Clinical manifestations and diagnosis of keratoconus. Treatment of iatrogenic keratoconus

2020 ◽  
pp. 37-42
Author(s):  
Fedor Ermolyuk
Keyword(s):  
Research Methods ◽  
Contact Lenses ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Refractive Errors ◽  
Dry Eyes ◽  
Advanced Stages ◽  
Dystrophic Disease ◽  
Iatrogenic Origin ◽  
Binocular Diplopia

Keratoconus is a dystrophic disease of the cornea, when it is thinned with the formation of a conus-like protrusion (protrusion of the cornea). This disease belongs to the group of keratectasia, it has a multifactorial nature and occurs in approximately 25 % of all corneal pathologies. The disease can be either primary, which is based on dystrophic changes in the cornea, or secondary, which develops against the background of prenatal keratitis. Keratoconus of iatrogenic origin, which develops as a result of refractive eye microsurgery, has become widespread during the last 20 years. Most often primary keratoconus manifests during puberty, progresses to 30–40 years, after which its development slows down. An early clinical manifestation of this corneal pathology is a progressive decrease in visual acuity, development of double vision (binocular diplopia) with the development of a strong headache against this background. Monocular polyopia — images and symbols with multiple contours — develops subsequently. Severe dry eyes, itching, photophobia appear in advanced stages. Diagnosis of keratoconus in some cases can be a significant difficulty, since the use of conventional research methods only allow to suspect refractive errors in the form of myopia or astigmatism. It is necessary to take into account the impossibility of correcting visual impairment using conventional methods — glasses or contact lenses — to make correct diagnosis. As a rule, diagnosis of keratoconus requires use of expanded spectrum of instrumental research methods.

scholarly journals Monocular Diplopia in Idiopathic Intracranial Hypertension: A Case Report and Literature Review

2021 ◽  
Author(s):  
Gianluigi R Palmieri ◽  
Mattia Sansone ◽  
Roberto De Simone ◽  
Marcello Moccia
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Acute Onset ◽  
Oculomotor Nerve ◽  
Refractive Errors ◽  
Double Vision ◽  
Single Object ◽  
Dry Eyes ◽  
Ocular Media ◽  
Binocular Diplopia

Background: Diplopia is the double vision of a single object, and can be binocular or monocular. Binocular diplopia is caused by the misalignment of the visual axes, with images falling on the fovea of the fixating eye and on the extra-foveal retina of the non-fixating eye, as a consequence of both neurological (i.e., oculomotor nerve palsies, ocular myopathies, neuromuscular junction disorders) and ophthalmic disorders (i.e., decompensation of a pre-existing strabismus). In contrast, monocular diplopia is generally explained by intraocular pathology (i.e., refractive errors, ocular media abnormalities, dry eyes), causing the image of a single object to fall, at the same time, on the fovea and on the extra-foveal retina of the same eye. Methods: We report the case of a 22-year-old woman presenting with acute-onset monocular diplopia. Results: The diagnosis of idiopathic intracranial hypertension (IIH) was based on the presence of papilloedema and elevated cerebrospinal fluid (CSF) pressure. Monocular diplopia resolved after CSF subtraction. Conclusions: We describe a case of monocular diplopia as a presenting symptom of IIH, and discuss diagnostic issues of this possibly underestimated symptom in neurology clinical practice. Careful ophthalmic and neuro-ophthalmic examination can identify clinical features of diplopia, and drive diagnosis and treatment.

Types of refractive errors and methods for their diagnosis

2020 ◽  
pp. 30-36
Author(s):  
Olga Lemzyakova
Keyword(s):  
Optical System ◽  
Contact Lenses ◽  
Vision Impairment ◽  
Refractive Errors ◽  
Vision Correction ◽  
Light Rays ◽  
Different Types ◽  
Almost All ◽  
Degrees Of Severity ◽  
The Brain

Refraction of the eye means its ability to bend (refract) light in its own optical system. In a normal state, which is called emmetropia, light rays passing through the optical system of the eye focus on the retina, from where the impulse is transmitted to the visual cortex of the brain and is analyzed there. A person sees equally well both in the distance and near in this situation. However, very often, refractive errors develop as a result of various types of influences. Myopia, or short-sightedness, occurs when the light rays are focused in front of the retina as a result of passing through the optical system of the eye. In this case, a person will clearly distinguish close objects and have difficulties in seeing distant objects. On the opposite side is development of farsightedness (hypermetropia), in which the focusing of light rays occurs behind the retina — such a person sees distant objects clearly, but outlines of closer objects are out of focus. Near vision impairment in old age is a natural process called presbyopia, it develops due to the lens thickening. Both myopia and hypermetropia can have different degrees of severity. The variant, when different refractive errors are observed in different eyes, is called anisometropia. In the same case, if different types of refraction are observed in the same eye, it is astigmatism, and most often it is a congenital pathology. Almost all of the above mentioned refractive errors require correction with spectacles or use of contact lenses. Recently, people are increasingly resorting to the methods of surgical vision correction.

Multiple Myeloma or Brucellosis: A Case Report

2020 ◽  
Vol 20 (1) ◽  
pp. 102-105 ◽  
Author(s):  
Hossein A. Rahdar ◽  
Mansoor Kodori ◽  
Mohamad R. Salehi ◽  
Mahsa Doomanlou ◽  
Morteza Karami-Zarandi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Brucella Melitensis ◽  
Severe Disease ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Bone Marrow Aspiration ◽  
Major Health Problem ◽  
Brucella Infection ◽  
Wide Range ◽  
Parental Treatment

Background: Brucellosis, a major health problem in developing countries, is a multisystem infection with a broad spectrum of clinical manifestations. Hematological complications, ranging from an intravascular coagulopathy to mild homeostasis disorders (such as gammopathy), have been reported in brucella infection. These signs and symptoms may lead to misdiagnosis of brucellosis with other hematological diseases. Case: A 65-year-old male whose occupation was shepherding was referred to our hospital as a known case of multiple myeloma with continuous fever, muscle weakness, and night sweating after taking 2 courses of chemotherapy. The laboratory diagnosis of multiple myeloma had been based on the observation of a high percent of plasma cells in the bone marrow aspiration. At follow- up, the result of patient's fever workup, with 2 sets of blood cultures, was positive for Brucella melitensis. Isolated brucella was confirmed as B. melitensis by 16S rRNA sequencing. Brucellosis serologic test was performed by agglutination test and positive results were obtained. The patient was discharged with the cessation of fever and general improvement after the end of the parental treatment phase of brucella bacteremia. Conclusions: Brucella infection may cause a severe disease, mimicking a primary hematological disease, which could complicate the correct diagnosis. In brucellosis cases, due to the wide range of symptoms, in addition to cultivation and serological methods, molecular methods should also be used to prevent inappropriate diagnosis and additional costs.

Acute Diplopia Following Rhinoplasty: Clearing the Air

2021 ◽  
pp. 229255032110270
Author(s):  
Ashley N. Boustany ◽  
Carly D. Comer ◽  
Harsha Gopal ◽  
Samuel J. Lin ◽  
Sumner A. Slavin
Keyword(s):  
Rare Complication ◽  
Therapeutic Interventions ◽  
Medical Attention ◽  
Delayed Presentation ◽  
Patient Evaluation ◽  
Acute Stroke Patient ◽  
Dry Eyes ◽  
Orbital Emphysema ◽  
Complete History ◽  
Binocular Diplopia

Diplopia after rhinoplasty is a rare complication that requires immediate medical attention. Workup should include a complete history and physical examination, appropriate imaging, and consultation with ophthalmology. Diagnosis may be challenging due to the wide differential ranging from dry eyes to orbital emphysema to an acute stroke. Patient evaluation should be expedient, though thorough to facilitate time-sensitive therapeutic interventions. Here, we present a case of transient binocular diplopia presenting 2 days after closed septorhinoplasty. The visual symptoms were attributed to either intra-orbital emphysema or a decompensated exophoria. This is the second documented case of orbital emphysema after rhinoplasty presenting with diplopia. It is the only case with a delayed presentation as well as the only case that resolved after positional maneuvers.

scholarly journals Diagnosis and Treatment Algorythm in Lyme Neuroborreliosis

2016 ◽  
Vol 62 (1) ◽  
pp. 121-127
Author(s):  
Brîndușa Țilea ◽  
Rodica Bălașa ◽  
Andrea Fodor ◽  
Țilea Ioan
Keyword(s):  
Borrelia Burgdorferi ◽  
Bacterial Species ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Lyme Neuroborreliosis ◽  
Early Administration ◽  
Serological Tests ◽  
Initiation Of Therapy ◽  
Low Sensitivity ◽  
Third Generation Cephalosporins

AbstractLyme neuroborreliosis is an infection of the nervous system caused by spirochetes of the Borrelia burgdorferi sensulato group. Neurological clinical manifestations usually present a steady evolution and are different in patients from Europe compared to those from America, possibly due to vector agents and different bacterial species. Various diagnostic markers were studied in consideration of a clear or possible diagnosis of the disease, because evolution and complications depend on early diagnosis and initiation of therapy. The isolation of the bacterium is difficult, microscopic examination and the bacterial dezoxiribonucleic acid amplification shows low sensitivity. However, the diagnosis of Lyme neuroborreliosis is mainly based on serological methods that have a satisfactory sensitivity and specificity. A correct diagnosis can be performed by strictly respecting clinical guidelines and protocols and carefully interpreting the serological tests. The presence of anti-borrelia burgdorferi antibodies in the cerebrospinal fluid with evidence of intrathecal antibody production is the gold standard diagnosis of Lyme neuroborreliosis. Early administration of antibiotic treatment (third generation cephalosporins, cyclins, aminopenicillins) can produce the remission of neurological symptoms, the eradication of spirochetes in acute phase of the disease, thus avoiding the development of the chronic disease.

scholarly journals New biohumoral markers of differential diagnosis in patients with suspected heart failure

2010 ◽  
Vol 63 (5-6) ◽  
pp. 387-392
Author(s):  
Radomir Matunovic ◽  
Zdravko Mijailovic ◽  
Milorad Rabrenovic ◽  
Violeta Rabrenovic
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Natriuretic Peptide ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
High Sensitivity ◽  
Renal Diseases ◽  
Significant Implication ◽  
Acute Patient ◽  
Degree Of Certainty

Introduction. In the regular clinic practice, the assessment of the cause of dispnea is a dilemma which has a significant implication in both the estimation of prognosis and treatment of the patient. In emergency cases, when most necessary, it is often very difficult to determine whether dispnea was caused by a heart or lung disease. Role of natriuretic peptide in patients with dispnea. An acute patient with dispnea might suffer serious consequences of inadequately established diagnosis so congestive heart failure (CHF) has to be diagnosed quickly and precisely in the ER. Unfortunately, symptoms and signs of CHF are unspecific, it is sometimes impossible to obtain an adequate anamnesis and diagnosic procedures currently applied are either insufficiently precise or provide scarce information or can not always be performed under appropriate conditions. On the basis of previous findings, it has been proved that brain natriuretic peptide (BNP) can considerably contribute to the establishment of correct diagnosis as well as to the possibility of introducing an adequate therapy for those patients. However, the real value of those peptides should be estimated in relation to other clinical manifestations and indicators and the specifics of examined patients including the age, gender and the presence or absence of pulmonary or renal diseases. Natriuretic peptide in accessement gradient of heart failure. Determination of natriuretic peptide has represented most probably the greatest progress in diagnosing the heart failure since the introduction of echocardiography into practice. Its high sensitivity and negative predicted value makes it a valid test for excluding congestive heart failure with a very high degree of certainty.

Hard and soft contact lenses: a comparison

1974 ◽  
Vol 12 (25) ◽  
pp. 97-99
Keyword(s):  
Contact Lenses ◽  
Refractive Errors ◽  
Soft Contact ◽  
Soft Contact Lenses

Contact lenses may be used to correct refractive errors, to treat diseased eyes, and to improve the appearance of disfigured eyes. Hard and soft lenses are now available. They have different properties and their relative merits depend upon the purpose for which the lens is required.

Concrescence of the cervical vertebrae and neurological complications

2021 ◽  
pp. 195-201
Author(s):  
Sabiyat Abdulaevna Yakhyaeva ◽  
Naida Isagadzhievna Garabova ◽  
Madina Garunovna Burzhunova
Keyword(s):  
Cervical Spine ◽  
Clinical Practice ◽  
Research Methods ◽  
Neurological Disorders ◽  
Cervical Vertebrae ◽  
Clinical Manifestations ◽  
Neurological Complications ◽  
Timely Diagnosis ◽  
Number Of Patients ◽  
Genetically Determined

In clinical practice, a sufficiently large number of patients complain of neurological disorders caused by osteochondrosis of the cervical spine. Despite this, in some cases, the development and progression of this symptomatology may be due to an anomaly in the structure of the cervical spine (Klippel-Feil syndrome), which is genetically determined. Timely diagnosis of this pathology with the implementation of complex research methods allows you to develop individual tactics for each individual patient, taking into account the severity of clinical manifestations to slow the progression of complications.

Cosmetics and Contact Lenses: Influence on Safety

The Eye ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 59-63
Author(s):  
S. V. Zimovets ◽  
A. Ya. Sverdlik
Keyword(s):  
Contact Lens ◽  
Contact Lenses ◽  
Cosmetic Products ◽  
Soft Contact ◽  
Dry Eyes ◽  
Soft Contact Lenses

The article describes the effect of decorative cosmetics on the material of soft contact lenses and studies specific features that can be observed in SCL wearers who use cosmetics extensively. Examples of complications associated with the use of various cosmetic products that may occur in contact lens wearers are given. Conclusion: in cases when patients have complaints about discomfort and dry eyes, doctors should pay attention to the amount of decorative cosmetics used as well as study the effect it can have on the surface of the contact lenses.

scholarly journals CLINICAL MANIFESTATIONS OF SARCOIDOSIS ON THE PROLABIUM AND ORAL MUCOSA: MANAGEMENT

2018 ◽  
pp. 34-36
Author(s):  
P.M. Skrypnikov ◽  
T.P. Skrypnikova ◽  
Yu.M. Vitko
Keyword(s):  
Oral Cavity ◽  
Oral Mucosa ◽  
Correct Diagnosis ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Morbidity Rate ◽  
Unknown Etiology ◽  
Toxic Substances ◽  
Male Population ◽  
Female Population

The statistics indicates on the tendency of morbidity rate of sarcoidosis to increase. The pathology affects young and older people notably. Sarcoidosis becomes a common chronic disease, which is often difficult to diagnose. Insufficient experience in recognition of this disease leads to misdiagnosis and ineffective treatment. All mentioned above highlights the extreme relevance of this issue. Sarcoidosis is a multisystem inflammatory nature disease of unknown etiology. The hereditary predisposition is taken to be but the whole family cases are also known. An abnormal immune response is also considered among the theories of the development of the disease. The infectious factor is also regarded as the cause of the disease. The increasing activity of lymphocytes, which start to produce substances promoting the formation of the granulomas, which are considered to be the basis for the pathological process, can initiate the onset of the disease. The maximum morbidity rate of sarcoidosis is observed between the ages of 35 to 55 years. Two age periods of the peak in male population are 35-40 years and about 55 years. The rate of sarcoidosis morbidity among female population is 65%. Up to 700 new cases of sarcoidosis are registered in Ukraine annually. The clinical signs of sarcoidosis vary. This pathology is more often manifested by the bilateral lymphadenopathy of lung roots, eyes and skin lesions. The liver, spleen, lymph nodes, heart, nervous system, muscles, bones and other organs can also be affected. In dental practice sarcoidosis can be manifested on the prolabium, oral mucosa and salivary glands. Blood laboratory indices (the increased level of calcium) are changed in sarcoidosis. Chest X-ray, MRI and CT also demonstrate changes in the lungs. The test for detection of granulomas shows positive Kveim reaction (the formation of purple-red nodules due to administration of antigen). Biopsy and bronchoscopy facilitate detection of both direct and indirect signs of sarcoidosis of the lungs. A general treatment of sarcoidosis is provided by a pulmonologist, who can assess the severity of the lesion and provide appropriate treatment. The core of treatment is based on corticosteroids. In severe cases immunosuppressors, anti-inflammatory drugs, antioxidants are prescribed. A dentist performs oral cavity sanation, professional hygiene. Mouth rinses with Dekasan solution, sublingual Lisobakt pills are prescribed to prevent inflammatory lesions. Patients with sarcoidosis are recommended to avoid solar radiation and contact with chemical and toxic substances harmful to the liver, reduction of the consumption of foods rich in calcium. Healthy life-style is crucial in prevention of exacerbations of sarcoidosis. In the remission period regular medical check-ups and oral cavity sanation are recommended. The correct diagnosis in rare diseases requires highly qualified dental professionals, the interdisciplinary approach in the diagnosing and management of patients with this pathology.

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