Spontaneous resorption of an insect hair in the corneal stroma: a case report.

A case of keratitis, due to an insect hair penetrating into the deep cornea, was reported. The patient felt right ocular pain while riding a motorcycle, as an insect struck into his eye. On examination, an insect hair was seen embedded into the corneal stroma with severe corneal edema, which caused a visual acuity of the right eye decreased to hand motion. The patient was treated by a topical antibiotics, cycloplegics, and anti-inflammatory drugs, without removing the hair. After a 6-week follow-up period, there was a spontaneous resorption of the hair. There was no apparent toxic sign during 6-months of follow up, and the visual acuity improved to 6/6. The insect hair could be left in the deep cornea with careful observation, and spontaneous resorption can occur.

Intravitreal foscarnet for cytomegalovirus retinitis in patients with AIDS.

To determine the visual outcome, progression, and complications of patients with acquired immuno-deficiency syndrome-related cytomegalovirus (CMV) retinitis treated with intravitrealfoscarnet (2.4 mg in 0.1 ml per injection), a retrospective study was carried out in 193 patients. Induction therapy consisted of two injections a week until the lesions were inactive. Maintenance therapy consisted of one injection a week until relapse, then re-induction was instituted. In 301 treated eyes, visual acuity remained stable in 184 (61%), improved in 16 (5%), and decreased in 101 (34%). Of these, 15 retinal detachments, 13 intravitreal hemorrhages, 3 endophthalmitis, and 2 cataract occurred. Median time of first progression was 15 weeks. Involvement of the fellow eye occurred in 35% of the patients during treatment of the first eye. Intravitreal foscarnet appeared to be a useful alternative treatment for patients intolerant or unaffordable to intravenous anti-CMV drugs, but the complications of this treatment should also be considered.

Epidemiology of the ocular complications of HIV infection in Chiang Mai.

OBJECTIVE: To identify the magnitude of ocular complications in HIV infection in Chiang Mai, and determine the signs or symptoms that indicate the risk factors for developing ocular complications in HIV-positive patients METHOD: A prospective study was carried out in newly diagnosed HIV-positive patients seen in the Ocular Infectious Disease Clinic of Maharaj Nakorn Chiang Mai Hospital from March 1, 2000 through February 28, 2001. A complete ophthalmic examination was performed on each patient together with a systemic evaluation of present illness and current medications. RESULTS: Three-hundred and ninety-five HIV-positive patients were seen for ophthalmic evaluation. Of these, 90 were in stage A (asymptomatic), 84 were in stage B (symptomatic), and 221 were in stage C (AIDS). Ocular complications were found in 44.6 per cent of the patients. Cytomegalovirus (CMV) retinitis was the most common ophthalmic complication (33%). Other ocular complications included cotton wool spot (8%), uveitis (4%), optic neuropathy (3%), and keratoconjunctivitis sicca (2%). The clinical presenting symptoms, which were the indicators for ocular complications and CMV retinitis, included chronic cough, oral thrush, chronic diarrhea, weight loss, wasting, and skin disorders. Ocular symptoms, which indicated a high risk of developing CMV retinitis, included flashing, floaters, and scotoma. CONCLUSIONS: Ocular complications are common in HIV-positive patients. CMV retinitis, which is a major vision-threatening problem, represented the most common finding. It is recommended that HIV-positive patients should have their eyes examined regularly, particularly when they have the clinical presenting symptoms previously mentioned. The patients should also notice early symptoms of CMV retinitis, which includes flashing, floaters, and scotoma.