Herpes zoster dendritic keratitis.
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Biomedical subjects
Publications and source records attributed to W L Jones.
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Peripheral microcystoid retinal degeneration and degenerative retinoschisis represent two findings frequently made during indirect ophthalmoscopy of the peripheral fundus. Peripheral microcystoid degeneration, a benign condition, may represent a precursor to degenerative retinoschisis, a potentially sight threatening condition. Discussed are the epidemiology, histologic and clinical appearance, and possible pathogenesis of each. The normal progression of both conditions, together with the prognostic value of inner and/or outer layer holes in degenerative retinoschisis are addressed. Methods of following degenerative retinoschisis and modes of treatment of progressive cases are considered.
The early detection and referral of a small basal cell carcinoma of the face will prevent extensive surgical excision and repair necessary for a neglected lesion. Since these tumors occur in the older population, careful examination of the skin should be performed on patients 50 years of age and older. This cancer has been estimated to constitute 90% of all malignant lid tumors and a suspicious lesion on the lid should be considered a basal cell carcinoma until proven otherwise. The lesion has a very characteristic appearance as described in the text; however, they can present with an atypical picture. An important sign in the evaluation of a possible malignant lid tumor is the loss of eyelashes within or adjacent to the lesion, which indicates the destructive nature of the tumor to the hair follicles. Basal cell carcinomas do not metastasize to distant locations in the body but rather extend locally and can produce deep tissue invasion. Differential diagnosis can present problems to the clinician but the definitive diagnosis is dependent upon the pathologist. The treatment usually requires surgical removal with wide excisional margins; however, other forms of treatment have been attempted. Recurrences of basal cell carcinomas are not uncommon, especially following an initial recurrence and it is mandatory that these patients be re-examined at least every six months for a two year follow-up period.
The association of Purtscher's retinopathy with acute pancreatitis has been noted only recently in the ophthalmic literature. Patients with acute pancreatitis may develop a retinopathy indistinguishable from the typical Purtscher's retinopathy seen in bone-crushing injuries. The etiology of this phenomenon has been linked to fat necrosis and involvement of complement and the immune system.
A patient developed a traumatic choroidal rupture of his left eye during a rodeo broncobusting ride. The unusual aspect of this horizontal rupture is that it produced an irregular altitudinal field defect. The trauma was severe enough to cause a field defect not typically seen in choroidal ruptures. This is thought to be the first such report.
A case is presented of hypertensive retinopathy seen in a patient with generalized scleroderma. Retinal changes are not generally found in scleroderma, which makes this case significant. Other systemic and ocular manifestations seen in scleroderma (some of which were present in this patient) are reviewed.
A microagglutination test was compared with a standard tube agglutination test for the detection of brucella antibodies. Advantages of the microagglutination test were that it required less time to perform, had a shorter incubation period, and used less antigen.
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Ingrown eyelashes are an interesting finding closely related to ingrown hairs of the body. This phenomenon is fairly uncommon and is sparsely referred to in the ophthalmic literature. The condition can produce patient complaints, and therefore deserves optometric recognition.
A microagglutination test for Francisella tularensis, with 0.025-ml amounts of diluted sera and 0.025-ml amounts of safranin-O-stained antigen in U-bottom microtitration plates, was compared with a tube agglutination test by using 137 sera. There was 86.3% agreement (+/- 1 dilution variation) between the microagglutination results and the tube agglutination results for sera with tube agglutination titers of greater than or equal to 20. There was 100% agreement (+/- 1 dilution variation) for sera with titers of less than 20. The advantages of the microagglutination test are: (i) it requires fewer man hours to perform; (ii) it requires only one-twentieth of the amount of antigen; and (iii) it is easier to read.
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An upper limit of normal microagglutination titer for the Knoxville strain of Legionella pneumophila was determined by testing 830 sera. The upper limit of normal titer was found to be 8; however, we suggest that when applied to single serum specimens a titer of 32 be considered the lowest titer suggestive of infection (not necessarily disease).
Toxocara canis, commonly known as the dog ascrid, is a frequent parasite of the domestic dog. If the eggs of an adult worm are accidentally ingested by a human host, usually a child, a larval form of the worm develops that can survive for a limited period in various human tissues. The retina is one of these tissues and upon the death of this organism a granulomatous reaction occurs and a fibrotic mass is formed in the retina. This unusual ophthalmoscopic appearance is demonstrated by the presentation of three fundus photographs of patients with suspected Toxocara lesions. A knowledge of this parasite and its life cycle will aid in its recognition, treatment, and possible prevention.