

Snellen Chart ◽

Pars Plana ◽

Phakic Eyes

Purpose. To quantify the frequency of visual loss after successful retinal detachment (RD) surgery in macula-on patients in a multicentric, prospective series of RD.Methods. Clinical variables from consecutive macula-on RD patients were collected in a prospective multicentric study. Visual loss was defined as at least a reduction in one line in best corrected visual acuity (VA) with Snellen chart. The series were divided into 4 subgroups: (1) all macula-on eyes (n=357); (2) macula-on patients with visual loss at the third month of follow-up (n=53) which were further subdivided in (3) phakic eyes (n=39); and (4) pseudophakic eyes (n=14).Results. Fifty-three eyes (14.9%) had visual loss three months after surgery (n=39phakic eyes;n=14pseudophakic eyes). There were no statistically significant differences between them regarding their clinical characteristics. Pars plana vitrectomy (PPV) was used in 67.2% of cases, scleral buckle in 57.7%, and scleral explant in 11.9% (36.1% were combined procedures).Conclusions. Around 15% of macula-on RD eyes lose VA after successful surgery. Development of cataracts may be one cause in phakic eyes, but vision loss in pseudophakic eyes could have other explanations such as the effect of released factors produced by retinal ischemia on the macula area. Further investigations are necessary to elucidate this hypothesis.

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Visual Functions in Children in Remote Postoperative Period after Laser Treatment of Threshold Stages of Retinopathy of Prematurity

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-2s-18-23 ◽

2018 ◽

Vol 15 (2S) ◽

pp. 18-23

Author(s):

M. V. Pshenichnov ◽

O. V. Kolenko ◽

V. V. Egorov ◽

E. L. Sorokin

Keyword(s):

Visual Acuity ◽

Postoperative Period ◽

Retinopathy Of Prematurity ◽

Vision Loss ◽

State Institution ◽

Laser Coagulation ◽

Visual Functions ◽

Functional Changes ◽

Continuous Sampling ◽

High Degree

Purpose.Analysis of visual functions in children in remote postoperative period after laser coagulation (LC) of threshold stages of retinopathy of prematurity (ROP).Patients and methods. In 2017, we selected and investigated 18 children, who previously had an LC of threshold stages of ROP in 2008–2009 in the Khabarovsk branch of the S.N. Fyodorov State Institution Eye Microsurgery Complex (continuous sampling method). There were 5 boys and 13 girls aged from 8 to 9 years at the time of LC. Anterior and posterior eye segments of the eyes (biomicroscopy, ophthalmoscopy), visual acuity, clinical refraction, concomitant pathology were evaluated.Results. We have revealed that regressive ROP after LC is characterized by the presence of serious anatomical and functional changes in the eyes. First, these are refractive disorders, which revealed in 90.5% of cases. Most often revealed: myopic refraction — 61% of all cases, of which more than half (53%) is its high degree; or its combination with compound myopic astigmatism (77% eyes); anisometropia was detected in 39% children. These refractive disorders led to the development of strabismus (61% children) and mixed amblyopia (60%). Despite the combined ophthalmologic pathology, 17% children developed visual functions with achievement of binocular vision, in most children visual functions still continue to develop, although they are not high due to amblyopia. High visual acuity (from 0.8 and above) in both eyes was formed in 22% children; visual acuity in the range of 0.5–0.7 in both eyes was formed in 17% children. Unfortunately, 44.5% children at the time of examination had low visual functions (in the range of 0.05–0.4) in both eyes. Extremely low visual acuity (from 0.01 to 0.04) in both eyes was identified in 11% children; absolute blindness in one of the eyes was in 11% children.Conclusions. LC is reliable way to prevent vision loss from retinal detachment in children with threshold stages of ROP.

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Visual Outcomes of Macula-Involving Rhegmatogenous Retinal Detachment in Patients with and Without Age-Related Macular Degeneration

10.21203/rs.3.rs-1178939/v1 ◽

2022 ◽

Author(s):

P. Barrett Paulk ◽

Dala Eloubeidi ◽

John O. Mason III ◽

Christine A. Curcio ◽

Jason N. Crosson ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Degeneration ◽

Rhegmatogenous Retinal Detachment ◽

Age Related Macular Degeneration ◽

Light Perception ◽

Postoperative Visual Acuity ◽

Age Related ◽

Functional Vision ◽

Better Than

Abstract Background Patients presenting with macula-off rhegmatogenous retinal detachment (RRD) with concomitant age-related macular degeneration (AMD) and their treating physicians would benefit from knowledge regarding the visual prognosis after repair. The prognosis for such patients is not well known. The purpose of this study is to compare visual outcomes in macula-off RRD in eyes with AMD versus a group of comparison eyes without AMD. Methods This was a retrospective chart review of 1,149 patients. A total of 191 eyes met study criteria, 162 non-AMD eyes (controls) and 29 AMD eyes. The main outcome measure was postoperative visual acuity in control eyes versus AMD eyes, and this was compared using Fisher’s exact test. Results There was a statistically significant difference in postoperative visual acuity by AMD status, with those without AMD having a higher frequency of Count Fingers (CF), Hand Motion (HM), Light Perception (LP), or No Light Perception (NLP) vision (p = 0.023). More specifically 5.56% of non-AMD eyes and 3.45% of AMD eyes were 20/40 or better, 77.16% of non-AMD and 55.17% of AMD eyes were worse than 20/40 and better than 20/200, 10.49% of non-AMD eyes and 37.93% of AMD eyes were 20/200 or worse, and there were 11 eyes in the non-AMD group with CF, HM, LP, or NLP vision while there was only 1 eye in the AMD group with CF vision. Conclusions Though postoperative visual acuity was worse in the non-AMD group with a higher frequency of patients having final vision of CF, HM, LP, or NLP, this is not likely a clinically significant finding. Rather, it is a function of the difference in sample size and composition between the two groups. Importantly, this study suggests AMD patients can expect similar outcomes to non-AMD patients after RRD repair. Our study suggests that approximately 58% of patients with AMD can expect to maintain functional vision better than 20/200. We conclude that AMD patients can achieve functional vision after RRD surgery, similar to those without AMD. These findings may be helpful in guiding realistic expectations of AMD patients with RRD.

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Prevalence and causes of visual impairment and blindness among school children in Muzaffarabad, Pakistan

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20181393 ◽

2018 ◽

Vol 4 (4) ◽

pp. 93

Author(s):

Abdul Rauf Awan ◽

Junaid Jamshed ◽

Muhammad Mushtaq Khan ◽

Zahid Latif

Keyword(s):

Visual Acuity ◽

Public Schools ◽

Visual Impairment ◽

Private Schools ◽

School Children ◽

School Health ◽

Vision Loss ◽

Screening Program ◽

Sampling Technique ◽

Cross Sectional

Background: Vision loss in childhood has serious implications in all stages of child’s growth and development. It poses social, educational and occupational challenges, with affected children being at greater risk of developing behavioral, psychological and emotional problems, lower self-esteem and poorer social integration. The aim of this study was to assess the prevalence and identify the causes of visual impairment and blindness in school children of UC Gojra, Muzaffarabad, Pakistan so that prevention strategies could be implemented.Methods: This was a school-based descriptive cross-sectional study conducted among public and private schools. A multi-stage stratified random sampling technique was used for selecting study participants aged 5-20 years from 24 schools in Muzaffarabad. The vision of school children was examined for visual acuity using standard Snellen chart. Those participants who had visual acuity of <6/18 in either eye underwent a more detailed ophthalmic examination to diagnose the causes of VI. An exploration of demographic variables was conducted using Chi-square test. Results: The mean age of participants was 10±2.83. The prevalence of visual impairment was 19.6% and 2.3% for severe visual impairment. The age group most affected by VI was 11-15 years (74.2%). There were increased chances of developing VI with advancing age of the participants. Males contributed 88.7% of the cases of VI while females contributed only 11.3%. The class category 5-6 had higher percentage of VI cases (32.7%). Public schools contributed 52.8% of the cases of VI while for private schools the corresponding percentage was 47.2%. The leading cause of VI was refractive error (89.3%) followed by amblyopia (5.0%). Other causes of VI included cataract (1.2%), corneal disease (1.8%), strabismus (1.8%) and nystagmus (0.6%).Conclusions: There is a need to implement school health policy on visual screening prior to admissions in schools and annual eye screening program for early detection and prompt treatment of eye problems among school children in Muzaffarabad.

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