Propionibacterium acnes keratitis.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
G W Zaidman
Publications and source records attributed to G W Zaidman.
Miconazole corneal toxicity.
A case of miconazole corneal toxicity is reported. This was seen in a patient who had had a penetrating keratoplasty for Acanthamoeba keratitis; the patient was treated with miconazole postoperatively. The miconazole toxicity manifested itself as a row of pinpoint vesicular elevations in the corneal epithelium associated with surrounding superficial punctate keratitis. Stopping the miconazole led to the resolution of the corneal epithelial changes.
Acanthamoeba Keratitis↗
Episcleritis and symblepharon associated with Lyme keratitis.
Explore the source record for details and available documents.
Adult↗
Listeria monocytogenes keratitis.
We treated a farmer who had Listeria monocytogenes bacterial keratitis. Therapy with topical antibiotics was unsuccessful; it was necessary to treat the patient with topical and systemic penicillin and gentamicin. To elucidate the pathogenesis of this infection, we developed a rabbit model. Using the patient's strain of L. monocytogenes, we determined that the severity of the rabbit infection was dose-related. If we used an inoculum of more than 10(7) organisms, many of the features of the human Listeria keratitis were mimicked. We also found that treatment with either penicillin or gentamicin did not control the infection as well as using both antibiotics simultaneously, a combination which resulted in relatively rapid resolution of infection and no corneal scarring. The human and animal data indicate that L. monocytogenes can be a virulent corneal pathogen. Listeria corneal infections must be treated aggressively with both penicillin and gentamicin to prevent permanent visual loss.
Adult↗
A prospective study on the implantation of anterior chamber intraocular lenses during keratoplasty for pseudophakic and aphakic bullous keratopathy.
Between April 1986 and April 1989, the authors conducted a prospective study of the use of open-loop anterior chamber intraocular lenses (AC IOLs) in patients undergoing penetrating keratoplasty for pseudophakic bullous keratopathy or monocular aphakic bullous keratopathy. All patients underwent the same operation--a penetrating keratoplasty combined with insertion of an open-loop AC IOL. Pseudophakic patients had an IOL exchange at the time of surgery. Thirty-six patients have been followed an average of 15 months. Thirty-two (89%) of the grafts are clear. Preoperatively, 100% of eyes had visual acuity less than 20/200. Postoperatively, 11 eyes (31%) have visual acuity better than 20/40 and 23 eyes (64%) have visual acuity better than 20/100. The most common causes for visual acuity less than 20/200 were cystoid macular edema, glaucoma, and immunologic graft failure. Using open-loop AC IOLs in patients with pseudophakic or aphakic bullous keratopathy can give good postoperative results and functional vision.
Aged↗
Surgical removal of cyanoacrylate adhesive after accidental instillation in the anterior chamber.
Cyanoacrylate adhesives are frequently used to seal small corneal perforations. Their use has been limited, however, because of concern over their toxic effect on ocular structures. We describe a post-keratoplasty patient with a wound dehiscence that a surgeon had attempted to seal with cyanoacrylate glue. The glue was accidentally injected into the anterior chamber. After surgical reconstruction of the eye, however, no permanent ocular damage was observed.
Aged↗
Transscleral YAG laser photocoagulation for uncontrollable glaucoma in corneal patients.
Control of intraocular pressure (IOP) in patients with severe alkaline burns is one of the most difficult problems facing the corneal specialist. Currently, when medical therapy cannot control intraocular pressure, the usual procedure of choice is cyclocryotherapy. This procedure, however, can be complicated by phthisis, retinal detachment, or macular edema. We have used transscleral YAG laser cyclophotocoagulation (TSYLC) to control the IOP in a patient with severe glaucoma after an alkali burn. This patient had previously had an unsuccessful cyclocryotherapy. After the TSYLC procedure, he suffered no complications and his IOP was normal. Our experience with this patient indicated that the TSYLC procedure might be an effective alternate to cyclocryotherapy, especially in corneal patients with uncontrollable inflammatory glaucoma.
Aged↗
Neurosyphilis and retrobulbar neuritis in a patient with AIDS.
A 33-year-old homosexual patient with acquired immune deficiency syndrome (AIDS) developed sudden unilateral loss of vision. Slit-lamp and funduscopic examination of the affected eye was completely within normal limits. The patient, however, had a Marcus Gunn pupil, decreased color vision, and a large central scotoma on visual field examination. This was consistent with retrobulbar optic neuritis. Laboratory investigation revealed a highly positive serum and cerebrospinal fluid venereal disease reaction level (VDRL). A diagnosis of neurosyphilis was made, and the patient was treated with ten days of intravenous penicillin therapy. Ophthalmologists should be aware that many patients with AIDS have also been exposed to syphilis. Regardless of their clinical presentation, all AIDS patients should be examined and tested for syphilis and treated as is necessary.
Acquired Immunodeficiency Syndrome↗
Work-related eye injuries.
Twenty-one patients admitted between 1977 and 1982 to the Medical College of Virginia were studied retrospectively for work-related eye injuries. This group comprised 7.7% of all eye-injury admissions. Patients suffered both blunt and penetrating injuries; penetrating injuries had poorer prognoses. Twenty of the 21 patients had not worn protective eyewear. The average per-patient cost related to ocular injury was $2946, and the average hospital stay was 6.4 days. In contrast, the one patient who had worn protective eyewear had ocular-related costs and hospitalization of only $350 and a one-day stay. Protective eyewear is important in lessening the severity of injury as well as decreasing the financial and psychologic burden to the patient, hospital, and employer.
Adult↗
The surgical management of dislocated traumatic cataracts.
Seven adult patients (six men and one woman, ranging in age from 50 to 83 years) underwent intracapsular cataract surgery for dislocated traumatic cataracts. Six of the seven also had anterior vitrectomies. All seven patients had preoperative visual acuities of counting fingers or worse. There were no serious postoperative complications and five of the patients had postoperative visual acuities of 20/60 or better. Visual acuity improved less in the other two patients because of pre-existing but unrecognized macular disease.
Aged↗
The histopathology of filamentary keratitis.
Filamentary keratitis is characterized by the presence of fine filaments of epithelium and mucus that are attached to the cornea. The exact pathogenesis of this entity has remained unclear. One reason has been the lack of pathologic specimens of corneas from patients with filamentary keratitis. We examined the corneas of a patient who had died while suffering from filamentary keratitis. Scattered groups of inflammatory cells and fibroblasts were present just below the basal epithelium. It seemed that these cells had disrupted the epithelial basement membrane and Bowman's layer. To our knowledge, this is the first postmortem analysis of a cornea in a patient with acute filamentary keratitis. These findings support the theory that filamentary keratitis results from damage to the basal epithelial cells, epithelial basement membrane, or both.
Adult↗
Fuchs' adenoma affecting the peripheral iris.
An elevated, pigmented lesion of the peripheral iris developed in a 73-year-old woman. The lesion was believed to be a malignant melanoma and was excised at the time of routine cataract extraction. Pathologic examination disclosed a Fuchs' adenoma. These lesions are common in the elderly and are almost invariably clinically silent. This case, however, demonstrates that under rare circumstances a Fuchs' adenoma may induce cataractous changes or produce clinical findings that can mimic an iris melanoma.
Adenoma↗
Hemolytic complement in tears.
We performed hemolytic assays for C1, C4, C3 and C5 on tear samples from 7 normal subjects and 10 patients with corneal ulcers. Hemolytic activities in tears were determined by 50% hemolysis of sensitized sheep red blood cells. Absent or low hemolytic activities of C1, C4 and C3 were found in normal tears. C5 was detected in tear samples from 4 of 7 normal subjects. Tear samples from patients with corneal ulcers showed elevated levels of C1, C4, C3 and C5, but wide ranges in values were found. C5 had the highest hemolytic activities in both normal tears and tears from eyes with corneal ulcers. Complement in tears may contribute to host defense in microbial corneal ulcers.
Adolescent↗
Use of pressure patching and soft contact lenses in superior limbic keratoconjunctivitis.
Eight patients with superior limbic keratoconjunctivitis (SLK) were successfully treated with the use of pressure patching and therapeutic soft contact lenses. In two patients, pressure patching alone was used to eliminate both the signs and symptoms of SLK. Therapeutic soft contact lenses were used after pressure patching in the other six patients to prevent recurrences of SLK. Our results suggest that eliminating the mechanical effect of the lid on the globe by pressure patching and then protecting the superior corneal limbus and adjacent bulbar conjunctiva by soft contact lenses may provide an alternative to silver nitrate applications in the treatment of SLK.
Adult↗
Postoperative pseudophakic bacterial endophthalmitis.
Five patients who had postoperative pseudophakic bacterial endophthalmitis were treated with topical, periocular, and systemic antibiotics. Four patients also received intravitreal antibiotics and oral corticosteroids. The causative organisms were Staphylococcus epidermidis, S. aureus, and Proteus mirabilis. Final visual acuities ranged from 6/7.5 (20/25) to no light perception. Response to treatment and final visual acuity did not appear to be related to retention or removal of the intraocular lens.
Adrenal Cortex Hormones↗
Peripheral corneal ulcers, conjunctival ulcers, and scleritis after cataract surgery.
After undergoing uneventful cataract extractions, four patients developed an inflammatory reaction that included scleritis and peripheral corneal infiltrates and ulcers. Two of these patients also developed conjunctival ulcers. The inflammatory reaction in all four patients responded to topical corticosteroids.
Aged↗
Corneal transplantation in an infant with corneal dermoid.
A 1-month-old infant had a protuberant congenital corneal dermoid that extended into the anterior chamber. The dermoid was excised in two stages. A 12-mm lamellar keratectomy was followed three months later by a smaller (8-mm) penetrating keratoplasty. This technique minimized the complications associated with large corneal transplants and increased the chance of long-term success. The graft has remained transparent and the posterior segment appears to be normal. The infant can maintain constant fixation and recognize small objects and crawls without difficulty.
Anterior Chamber↗