scholarly journals Keratitis Treatment by Removal of Concealed Retrocorneal Plant Foreign Body

2021 ◽  
Vol 62 (12) ◽  
pp. 1667-1671
Author(s):  
Seongmi Kim ◽  
Hye Jin Lee ◽  
Ahnul Ha ◽  
Jong Young Lee ◽  
Jinho Jeong

Purpose: We report a case of keratitis that improved after removal of a causative plant foreign body from below the posterior surface of an opaque cornea. The foreign body was revealed by anterior segment optical coherence tomography (AS-OCT) and gonioscopy.Case summary: A 79-year-old woman was referred with an impression of left-eye keratitis; the eye had been injured by a branch of a tangerine tree 1 month prior. She had been given the usual topical antibiotics by a local clinic, but they were ineffective. At her initial visit, her visual acuity was only hand motion in the left eye; slit-lamp examination revealed a 3 × 3-mm corneal infiltration with a hypopyon in the anterior chamber. Despite administration of strong topical antibiotics on an hourly basis, the corneal lesion worsened. AS-OCT and gonioscopy revealed a small foreign body below the posterior surface of the cornea; this was surgically removed. The corneal opacity and corneal epithelial defects dramatically improved, and the hypopyon disappeared.Conclusions: The possibility of a residual foreign body should be considered if trauma precedes infectious keratitis that does not improve with conventional treatment and the posterior surface of the cornea is not visible because of corneal opacity. In such a case, AS-OCT and gonioscopy can be useful.

2020 ◽  
Vol 18 (1) ◽  
pp. 64-66
Author(s):  
Anubhav Chauhan ◽  
◽  
Neha Gautam ◽  

Introduction. Myiasis is caused by larvae of flies infesting animal or human tissues and organs. Aim. In this report we present 2 cases of external ophthalmomyiasis by sheep botfly. Description of the cases. We report a case of two patients who presented with a history of foreign body sensation in the left and the right eye respectively. Slit lamp examination revealed larvae of Oestrus ovis (sheep botfly). In both cases, there was no contact history with sheep or goats. Signs of conjunctival inflammation and corneal involvement were absent in both cases. In most of the previous reports, corneal and conjunctival inflammation was present. Conclusion. Treatment for external ophthalmomyiasis is based on larvae removal and application of topical antibiotics and steroids.


Author(s):  
Furkaan Majied Hamied ◽  
Deyaa Neama Kadhim ◽  
Sohaib A Mahmood

In order to facilitate the corneal stromal ablation in photorefractive keratectomy the epithelium is removed so corneal repair associated with changes in epithelium and stroma. To study the corneal epithelial thickness and pachymetry profile changes after photorefractive keratec­tomy (PRK) for myopia. Retrospective analysis of the postoperative corneal epithelial thickness and pachymetry profile changes in 22 eyes of 12 patients treated with PRK for myopia or myopic astigmatism. Corneal and epithelial thickness maps within the central 6 mm were obtained by anterior segment spectral-domain optical coherence tomography (SD-OCT) preop­eratively and at 3 months postoperatively. Correlations between pachymetry,epithelial thickness changes and the amount of correction,were analyzed.Compared to preoperative values,the central 2 mm and the paracentral 2 to 5 mm zone epithelium was 1 ± 2.85 and 1 ± 3.11 μm thicker,respec­tively,at 3 months postoperatively (P <.05). The spheri­cal equivalent (SE) changed from-2.80 ± 2.028 diop­ters (D) preoperatively to -0.40 ± 0.42 D at 3 months postoperatively. Females show greater postoperative epithelial thickening, 2.6 ± 3.77 μm,than males,0.34 ± 1.98 μm. There was a trend toward greater epithelial thickening with a larger amount of programmed SE correction, and thinner preoperative epithelium. No correlation between epithelial thickness change and postoperative change in refraction was detected.Negative correlation between between age, refractive error,with the pre and post-operative pachymetry. In general female pachymetry reading is higher than it in male.The corneal epithelial thickness in­creased after PRK up to 3 months postoperatively. It was affected by the amount of myopia treated, gender, and preoperative epithelial thickness. The refractive outcomes did not affected by the postoperative epithelial thickening. Negative correlation between between age, refractive error, with the pre and post-operative pachymetry. In general female pachymetry reading is higher than it in male.


Author(s):  
N. I. Latyshevskaya ◽  
M. A. Alborova ◽  
L. A. Davydenko ◽  
A. V. Belyaevа

Introduction. The profession of “machine operator in metalworking”, one of the most common professions in various industries, characterized by a large volume of abrasive operations, accompanied by dust formation, which creates a potential for the occurrence of diseases of the visual organ.The aim of the study is to provide a hygienic assessment of working conditions and occupational risk of visual organ pathology in metalworking machine operators.Materials and methods. Observation groups — machine operators for metalworking of two training groups (experience up to 5 years, experience of 6–20 years). Two comparison groups (administrative and technical personnel of the enterprise) are formed according to the same age-experience principle.Results. The working conditions of machine operators were classified as class 3.2. taking into account the severity and intensity of the work process and the noise level (80 dBA) in the workplace. Nitrogen oxide, carbon monoxide, and manganese were registered in the air of the working area in concentrations below the permissible concentration (PC), and the aerosol dihydroxide was registered above the PC in 25.8% of cases. In the main working groups, diseases of the anterior segment of the eye were more often registered, among which dry eye syndrome (DYS) prevailed (94.1%), chronic blepharoconjunctivitis (79.9%), persistent corneal opacification (21.7%). There was an increase in the prevalence of detected diseases with an increase in work experience (p≤0.05). In machine operators, the frequency of inhibition of lacrimal formation and decreased stability of the tear film was recorded significantly more often, with increasing work experience, the degree of violation of lacrimal formation and stability of the tear film increased. The chances of detecting pathology of the anterior segment of the eye in machine operators are 5.9 and 3.5 times higher than in the comparison group. There are different forces of connection, increasing with the increase of work experience in the profession, between the working conditions of machine operators and the occurrence of SHG (relatively strong), with chronic blepharoconjunctivitis and persistent corneal opacity (medium strength), which suggests the professional conditionality of this pathology.Conclusions. The results obtained suggest that the pathology of the anterior segment of the eye is professionally conditioned in metalworking machine operators and necessitate the introduction of preventive measures aimed at protecting the visual organ.


2020 ◽  
Vol 11 (1) ◽  
pp. 120-126
Author(s):  
Pham Ngoc Dong ◽  
Le Xuan Cung ◽  
Tran Khanh Sam ◽  
Do Thi Thuy Hang ◽  
Doug D. Chung ◽  
...  

Meesmann epithelial corneal dystrophy (MECD) is a rare dominantly inherited disorder that is characterized by corneal epithelial microcysts and is associated with mutations in the keratin 3 (KRT3) and keratin 12 (KRT12) genes. In this study, we report a novel mutation in the KRT12 gene in a Vietnamese pedigree with MECD. Slit-lamp examination was performed on each of the 7 recruited members of a Vietnamese family to identify characteristic features of MECD. After informed consent was obtained from each individual, genomic DNA was isolated from saliva samples and screening of KRT3and KRT12 genes was performed by Sanger sequencing. The proband, a 31-year-old man, complained of a 1-year history of eye irritation and photophobia. Slit-lamp examination revealed intraepithelial microcysts involving only the corneal periphery in each eye with clear central corneas and no stromal or endothelial involvement. Three family members demonstrated similar intraepithelial microcysts, but with diffuse involvement, extended from limbus to limbus. Sanger sequencing of KRT3 (exon 7) and KRT12 (exons 1 and 6) in the proband revealed a novel heterozygous KRT12 variant (c.1273G>A [p.Glu425Lys]) that was present in the three affected family members but was absent in the three family members with clear corneas. This study is the first report of a Vietnamese family affected with MECD, associated with an atypical peripheral corneal epithelial phenotype in the proband and a novel mutation in KRT12.


2018 ◽  
Vol 29 (6) ◽  
pp. 689-693
Author(s):  
Miklós D Resch ◽  
Anikó Balogh ◽  
Gábor L Sándor ◽  
Zsuzsanna Géhl ◽  
Zoltán Zsolt Nagy

Introduction: Vitrectorhexis is an alternative for manual continuous curvilinear capsulorhexis originally developed for paediatric cataract surgery. The aim of our study was the evaluation of the technique in adult patients with penetrating ocular injury and traumatic cataracts. Methods: Eight eyes of 8 patients (23–41 years, all males) had penetrating mechanical corneal trauma. Anterior lens capsule was penetrated in all cases and additional posterior capsule defect in five cases. Intraocular foreign body was detected in one case in the crystalline lens and in two cases in the posterior segment. Standard 23G infusion cannula and vitreous cutter were applied to perform anterior capsule opening, removal of lens material, anterior vitrectomy and pars plana vitrectomy if needed. No phacoemulsification or irrigation/aspiration probe was used. Results: Vitrectorhexis could be performed in 7 out of 8 cases with the preservation of peripheral anterior capsule; primary implantation of posterior chamber intraocular lens was possible in all cases (in the bag in three eyes and into the sulcus in five eyes). Anterior chamber was stable in all cases intraoperatively, and no dropped nucleus or lens fragment loss was observed. Surgery was combined with pars plana vitrectomy in three cases, with foreign body removal (when necessary). No postoperative complication occurred. Conclusion: Vitrectorhexis was found to be an effective and safe alternative method in the management of complex anterior segment trauma cases. With its use, traditional cataract surgical devices can be substituted and additional benefits of vitreous cutter can be utilized in selected cases, especially in young adults.


2020 ◽  
Vol 9 (12) ◽  
pp. 3814
Author(s):  
Ivano Riva ◽  
Eleonora Micheletti ◽  
Francesco Oddone ◽  
Carlo Bruttini ◽  
Silvia Montescani ◽  
...  

Assessment of the anterior chamber angle (ACA) is an essential part of the ophthalmological examination. It is intrinsically related to the diagnosis and treatment of glaucoma and has a role in its prevention. Although slit-lamp gonioscopy is considered the gold-standard technique for ACA evaluation, its poor reproducibility and the long learning curve are well-known shortcomings. Several new imaging techniques for angle evaluation have been developed in the recent years. However, whether these instruments may replace or not gonioscopy in everyday clinical practice remains unclear. This review summarizes the last findings in ACA evaluation, focusing on new instruments and their application to the clinical practice. Special attention will be given to the comparison between these new techniques and traditional slit-lamp gonioscopy. Whereas ultrasound biomicroscopy and anterior segment optical coherence tomography provide quantitative measurements of the anterior segment’s structures, new gonio-photographic systems allow for a qualitative assessment of angle findings, similarly to gonioscopy. Recently developed deep learning algorithms provide an automated classification of angle images, aiding physicians in taking faster and more efficient decisions. Despite new imaging techniques made analysis of the ACA more objective and practical, the ideal method for ACA evaluation has still to be determined.


2020 ◽  
pp. 247412642096503
Author(s):  
Filippos Vingopoulos ◽  
Yvonne Wang ◽  
Seanna Grob ◽  
Chloe Yang Ling Li ◽  
Dean Eliott ◽  
...  

Purpose: To investigate characteristics of Open Globe Injuries (OGI) that presented with Intra-Ocular Foreign Body (IOFB), along with their long-term visual outcomes and complications. Methods: Retrospective interventional consecutive case series of OGIs with IOFBs that presented at Massachusetts Eye and Ear from 2010 to 2015. Data collected included time from injury to OGI repair, location of IOFB, retinal detachment (RD) rate, presenting and final visual acuity and subsequent surgeries. Results: Fifty-seven consecutive cases of OGIs with IOFBs were included. Mean follow-up was 28 months and median time from injury to OGI repair was 0 days. Overall, 38/57 (66.7%) eyes achieved final vision of 20/40 or better and 43/57 (75.4%) 20/150 or better. Thirty-three cases had IOFBs in the anterior segment only, 24 cases had posterior segment involvement. Thirty percent of cases (17/57) were complicated by an RD, 58.3% (14/24) in the posterior versus 9.1% (3/33) in the anterior IOFB group ( P = .01). There were no cases of endophthalmitis. Posterior IOFB and higher zone of injury were risk factors for RD both at presentation (both P < .001) and post-primary repair (both P < .001). Posterior IOFB was associated with higher vitrectomy rates both at presentation ( P < .001) and post-primary repair ( P = .002) and worse long-term visual outcome ( P = .01). Conclusions: OGIs with IOFB involving the posterior segment are associated with higher complication and re-operation rates and worse visual prognosis compared to those involving the anterior segment only.


2018 ◽  
Vol 55 (4) ◽  
pp. 584-590 ◽  
Author(s):  
Lorelei L. Clarke ◽  
Kevin D. Niedringhaus ◽  
K. Paige Carmichael ◽  
M. Kevin Keel ◽  
Heather Fenton

Congenital ocular abnormalities in cervids have been previously reported as individual cases from various regions of the United States and include microphthalmia, anophthalmia, congenital cataracts, dermoids, and colobomata. A common underlying cause for these abnormalities, such as nutritional deficiencies, environmental toxin exposures, or genetic mutations, has not been established. This retrospective study summarized and compared cases of suspected congenital ocular abnormalities in free-ranging white-tailed deer ( Odocoileus virginianus) submitted to the Southeastern Cooperative Wildlife Disease Study (SCWDS) in Athens, Georgia, to the preexisting literature. Of 3645 accessions of white-tailed deer submitted to SCWDS, 15 qualifying case records were found. An additional 15 cases were reported previously in the literature. Conditions described in SCWDS cases included microphthalmia (8/15), congenital cataracts (3/15), anophthalmia (2/15), colobomata (1/15), anterior segment dysgenesis (1/15), ectopic lacrimal gland tissue (1/15), and congenital blindness with corneal opacity (1/15). Most (11/15; 73%) of the SCWDS cases were male fawns with an average age of 4 months at presentation, consistent with previously described cases. Most animals had bilateral abnormalities with few extraocular congenital abnormalities, also consistent with existing reports. Cases were variably tested for various infectious agents at the time of submission; 2 cases were seropositive for bluetongue virus. Spatiotemporal clustering of cases was not evident. This study provided a concise and systematic summary of known existing cases of congenital ocular defects in fawns but did not identify a cause.


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