ABSTRACT
OBJECTIVE: To characterize the ocular fundus findings of patients who suffered sudden visual loss associated with sexual activity. DESIGN: Case series. SETTING: Outpatient ophthalmic practice. PATIENTS: Six patients presented with a precipitous decrease in vision in one eye with no apparent predisposing factors. After obtaining a careful history, each patient revealed that he or she had been engaging in rigorous sexual activity immediately before experiencing the visual loss. INTERVENTION: Five of the six patients were followed up without intervention. One patient required prophylactic laser photocoagulation of a retinal tear to decrease the risk of retinal detachment. RESULTS: Six patients aged 24 to 53 years suffered sudden loss of vision secondary to intraretinal, preretinal, or vitreous hemorrhaging. Visual acuity in the affected eyes ranged from a mild decrease (20/40) to profound visual loss (counting fingers at 6 in). Five of the six patients were followed up for at least 1 month and showed spontaneous improvement in vision as the blood cleared. Those who returned for long-term follow-up enjoyed complete visual recovery without any sequelae. CONCLUSIONS: Sudden debilitating visual loss may occur during sexual activity from the rupture of retinal blood vessels in the macular region or from the development of vitreous bleeding from an induced retinal tear. The long-term prognosis after such hemorrhaging appears to be excellent, with good visual recovery occurring as the blood resorbs spontaneously.
Subject(s)
Coitus , Retinal Hemorrhage/etiology , Vision Disorders/etiology , Vitreous Hemorrhage/etiology , Adult , Female , Follow-Up Studies , Fundus Oculi , Humans , Laser Coagulation , Male , Middle Aged , Retina/pathology , Retinal Hemorrhage/pathology , Retinal Hemorrhage/surgery , Sexual Behavior , Vision Disorders/pathology , Vision Disorders/surgery , Visual Acuity , Vitreous Hemorrhage/pathology , Vitreous Hemorrhage/surgeryABSTRACT
Six patients with evidence of secondary syphilis presented with visual loss in both eyes caused by large, placoid, yellowish lesions with faded centers at the level of the pigment epithelium in the macula and juxtapapillary areas. All eyes had vitreitis. All of the lesions showed a similar fluorescein angiographic pattern of early hypofluorescence and late staining. Five patients had mucocutaneous lesions typical of secondary syphilis. All five patients treated with antibiotics had prompt improvement in visual function and resolution of the fundus lesions. The ophthalmoscopic and angiographic appearance of these posterior fundus lesions was sufficiently characteristic to suggest a diagnosis of secondary syphilis. Modification of the host response to syphilis by human immune deficiency virus (HIV) infection may be partly responsible for this peculiar fundus picture. Three of the four patients tested positive for HIV.
Subject(s)
Chorioretinitis/etiology , Syphilis/complications , Acquired Immunodeficiency Syndrome/complications , Acute Disease , Adult , Anti-Bacterial Agents/therapeutic use , Chorioretinitis/drug therapy , Fluorescein Angiography , Fundus Oculi , HIV Seropositivity/complications , Humans , Male , Middle Aged , Syphilis/drug therapy , Syphilis Serodiagnosis , Syphilis, Cutaneous/complications , Syphilis, Cutaneous/pathology , Vision Disorders/etiology , Visual AcuityABSTRACT
Perfluoropropane (C3F8), an expanding fluorinated hydrocarbon gas, was used as an adjunct to vitreous surgery in the management of 18 patients with retinal detachment complicated by proliferative vitreoretinopathy. Ten patients had reattached retinas six months after disappearance of the gas. The average intraocular longevity of the gas in successful cases was 92 days; that in failed cases was 62.7 days. This difference was not statistically significant. However, internal retinal tamponade by longer-lasting gases appears to increase the rate of retinal reattachment in the surgical management of proliferative vitreoretinopathy.
Subject(s)
Gases , Hydrocarbons, Fluorinated/therapeutic use , Retinal Detachment/surgery , Retinal Diseases/therapy , Vitreous Body , Eye Diseases/complications , Eye Diseases/therapy , Humans , Intraocular Pressure , Retinal Detachment/complications , Retinal Diseases/complications , Retinal Perforations/surgery , Scleral Buckling , Visual Acuity , VitrectomyABSTRACT
Diffuse unilateral subacute neuroretinitis (DUSN) is a clinical syndrome characterized early by visual loss, vitritis, papillitis, and recurrent crops of gray-white retinal lesions and later by progressive visual loss, optic atrophy, retinal vessel narrowing, and diffuse pigment epithelial degeneration. Evidence is presented that it is caused by a nematode that is probably not Toxocara canis; that at least two nematodes of different sizes are involved; that there are at least two endemic areas for the disease; that these areas are related to the size of the nematode; that the nematode may remain viable in the eye for three years or longer and cause progressive ocular damage; that thiabendazole and diethylcarbamazine citrate are ineffective therapeutically; and that photocoagulation is effective in destroying the nematode. Surgical excision of the nematode was attempted in two patients.
Subject(s)
Eye/parasitology , Nematode Infections/complications , Optic Nerve Diseases/etiology , Retinal Diseases/etiology , Adolescent , Adult , Aged , Child , Child, Preschool , Electroretinography , Female , Humans , Infant , Light Coagulation , Male , Middle Aged , Nematoda/growth & development , Optic Atrophy/etiology , Optic Nerve Diseases/diagnosis , Optic Nerve Diseases/therapy , Retinal Diseases/diagnosis , Retinal Diseases/therapy , Syndrome , Visual AcuitySubject(s)
Arterial Occlusive Diseases/etiology , Chorioretinitis/etiology , Retinal Artery , Toxoplasmosis, Ocular/complications , Acute Disease , Adult , Chorioretinitis/complications , Female , Fluorescein Angiography , Humans , Male , Middle Aged , Radiography , Retinal Artery/diagnostic imagingABSTRACT
Thirty-one patients had senile macular disease with serous detachments of the retinal pigment epithelium without evidence of choroidal neovascularization. Of these 31 patients the natural history of 24 eyes was compared with 21 eyes treated with photocoagulation. Eight patients with bilateral detachments had treatment applied to one eye. There was no conclusive evidence that photocoagulation alters the natural course of this condition.
