Localised retinal vasculitis in cat scratch disease.

We report an atypical presentation of ocular cat scratch disease (CSD) in an 8-year-old Caucasian male who presented with localised retinal arterial vasculitis and associated retinal oedema. His history of headaches, frequent contact with a kitten and a high Bartonella henslelae titre confirmed the diagnosis of CSD. Over an 18-month follow-up period, his best corrected visual acuity in the affected eye improved from 20/30-2 to 20/25+3 without treatment; however, the affected retinal artery remained sheathed.

Visual results, prognostic indicators, and posterior segment findings following surgery for cataract/lens subluxation-dislocation secondary to ocular contusion injuries.

OBJECTIVE: To determine visual outcomes, incidence of posterior segment abnormalities, and prognostic factors in eyes undergoing lens removal for cataract or lens subluxation-dislocation secondary to ocular contusion injuries. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Forty eyes in forty consecutive patients undergoing lens extraction for ocular contusion-related cataract or lens subluxation, all with a minimum of 6 months' follow-up. INTERVENTION: Lens extraction in the traumatized eye. MAIN OUTCOME MEASURE: Final best-corrected visual acuity. RESULTS: Final best-corrected visual acuity was 20/40 or better in 55% of eyes, and ambulatory vision (>5/200) was achieved in 88%. Preoperative factors associated with poorer visual outcome (<20/40) were the presence of an afferent pupillary defect or an iridodialysis (P < 0.05). Seventy percent of eyes were determined to have significant posterior segment injuries. The cause of final visual acuity less than 20/40 included macular scarring (23%), retinal detachment (15%), and optic atrophy (5%). CONCLUSION: Cataract or lens subluxation secondary to ocular contusion injuries is often associated with severe posterior segment sequelae and poor visual outcomes.

Clinically significant corneal astigmatism and pars plana vitrectomy.

PURPOSE: To report a rare and previously unappreciated potential wound-related complication of repeat pars plana vitrectomy (PPV) combined with anterior segment surgery. METHODS: From a total of 135 patients who had undergone PPV over a period of 15 months, 7 patients were identified on the basis of a visually disabling degree of astigmatism persisting at 3 to 4 months following their surgery. These patients were retrospectively studied from the standpoint of the numbers and combination of procedures they had experienced. Videokeratoscopy was employed as an objective method of documenting the astigmatism. RESULTS: The average astigmatism at the corneal plane in these 7 eyes was 4.5 diopters (D). In the 5 patients who required suture lysis for visual rehabilitation, the average corneal astigmatism was slightly greater than 5.0 D. In all cases, the astigmatism was a symmetric "bow-tie" pattern and was in the meridian corresponding to the superonasal and inferotemporal sclerotomies. All 5 of the patients requiring suture lysis had undergone repeat PPV through the same sclerotomies; all had their astigmatism reduced to an average of 1.5 D. CONCLUSION: Visually disabling astigmatism present months after surgery is almost certainly a rare, wound-related complication of PPV, but remains a previously unappreciated possibility in eyes undergoing repeat procedures through the same sclerotomies. Videokeratoscopy provides a reliable and rapid method of detection, while suture lysis in the steep axis represents a simple remedy.