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Biomedical subjects

G W Zaidman

Publications and source records attributed to G W Zaidman.

36 records · Page 2Linked to original sources

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↗

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↗

Orally administered tetracycline for phlyctenular keratoconjunctivitis.

We treated six patients who had recurrent episodes of nontuberculous phlyctenular keratoconjunctivitis and progressive corneal vascularization and scarring with oral tetracycline. This treatment resulted in rapid relief of symptoms and the apparent arrest of this disease. There have been no complications secondary to the use of tetracycline. To date, there has been only one recurrence in the patients treated with tetracycline which consisted of mild conjunctival hyperemia. We believe oral tetracycline is a safe and effective treatment for resistant and recurrent nontuberculous phlyctenular keratoconjunctivitis and an alternative to topical corticosteroid treatment in those patients suffering from corticosteroid-induced complications.

Administration, Oral↗

A light and electron microscopic study of recurrent granular dystrophy of the cornea.

Light and electron microscopic studies in three cases of recurrent granular dystrophy with corneal epithelial involvement showed intracellular rod and trapezoidal crystalline granules characteristic of granular dystrophy. Small intraepithelial cytoplasmic granules were rimmed by 15-nm particles, while larger deposits were often membrane-bound. The granules were closely associated with tonofilaments. There were ultrastructural similarities to keratohyaline. Extracellular granules were often intermixed with cytoplasmic organelles of disintegrated squamous epithelial cells. There was no evidence of a subepithelial pannus. These findings suggest an epithelial origin of the granular dystrophic deposits in these recurrent cases.

Adult↗

Peripheral uveitis and ulcerative colitis.

A 26-year-old woman developed bilateral peripheral uveitis. This was followed five years later by the onset of ulcerative colitis. To our knowledge this is the first report of a relationship between these two entities. A brief review of the literature is undertaken along with a description of some of the immunologic phenomena common to these two disorders. Systemic manifestations with peripheral uveitis are rarely reported, and we feel that many case of uveitis in patients with ulcerative colitis may go undetected. Therefore the true incidence of uveitis in ulcerative colitis may be higher than is realized. It is emphasized that a complete and extensive ocular examination be made in all patient with ulcerative colitis or other forms of inflammatory bowel disease. In this way, the true relationship between these disorders may be elicited and the presence or absence of a common immunologic disturbance may be determined.

Adult↗

Allergic and toxic reactions of soft contact lens wearers.

The allergic and toxic effects of preservatives found in soft contact lens solutions are reviewed. Thimerosal, a preservative commonly found in soft contact lens solutions, may cause ocular delayed hypersensitivity. Patients with delayed hypersensitivity to thimerosal may develop conjunctival hyperemia, corneal infiltrates and intolerance to lens wear with the use of soft contact lens solutions containing thimerosal. Delayed hypersensitivity to thimerosal can be demonstrated by an occlusive patch test or intradermal injection. Discontinuation of chemical disinfection with substitution of thermal disinfection using unit-dose, non-preserved saline causes resolution of signs and symptoms. Another cause of lens wear intolerance is contact lens-associated giant papillary conjunctivitis. Protein deposits on the lens may act as antigens and initiate an allergic condition which disappears when the lens is discontinued. Alternatively, the giant papillae may be the result of mechanical irritation induced by the contact lenses. The chemical preservatives that are found in soft contact lens solutions cause epithelial toxicity when applied to isolated rabbit corneas. However, corneal toxicity toxicity in a clinical setting has not been demonstrated.

Animals↗