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Biomedical subjects

Tova Lifshitz

Publications and source records attributed to Tova Lifshitz.

At least 55 records · Page 3Linked to original sources
PubMed2004

Severe conjunctival and eyelid involvement in pemphigus vulgaris.

Pemphigus vulgaris (PV) is only rarely associated with severe ocular involvement. We present a case of PV with bilateral severe swelling, induration and thickening of eyelids, and multiple conjunctival and lid margin erosions, complicated by high intraocular pressure secondary to steroid treatment. After successful systemic immunosuppressive, steroid, and antiglaucomatous treatment, clinical features were resolved, and intraocular pressure returned to normal. Severe ocular diseases without dermatological involvement may be present in PV patients.

Adult↗
PubMed2004

Intrasinus wood foreign body causing orbital cellulitis in congenital insensitivity to pain with anhidrosis syndrome.

A 2-year-old boy with congenital insensitivity to pain with anhidrosis (CIPA) was referred with a 2-day history of left periorbital swelling and mucoid conjunctival discharge. Marked worsening was noted despite intramuscular ceftriaxone treatment for 3 days, with marked proptosis, conjunctival chemosis, and a frozen eye. Orbital cellulitis was suspected. Ceftriaxone was intravenously administered. Orbital computed tomography (CT) disclosed an inflammatory process in the medial aspect of the left orbit with ethmoiditis. Improvement was not noted after external ethmoidectomy and drainage of the intraconal abscess. Repeat CT showed a recurrent intraconal abscess. A revision external ethmoidectomy was performed, and a bent wooden match was removed from the posterior aspect of the ethmoidal sinus, after which significant clinical improvement was noted. In patients with CIPA, accidental or self-penetrated foreign bodies must be kept in mind when treating all types of wounds.

Cellulitis↗
PubMed2004

Ophthalmic manifestations in Langerhans cell histiocytosis.

Histiocytosis of childhood is characterized by localized or generalized proliferation of cells of the mononuclear phagocyte system and the dendritic cell system. In patients with Langerhans cell histiocytosis, the orbit is the most involved site encountered in ophthalmic practice, usually as a lytic lesion in the zygomaticofrontal suture. Patients usually present with acute or chronic periorbital swelling. Electron microscopic findings of Birbeck granules and positive staining for CD1 antigenic determinant confirm the diagnosis.

Eye Diseases↗
PubMed2004

Endoscopic orbital decompression for Graves' ophthalmopathy.

BACKGROUND: In patients with Graves' ophthalmopathy, orbital decompression surgery is indicated for compressive optic neuropathy, severe corneal exposure, or for cosmetic deformity due to proptosis. Traditionally this has been performed through a transantral approach, but the associated complication rate is high. More recently, endoscopic orbital decompression has been performed successfully with significantly fewer postoperative complications. OBJECTIVE: To report our experience of endoscopic orbital decompression in patients with severe Graves' ophthalmopathy. METHODS: Three patients (five eyes) underwent endoscopic orbital decompression for Graves' ophthalmopathy at Soroka Medical Center between the years 2000 and 2002. The indications for surgery were compressive optic neuropathy in three eyes, severe corneal exposure in one eye, and severe proptosis not cosmetically acceptable for the patient in one case. An intranasal endoscopic approach with the removal of the medial orbital wall and medial part of the floor was performed. RESULTS: In all five eyes an average reduction of 5 mm in proptosis was achieved. Soon after surgery, visual acuity improved in the three cases with compressive optic neuropathy, and exposure keratopathy and cosmetic appearance also improved. The diplopia remained unchanged. No complications were observed postoperatively. CONCLUSIONS: Endoscopic orbital decompression with removal of the medial orbital wall and medial part of the floor in the five reported eyes was an effective and safe procedure for treatment of severe Graves' ophthalmopathy. A close collaboration between ophthalmologists and otorhinolaryngologists skilled in endoscopic sinus surgery is crucial for the correct management of these patients.

Adult↗
PubMed2004

[Primary congenital glaucoma].

Primary congenital glaucoma (PCG) is a rare genetic disease usually diagnosed during the first year of life. It occurs because of developmental anomalies of the chamber angle that prevents drainage of aqueous humor, thereby elevating intraocular pressure. Its incidence is 1 in 10,000 live newborns in Western societies and 1 in 1,200 live newborns in the Arab-Bedouin population of the Negev region in Israel. Most cases of PCG appear to be sporadic. The cytochrome P4501B1 gene located within the GLC3A locus on chromosome 2p21 is mutated in individuals with PCG. The triad of epiphora, photophobia, and blepharospasm is classical for PCG. General anesthesia is usually required for an adequate examination of intraocular pressure, corneal diameter, optic disc, and axial length in young children. Congenital glaucoma is almost always managed surgically, with medical therapy being used only as a temporizing measure before surgery or when surgical intervention has repeatedly failed. At least 50% of eyes with PCG presenting at birth will become legally blind (visual acuity < 6/60). Patients with PCG require follow-up examinations throughout their lives.

Aryl Hydrocarbon Hydroxylases↗
PubMed2003

Langerhans cell histiocytosis with periorbital cellulitis.

PURPOSE: To report a case of Langerhans cell histiocytosis presenting as periorbital cellulitis. DESIGN: Interventional case report. METHODS: A 3-year-old girl presented with periorbital swelling of the right upper lid laterally of two days' duration. A history of recent eye trauma was reported. RESULTS: Computed tomography showed a soft tissue mass that eroded the frontozygomatic suture. The lesion was debulked through a lateral orbitotomy. Electron microscopy disclosed Birbeck granules. Immunohistochemistry stained positively for CD68 and CD1a antigenic determinants. CONCLUSIONS: Although rare, Langerhans cell histiocytosis can cause acute periorbital cellulitis in children. Trauma can induce an inflammatory response, allowing for earlier diagnosis of the orbital lesion.

Antigens, CD↗
PubMed2003

Attempted bilateral manual enucleation (gouging) during a physical assault.

OBJECTIVE: To report a rare, severe case of partial traumatic bilateral enucleation and its assessment and management. DESIGN: Case report and literature review. METHODS: A report of clinical and imaging findings, surgical procedure, medical treatment, and final outcome. RESULTS: Complete avulsion of the extraocular muscles and optic nerve resulted in total loss of vision in one eye. Partial visual recovery was achieved by operating on the fellow eye, which was partially avulsed. Both eyes underwent lateral canthotomy in the emergency room. This was followed by exploration, repair of all ruptured extraocular muscles, and anterior chamber tap under general anesthesia. The few previously reported cases of traumatic manual avulsion of the globe are reviewed and discussed in the context of the present case. CONCLUSIONS: Partial visual recovery can be achieved after severe orbital and optic nerve trauma. A multidisciplinary approach to the assessment and management of these patients is recommended.

Adult↗
PubMed2003

Visual problems among people with mental retardation.

Vision impairment can be a debilitating condition, affecting not only the social, emotional, mental and physical functioning of an individual, but also the individual's ability to perform basic and instrumental activities of daily living. Scant knowledge exists about visual impairment among people with mental retardation. The results of this prospective study were based on interviews and eye ophthalmologic screening of 106 adults with a moderate level of mental retardation, ranging in ages from 19 to 62 years. Findings show that only 3% of those interviewed recalled having had an eye examination, yet 24% reported that they had visual problems. In spite of the high probability of visual problems for this group, only 13% reported having glasses and 20% said they needed glasses; 92% reported watching television but 22% stated they had difficulty seeing the TV; 62% of the respondents reported that they cook for themselves but 17% reported that visual problems affected their ability to perform this activity. Medical eye screening of the participants found that 79% had ocular problems - 42% were in need of eyeglasses, 12% had a cataract problem requiring surgery and 25% needed outpatient care at the local hospital. The study findings are discussed in terms of policy implications and service provision, and recommendations are made for additional research.

Adult↗
PubMed2002

Videokeratography findings in children with vernal keratoconjunctivitis versus those of healthy children.

PURPOSE: To determine videokeratographic topography of eyes with vernal keratoconjunctivitis (VKC) and to assess whether the severity of the VKC is related to the presence of changes compatible with keratoconus. PARTICIPANTS: Seventy-six persons aged 6 to 21 years: 40 patients with VKC and 36 healthy controls. DESIGN: A comparative, observational case series. METHODS: We examined 76 persons, of whom 40 were patients with VKC and 36 were control subjects, and compared the outcomes of videokeratography (VKG) patterns (EyeSys Laboratories, Houston, TX), numerical corneal indices, and spherical equivalent refraction. MAIN OUTCOME MEASURES: Corneal topographic patterns, corneal numeric indices, and corneal mirror imagery. RESULTS: We found many more abnormal patterns on VKG among the VKC patients than expected when compared with 'normal' eyes (P = 0.02 for the right eye and P = 0.001 for the left eye). Videokeratography allowed us to define a subgroup of patients with infraclinical keratoconus. A trend of superior corneal steepening ('superior keratoconus') was also found. CONCLUSIONS: Vernal keratoconjunctivitis patients have more abnormal corneal topographic patterns than non VKC controls. Videokeratography may help decide how to follow-up and treat a presumed self-limiting disease.

Adolescent↗
PubMed2002

Branch retinal vein occlusion in Churg-Strauss syndrome.

The case is reported of a 64-year-old man who was diagnosed as having Churg-Strauss syndrome associated with branch retinal vein occlusion, without accompanying retinal vasculitis. It was assumed that the blood thrombocytosis caused a hypercoagulable state and thromboembolism leading to the branch retinal vein occlusion.

Churg-Strauss Syndrome↗
PubMed2002

High postdialysis urea rebound can predict intradialytic increase in intraocular pressure in dialysis patients with lowered intradialytic hemoconcentration.

BACKGROUND: Intradialytic (ID) decrease in intraocular pressure (IOP) parallel to ultrafiltration-induced hemoconcentration has been recently reported. However, exacerbation of glaucoma in hemodialysis (HD) patients during HD sessions is occasionally observed. Postdialysis urea rebound (PDUR) is induced by the lag in urea removal from the cells to urea removal from the extracellular fluid, which when increased can result in ID drag of water to intracellular compartment. It is our hypothesis that similar lag in urea removal from ocular compartments may also be reflected by PDUR, and may induce drag of water into ocular compartments counteracting the effect of hemoconcentration. Our assumption was, therefore, that PDUR might predict ID increase in IOP. METHODS: IOP, serum urea and hematocrit levels were measured at the start, end and 1 h postdialysis, in 19 chronic HD patients with normal IOP. RESULTS: PDUR was positively correlated with mean (both eyes) ID changes in IOP (MIDIOP) (r = 0.5, p = 0.03) and % MIDIOP (r = 0.55, p = 0.02). ID increase in IOP was observed only in the 7 patients with relatively higher PDUR (> or = 9 mg%), who had also a relatively lower % ID change in Hct (<8%). MIDIOP was negatively correlated with % ID changes in Hct (r = -0.65, p = 0.03) in the 12 patients with PDUR > or = 9 mg, and positively correlated with PDUR (r = 0.57, p = 0.03) in the 14 patients with % ID change in Hct <8%. CONCLUSION: High PDUR may predict susceptibility to ID increase in IOP in patients with lowered ID hemoconcentration.

Aged↗
PubMed2002

Telemedicine in the service of peace.

Ophthalmology is well suited to telemedicine, since optical and imaging devices provide the basis for virtually all ophthalmic patient evaluations. We established the Middle East Ophthalmology Network among ophthalmologists working in 10 major ophthalmology centres in Israel, Jordan, Morocco, the Palestinian Authority and Tunisia. The project offered some 50 physicians around the Middle East the opportunity to benefit from sharing clinical consultation for diagnosis and management decisions beyond physical and political boundaries. In the first year, over 100 consultations took place. The system overcame some of the constraints imposed by the uneven distribution of medical resources and expertise in the region, reduced professional isolation, encouraged more collaboration between physicians and offered peace dividends from cooperation between physicians across the political divide.

Humans↗