Fluffy white iris precipitates in Fuchs uveitis: a new sign for an old disease.

To describe particular iris precipitates in a series of five eyes from six patients with Fuchs uveitis (FU). Iris precipitates were noted by four independent examiners during routine physical examination of the angle by gonioscopy with Goldmann's three-mirror lens in patients with FU. The result was confirmed by examination, using the same method, of five other consecutive patients with FU and compared to 10 normal control eyes from five healthy individuals. Other causes of anterior uveitis were excluded. There were no iris precipitates in the healthy eyes. In eyes with FU, there were fluffy white iris precipitates, not visible by full-face examination or by classic slit-lamp examination. They were similar to keratic precipitates described in FU: starry, blurry and transparent with a tendency towards the white. Situated on the surface of the iris, they were visible only with the particular diffusion of the light from the gonioscopy's glass on the darkly pigmented iris of patients from North Africa. Fluffy white iris precipitates, seen in FU patients, appear to represent an additional clinical sign and may improve our diagnostic accuracy in this disease. Its visibility requires a specific technique during clinical examination. The validity of this new clinical sign based on this fact is yet to be determined.

[Epidemiology of work-related eye injuries]. / Epidémiologie des accidents oculaires du travail.

BACKGROUND: Occupational injury represents 7,7 at 69,9% of the total ocular traumatisms. They can be a major source of visuel loss and blindness. The aim is to study the epidemiology of work-related ocular injuries: objects frequencies,works most exposed. METHODS: We performed a prospective study that interest 78 patients having a work-related ocular traumatism during a 4 months period. They were admitted at ocular emergeney All patients underwent an ophtalmologic examination completed with orbital radiography and echography. A medical and/or chirurgical appropriate treatment was institued. RESULTS: Occupationnal injury frequency was 9% of the whole ocular traumatisms in the same period. The mean age was 31 years. 55% of cases were under 30 years. 91% were male. Most exposed works were industrial and mecanical sectors In 70,5% of cases work-related eye injuries were caused by projectile objects. Most common lesion was corneal superficial foreign body (58%). Open globe injury was noted in 8%. 95% of patients had no eye protection at the time of the accident. 13% were blind or unilateral partially sighted (according to the OMS classification). CONCLUSION: The authors discussed the importance and different prevention strategies to prevent the risk of blindness and socio-economical cost of occupationnal accidents. There is a need for systematic periodic sensibilization to reduce these accidents and blindness.

Bilateral retinal pigment epithelium tears in acute Vogt-Koyanagi-Harada disease.

PURPOSE: To report an original case of retinal pigment epithelial (RPE) tears in acute Vogt-Koyanagi-Haradadisease. METHODS: Observational case report of a patient who presented with RPE tears in acute Vogt-Koyanagi-Harada disease, who underwent clinical examination, fluorescein and infracyanine green angiographies, and optical coherence tomography evaluation. RESULTS: A 42-year-old woman presented with bilateral serous retinal detachment related to Vogt-Koyanagi-Harada disease. Eight days after high-dose systemic corticosteroids, she developed bilateral RPE tears. At the 15-month follow-up, visual acuity was 20/20 in both eyes. CONCLUSION: The RPE tears are rarely observed in acute Vogt-Koyanagi-Harada disease. The RPE tears were likely caused by acute inflammation of the choroidal stroma.