ABSTRACT
BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune, multisystem disorder with diverse manifestations. There are limited reports on the neuro-ophthalmic and neuropsychiatric findings in childhood SLE. CASE REPORT: An 8-year-old patient with suspected SLE with a history of skin rash, joint pain, transient hematologic abnormality, headaches, seizures, and psychosis, presented with papilledema secondary to acquired, obstructive hydrocephalus. DISCUSSION: SLE-related ocular and neuropsychiatric findings are reviewed. Proposed mechanisms for ocular and cerebral lupus include immune complex deposition, vascular thrombosis, and postinflammatory lesions. CONCLUSION: The prevalent neurologic and neuropsychiatric complications of pediatric SLE require close follow-up and interdisciplinary management.
Subject(s)
Depression/etiology , Hydrocephalus/etiology , Keratoconjunctivitis Sicca/etiology , Lupus Erythematosus, Systemic/complications , Papilledema/etiology , Seizures/etiology , Child , Depression/diagnosis , Diagnosis, Differential , Female , Humans , Hydrocephalus/diagnosis , Keratoconjunctivitis Sicca/diagnosis , Lupus Erythematosus, Systemic/diagnosis , Magnetic Resonance Imaging , Papilledema/diagnosis , Seizures/diagnosis , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Posterior keratoconus is a rare corneal disorder characterized by a diffuse or localized protrusion of the posterior corneal surface into a thinning stroma. It is believed to be a congenital, nonprogressive condition. CASE REPORT: A case of bilateral circumscribed posterior keratoconus is presented. Diagnostic ocular signs include localized protrusion of the posterior corneal surface, normal anterior corneal surface, stromal thinning, and endothelial changes. However, anterior corneal contour reveals progressive steepening in this case. CONCLUSION: Posterior keratoconus is an unusual corneal anomaly with subtle clinical features. Recognition of these signs is essential in the diagnostic and management processes.
Subject(s)
Corneal Stroma/pathology , Endothelium, Corneal/pathology , Keratoconus/diagnosis , Contact Lenses , Corneal Topography , Diagnosis, Differential , Eyeglasses , Female , Humans , Keratoconus/congenital , Keratoconus/therapy , Middle Aged , Prescriptions , Visual AcuityABSTRACT
BACKGROUND: Fetal alcohol syndrome (FAS) describes the systemic and ocular anomalies resulting from the teratogenic effect of maternal alcohol abuse during pregnancy. It is a leading cause of preventable birth defects in the U.S. CASE REPORTS: Two case reports illustrate the characteristic findings in FAS. These include growth retardation, cognitive impairment, and facial dysmorphism. Ocular signs are prevalent, including small palpebral fissure, microcornea, strabismus, myopia, astigmatism, and optic nerve hypoplasia. DISCUSSION: Fetal alcohol exposure can lead to a wide spectrum of systemic defects and vision deficits. The increasing frequency of drinking among pregnant women in recent years should call more public attention to this detrimental yet preventable syndrome. CONCLUSION: The high frequency of ocular manifestations aids in making a diagnosis of FAS, which can be challenging. Eye-care professionals can play an important role in patient management and the educational process.
