[Assessment of vision in children].
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Biomedical subjects
Publications and source records attributed to S Harrer.
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Incompatibility of HEMA contact lenses leads to changes in the conjunctiva and cornea which frequently appear in the region of the corneal limbus. From the limbus toward the sclera one can differentiate four stages according to the clinical picture: (1) enlargement of the pericorneal capillary network; (2) pronounced pericorneal injection right to the rim of the contact lens; (3) border-like edema in the area actually in contact with the lens; (4) additional haemorrhage in this area. From the limbus toward the cornea three typical changes occur: (1) peripheral edema of the cornea; (2) neovascularization of the cornea; (3) pannus formation.
The topic of this paper is the appearance of palisade-shaped, soft, gray opacities of the corneal epithelium in wearers of HEMA lenses. The opacity emanates from the limbus and is located under the upper eyelid. The paper also deals with the formation of folds in Bowman's membrane. They are approximately horizontal, are usually located within the lid-fissure and occur in combination with large-scale opacity of the corneal epithelium in the upper third of the cornea. The differential diagnosis of well-known corneal changes is also discussed.
The authors report on a disease of the cornea resembling keratitis nummularis developed by patients wearing Hema lenses. The large disk-shaped subepithelial opacities are accompanied by pathologic changes in the endothelium of the peripheral parts of the cornea. Etiologically, it is believed that there is an immunologic process acting on components of the lenses and the solutions they are cleaned with and kept in. The differential diagnosis between Dimmer's nummular keratitis, epidemic keratoconjunctivitis and herpetic corneal diseases in discussed.
Report on a 19-year-old patient with bilateral papilledema and suffering from chronic granulocytic leukemia. No signs of increased intracranial pressure could be demonstrated. Under repeated leukapheresis therapy the extreme leukemic leukocytosis regressed and, as a result, the condition of the optic disk returned to normal.
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