ABSTRACT
PURPOSE: To describe the management of endophthalmitis in an eye filled with silicone oil for prolonged internal retinal tamponade. METHODS: A patient with a silicone oil-filled eye developed endophthalmitis postoperatively. Results of clinical examination, diagnostic procedures, and surgical management are described. RESULTS: Removal of the silicone oil, injection of antibiotics into the fluid-filled vitreous cavity, and reinjection of silicone oil resulted in resolution of the endophthalmitis and improvement in vision. CONCLUSIONS: Aggressive management of endophthalmitis in an eye requiring silicone oil tamponade may salvage useful vision.
Subject(s)
Endophthalmitis/drug therapy , Eye Infections, Bacterial/drug therapy , Postoperative Complications/drug therapy , Retinal Detachment/therapy , Silicone Oils , Staphylococcal Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Cefazolin/therapeutic use , Cephalosporins/therapeutic use , Endophthalmitis/microbiology , Eye Infections, Bacterial/etiology , Humans , Laser Coagulation , Male , Middle Aged , Postoperative Complications/microbiology , Staphylococcal Infections/etiology , Vancomycin/therapeutic use , VitrectomyABSTRACT
PURPOSE: To obtain long-term photographic follow-up of retinal astrocytic hamartomas in patients with tuberous sclerosis to learn about their stability or possible growth patterns. METHODS: Sixteen patients with a confirmed diagnosis of tuberous sclerosis and in whom retinal astrocytic hamartomas were photographed before 1986 at the Mayo Clinic underwent a complete ophthalmic examination, and fundus photographs were taken. The new photographs were compared with previous photographs, and changes in size, character, or number of retinal hamartomas were determined. The minimum follow-up period was five years. RESULTS: A total of 37 astrocytic hamartomas were found. Follow-up ranged from almost six years to more than 34 years, with an average of 16 years. Hamartomas in three patients showed progressive or new calcification. In a fourth patient a retinal hamartoma appeared to originate from a site that had been previously photographically documented to be normal. The remaining hamartomas appeared unchanged over the follow-up period. CONCLUSIONS: Although most retinal lesions in tuberous sclerosis remain stable, some become calcified over time. Additionally, new lesions may develop from previously normal-appearing retina.
Subject(s)
Hamartoma/pathology , Retina/pathology , Retinal Diseases/pathology , Tuberous Sclerosis/complications , Adolescent , Calcinosis/pathology , Child , Child, Preschool , Follow-Up Studies , Fundus Oculi , Hamartoma/etiology , Humans , Longitudinal Studies , Retinal Diseases/etiologyABSTRACT
OBJECTIVE: This study was designed to describe the usual clinical findings of orbital emphysema as well as unusual and infrequent but important causes of this condition. DESIGN: We present seven detailed cases of orbital emphysema and review the pertinent English-language literature published since 1900. MATERIAL AND METHODS: Characterization of the seven patients with orbital emphysema illustrates the various causes and clinical findings of the disorder. Additionally, we review 78 previously published cases of orbital emphysema to determine the treatment and prognosis of this condition. RESULTS: Trauma is the most frequent cause of orbital emphysema; however, orbital emphysema also may occur spontaneously or as a complication of pulmonary barotrauma, infection, and operation. In most cases, orbital emphysema resolves spontaneously without compromising ocular function. If excessive amounts of air accumulate within the orbit, however, complications such as occlusion of the central retinal artery or compressive optic neuropathy may lead to loss of vision if not recognized promptly and treated. CONCLUSION: In most cases, orbital emphysema is an incidental, benign finding that resolves with time. Careful observation is the only treatment necessary unless an orbital fracture involves an infected sinus, in which case prophylactic orally administered antibiotics may be prescribed.
