Biomedical subjects
Publications and source records attributed to L Verma.
Ocular cysticercosis, a platyhelminth infection, involves various ocular and adnexal sites. Orbital cysticercosis is a relatively rare site of presentation. We illustrate that this parasitic cyst, when present in the orbit, mimics an orbital pseudotumour. We have used ultrasound as an effective pre-operative diagnostic modality.
Ophthalmomyiasis is a rare entity caused by infestation with certain dipterous larvae. We describe a 71-year-old farmer with herpes zoster ophthalmicus on the left side of the face in whom the blisters became secondarily infested with Chrysomyia bezziana maggots. The maggots were removed mechanically, and the corneal involvement secondary to zoster ophthalmicus responded to therapy with topical steroids and cycloplegics. To our knowledge this is the first report of external ophthalmomyiasis due to C. bezziana.
Three patients who experienced temporary visual loss after retrobulbar anesthesia with 2% lidocaine (Xylocaine) are described. Visual evoked potentials (VEPs) consistently increased in latency and decreased in amplitude. Abnormal VEPs such as these recorded for humans after retrobulbar anesthesia are, to our knowledge, reported here for the first time.
The involvement of the neurological system in epidemic dropsy is controversial. During two outbreaks of epidemic dropsy, detailed neurological and ocular examinations and electrophysiological studies of peripheral nerves and muscles (motor nerve conduction velocities, sensory nerve latencies and electromyography) and eye (electroretinogram and visually evoked cortical responses) were therefore undertaken. Amongst the 239 subjects examined, burning sensation and tingling paraesthesias of feet were reported by 42.3 and 35.6%, respectively; but none had any objective evidence of central or peripheral nervous system involvement. Electrophysiological studies of peripheral nerves and muscles (10 cases with subjective manifestations) and eyes (24 eyes of 12 patients hospitalized for control of glaucoma) were essentially normal. It is concluded that Argemone mexicana or its toxins do not have any significant effect on the nervous system.
A viable intravitreal cysticercus cellulosae communicating with subretinal space was identified in a 45-year-old man. The cyst was removed in toto via the direct scleral approach without incident. To our knowledge this is the first report of intravitreal cysticercus with subretinal extension removed successfully by the direct route. The role of careful ultrasonic scanning in cases of intravitreal cysticercosis is emphasized.
An unusual case of Bardet-Biedl syndrome which presented with sudden total visual loss in both eyes is documented. The fundus picture and angiographic findings were consistent with the diagnosis of bilateral disc oedema with retinitis pigmentosa. The various etiological possibilities resulting in the manifestation of bilateral disc oedema in this case of retinitis pigmentosa are considered. Inflammatory disc oedema secondary to photoreceptor degeneration as a possible cause of acute loss of vision in retinitis pigmentosa is discussed.
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A 26-year-old male patient with dermatological and systemic features suggestive of dyskeratosis congenita is reported with an unusual associated ocular feature of bilateral cataract.
PURPOSE: To determine factors predisposing to the development of choroidal detachment following conventional retinal detachment surgery, to evaluate its clinical course, and to identify possible measures to reduce its occurrence. METHODS: Analysis of 25 consecutive cases of choroidal detachment following retinal detachment surgery out of a total of 510 cases undertaken at a tertiary care referral eye center over a period of 15 months. RESULTS: The incidence of developing choroidal detachment was 4.9%. The mean age was 61 years (range 28 to 76 years) and there was no sex predilection. Hypertension was present in 16% (n=4). A total of 44% (n=11) of patients had myopia and with respect to the lens status, 44% (n=11) were phakic, 36% (n=9) were pseudophakic, and 20% (n=5) were aphakic. Redetachment of the retina was observed in 12% (n=3) of cases. Elevated intraocular pressure developed in 12% (n=3). In one patient with an anterior chamber intraocular lens and "kissing" choroidal detachment, drainage of the choroidals was undertaken to prevent corneo-lenticular touch and corneal decompensation. In two patients with redetachment, anatomic settlement of the retina was achieved only following vitreoretinal surgery. CONCLUSIONS: The following preoperative and intraoperative factors are associated with a significantly increased risk of choroidal detachment following retinal detachment: higher age, myopia, posteriorly placed explants even if its extent is less, anteriorly placed explants whenever its extent is large, drainage of subretinal fluid, and intraoperative hypotony. Choroidal detachment may also occur in patients with only a radial sponge. Designing a notch intraoperatively in the region of the explants overlying the vortex veins may help to reduce the risk of choroidal detachment following conventional retinal detachment surgery.
Combined hamartoma of the retina and retinal pigment epithelium has been described as a rare, benign tumor formed by an overgrowth of several constituents of the retina such as the retinal pigment epithelial cells, vascular elements, and glial components.1 Despite its varied clinical appearance it is important to recognize this tumor as it is known to simulate intraocular malignancies like retinoblastoma and choroidal melanoma.
An unusual case of Sturge-Weber syndrome with raised intraocular pressure is presented. The slit lamp examination and anterior segment fluorescein angiography were consistent with iris neovascularization. Cause and effect relationship of iris neovascularization with glaucoma in this syndrome is discussed.
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Conjunctival sacs of seventy one leprosy patients, paramedical and medical personnel working in a leprosy home were cultured. None of these eyes had any pathology in the outer eye. Surprisingly, 46.2% of the eyes which showed a positive culture carried accepted pathogens; Staphylococcus aureus being the commonest. Determining the preoperative bacterial flora and their elimination before undertaking intraocular surgery is recommended.
Pre-vitrectomy errors in diagnostic A & B mode ultrasound may result in affection of the surgical outcome. We have done a retrospective analysis of fifty patients who were screened by both A & B mode echography and analyzed the data which revealed that real-time kinetic echography is required for accurate interpretation of the vitreoretinal status. Besides, quantitative A scan examination also has fallacies due to the echo beam not striking the sclerochoroid complex at right angles, and a modification of this technique is suggested. Lastly old retinal detachments may not produce echo-patterns diagnostic of retinal detachments resulting in fallacious interpretation. We recommend that combined A mode and real time B-mode and often repeat echography is essential for accuracy in diagnosis.
Standardized 'A' mode of Kretztechnik--7200 mA was used in 40 eyes of 20 patients for the measurement of extraocular muscle thickness. The mean thickness value of medial, lateral, superior and inferior rectus in the normal Indian population was found to be as 4.015 +/- 0.762 mm, 3.548 +/- 0.369 mm, 3.757 +/- 0.654 mm and 3.177 +/- 0.662 mm respectively.
Conjunctival sacs of seventy-one leprosy patients, paramedical and medical personnel working in a Leprosy Home were cultured. None of these eyes had any pathology of the outer eye. Surprisingly, 46.2% of the culturally positive eyes carried accepted pathogens, Staphylococcus aureus being the commonest. Determining the preoperative bacterial flora and their elimination before undertaking intraocular surgery is recommended.
A rare case of gyrate atrophy of the choroid and retina is reported in two female siblings. The diagnosis was made on clinical, electrophysiological, angiographic and biochemical features. This possibly is the first documentation of hyperornithemic gyrate atrophy (HOGA) from the Indian subcontinent.