Acquired anterior staphyloma after corneal ulcer associated with the use of crack.

We describe an unusual case of acquired anterior staphyloma in a patient addicted to crack cocaine. At the beginning of his crack cocaine abuse, he noticed redness and irritation of his eyes. Over the next 4 months, the patient also noticed the onset of decreasing visual acuity in his right eye (OD). Initially, his visual acuity was light perception in OD, and slit-lamp examination revealed a corneal infiltrate with a peripheral perforation and an iris prolapse. The patient was hospitalized to ensure compliance with the prescribed treatment and was advised to undergo therapeutic keratoplasty; however, the patient left the hospital against medical advice and was lost to follow-up for the next 6 months. He returned with complaints of photophobia and the inability to close his right eyelids. At this time, his cornea had developed an anterior staphyloma and required a sclerokeratoplasty. Following surgery, the patient was again lost to follow-up.

Análise da microbiota em tonômetros de aplanação de Goldmann / Analysis of the microbiota in Goldmann applanation tonometers

RESUMO Objetivos: Analisar a prevalência da microbiota nos tonômetros de aplanação de Goldmann nos consultórios do SUS e definir o grau de contaminação dos tonômetros e a eficácia da assepsia do cone do tonômetro de aplanação. Métodos: Estudo transversal em que foi realizado a coleta de 60 "swabs", divididos nos três tonômetros de aplanação dos ambulatórios do SUS em dois momentos distintos. No primeiro realizou-se a coleta no início dos atendimentos e no segundo momento, a coleta foi realizada ao final de todos os atendimentos. Todos "swabs" foram colhidos no meio Stuart e foi realizada a cultura em meio de bactérias. Resultados: Das 60 amostras, apenas uma apresentou crescimento de agente patogênico, a Escherichia coli. Conclusão: Independente dos vários métodos que o oftalmologista escolher para realizar a assepsia, a mesma é imprescindível para a manutenção de uma boa saúde ocular do paciente, evitando assim a transmissão e propagação de patógenos por meio do exame oftalmológico e concluímos também que o método utilizado pelo nosso serviço parece ser eficaz nesta profilaxia.

ABSTRACT Objective: Analyze the microbiota prevalence in the Goldmann applanation tonometers in the clinic of the SUS to define the contamination of the tonometers and the efficacy of asepsis of the applanation tonometer cone. Methods: A cross-sectional study was carried out to collect 60 "swabs" divided into the three aplanation tonometers of SUS clinics at two different times. In the first one, the collection will be performed at the beginning of the visits and at the second moment, the collection will be performed at the end of all the visits. All swabs will be harvested in the Stuart medium and culture was carried to sow bacteria. Results: Of the 60 samples, only one showed pathogen growth, Escherichia coli. Conclusion: Regardless of the various ways the ophthalmologist chooses to perform asepsis, it is essential for the maintenance of good patient eye health, thus avoiding the transmission and propagation of pathogens through ophthalmologic examination, and we also conclude that the method used by our patient seems to be effective in this prophylaxis.

Acquired anterior staphyloma after corneal ulcer associated with the use of crack / Estafiloma anterior adquirido após úlcera de córnea associado a uso de crack

ABSTRACT We describe an unusual case of acquired anterior staphyloma in a patient addicted to crack cocaine. At the beginning of his crack cocaine abuse, he noticed redness and irritation of his eyes. Over the next 4 months, the patient also noticed the onset of decreasing visual acuity in his right eye (OD). Initially, his visual acuity was light perception in OD, and slit-lamp examination revealed a corneal infiltrate with a peripheral perforation and an iris prolapse. The patient was hospitalized to ensure compliance with the prescribed treatment and was advised to undergo therapeutic keratoplasty; however, the patient left the hospital against medical advice and was lost to follow-up for the next 6 months. He returned with complaints of photophobia and the inability to close his right eyelids. At this time, his cornea had developed an anterior staphyloma and required a sclerokeratoplasty. Following surgery, the patient was again lost to follow-up.

RESUMO Descrevemos um raro caso de estafiloma anterior adquirido em um paciente viciado em crack. No início do uso do crack, paciente observou hiperemia e irritação nos seus olhos. Durante os próximos 4 meses, evoluiu com piora progressiva da visão em seu olho direito (OD). Inicialmente, sua visão no OD era de percepção luminosa e ao exame de biomicroscopia observava-se um importante infiltrado corneano com uma perfuração periférica e hérnia de íris. O paciente foi hospitalizado para garantir seu correto tratamento e indicado ceratoplastia terapêutica; no entanto, o paciente abandou o hospital e ficou 6 meses sem acompanhamento. Após esse período, paciente retornou queixando-se de importante fotofobia e inabilidade em ocluir o OD. Neste momento, sua córnea havia desenvolvido um importante estafiloma anterior e necessitou de uma escleroceratoplastia no OD. Após a cirurgia, mais uma vez o paciente abandonou o tratamento e perdeu o seguimento pós-operatório.