ABSTRACT
Alcohol is the most frequent and most important teratogenic agent causing mental and physical retardation in childhood. The alcohol fetal syndrome is characterized by pre- and postnatal growth retardation, hypotonia, hyperactivity, microcephalus, mental retardation and typical craniofacial malformations. The latter includes short palpebral fissures, a poorly developed philtrum, thin upper lip vermillion, short mandibles, a flattened midface structure and dysplastic ears. Ophthalmological signs occur in 90% and include epicanthus, ptosis, myopia, optic nerve hypoplasia and tortuous retinal vessels. Microphthalmus, coloboma and Peters' anomaly have also been described. Five children with alcohol embryopathy are presented. The histopathological findings of the enucleated eye of a 6th child with alcohol embryopathy which was sent to us for examination and which revealed an anterior staphyloma with Peters' anomaly is also described. Ophthalmologists should be aware of alcohol in pregnancy as a preventable cause of eye malformation.
Subject(s)
Eye Abnormalities/diagnosis , Fetal Alcohol Spectrum Disorders/diagnosis , Child, Preschool , Eye/pathology , Eye Abnormalities/pathology , Eye Enucleation , Female , Fetal Alcohol Spectrum Disorders/pathology , Fluorescein Angiography , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Optic Disk/pathology , Retinal Vessels/pathologyABSTRACT
Necrotic foci within the iris and ciliary body were present in 104 eyes examined at the histopathological laboratory of the University Eye Clinic, Hamburg. Three different aetiological mechanisms were found: 1) Vascular acute glaucoma, diminished arterial supply, or radiogenic occlusive vasculitis can lead to ischaemic infarction. 2) Inflammatory: direct contact with the noxious agent can lead to cell death, either via liberation of toxines and enzymes--usually bacterial--or due to direct cytotoxic effect, in case of viruses. Both can further cause cell death via immunological mechanisms. Intraocular suppurative bacterial infections predominate in this group. 3) Traumatic and operative: tissue damage is caused by mechanical or thermal injury. Besides accidental trauma, uveal necrosis also occurs frequently after surgical coagulation or dialysis of the ciliary body for glaucoma. The sequelae of iris and ciliary body necrosis depend on the extent of the damage. Small necrotic areas are followed by scarring, which has no injurious consequences on visual function. Widespread necrosis, on the other hand, is complicated by immediate atrophia bulbi or secondary angle-closure glaucoma with or without rubeosis iridis.
Subject(s)
Ciliary Body/pathology , Iris/pathology , Ciliary Body/ultrastructure , Humans , Iris/ultrastructure , NecrosisABSTRACT
The clinical, fluorescencangiographical and histopathological findings in 3 cases of non-pigmented iris cysts are described. The first case was a posttraumatic cyst after cataractextraction, the second in all probability, also a posttraumatic cyst and the third case was a spontaneous intrastromal nonpigmented iris cyst. Although the clinical and histopathological findings are not always helpful in the differential diagnosis between non-pigmented posttraumatic and non-pigmented spontaneous iris cysts, we believe, that fluorescencangiography may provide valuable additional information. The preoperative differentiation is important, because radical excision including the affected cornea or sclera is necessary in the posttraumatic cases, whereas only a simple iridectomy is required for the spontaneous cysts.
Subject(s)
Cysts/diagnosis , Iris , Adult , Cysts/diagnostic imaging , Cysts/pathology , Cysts/surgery , Diagnosis, Differential , Female , Fluorescein Angiography , Humans , Iris/pathology , Iris/surgery , Male , Middle Aged , Preoperative Care , Radiography , Uveal Diseases/diagnosis , Uveal Diseases/diagnostic imaging , Uveal Diseases/pathology , Uveal Diseases/surgeryABSTRACT
A case of cystoid macular oedema lying over a malignant melanoma of the choroid is reported. A direct correlation between the histopathological findings and the fluorescencangiographic picture is shown. The fluorescencangiography was taken 14 days before enucleation and showed the typical structure of a cystoid maculaoedema. The pathogenesis of the accumulation of the fluid within the layers of the Henle' fibres and the inner nuclear layer are discussed.
Subject(s)
Choroid Neoplasms/complications , Cysts/diagnosis , Edema/diagnosis , Macula Lutea , Melanoma/complications , Aged , Female , Fluorescein Angiography , Humans , Retinal Diseases/diagnosisABSTRACT
Iris involvement in leukaemia has only rarely been described. A case of chronic myeloid leukaemia with uniocular involvement of the iris in particular, presenting with a spontaneous haemophthalmus, is reported, together with the ocular histopathology. The eye was blind due to a preceding injury.
Subject(s)
Eye Diseases/etiology , Hemorrhage/etiology , Leukemia, Myeloid/complications , Aged , Eye/pathology , Eye Diseases/pathology , Hemorrhage/pathology , Humans , Iris/pathology , Leukemia, Myeloid/pathology , MaleABSTRACT
A short film showing our technique of combined penetrating keratoplasty and intracapsular cataract extraction was shown, and the postoperative results in 72 eyes after an average of 3 years were reported.
Subject(s)
Cataract Extraction , Corneal Transplantation , Humans , Methods , Transplantation, HomologousABSTRACT
The results of magnet implantation in the upper and lower eyelids of 29 patients suffering from Keratopathia due to lagophthalmos due to facial palsy as well as the surgical techniques involved are described. Contrary to a lateral tarsorrhaphy - still popular today - this method does not alter the form or the size of the palpebral fissure nor does it hinder the visual field. It is technically simple to perform and easily reversible should nerve function recover. The subjective results were also good.
Subject(s)
Eyelid Diseases/surgery , Facial Paralysis/complications , Magnetics , Eyelids/innervation , Eyelids/surgery , Facial Paralysis/surgery , Humans , Male , Methods , Middle Aged , Ophthalmic Nerve/surgeryABSTRACT
A study of almost 1000 outpatients at a London eye hospital showed the presence of asymptomatic yellowish, spheroidal deposits in the peripheral cornea or conjunctiva, or both, in about 6 per cent, with a preponderance of males and older subjects among those affected. This prevalence is less than is observed in people in countries exposed to higher levels of sunlight. Histological study of the deposits showed some tinctorial similarities with pseudoelastic fibres of pingueculae, with which they were sometimes associated, but also significant differences suggesting that the spheroidal deposits might be a composite of degenerate collagen and a second non-collagenous protein. Until a more precise terminology is feasible we suggest that a purely descriptive name such as spheroidal degeneration or droplet keratopathy should be used to describe this entity.
Subject(s)
Conjunctiva , Corneal Diseases , Adult , Age Factors , Aged , Collagen , Conjunctiva/pathology , Cornea/pathology , Corneal Diseases/diagnosis , Corneal Diseases/pathology , Elastic Tissue , Eye Diseases/diagnosis , Female , Humans , Male , Middle Aged , Sex FactorsABSTRACT
Between February, 1974, and mid-December, 1975, 43 patients with paralytic facial palsy were operated upon with lid magnets, according to a method first devised by Mühlbauer and others (1973). When 37 patients were re-examined 3 months to 2 years post-operatively, 27 had both magnets in situ functioning well. In nine patients one or both magnets had been removed because of return of 7th nerve function. Including our information about those patients not available for re-examination, the method has definitely failed in only four. Cosmetically and functionally the results are subjectively as well as objectively encouraging and appear superior to a lateral tarsorrhaphy.
Subject(s)
Eyelid Diseases/surgery , Facial Paralysis/surgery , Magnetics , Surgery, Plastic/methods , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prostheses and ImplantsABSTRACT
A 68-year-old man died 18 days after the onset of ischemic optic neuropathy caused by histologically proven giant-cell arteritis. On histopathologic study of the eye, ischemic necrosis of the prelaminar and retrolaminar optic nerve was seen, along with the massive presence of acid mucopolysaccharides sensitive to testicular hyaluronidase. This finding was interpreted as an intrusion of vitreal material resulting from breaks in the internal limiting membrane and the pressure gradient from intraocular to extraocular tissues, an analogy to Schnabel degeneration in acute glaucoma.
Subject(s)
Aortic Arch Syndromes/pathology , Giant Cell Arteritis/pathology , Glycosaminoglycans , Optic Nerve/pathology , Papilledema/pathology , Aged , Blindness/etiology , Eye , Humans , Intraocular Pressure , MaleABSTRACT
Mycotic Septicaemia (especially with the Candida species) is not an uncommon hazard of hospitalized patients, especially those on intravenous hyperalimentation. Two such patients with endogenous mycotic bilateral endophthalmitis are presented. In spite of typical ocular symptoms diagnosis was delayed. Two further unilateral cases of a more atypical form of endogenous mycotic endophthalmitis in otherwise seemingly healthy patients are also described. Correlating histopathological findings in three of these 4 cases to the clinical histories, conclusions are drawn to aid an early diagnosis which is of paramount importance if the necessary antimyotic treatment is to preserve visual function.
Subject(s)
Candidiasis/complications , Endophthalmitis/etiology , Aged , Candidiasis/pathology , Endophthalmitis/pathology , Female , Humans , Male , Sepsis/etiology , Sepsis/pathologyABSTRACT
Between 1966 and 1974, 1260 lidtumours were sent to the histological laboratory of the University Eye Hospital Hamburg. The clinical diagnosis "chalazion" in 138 cases could not be verified histologically in 33 cases. Other benign lesions were diagnosed 23 times and malignant lesions in 10 cases (4 times a Meibom's sebaceous cell carcinoma). The symptoms of all 7 Meibom's sebaceous cell carcinomatas diagnosed histologically during this time (the most common metastasizing lid-tumor in this series) were also analysed as they present the gravest diagnostic error for chalazia. Histologic examination of excised "chalazion"-material must be considered mandatory in all patients with a typical symptomatology, recurrence at the same site, high age, unilateral therapy-resistant keratoconjunctivities and involved regional lymphnodes.
Subject(s)
Diagnostic Errors , Eyelid Neoplasms/diagnosis , Aged , Carcinoma/pathology , Diagnosis, Differential , Epidermal Cyst/diagnosis , Eyelid Neoplasms/pathology , Female , Humans , Male , Meibomian Glands/pathology , Middle Aged , Neoplasm Metastasis , Papilloma/pathology , Sebaceous Gland Neoplasms/diagnosisABSTRACT
29 cases of Endophthalmitis phacoanaphylactica were diagnosed out of a total of 1300 enucleated eyes examined histologically between 1966 and 1974. Clinically the correct diagnosis was made only once. Most frequent misdiagnoses were: phthisis, recurrent iritis, and panophthalmitis. Important factors for a correct clinical diagnosis are: 1. history of injury at least 2-3 weeks previously, 2. a cataract present at the onset of the disease, 3. an endophthalmitis, often associated with extreme i.o. hypotension. Treatment consists of an immediate and total removal of lens material, regardless of the hypotension or of inflammatory signs. The retinal architecture is usually astonishingly well preserved, even in cases with extreme destruction of the anterior segments.