Persistent hyperplastic primary vitreous

It is a congenital anomaly related to the persistence of the fetal hyaloidien system and hyperplasty of primary vitreous. The aim of our study is to analyze the epidemiological profile and the diagnostic and therapeutic difficulties of persistent hyperplastic primary vitreous. 13 children [15 eyes] with PHVP treated and followed between 2004 and 2012. Age at admission ranged from 3 months to 14 years. The main call sign was leukocoria in 69.23% of cases; unilateral in 84.6% of our patients. It was an anterior form in 13.3% of eyes, posterior in 6.66% and mixed in 80%. An indication for surgery was raised in 60% of eyes. The postoperative aphakia was corrected with an implant in 77.7% of operated cases. Therapy for amblyopia was performed in all patients. The best visual result: 2/10 and counting fingers in both anterior forms; 1/10 in a posterior form unoperated. Discussion This is an isolated and unilateral affection usually occurs in infants born at term, it is most often revealed by leukocoria. There are 3 clinical forms. The functional prognosis is poor and the PHPV depends on several criteria. Treatment should be tailored to the clinical form. All studies support the value of early diagnosis and early intervention to maximize the visual potential in selected patients. Vision therapy should not be neglected and started quickly in the postoperative period, with appropriate refractive correction of aphakia

Corneal abscesses under contact lens

It's represents a severe complication that could lead to vision lost. They are caused by a bad hygiene, a permanent wear of contact lenses and a contamination of boxes. We report a retrospective study of 10 years from January 2003 to december 2013, of patients seen in our hospital for severe corneal abcesses under contact lens. These patients have undergone the same treatement: an initial clinical exam with the assessement of visual acuity, slit lamp exam in order to analyse the corneal infection [superficiel or stromal corneal infection], conjunctival samples or samples within the abcesses, associated to bacterial exam, antibiotherapy in local or general administration, adapted after to bacteriologic results. Corneal abscess represent the major risk wearing contact lenses. Infectious complications have been reported frequently in patients with contact lenses in several series. The corneal abscess is a dramatic complication among patients with contact lenses. A good support is based primarily on early diagnosis and quality of the first treatment

chronicles dacrocystisis in child

Introduction Chronic dacryocystitis in child is responsible for a significant functional gene by epiphora and may cause complications. The purpose of this study was to report our experience of management of this type of condition. Retrospective study of 33 children aged 08-16 years collected in our department between 2003 and 2008. All patients underwent a survey, the recommended treatment is the establishment of a single probe or bicanaliculo-nasal dacryocysto rhinostomy. Functional signs are watery found in 27 cases, acute dacryocystitis in 9 cases. 20% of our patients received medical treatment associated with a survey cannula Bowman. Chronic dacryocystitis in children is most often secondary to an unknown defect lacrimal. 6% of children are born before their permeabialisation total naso-lacrimal duct obstruction by the membrane Hesner which opens at the age of 1 year in 90% of cases C Tearing in the child is a common symptom. Early detection through awareness of parents, GPs and paediatricians

Recurrent primary mucinous carcinoma of the two left eyelids

The proliferative center of Aschoff, better known as radial scar, resembles carcinoma mammographically and histologically. It is a begnin conMucinous carcinoma of the eyelid is a rare tumor that usually occurs in the periorbital region. We propose a case of tumor affecting both eyelids on the same side. 55 year old man with swelling of the entire left lower eyelid, and a second swelling of the outer third of the upper eyelid evolving for over 5 years and has recurred after several incomplete excisions previously performed. A biopsy was performed with a result of mucinous carcinoma, The staging [CT orbitocerebrale, abdominal ultrasound, cervical ultrasound] did not reveal any other sites ormetastasis of the tumor. The patient was operated on in our department with complete resection of both tumors eyelid donating extemporaneous examinations obedient standards cancer surgery with rotation flaps and sliding. Primitive recurrent mucinous carcinoma of the eyelid is a rare malignancy tumor affecting the patients on their sixties. Clinically, it is in the form of an irregular nodular lesion on the eyelid, painless, with slow development, unaggressive. The evolution is characterized by frequent recurrences, sometimes late. Its diagnosis is histological. Treatment consists of complete excision of the tumor. Although it has a low metastatic potential, it has a high rate of recurrence

Oculaire toxoplasmosis

Toxoplasmosis is the leading cause of posterior uveitis in immunocompetent patients. Our series includes 15 cases of ocular toxoplasmosis collected in the [B] ophthalmology department over the last 5 years. The mean age was 26 years. Male involvement is predominant. Lesions are mostly chorioretinal. Scarringare found in 60% of cases. Generally clinical appearance is typical, but sometimes the diagnosis can only be obtained by biology based on the detection of a local production of toxoplasmosis antibodies. Through this study, the authors emphasize the interest of the ophthalrnoscopic appearance in the diagnosis of this condition. Treatment is based on the combination pyrimethamine-sulfadiazine

contribution of MRI in malignant choroidal melanoma

Malignant melanoma of the choroid is a rare condition, however it is the most common primary intraocular tumor in adults. The contribution of MRI in choroidal melanoma is considerable, given its specificity for melanin. We report one case of malignant choroidal melanoma. Our case of malignant choroidal melanoma whose ultrasound signs are very suggestive. An MRI signal intensity on Tl and hypo intensity on T2 are obvious, we also found no metastases. Enucleation was performed for the patient, histological analysis confirmed the diagnosis. At the genetic level, melanoma usually presents no recognized character of inheritance. The importance of the degree of pigmentation and growth uveal melanoma varies from one subject to another. It is very important to determine the value of imaging and especially MRI in the diagnosis of choroidal tumors

Ocular manifestations in subacute bacterial endocarditis

Subacute Bacterial Endocarditis [SBE] is a flammable bacterial infection of the endocardium and usually builds on a pre-existing heart disease. Ocular events are a particularly rare complication that occurs in a child. A 10 year old patient having a history of recurrent tonsillitis and hospitalized in pediatric for kidney failure, shows a decrease in visual acuity reduced to finger counting at 1 meter. Ophthalmologic examination revealed papilledema, premacular hemorrhage, Roth spots and several intraretinal hemorrhages in both eyes and the presence of a segmental vasculitis in the left eye. Under etiological assessement, a transthoracic echocardiography was performed retaining the diagnosis of infective endocarditis. Blood culture isolated viridans streptococci. The patient received appropriate systemic antibiotics. Two months later, the evolution was marked by the recovery of visual acuity to 10/10 and net regression both papilledema as hemorrhagic lesions. Although rheumatic fever has become an exceptional condition in developed countries, it may still be a rheumatic valve that is grafted sepsis. In infective endocarditis, several ophthalmologic manifestations have been described in the literature. They result for most of infectious emboli in the retinal vessels and in some cases may reveal endocarditis. Besides vital prognosis engaged in bacterial endocarditis, visual functional prognosis may also be threatened by serious eye damage. Thus, an eye examination

[Acanthamoeba keratitis]

Prognosis for Acanthamoeba is worse than for many other types of infectious keratitis. Treatment is difficult especially in advanced stages and it may result in permanent visual impairment or blindness. However, especially if caught early, satisfactory outcomes can certainly be achieved. The purpose was to evaluate the clinical features in five patients diagnosed in our department between 2007 and 2011. Risk factors, clinical diagnosis and therapeutic characteristics were studied retrospectively in this study. All patients were referred in a second or third intention. These are three women and two men with a mean age of 38.5 years admitted for corneal abcess in 3 cases and pseudendritic keratitis in 2 others. The risk factors found were: contact lens wear in 2 cases, contact with contaminated water in 2 cases and the laboratory tests revealed an unrecognized diabetes in a case. Corneal sampling allowed the isolation of Acanthamoeba in 3 cases and in two cases the diagnosis was made by Polymerase Chain Reaction. All patients received broad-spectrum antibiotics and Hexamidine. ketoconazole was associated in 3 cases and Polyhexamethylene biguanide [PHMB] in 1 case. Evolution was marked by panophthalmitis and eyeball phthysis in 1 case, corneal opacity with neovascularization in two cases justifying a corneal graft. Regression with ad integrum recovery was observed in 2 cases of epithelial keratitis. The incidence of Acanthamoeba keratitis varies from one country to another between 0.15 and 1.4 per million inhabitants. Acanthamoeba are naturally occurring amoeba [tiny, one-celled animals] commonly found in water sources, such as tap water, well water, hot tubs, and soil and sewage systems. Contact lenses are still responsible for the majority of cases [2 cases] despite knowledge of this now well-established major risk factor and its preventive measures including strict hygiene for the maintenance of contact lenses. Medical treatment is very disappointing in advanced forms [3 cases]. The dramatic consequences of this complication justify a systematic treatment against amoeba in each case of suspected diagnosis. Acanthamoeba keratitis is a serious vision-threatening disease. Early diagnosis and treatment are essential for improving visual outcome

[Strabismic amplyopia],49 Cases

Our study from January 1988 to May 1993 relates to 49 strabismic amblyopia records which represent 56 percent of strabismic children. The objective of this work is to insist on the interest of tracking down and early treatment of strabismic amblyopia because the therapeutic efficacy depend on the child age, and on the time between strabismus beginning and the treatment. The children age varied between 2 and 14 years. The strabismus was convergent in 44 cases, and divergent in 5 ones, with an oculary dominance in 90 percent of cases. The visual acuteness different between the two eyes was lower or equal to 4/10 in 26 cases and higher than 4/10 in 23 ones. Treatment consisted in an optic correction after cycloplegia and an amblyopia reeducation by occlusions of fixing eye with a variable frequency according to the age of the child and to the amblyopia deepness. The keeping treatment called for alternated occlusions over a right eye optic penalization. The functional recuperation after amblyopia reeducation is better among children group of 6 years [81,25%]

Herpetic Uveitis: a case report

We present a patient with severe, unilateral panuveitis associated with retinal detachment, which did not respond to standard treatment for uveitis. Titers of antibodies against herpes simplex virus [HSV], cytomegalovirus, and toxoplasmosis were measured in the aqueous and in the serum. A high anti-HSV antibody titer was found in the aqueous humor. The Goldmann Witmer coefficient was 4, suggesting the synthesis of antibody within the eye. Systemic intravenous and oral acyclovir resulted in complete resolution of the uveitis

[Surgery operation of congenital eyelids ptosis]

This retrospective study concerns 12 patients with congenital eyelids ptosis [bilateral in four cases]. Ten lids were treated by levator resection. In the other cases where levator was functionally and anatomically inappropriate, the authors used frontalis suspension with silicone sling. Good results were obtained in 12 cases

Inflammatory orbital pseudotumor

We studied a total of eight cases with inflammatory orbital pseudotumour. Three [38%] of the eight cases were subjected to biopsy of the pseudotumour. Histopathologic confirmation of the inflammatory orbital pseudotumour was obtained. One five-year-old child was suspected to have rhabdomyosarcoma before obtaining the biopsy specimens. Histopathologic evaluation of the orbital tumour confirmed the diagnosis of inflammatory orbital pseudotumour