ABSTRACT
The association between inflammation of the eyes and the intestine is not often recognized by ophthalmologists. We report two patients who developed peripheral corneal ulcers, episcleritis, and scleritis just prior to the onset of Crohn's disease. The severity of the eye disease paralleled that of the intestinal symptoms, and both conditions subsided after treatment with topical steroids, oral prednisone, oral sulfasalazine, and hydrocortisone retention enemas. Inflammatory bowel disease should always be included in the differential diagnosis of scleritis and uveitis, as the patient may be benefited greatly by appropriate, early therapy of this gastrointestinal disorder.
Subject(s)
Crohn Disease/complications , Eye Diseases/complications , Intestinal Diseases/complications , Adult , Aged , Corneal Ulcer/complications , Crohn Disease/drug therapy , Female , Humans , Hydrocortisone/therapeutic use , Inflammation/complications , Male , Prednisone/therapeutic use , Sclera , Steroids/therapeutic use , Sulfasalazine/therapeutic useABSTRACT
A 42-year-old woman developed a transient partial third cranial nerve palsy after a supraperiosteal injection in the area of the middle superior alveolar nerve with mepivacaine HCl for dental anesthesia. This effect may have been caused by direct extension through a bony defect rather than by inadvertent intravascular injection of the anesthetic. Dentists and ophthalmologists should be aware of this phenomenon, which can result in permanent ocular palsy and even amaurosis.
Subject(s)
Anesthesia, Dental/adverse effects , Mepivacaine/adverse effects , Ophthalmoplegia/etiology , Adult , Diplopia/etiology , Female , Humans , Male , Mepivacaine/administration & dosage , Middle Aged , Oculomotor NerveABSTRACT
A 58-year-old woman had the sudden onset of unilateral painful proptosis, ophthalmoplegia, vomiting, and loss of vision. Computed axial tomography showed a mass that was greatly attenuated in the orbit. The initial reading of the internal carotid angiogram was normal, but a subtraction study showed a hypervascular lesion within the orbit with features indicating a hemangioma. Orbital decompression failed to restore the vision as intraorbital hemorrhage had irreparably damaged the optic nerve.
Subject(s)
Hemorrhage/diagnosis , Nerve Compression Syndromes/etiology , Optic Nerve , Orbit , Carotid Arteries/diagnostic imaging , Female , Hemangioma/complications , Hemorrhage/complications , Hemorrhage/surgery , Humans , Middle Aged , Orbital Neoplasms/complications , Subtraction Technique , Tomography, X-Ray ComputedABSTRACT
A 64-year-old man had vascular ingrowth of a surgical wound resulting in recurrent hyphema and pupillary block glaucoma three years after cataract extraction. Argon laser photocoagulation of an abnormal vessel in the inner lip of the wound resulted in complete clearing of a chronic hyphema, with a four-month follow-up. We used 500-micron laser spots of 2,000 mW and 0.5 seconds' duration to closr the vessels. This approach is recommended for its relative safety and simplicity.
