ABSTRACT
PURPOSE: To report 2 cases of ocular chemical burns associated with the use of a swim goggle antifog agent and to review the literature for this and similar antifog products. METHODS: Case reports and systematic review of the medical literature, material safety data, product safety reports, and consumer reviews. RESULTS: Two males, one 46 years and the other 41 years, were referred to our clinic with chemical burns of the ocular surface after using the same goggle antifog agent while swimming in a triathlon. Both sustained significant epithelial defects. Fortunately, with prompt treatment, both of our patients returned to their baseline vision within a few weeks without suffering sight-threatening complications. CONCLUSIONS: These are the first cases of ocular chemical burn secondary to use of an eyewear antifog agent to be reported in the medical literature. Similar reports found in consumer forums suggest that our cases are not isolated and these products may have the potential to cause vision-threatening chemical burns.
Subject(s)
Alkalies/adverse effects , Burns, Chemical/etiology , Cornea/drug effects , Eye Burns/chemically induced , Eye Protective Devices , Adult , Anti-Bacterial Agents/therapeutic use , Burns, Chemical/diagnosis , Burns, Chemical/therapy , Drug Therapy, Combination , Eye Burns/diagnosis , Eye Burns/therapy , Eye Pain/chemically induced , Glucocorticoids/therapeutic use , Humans , Hydrogen-Ion Concentration , Male , Middle Aged , Mydriatics/therapeutic use , Tears/chemistry , Therapeutic Irrigation , Vision Disorders/chemically inducedSubject(s)
Allergens/adverse effects , Betaine/analogs & derivatives , Blepharitis/chemically induced , Dermatitis, Allergic Contact/etiology , Detergents/adverse effects , Hair Preparations/adverse effects , Surface-Active Agents/adverse effects , Betaine/adverse effects , Blepharitis/diagnosis , Chronic Disease , Conjunctivitis, Allergic/chemically induced , Conjunctivitis, Allergic/diagnosis , Dermatitis, Allergic Contact/diagnosis , Female , Humans , Middle AgedABSTRACT
Cytomegalovirus (CMV) retinitis remains the most common opportunistic ocular infection in immunocompromised patients. Patients with immunocompromising diseases, such as acquired immunodeficiency syndrome, inherited immunodeficiency states, malignancies, and those on systemic immunosuppressive therapy, are known to be at risk. Recently, it has been suggested that patients undergoing intravitreal injection of immunosuppressive agents may also be predisposed. One previous case report speculated that there may be an additional risk for CMV retinitis in acquired immunodeficiency syndrome patients with venoocclusive disease. This case study presents a case of CMV retinitis following central retinal vein occlusion in a patient on systemic immunosuppressants.
ABSTRACT
PURPOSE: To retrospectively review the occurrence, treatment, and visual outcomes associated with various etiologies of keratitis as a postoperative complication of laser in situ keratomileusis (LASIK) at an academic surgical center. SETTING: John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. METHODS: The charts of 5618 post-LASIK patients (10 477 eyes) were reviewed for the development of keratitis. Occurrence rates, management regimens, and final best spectacle-corrected visual acuity (BSCVA) were reported for infectious and noninfectious keratitis etiologies. RESULTS: Post-LASIK keratitis was diagnosed in 279 eyes. The keratitis was diagnosed as infectious in 33 eyes (12%) and as noninfectious in 246 eyes (88%). Infectious cases included 5 eyes (15%) with herpes simplex keratitis (HSV), 18 (55%) with adenoviral keratitis, and 10 (30%) with nonviral (including bacterial, fungal, and parasitic) keratitis. Of noninfectious cases, 193 (78%) were classified as diffuse lamellar keratitis (DLK), 36 (15%) as staphylococcal marginal hypersensitivity, and 17 (15%) as localized debris-related keratitis. CONCLUSIONS: The occurrence of post-LASIK keratitis was 2.66%, with DLK being the most common diagnosis overall. The occurrence of noninfectious keratitis (2.34%) was 7.5 times greater than the occurrence of infectious keratitis (0.31%). Adenoviral keratitis had the best visual outcomes overall, with all 18 patients achieving 20/20 BSCVA. In contrast, all 5 eyes with HSV keratitis lost 1 or 2 lines of BSCVA. Excluding adenoviral keratitis, infectious etiologies had significantly worse visual outcomes than noninfectious etiologies at the 20/40 and 20/20 levels (P = .0013 and P<.001, respectively).
