RESUMO
An elderly male presented with epithelial defect which resisted all medical and therapeutic approaches until Gram stain and cultural report documented the presence of Nocardia asteroides of the offending organism. A 3-month course of chronic keratitis with persistent epithelial defect resolved in 48 h following the use of topical trimethoprim-sulfamethoxazole.
Assuntos
Ceratite/patologia , Nocardiose/patologia , Idoso , Técnicas Bacteriológicas , Córnea/patologia , Combinação de Medicamentos/administração & dosagem , Epitélio/patologia , Humanos , Infusões Intravenosas , Ceratite/tratamento farmacológico , Ceratite/microbiologia , Masculino , Nocardiose/tratamento farmacológico , Nocardiose/microbiologia , Nocardia asteroides/ultraestrutura , Sulfametoxazol/administração & dosagem , Trimetoprima/administração & dosagem , Combinação Trimetoprima e SulfametoxazolRESUMO
A patient, initially examined at the age of 16 years and monitored for almost two decades, had corneal warpage and keratoconus associated with contact lens wear. Although the patient was advised repeatedly of the risk of continued contact lens use, she persisted. Contact-lens corrected visual acuity continued to deteriorate in the left eye (from 20/20 to 20/200) and keratometric readings continued to increase (from 43.50/44.12 to 56/59). The patient eventually required a corneal transplant in the left eye because of advanced keratoconus. The host button was subjected to light and electron microscopy, which disclosed keratoconus of the round cone type. Spectacle-corrected visual acuity was 20/20 18 months postoperatively.
Assuntos
Lentes de Contato/efeitos adversos , Ceratocone/etiologia , Adolescente , Transplante de Córnea , Feminino , Humanos , Ceratocone/patologia , Ceratocone/fisiopatologia , Ceratocone/cirurgia , Acuidade VisualRESUMO
The onset of bilateral necrotising scleritis and marginal corneal ulceration after cataract surgery are described in a patient with diffuse vasculitis syndrome. The finding of immune complexes in this patient's tissue biopsy suggests that they are the cause of a localised primary vasculitis triggered by surgical inflammation. Clinically, this patient's marginal corneal ulceration preceded the scleral necrosis. A past history of orbital inflammation may have been due to a posterior scleritis. The corneal ulcerations responded to conjunctival debridement and steroids. The scleral necrosis was unresponsive to the 2 anti-inflammatory preparations tried, and the patient eventually went into remission while off all treatment.
Assuntos
Extração de Catarata/efeitos adversos , Úlcera da Córnea/etiologia , Vasculite/complicações , Idoso , Complexo Antígeno-Anticorpo , Catarata/complicações , Túnica Conjuntiva/imunologia , Túnica Conjuntiva/patologia , Oftalmopatias/etiologia , Oftalmopatias/terapia , Feminino , Humanos , Lentes Intraoculares/efeitos adversos , Necrose , Esclera/patologia , Vasculite/imunologiaRESUMO
Dermojet is a spring-loaded device that injects a high velocity microspray capable of perforating the globe. An accidental intraocular injection of triamcinolone acetonide from a Dermojet syringe by a dermatologist is reported. The lack of untoward effects led to experimental intravitreal injections. The Dermojet syringe was used for intravitreal injections in 7 rabbit eyes with normal saline as the vehicle in 6 and India ink in one. There were no irreversible effects attribute to the injection noted clinically or histopathologically. While modification and further animal experimentation with this device are in order, it should not be use on human eyes at this time.
