ABSTRACT
1-year-old girl was admitted for fever of unknown origin. Funduscopy revealed juxtapapillary retinal inflammatory mass in one eye with a differential diagnosis of sarcoidosis, tuberculosis, retinoblastoma or metastatic disease. Retinal biopsy showed necrotizing granulomatous retinitis. Extensive workup and therapeutic trials failed to confirm the diagnosis of tuberculosis or sarcoidosis. Her 7-month brother and 4-year-old male cousin presented with nystagmus, poor vision, paravascular pigmentary changes and were initially diagnosed as recessive retinal dystrophy. The girl died at age 2 from tuberculous meningitis and the boys had recurrent tuberculous and Aspergillus infections. Awareness of the typical fundus findings in chronic granulomatous disease allows early diagnosis of the disorder.
ABSTRACT
We describe a standing phacoemulsification technique (SPT) with the patient in reverse Trendelenburg position (RTP) as a means of performing surgery in morbidly obese patients. These patients have elevated vitreous pressure, leading to a high rate of posterior capsule rupture and vitreous loss. The SPT with RTP normalizes vitreous pressure, facilitating cataract surgery.
