Use of micropulse trans-scleral cyclophotocoagulation for acute rise in intraocular pressure due to anterior segment inflammation

2020 ◽  
pp. 112067212092434
Author(s):  
Shotaro Asano ◽  
Victor Koh Teck Chang ◽  
Maria Cecilia Domingo Aquino ◽  
Paul Chew Tec Kuan
Keyword(s):  
Intraocular Pressure ◽  
Rescue Therapy ◽  
Anterior Segment ◽  
Poor Response ◽  
Posterior Capsular Opacification ◽  
Nd:Yag Laser Capsulotomy ◽  
Pressure Spike ◽  
History Of ◽  
The Right ◽  
Rescue Procedure

Purpose The aim of this study was to report the use of micropulse trans-scleral cyclophotocoagulation as an adjunct therapy for two cases of medically uncontrolled intraocular pressure spikes due to anterior segment inflammation. Case description: Case 1 had previous cataract surgery and exhibited an intraocular pressure spike due to phacoantigenic uveitis (right eye intraocular pressure = 52 mmHg). Despite medical treatment, the right eye intraocular pressure remained high (43 mmHg), thus micropulse trans-scleral cyclophotocoagulation was carried out as a rescue therapy. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 3 weeks was 9 and 16 mmHg, respectively. Case 2 had a history of previous blunt ocular trauma and 180° of angle recession. Both eyes were pseudophakia and underwent right eye Nd:YAG laser capsulotomy for posterior capsular opacification. Immediately after the procedure, the right eye intraocular pressure increased to 64 mmHg. Due to poor response to medical therapy, rescue micropulse trans-scleral cyclophotocoagulation was performed. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 2 months was 12 and 21 mmHg, respectively. Conclusion Micropulse trans-scleral cyclophotocoagulation successfully decreased intraocular pressure in both cases of acute rise in intraocular pressure. Micropulse trans-scleral cyclophotocoagulation can potentially be useful as a rescue procedure to safely reduce medically uncontrollable intraocular pressure spike due to anterior segment inflammation.

scholarly journals “Old wine in a new bottle” - post COVID-19 infection, central serous chorioretinopathy and the steroids

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Srinivasan Sanjay ◽  
Poornachandra B. Gowda ◽  
Bhimasena Rao ◽  
Deepashri Mutalik ◽  
Padmamalini Mahendradas ◽  
...  
Keyword(s):  
Virus Disease ◽  
Anterior Segment ◽  
Central Serous Retinopathy ◽  
Oral Antibiotics ◽  
Rt Pcr ◽  
Case Presentation ◽  
Ocular Manifestations ◽  
Corrected Distance Visual Acuity ◽  
History Of ◽  
The Right

Abstract Introduction Corona virus disease (COVID-19) pandemic can cause myriad of ocular manifestations. We report a case of unilateral multi focal central serous retinopathy, post COVID-19 infection in an Asian Indian female. Case presentation A 42-year-old female presented to us with unilateral blurring, in the right eye (OD), 12 days after COVID-19 infection. She had fever, chills, shortness of breath and cough with tiredness and was COVID- RT PCR positive. She was administered intravenous and oral antibiotics with injection heparin/remdesivir, during her 7 day stay at the hospital. She was also on steroid inhalers. She had no systemic history of note. On ocular evaluation, her corrected distance visual acuity was 20/40 in OD and 20/20 in left eye (OS). Anterior segment was normal. Anterior vitreous was clear. Fundus examination of the OD showed central serous retinopathy (CSCR) with OS being normal. Conclusion CSCR can occur post COVID-19 due to steroid administration and physicians administering it should be aware of this and refer the patients to an ophthalmologist earlier.

Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

2021 ◽  
pp. 112067212110104
Author(s):  
Mehmet Talay Koylu ◽  
Fatih Mehmet Mutlu ◽  
Alper Can Yilmaz
Keyword(s):  
Intraocular Pressure ◽  
Female Patient ◽  
Congenital Glaucoma ◽  
Safe Procedure ◽  
Primary Congenital Glaucoma ◽  
History Of ◽  
Kahook Dual Blade ◽  
The Right ◽  
Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

scholarly journals Venipuncture Induced Complex Regional Pain Syndrome Presenting as Inflammatory Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Punit Pruthi ◽  
Pramod Arora ◽  
Manoj Mittal ◽  
Anugrah Nair ◽  
Waqia Sultana
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Inflammatory Arthritis ◽  
Young Male ◽  
Pain Syndrome ◽  
Poor Response ◽  
History Of ◽  
Diagnostic Modalities ◽  
Musculoskeletal Ultrasonography ◽  
The Right

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

scholarly journals Third nerve paralysis due to cranial metastasis of prostate tumor

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Rao Muhammad Rashad Qamar ◽  
Qasim Mansoor ◽  
Majeed T
Keyword(s):  
Previous History ◽  
Anterior Segment ◽  
Petrous Apex ◽  
Nerve Paralysis ◽  
History Of ◽  
Total Body ◽  
The Right ◽  
Cranial Metastasis ◽  
Oncology Unit ◽  
Third Nerve

A 90 years old man presented with outward deviated right eye with droopy lid. These symptoms were developed over a period of two weeks and there was no pain behind the eye. There was no previous history of Diabetes mellitus, hypertension etc. He had a treatment for adenocarcinoma of prostate six years ago. On examination his best-corrected visual acuity was 6/60 in each eye. There was right complete third nerve paralysis with pupil involvement. Anterior segment examination showed nucleosclerotic changes on both sides. Posterior segment examination showed ARMD (dry type) in both eyes. Intraocular pressure and discs were normal. Contrast enhanced MR scan brain revealed a destructive mass at the base of skull at petrous apex on the right side extending forward to orbital apex on the same side. Total body bone scan also showed multiple metastatic lesions. Patient was referred to oncology unit for further management

Intraocular schwannoma with extrascleral extension

2020 ◽  
pp. 112067212092021
Author(s):  
Sanika Udyaver ◽  
Li-Anne S Lim ◽  
Tatyana Milman ◽  
Arman Mashayekhi ◽  
Jerry A Shields ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Anterior Segment ◽  
Subretinal Fluid ◽  
Ultrasound Biomicroscopy ◽  
Orange Pigment ◽  
Neoplastic Processes ◽  
Benign Schwannoma ◽  
S 100 ◽  
History Of ◽  
The Right

Purpose To report a rare case of intraocular schwannoma with extrascleral extension in a patient with juvenile idiopathic arthritis and to review the literature for this topic. Methods Case report. Results A 19-year-old male with a history of juvenile idiopathic arthritis was referred for diagnosis and management of an episcleral mass, initially thought to be focal nodular scleritis. The ocular surface of the right eye revealed an elevated amelanotic episcleral nodule inferonasally, with thin strands of overlying sclera, feeding episcleral vessels, and measuring 11 mm × 11 mm in diameter and 5 mm in thickness. Ophthalmoscopic examination revealed a minimally pigmented ciliochoroidal tumor measuring 13 mm in diameter and 11.4 mm in total thickness and without associated subretinal fluid, orange pigment, or drusen. Ultrasound biomicroscopy and anterior-segment optical coherence tomography confirmed a solid mass with scleral disruption and extraocular extension. Shave biopsy revealed palisading spindle cells and interspersed eosinophilic fibrillary cytoplasmic processes, forming Verocay bodies. The specimen stained positive for S-100 and negative for Melan-A, consistent with benign schwannoma. Observation was recommended. Conclusion Intraocular schwannoma is a rare, benign uveal tumor that can demonstrate extrascleral extension, mimicking inflammatory and malignant neoplastic processes. Clinical diagnosis is challenging, and tissue biopsy is required for definite diagnosis.

Unusual presentation of Retinoblastoma

2020 ◽  
pp. 112067212093938
Author(s):  
Subina Narang ◽  
Meenakshi Sindhu ◽  
Jitender Jinagal ◽  
Uma Handa ◽  
Suman Kochhar
Keyword(s):  
Age Groups ◽  
Anterior Segment ◽  
Malignant Tumour ◽  
Sympathetic Ophthalmia ◽  
Mass Lesion ◽  
Keratic Precipitates ◽  
Penetrating Eye Injury ◽  
History Of ◽  
Intraocular Retinoblastoma ◽  
The Right

Most cases of retinoblastoma are diagnosed before the age of 5 years. The cases in older age groups can have variable presentations leading to misdiagnosis and management challenges. We report a case of retinoblastoma in an 8-year-old female who was primarily referred as a case of sympathetic ophthalmia due to a co-incidental misleading history of penetrating eye injury to other eye 3 weeks prior. The patient complained of decreased vision in the left eye after 3 weeks of repair of the corneo-scleral laceration in the right eye. Visual acuity in the right and left eye was 3/60 and light perception respectively. The anterior segment examination showed moderate sized keratic precipitates, intense inflammatory cellular reaction with large fluffy cells, hypopyon and dense vitreous exudates. Ultrasonography showed abundant hyperechoic contents within the vitreous cavity in the left globe. The retino-choroid was thickened. The possibility of endophthalmitis and sympathetic ophthalmia was considered. Diagnostic vitrectomy was planned. Intraoperatively, after clearing the exudates, a yellowish white mass lesion was seen superiorly. Post- operatively contrast-enhanced MRI scan confirmed the presence of an enhancing mass lesion in the globe consistent with the diagnosis of intraocular retinoblastoma. Enucleation of left globe was done after chemotherapy. Thus, a high risk of suspicion has to be kept for this malignant tumour in children with unexplained visual loss.

Successful Treatment of Inflammatory Linear Verrucous Epidermal Nevus with Tacrolimus and Fluocinonide

2006 ◽  
Vol 10 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Diya F. Mutasim
Keyword(s):  
Successful Treatment ◽  
Age At Onset ◽  
Topical Steroid ◽  
Poor Response ◽  
Therapeutic Agents ◽  
Response To Treatment ◽  
Early Age ◽  
Epidermal Nevus ◽  
History Of ◽  
The Right

Background: Inflammatory linear verrucous epidermal nevus (ILVEN) is a relatively rare disorder that is characterized by an early age at onset; severely pruritic linear papules and plaques; histologic features resembling spongiotic dermatitis, psoriasis, or lichenified dermatitis; and poor response to treatment. Objective: To report the successful treatment of ILVEN with potent topical steroid and tacrolimus ointments. Methods: An 11-year-old girl presented with a 1-year history of markedly pruritic, progressive linear eruption that extended from the right foot to the right buttock. She had failed treatment with pimecrolimus, calcipotriol, mometasone furoate, triamcinolone, tazarotene, and alpha-hydroxy acid. Histologic examination revealed the findings of spongiotic dermatitis. Results: The lesions resolved with fluocinonide ointment and tacrolimus 0.1% ointment. Conclusion: The combination of two therapeutic agents with different mechanisms of action likely resulted in the successful treatment of this usually resistant condition.

scholarly journals Ocular blastomycosis in a dog

2021 ◽  
Vol 14 (2) ◽  
pp. 133-136
Author(s):  
Bianca de Cecco ◽  
◽  
Mariano Carossino ◽  
Pilar Camacho-Luna ◽  
Christopher Alling ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Poor Prognosis ◽  
Emergency Service ◽  
Clinical History ◽  
Secondary Glaucoma ◽  
Response To Treatment ◽  
State University ◽  
Louisiana State University ◽  
History Of ◽  
The Right

Clinical History: A 2-year-old, female Poodle dog presented to the Emergency Service at the Veterinary Teaching Hospital (VTH), Louisiana State University School of Veterinary Medicine with a history of lethargy and anorexia. At clinical examination the dog was anemic and febrile. The dog was bilaterally blind. The right eye was buphthalmic and the intraocular pressure was elevated (42 mm Hg). During an ophthalmological consult, bilateral severe panuveitis and optic neuritis with secondary glaucoma in the right eye was diagnosed and treatment was instituted. Despite treatment, the intraocular pressure kept increasing (up to 72 mm Hg overnight), and the clinicians decided to enucleate the right eye due to poor prognosis. After one month, and no response to treatment, the left eye was also enucleated. Gross Findings: Right and left eyes: The vitreous chamber was filled with a yellow, gelatinous exudate while the anterior chamber was filled with a translucent, gelatinous fluid. The retina appeared detached and embedded within the exudate present in the vitreous chamber.

scholarly journals Trabeculectomy in Staphyloma Eye with High Intraocular Pressure Following Ocular Trauma – A Case Report

2021 ◽  
Vol 9 (T3) ◽  
pp. 23-25
Author(s):  
Masitha Dewi Sari
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Anterior Chamber ◽  
Ocular Trauma ◽  
Anterior Segment ◽  
Rectus Muscle ◽  
Tissue Destruction ◽  
Corneal Scar ◽  
History Of ◽  
Blurry Vision

BACKGROUND: Ocular trauma may alter the anterior segment condition that may lead to secondary glaucomas such as inflammation, hyphema, angle recession, and lens subluxation. One of the most common procedures to decrease intraocular pressure (IOP) is trabeculectomy by creating pathways that allow aqueous humor to flow out of the anterior chamber. Scleral tissue destruction can cause damage in thin areas (such as posterior to the rectus muscle insertions) as in case of scleritis. CASE REPORT: An 11-year-old boy presented to the Ophthalmology Department of Universitas Sumatera Utara Hospital with a bigger white grayish mass and blurry vision. There was a history of the left ocular trauma 6 years ago, followed by redness of the eye, but not treated properly. On the general examination, the patient’s left eyes looked cloudy. On ocular examination, the left eye visual acuity was 1/300 and IOP was 28 mmHg. Segment anterior examination showed staphyloma from 9 to 12 o’clock, conjunctival injection, corneal scar, shallow anterior chamber, and cloudy lens. We could not asses the posterior segment due to cloudy media. We gave anti-glaucoma medication for 1 month, but the IOP did not decrease. We performed a trabeculectomy to control IOP and to prevent staphyloma from getting bigger. CONCLUSION: Trabeculectomy was an effective procedure to control IOP in a staphyloma eye following ocular trauma.

scholarly journals Unilateral Post-LASIK Ectasia in a Topographical Normal Eye with a Slight Asymmetry in the Contralateral Eye

2014 ◽  
Vol 3 (1) ◽  
pp. 47-51
Author(s):  
Marouen Berguiga ◽  
Alain Saad
Keyword(s):  
Visual Acuity ◽  
Refractive Surgery ◽  
Anterior Segment ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
History Of ◽  
Orbscan Ii ◽  
Contralateral Eye ◽  
The Right ◽  
Radial Axis

ABSTRACT Purpose To report a case of post-LASIK unilateral corneal ectasia. Setting Department of anterior segment and Refractive surgery, Rothschild Foundation, Paris. Case report A 33-year-old woman was referred with a history of unilateral post-LASIK ectasia in her left eye, 18 months post operatively. Her best-corrected visual acuity was 20/20 with a manifest refraction of +1.75 (–4.75 × 90). Orbscan ii® revealed an inferior steepening associated with irregular astigmatism. The preoperative Placido topographies revealed a slight skewed radial axis in the right eye associated with an inferior-superior keratometry difference of 1.6 Diopters at 3 mm. in the left eye that developed ectasia, regular symmetric astigmatism was present. Uncorrected visual acuity improved to 20/25 2 weeks after keraRing® segment insertion. How to cite this article Berguiga M, saad a, Gatinel D. Unilateral Post-LASIK Ectasia in a Topographical Normal Eye with a slight asymmetry in the Contralateral Eye. int J kerat Ect Cor Dis 2014;3(1):47-51.

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