ABSTRACT
Abstract The authors report a case of unilateral floppy eyelid syndrome with ipsilateral intolerance to brimonidine in a 65-year-old man. The singularity of this case is the combination of two rare illnesses of great phlogistic potentiality in the same eye. The purpose of this article is to report a case of unilateral floppy eyelid syndrome with ipsilateral intolerance to brimonidine, emphasizing a possible relation between them. The result was a unilateral keratopathy that emulated an intraepithelial neoplasia. The key to solving the problem was an unexplained anterior uveitis that raised the suspicion of drug toxicity.The upper eyelid eversion of the affected eye during sleep seemed to be the common denominator of both ailments. The bizarre aspect of the epitheliopathy most likely resulted from the combination of trauma, insufficient lubrication, and drug intolerance.
Resumo Os autores relatam um caso de síndrome da pálpebra flácida unilateral com intolerância ipsilateral à brimonidina em um homem de 65 anos de idade. A singularidade deste caso é a combinação de duas doenças raras de grande potencialidade inflamatória no mesmo olho. O objetivo deste artigo é relatar um caso de síndrome da pálpebra flácida com intolerância ipsilateral à brimonidina, enfatizando uma possível relação entre eles. O resultado foi uma ceratopatia unilateral que simulou uma neoplasia intra-epitelial. A chave para resolver o problema foi uma uveíte anterior inexplicável que levantou a suspeita de toxicidade medicamentosa. A eversão da pálpebra superior do olho afetado durante o sono parece ser o denominador comum de ambas as doenças. O aspecto bizarro da epiteliopatia provavelmente resultou da combinação de trauma, lubrificação insuficiente e intolerância ao medicamento.
Subject(s)
Humans , Male , Aged , Uveitis, Anterior/chemically induced , Eyelid Diseases/complications , Eyelid Diseases/diagnosis , Eyelid Diseases/therapy , Brimonidine Tartrate/adverse effects , Ophthalmic Solutions , Fluorometholone/therapeutic use , Carboxymethylcellulose Sodium/therapeutic use , Glaucoma/drug therapy , Corneal Diseases/etiology , Brimonidine Tartrate/therapeutic use , Slit Lamp MicroscopyABSTRACT
A 55-year-old woman, with history of cataract surgery 1 year back, presented with features of ocular inflammation for last 3 months. She had no history of any other intraocular surgery. On examination, anterior segment showed frothy material in the inferior angle with moderate anterior chamber reaction (cells+/flare+) and sulcus intraocular lens with large posterior capsule rent. Fundoscopy showed multiple, small to medium-sized transparent bubbles of perfluorocarbon liquid (PFCL) with membranes in the vitreous cavity. Ultrasonography confirmed the presence of PFCL in the vitreous cavity. Pars plana vitrectomy with anterior chamber wash was done which led to good visual recovery. To conclude, retained PFCL can cause late onset fibrinous inflammation after a quiescent period but surgical intervention may lead to good visual outcome.
Subject(s)
Anterior Chamber/pathology , Cataract Extraction/adverse effects , Diagnosis, Differential , Female , Fluorocarbons/adverse effects , Follow-Up Studies , Humans , Inflammation/chemically induced , Inflammation/diagnosis , Inflammation/surgery , Middle Aged , Time Factors , Uveitis, Anterior/chemically induced , Uveitis, Anterior/diagnosis , Uveitis, Anterior/surgery , Vitrectomy/methodsABSTRACT
We describe a case of acute nongranulomatous anterior uveitis associated with alendronate therapy, in an adult woman, without medical history of previous diseases, except for intercurrent problems of osteoporosis. The symptoms disappeared abruptly after anti-inflammatory therapy and discontinuation of alendronate. Side effects associated with ocular inflammation have been recently documented in 3 patients under alendronate therapy. Clinical and laboratory diagnosis of ocular inflammation syndromes are also reviewed.