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2.
Optom Vis Sci ; 100(2): 170-173, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: covidwho-2258866

RESUMEN

SIGNIFICANCE: Brown syndrome, or superior oblique tendon sheath syndrome, is characterized by limitation of elevation on adduction. The disorder is thought to involve the trochlea/superior oblique tendon complex through traumatic, surgical, and inflammatory mechanisms. It could be an indication of multiple underlying immunological or rheumatological disorders. PURPOSE: This study aimed to report an unusual strabismus after receiving the first dose of a live attenuated coronavirus disease 2019 (COVID-19) vaccine. CASE REPORT: A 31-year-old female patient presented with painful vertical diplopia and tenderness of the left trochlear area 3 days after the first dose of COVID-19 vaccination. She had a compensatory chin elevation and face turn to the right, as well as a left 10-prism-diopter hypotropia in the primary position, which increased to 15 prism diopters in the right gaze and disappeared in the left gaze. Ocular motility revealed the limitation of elevation on adduction. The patient denied any history of ocular trauma and was consequently investigated for dysthyroid disease and various immunological and rheumatological disorders, which were excluded. A Hess chart was obtained to document the motility disorder. CONCLUSIONS: We report a case of acquired Brown syndrome in a 31-year-old otherwise healthy woman shortly after COVID-19 vaccination. It is possible that the patient may have developed trochleitis and/or superior oblique tenosynovitis brought on by cross-reacting antibodies generated by the immune response to the vaccine. In the age of the widest vaccination campaign in human history, it is highly likely that we will continue to observe many unexpected potential adverse effects of these vaccines in our clinical practice.


Asunto(s)
COVID-19 , Trastornos de la Motilidad Ocular , Enfermedades Reumáticas , Estrabismo , Femenino , Humanos , Adulto , Vacunas contra la COVID-19 , Músculos Oculomotores/cirugía , Vacunación
3.
BMJ Case Rep ; 16(3)2023 Mar 06.
Artículo en Inglés | MEDLINE | ID: covidwho-2257436

RESUMEN

We present a case of a unilateral extraocular muscle haematoma in an adult female patient who was compliant with life-long oral anticoagulation for recurrent deep vein thrombosis. The patient presented with symptoms of sudden-onset left-sided headache radiating to the temporal region, which started 2 days prior. No obvious triggering factors were identified. Cranial and ocular examinations were within normal limits. Imaging revealed a haemorrhage related to the lateral rectus muscle of the left eye. Conservative management was employed with abstinence from anticoagulation for 2 weeks and a weaning regime of oral steroids. Under the clinical review of ophthalmology and interval radiological monitoring, symptoms were reduced with reduction of haemorrhage size. Anticoagulation was reinstated after 2 weeks. To our knowledge, this is the first case of a non-traumatic extraocular muscle haematoma to be reported in a patient on anticoagulation.


Asunto(s)
Tratamiento Conservador , Músculos Oculomotores , Adulto , Femenino , Humanos , Músculos Oculomotores/diagnóstico por imagen , Ojo , Hematoma/inducido químicamente , Hematoma/diagnóstico por imagen , Anticoagulantes/efectos adversos
4.
Acta Ophthalmol ; 101(5): 546-552, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-2213478

RESUMEN

PURPOSE: To evaluate whether strabismus surgery improves the learning performance - calculation, reading and drawing - of school-aged children. METHODS: In a case-control study, patients between the ages of 7 and 10 years with horizontal strabismus, recommended for surgical correction, were prospectively included. Reading, calculating and drawing abilities were evaluated before and 3 months after corrective strabismus surgery using standardized tests. Cases were compared to control patients: patients with a surgical indication postponed due to the COVID lockdown. RESULTS: Forty-two operated patients and 42 controls between the ages of 7 and 10 years with horizontal strabismus were included. The average reading speed was 65.8 words per minute pre-operatively compared to 80.6 words per minute post-operatively (p = 0.0038). The average drawing score was 71.1 pre-operatively compared to 84.3 post-operatively (p = 0.012). The average calculation score was 3.2 pre-operatively compared to 3.4 post-operatively (p = 0.363). Improvement given by strabismus surgery was confirmed avoiding the learning effect by comparison with the control group. The improvements observed were more significant in the youngest patients and esotropia. CONCLUSIONS: This study highlights that strabismus surgery significantly improved the children's reading fluency and drawing task execution. These encouraging data should be taken into account when considering the indications for strabismus surgery.


Asunto(s)
COVID-19 , Esotropía , Estrabismo , Humanos , Niño , Estudios de Casos y Controles , Procedimientos Quirúrgicos Oftalmológicos , Control de Enfermedades Transmisibles , Músculos Oculomotores/cirugía , Estrabismo/cirugía , Esotropía/cirugía , Estudios Retrospectivos , Visión Binocular
5.
Orbit ; 40(6): 532-535, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: covidwho-1360232

RESUMEN

A 44-year-old male patient developed proptosis, edema, and erythema progressing to complete ptosis and supraduction deficit 2 days after positive COVID-19 test. He failed to improve on systemic antibiotics. MRI showed thickening and T2 enhancement of the superior rectus/levator complex consistent with orbital myositis. He improved on intravenous corticosteroids and experienced continued gradual improvement on oral steroids.


Asunto(s)
COVID-19 , Exoftalmia , Miositis Orbitaria , Adulto , Exoftalmia/diagnóstico , Exoftalmia/tratamiento farmacológico , Exoftalmia/etiología , Humanos , Masculino , Músculos Oculomotores/diagnóstico por imagen , Miositis Orbitaria/diagnóstico por imagen , Miositis Orbitaria/tratamiento farmacológico , SARS-CoV-2
6.
Ocul Immunol Inflamm ; 29(4): 669-670, 2021 May 19.
Artículo en Inglés | MEDLINE | ID: covidwho-1165118

RESUMEN

Purpose: The authors present a case of unilateral orbital myositis of new onset following COVID-19 without a severe course.Methods: The patient had been received topical treatment with a preliminary diagnosis of conjunctivitis but no recovery had been noticed. The history revealed that the ocular signs had started 1 week after the COVID-19.Results: The examination revealed sectoral hyperemia of the temporal region in the bulbar conjunctiva together with marked limitation of right inward gaze. MRI of the orbits demonstrated diffuse fusiform enhancing enlargement of the right lateral rectus and superior rectus. The results of the laboratory tests and examination findings were normal. Systemic corticosteroids were started for the orbital myositis.Conclusions: Although conjunctivitis is the more common ocular disease following COVID-19, the possibility of orbital myositis should be considered in cases with resistance to topical treatment and/or gaze limitation. The possible role of orbital myositis as a trigger for COVID-19 could be explained with an immune-mediated mechanism.


Asunto(s)
COVID-19/complicaciones , Infecciones Virales del Ojo/diagnóstico , Músculos Oculomotores/diagnóstico por imagen , Órbita/diagnóstico por imagen , Miositis Orbitaria/etiología , SARS-CoV-2/genética , Adulto , COVID-19/diagnóstico , COVID-19/epidemiología , Infecciones Virales del Ojo/etiología , Infecciones Virales del Ojo/virología , Femenino , Humanos , Imagen por Resonancia Magnética , Músculos Oculomotores/virología , Miositis Orbitaria/diagnóstico , Miositis Orbitaria/virología , Pandemias , Tomografía Computarizada por Rayos X
7.
J AAPOS ; 25(3): 169-170, 2021 06.
Artículo en Inglés | MEDLINE | ID: covidwho-1118493

RESUMEN

We report the case of a 2-year-old girl with acute-onset divergent strabismus and ptosis in the right eye. She had an exotropia of 45Δ for near, eyelid ptosis affecting the visual axis, adduction, limitations of up- and downgaze, and a discrete mydriasis in the right eye. Neurological conditions were ruled out. Serology was positive for SARS-CoV-2 antibodies. The patient was managed conservatively with ocular physiotherapy and close visual acuity monitoring. On follow-up examination at 1 month, there was marked improvement of the exotropia (25Δ for near), adduction, ptosis, and mydriasis.


Asunto(s)
Blefaroptosis , COVID-19 , Exotropía , Enfermedades del Nervio Oculomotor , Blefaroptosis/diagnóstico , Preescolar , Exotropía/diagnóstico , Femenino , Humanos , Músculos Oculomotores , Enfermedades del Nervio Oculomotor/diagnóstico , SARS-CoV-2
8.
J AAPOS ; 24(4): 216-217, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-613504

RESUMEN

We present a case of an abducens nerve palsy in a previously healthy young man in the setting of SARS-CoV-2 infection. Magnetic resonance imaging obtained 5 weeks after the onset of diplopia demonstrated an atrophic left lateral rectus muscle, which was hyperintense on T2 weighting, consistent with denervation. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to his viral illness, because the patient had no preexisting vascular risk factors or evidence of other neurologic disease on neuroimaging. Cranial nerve palsies may represent part of the neurologic spectrum of COVID-19.


Asunto(s)
Enfermedades del Nervio Abducens/etiología , COVID-19/complicaciones , Imagen por Resonancia Magnética/métodos , Músculos Oculomotores/diagnóstico por imagen , Pandemias , SARS-CoV-2 , Enfermedades del Nervio Abducens/diagnóstico , Adulto , COVID-19/epidemiología , Humanos , Masculino , Músculos Oculomotores/fisiopatología
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