ABSTRACT
RESUMEN Se reportó el caso clínico de una fémina de 50 años de edad. Acudió a los Servicios de Oftalmología, del Hospital Provincial Comandante Faustino Pérez Hernández, de Matanzas. Refirió síntomas irritativos y disminución visual por el ojo izquierdo. El examen oftalmológico mostró en dicho ojo la presencia de lesiones esferoideas de color ámbar, conjuntivo corneales en periferia (horas 3-4 y 9). Se extendían en banda a la córnea central, algunas con aspecto nodular. En el ojo derecho presentaba lesiones similares pero localizadas mayoritariamente en la periferia corneal y conjuntiva horas 3 y 9. Con estos elementos se estableció diagnóstico clínico de degeneración esferoidea, enfermedad degenerativa corneal poco frecuente y generalmente asintomática siempre que no progrese y afecte la visión. Se aplicó como tratamiento una queratectomia superficial, manual, con colocación de una lente de contacto terapéutica en el ojo izquierdo, sin complicaciones. Hubo regresión de los síntomas irritativos y mejoría de la agudeza visual constatada en las consultas de seguimiento. Se recomendó la necesidad de protección solar al constituir las radiaciones ultravioletas un factor de riesgo de importancia en el desarrollo de esta enfermedad.
ABSTRACT The authors reported the case of a woman, aged 50 years, who assisted the Ophthalmology service of the Provincial Hospital "Comandante Faustino Pérez Hernández", of Matanzas. She referred irritant symptoms and left eye visual decrease. The ophthalmologic examination showed the presence of amber-color spheroidal lesions, corneal conjunctives in periphery (3-4 and 9 hours) in that eye. They extended in bands to the central cornea, some of them with nodular aspect. There were similar lesions in the right eye, but they were located mainly corneal and peripheral conjunctive hours 3 and 9. With these elements it was established the clinical diagnosis of spheroidal degeneration, a few frequent corneal degenerative disease that is almost always asymptomatic if it does not progress and affects sight. As a treatment the patient underwent a manual, superficial keratectomy with location of therapeutic contact lens without complications. There it was a regression of the irritant symptoms and an improvement of the visual acuity stated in the follow-up consultations. The patients was recommended sun protection because ultraviolet rays are important risk factors in the development of this disease.
Subject(s)
Humans , Female , Middle Aged , Corneal Diseases , Sun Protection Factor , Keratectomy/methods , Keratitis/surgery , Keratitis/diagnosis , Keratitis/therapy , Ophthalmic Solutions , Steroids , Contact Lenses , Corneal Diseases/surgery , Corneal Diseases/therapy , Anti-Inflammatory AgentsABSTRACT
A case of a two-year-old male Pinscher with a history of discomfort in the right eye was reported. The left eye had been enucleated by the referring veterinarian due to the same symptom with unsuccessful clinical treatment. The Schirmer tear test value was elevated and a decreased intraocular pressure was observed by applanation tonometry. Biomicroscopy revealed profuse corneal edema and keratoconus and fluorescein staining was negative. Gonioscopy and ophthalmoscopy did not provide any relevant data due to the corneal alterations. Bullous keratopathy was diagnosed. Surgery was performed in two steps: 1) superficial keratectomy and 360º conjunctival flap, and 2) superficial keratectomy to restore corneal transparency. Thirty days after the second superficial keratectomy, the third eyelid flap was removed. Conjunctivalization of the upper nasal quadrant of the cornea was observed. The axial portion of the cornea was transparent and vision was restored.
Relata-se o caso ocorrido em um cão, da raça Pinscher, com dois anos de idade e histórico de desconforto no olho direito. O olho esquerdo havia sido enucleado por outro profissional, por apresentar os mesmos sinais, cujo tratamento clínico instituído não lograra êxito. O valor do teste da lágrima de Schirmer encontrava-se aumentado e identificou-se diminuição da pressão intraocular à tonometria de aplanação. Observaram-se, à biomicroscopia, edema corneal profuso e ceratocone, e o teste da fluoresceína foi negativo. Gonioscopia e oftalmoscopia não lograram fornecer dados relevantes dadas as condições da córnea. Diagnosticou-se ceratite bolhosa. Optou-se pelo tratamento cirúrgico, que fora realizado em duas etapas: 1- ceratectomia superficial e "flap" conjuntival de 360º; 2- ceratectomia superficial para devolver transparência à córnea. Transcorridos 30 dias da segunda ceratectomia superficial, o "flap" de terceira pálpebra foi desfeito. Observou-se conjuntivalização do quadrante nasal superior da córnea, córnea clara no eixo visual e retorno da visão.
Subject(s)
Animals , Dogs , Keratitis/veterinary , Photorefractive Keratectomy , Diagnostic Techniques, Ophthalmological/veterinaryABSTRACT
An 18-year-old woman was referred with late sequelae of chloroquine-induced Steven–Johnson syndrome. At the time of presentation, the symblepharon was involving the upper lids to almost the whole of the cornea, and part of the lower bulbar conjunctiva with the lower lid bilaterally. Other ocular examinations were not possible due to the symblepharon. B-scan ultrasonography revealed acoustically clear vitreous, normal chorioretinal thickness, and normal optic nerve head, with an attached retina. Conjunctivo-corneal adhesion released by superficial lamellar dissection of the cornea. Ocular surface reconstruction was carried out with a buccal mucous membrane. A bandage contact lens was placed over the cornea followed by the symblepharon ring to prevent further adhesion. The mucosal graft was well taken up along with corneal re-epithelization. Best corrected visual acuity of 20/120 in both sides after 1 month and 20/80 after 3 months was achieved and maintained till the 2.5-year follow-up.