scholarly journals Asymptomatic chronic hypotony due to subclinical choroidal effusion after blunt trauma

2020 ◽  
Vol 17 (2) ◽  
pp. 203-208
Author(s):  
John Mark Sim De Leon ◽  
Ronald Steven Medalle
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Case Report ◽  
Blunt Trauma ◽  
Ultrasound Biomicroscopy ◽  
Scleral Flap ◽  
Hypotony Maculopathy ◽  
Post Traumatic ◽  
Choroidal Effusion ◽  
Cyclodialysis Cleft

Objective: To present a case report of asymptomatic post-traumatic chronic hypotony in which the cause was undetected until phacoemulsification. Methodology: Case report. Results: A 55-year-old female’s left eye suffered blunt trauma causing hyphema and iritis, which were successfully managed; however, up to a year after, the intraocular pressure (IOP) ranged from 3 to 5 mmHg and the anterior chamber remained very shallow (Van Herick grade 4) with the lens–iris diaphragm pushed anteriorly with difficulty assessing the angles for recession or clefts . Visual acuity was initially 20/20 upon resolution of the hyphema but worsened to 20/40 a year after, presumably due to a developing cataract. Periodic dilated fundus examinations revealed no hypotony maculopathy or choroidal effusions. Prior to phacoemulsification, ultrasound biomicroscopy (UBM) revealed 360 degrees of mild peripheral choroidal effusions. During phacoemulsification, after intraocular lens insertion, direct gonioscopy revealed a supero-nasal cyclodialysis cleft (2 clock hours) and this was repaired intraoperatively with direct cyclopexy through a partial thickness scleral flap. Postoperatively, the vision improved to 20/20 without correction and the IOP normalized to 16 to 18 mmHg. Conclusion: Chronic hypotony post-trauma may be asymptomatic and the cause may not be clinically evident and may be detected by UBM (choroidal effusion). In our case, the proximate aetiology (cyclodialysis cleft) of the effusion was only observed intraoperatively after phacoemulsification for which cyclopexy was performed which increased the IOP to physiologic levels.

scholarly journals Concurrent Phacoemulsification and Encircling for Hypotony Maculopathy after Blunt Trauma

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Takayuki Baba ◽  
Hirotaka Yokouchi ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Blunt Trauma ◽  
Intraocular Lens ◽  
Secondary Cataract ◽  
Hypotony Maculopathy ◽  
Uveoscleral Outflow ◽  
Old Japanese ◽  
One Year

A 37-year-old Japanese man had his right eye hit by a fist. His right eye developed hypotony maculopathy and secondary cataract, and his visual acuity decreased to 20/200 with an intraocular pressure of 4 mmHg. He underwent phacoemulsification and aspiration, implantation of the intraocular lens, and encircling with a silicone tire. His visual acuity improved to 20/20 and stable for more than one year postoperatively. The intraocular pressure in his right eye increased to 12 mmHg, and maculopathy was resolved entirely. It was suggested that an encircling buckle obstructed the uveoscleral outflow through the cyclodialysis and increased intraocular pressure. Concurrent cataract surgery and encircling was sufficient to improve the vision.

scholarly journals A Novel Method for the Localization and Management of Traumatic Cyclodialysis Cleft

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Mingling Wang ◽  
Shufang Hu ◽  
Zhenquan Zhao ◽  
Tianlin Xiao
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Clinical Study ◽  
Ultrasound Biomicroscopy ◽  
Slit Lamp ◽  
Normal Range ◽  
Postoperative Visual Acuity ◽  
Novel Method ◽  
Cyclodialysis Cleft

Purpose.To propose a novel surgical method for the localization and management of traumatic cyclodialysis clefts.Methods.Five patients with traumatic cyclodialysis clefts who underwent the innovative surgery were retrospectively reviewed. The new method was introduced to repair a cyclodialysis cleft with two running sutures from the middle to each end of the cleft under the guidance of a probe. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), slit lamp and gonioscopic results, ultrasound biomicroscopy (UBM), and optical coherence tomography (OCT) findings were recorded.Results.Cyclodialysis clefts were completely closed postoperatively in four patients (four eyes); this was confirmed by progressively improved VA, restoration into the normal range of the IOP, disappearance of suprachoroidal fluid, and reduced macular edema. Only one patient with multiple clefts had an incomplete reattachment.Conclusions.This clinical study offers a novel and efficient method to localize and repair the cyclodialysis clefts.

scholarly journals Diagnostic and Therapeutic Approach in a Case of Severe Post-Traumatic Hyphema with Subtotal Iridodialysis

2017 ◽  
Vol 8 (3) ◽  
pp. 496-502 ◽  
Author(s):  
Filippo Romanazzi ◽  
Anna Morano ◽  
Antonio Caccavale
Keyword(s):  
Intraocular Pressure ◽  
Blunt Trauma ◽  
Vitreous Hemorrhage ◽  
Ultrasound Biomicroscopy ◽  
Single Step ◽  
Moderate Pain ◽  
Light Perception ◽  
Traumatic Cataract ◽  
Scleral Fixation ◽  
Post Traumatic

Purpose: To report our diagnostic ultrasound-based approach and surgical strategy in a case of severe blunt trauma with complete hyphema, 270° iris disinsertion, and traumatic subluxated cataract. Case Report: A 70-year-old male was referred to our hospital for a blunt trauma in his right eye. A complete examination revealed visual acuity consisting in light perception, a complete hyphema, and an intraocular pressure of 45 mm Hg with moderate pain. Our diagnostic approached was ultrasound based with B-scan examination showing some vitreous hemorrhage and ultrasound biomicroscopy showing a large iris disinsertion of 270° with the iris entirely dislocated in the inferior sector of the anterior chamber. The patient was hospitalized and a systemic and topical treatment was started to lower intraocular pressure. Our surgery consisted in a single-step approach with removal of traumatic cataract with scleral fixation of an intraocular lens and iridoplasty. Conclusion: In our patient, the single-step surgery, supported by anterior and posterior ultrasound imaging, achieved a satisfactory anatomical and functional outcome.

scholarly journals Pseudophacocele following a Bicycle Handle Injury: A Case Report

2018 ◽  
Vol 10 (1) ◽  
pp. 94-97
Author(s):  
Sahil Thakur ◽  
Parul Ichhpujani ◽  
Suresh Kumar
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Blunt Trauma ◽  
Surgical Management ◽  
Clinical Course ◽  
Rare Complication ◽  
Vitreous Haemorrhage ◽  
Visual Outcomes ◽  
Subconjunctival Space ◽  
The Right

Background: Pseudophacocele is a rare complication of blunt trauma in pseudophakic eyes.Case: We present a case of 60-year-old male who presented with pseudophacocele after injury from a bicycle handle. On presentation, visual acuity in the right eye was perception of light (PL) in 2 quadrants (superior and temporal) and left eye was 20/20. A PCIOL was seen superonasally in the right subconjunctival space with total hyphaema. Ultrasound demonstrated vitreous haemorrhage with membranes in right eye. We describe the surgical management and further clinical course of the patient.Conclusion: It is imperative to surgically manage these challenging cases. Despite optimum care visual outcomes are guarded in patients with severe blunt trauma.

Ibopamine Treatment in Chronic Hypotony Secondary to Long-Lasting Uveitis. A Case Report

2000 ◽  
Vol 10 (4) ◽  
pp. 332-334 ◽  
Author(s):  
P. Pivetti-Pezzi ◽  
S. Da Dalt ◽  
M. La Cava ◽  
M. Pinca ◽  
F. De Gregorio ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Case Report ◽  
Side Effects ◽  
Visual Field ◽  
Clinical Efficacy ◽  
Eye Drops ◽  
Days Of Therapy ◽  
History Of

Purpose To assess the clinical efficacy of ibopamine eye drops in severe hypotony secondary to chronic progressive uveitis. Methods Case report. A 47-year-old man with a 37-year history of diffuse uveitis and severe refractory hypotony was treated with topical 2% ibopamine (Trazyl®) six times a day. Intraocular pressure, visual acuity, visual field and side effects were recorded during 15 months of follow-up. Results IOP, visual acuity and visual field increased after four days of therapy and lasted for two months when the drug was suspended because of the onset of filamentous keratopathy. A new course of treatment with 2% ibopamine eye drops in a different solvent (BSS®) resulted in a stable increase in IOP, VA and visual field, with no side effects in a follow-up of 13 months. Conclusions Ibopamine 2% eye drops in BSS® solvent seem effective in the treatment of uveitis-related hypotony.

Active iris vascular tufts bleeding successfully treated with argon laser photocoagulation

2018 ◽  
Vol 28 (2) ◽  
pp. 241-242 ◽  
Author(s):  
Ambreen Sarmad ◽  
Fadi Alfaqawi ◽  
Monali Chakrabarti ◽  
Arijit Mitra ◽  
Bushra Mushtaq
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Case Report ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Active Bleeding ◽  
Blurred Vision ◽  
Argon Laser Photocoagulation ◽  
The Right ◽  
Effective Use

Purpose: Iris vascular tufts (IVT) are rare biomicroscopic capillary outgrowths from the pupillary margins. Patients are usually asymptomatic until presenting with blurred vision due to spontaneous hyphema or with raised intraocular pressure. Case report: A 61-year-old woman presented to eye casualty with left eye (LE) blurred vision and discomfort for 1 day. Her external ocular examination was unremarkable and visual acuity was 6/6 in the right eye (RE) and 6/9 in the LE. Biomicroscopic examination revealed a 2-mm hyphema in her LE and bilateral multiple small IVT and active bleeding from IVT at the pupillary margin of the LE at the 5 o’clock position. Diagnosis of LE active bleeding from IVT was made and she underwent argon laser photocoagulation directed at the source of bleeding. The bleeding stopped immediately after the second burn. She was followed up for 3 months; her visual acuity was 6/5 and 6/6 in the RE and LE, respectively, with no further problems. Conclusions: Iris vascular tufts are benign and recurrent hemorrhages are unlikely. Therefore, definitive argon laser photocoagulation or surgical treatment are reserved to arrest further episodes of hyphema. Our case demonstrates the effective use of argon laser photocoagulation to completely arrest active bleeding from IVT and excellent recovery of hyphema with no further problems for 5 years.

scholarly journals Secondary glaucoma as a result of a sling shot accident, diagnosed half a century later

2012 ◽  
Vol 5 (1) ◽  
pp. 16-20
Author(s):  
Ellen Svarverud
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Optic Nerve ◽  
Blunt Trauma ◽  
Ocular Trauma ◽  
Secondary Glaucoma ◽  
Eye Examination ◽  
Near Work ◽  
Ocular Signs ◽  
Angle Recession

Secondary glaucoma following blunt trauma is relatively uncommon in regular optometric practice. Onset of this type of glaucoma may occur within weeks, but may also be delayed several decades. This case report presents a 57 year old male who, 48 years ago, suffered a sling shot accident yet was only recently diagnosed with traumatic glaucoma in his left eye. The trauma caused severely reduced vision in his left eye but, aside from this, the patient did not report any eye- or vision problems and he had never had an eye examination as an adult. He successfully wore ready-made glasses for near work. While all findings were normal in his right eye, his left eye showed reduced vision, inferionasal iridodialysis, angle recession, increased intraocular pressure and heavily excavated optic nerve head. The patient was referred to an ophthalmologist who confirmed unilateral glaucoma. The case report reviews situations where secondary glaucoma from blunt trauma may occur, which ocular signs might be present and which ocular examinations should be undertaken. Further, the importance of following up patients with ocular trauma is discussed.

scholarly journals Wick technique in subscleral and subconjunctival Ologen™ implantation with trabeculectomy in patients with high risk of failure

2021 ◽  
Vol 17 (4) ◽  
pp. 366-374
Author(s):  
Muralidhar Rajamani ◽  
Chitra Ramamurthy
Keyword(s):  
Intraocular Pressure ◽  
High Risk ◽  
Retrospective Review ◽  
Ultrasound Biomicroscopy ◽  
Scleral Flap ◽  
Modified Technique ◽  
Topical Medication ◽  
Number Of Patients ◽  
The Mean ◽  
Wick Technique

Introduction: Ologen™ is traditionally placed subconjunctivally during trabeculectomy, which limits its area of action. Subscleral implantation of Ologen has been described involving fashioning a gutter beneath the scleral flap. This, however, would not prevent fibrosis at the margins of the scleral flap. We describe a modified technique of Ologen® placement that has the potential to prevent scarring at the margins of the flap withoutthe need to fashion a gutter. Materials and methods: The study involved a retrospective review of patients who had undergone trabeculectomy with Ologen implantation by the wick technique between January 2015 and August 2016. Patients judged to be at high risk of trabeculectomy failure were operated with this technique. Results: A total of six patients with median age of 38.5 years were included in the study. The mean preoperative intraocular pressure (IOP) was 30.8 ± 7.3 mmHg, which reduced to 10.6 ± 2.2 mmHg 18 months after surgery. By 18 months postoperative, all patients had IOP in the low teens (two patients required additional topical medication). One patient had two episodes of hypotony that responded to steroids and cycloplegics. Another patient required two needlings to bring IOP under control. No other complications were noted. Ultrasound biomicroscopy done 3 months after surgery showed two pieces of Ologen in one patient. Conclusions: The results of our study show that this technique may be used effectively in patients at high risk of trabeculectomy failure. Further studies in a larger number of patients with diverse high-risk conditions are required before this technique is recommended for general use.

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