ABSTRACT
PURPOSE: To describe the ocular complications at the end of serious drug eruptions such as Lyell syndrome or toxic epidemic necrolysis (TEN) syndrome, Stevens-Johnson syndrome (SJS), and SJS/TEN overlap syndrome; to analyze their relationship using disease severity scores. PATIENTS AND METHODS: A retrospective study carried out in the dermatology department in collaboration with the ophthalmopathy department in a series of 81 dossiers collated over a 10-year period. The severity of ophthalmological involvement was evaluated using the Foster score, and the drug eruption score was assessed using the Bastuji-Garin classification and the SCORTEN prognostic score. RESULTS: The average patient age was 36 years; the clinical forms seen were Lyell's syndrome in 57.8 % of cases, Stevens-Johnson syndrome in 32.8 % and overlap syndrome in 9.4 % of cases. According to the Foster classification, 34 % of patients were in stage I, 43 % in stage II, and 22 % in stage III. Stage I was seen in 50 % of cases presenting with overlap syndrome and in 42 % of patients with Stevens-Johnson, whereas stage III accompanied Lyell's syndrome in 27 % of cases, followed by SJS/TEN overlap syndrome in 16.6 % of cases. Photophobia persisted in 36 patients, and there were 17 cases of decreased visual acuity and 13 cases of eyelid malposition. Dry eye syndrome was noted in 39 cases and corneal perforation in 3 cases. DISCUSSION: The ocular manifestations of drug eruptions are daunting. It was suggested that ocular involvement is more serious when the peeled skin surface is extensive.
Subject(s)
Eye Diseases/etiology , Stevens-Johnson Syndrome/complications , Adolescent , Adult , Aged , Child , Child, Preschool , Corneal Neovascularization/epidemiology , Corneal Neovascularization/etiology , Corneal Perforation/epidemiology , Corneal Perforation/etiology , Dry Eye Syndromes/epidemiology , Dry Eye Syndromes/etiology , Eye Diseases/epidemiology , Eyelid Diseases/epidemiology , Eyelid Diseases/etiology , Female , Humans , Male , Middle Aged , Photophobia/epidemiology , Photophobia/etiology , Retrospective Studies , Severity of Illness Index , Visual Acuity , Young AdultABSTRACT
Rhabdomyosarcoma is a malignant mesenchymal tumor of childhood. The eyelid localization is unusual. We report the case of a 7-year-old child with upper palpebral rhabdomyosarcoma revealed by an isolated blepharoptosis. The CT-scan revealed a well delimited enhancing soft tissue mass involving the upper eyelid. The tumor was excised totally by an upper eyelid incision under general anesthesia. It was limited in preseptal eyelid without extension to the orbit. Histopathologic examination confirmed the diagnosis of embryonic rhabdomyosarcoma. Postoperatively, the upper eyelid regained its motility. The visual axis was cleared. After surgery, three cures of chemotherapy including ifosfamide, vincristine, and actinomycin were administered. After a 4 months follow up period, there was no sign of tumor recurrence.
Subject(s)
Eyelid Neoplasms/diagnostic imaging , Eyelid Neoplasms/surgery , Rhabdomyosarcoma/diagnostic imaging , Rhabdomyosarcoma/surgery , Child , Eyelid Neoplasms/pathology , Female , Humans , Rhabdomyosarcoma/pathology , Tomography, X-Ray ComputedABSTRACT
Giant cell arteritis (Horton's disease) is an inflammatory panarteritis occurring most frequently in the elderly. Its common ocular manifestations are anterior ischemic optic neuropathy, choroidal ischemia and central retinal artery occlusion. We describe a case of Horton's disease revealed by a retinal detachment, optic neuropathy and severe choroidal ischemia. Prompt treatment with corticosteroids led to preservation of vision and resolution of the retinal detachment. This observation of a retinal detachment revealing a giant cell arteritis had not been yet reported in the literature.
Subject(s)
Giant Cell Arteritis/complications , Giant Cell Arteritis/diagnosis , Retinal Detachment/etiology , Adrenal Cortex Hormones/therapeutic use , Giant Cell Arteritis/drug therapy , Humans , Male , Middle Aged , Retinal Detachment/diagnosis , Retinal Detachment/drug therapyABSTRACT
The goal of our work is to analyze the clinical aspects, study the change in intraocular pressure and functional prognosis after trabeculectomy and amblyopia treatment of children followed for congenital glaucoma. The present study is a retrospective study including 86 patients (143 eyes) followed over a period from March 2009 to September 2015. The median age at diagnosis was 6 months. The mean intraocular pressure was 25±5mmHg preoperatively and 11.6±4mmHg at the conclusion. The average initial cup was 0.5. Trabeculectomy was performed in all cases. Twelve eyes were operated twice. After a follow-up of 4 years, normalization of the intraocular pressure was obtained in 35% after the first surgery, in 44% on mono or dual therapy, in 10% after a surgical revision. Cycloplegic refraction was performed; myopia was found in 55% of cases, the mean was -6.5 diopters. 20% of children were hyperopic with a mean of 2.5D. A mean 2D of astigmatism was found in 60 eyes (42%). Anisometropia was present in 10 children. Corrected visual acuity was quantified in 37% of children. The mean was 2/10±3 initially and 4/10 at the conclusion. It was≥4/10 in 41% of cases and≤1/10 in 56%. Unilateral amblyopia was found in 40% of the children. Seventy percent of the patients had strabismus. This study highlights the need for prolonged treatment of amblyopia in congenital glaucoma to achieve the best possible visual recovery.
Subject(s)
Amblyopia/rehabilitation , Glaucoma/congenital , Glaucoma/surgery , Intraocular Pressure/physiology , Trabeculectomy/rehabilitation , Visual Acuity/physiology , Amblyopia/etiology , Amblyopia/physiopathology , Child, Preschool , Female , Glaucoma/diagnosis , Glaucoma/physiopathology , Humans , Infant , Infant, Newborn , Male , Prognosis , Retrospective Studies , Tonometry, Ocular , Trabeculectomy/adverse effects , Trabeculectomy/methods , Treatment Outcome , Vision TestsABSTRACT
PURPOSE: To evaluate the contribution of scleral lenses in terms of improving quality of life and vision. METHODS: We conducted a retrospective study of the quality of life (QOL) of patients fitted with scleral lenses, between November 2015 and November 2016 in the Marrakech university hospital department of ophthalmology. QOL was assessed before and after scleral lens (ICD) adaptation using a version of the National Eye Institute Visual Function Questionnaire 25 translated into the Moroccan dialect of Arabic. RESULTS: We included 48 patients (68 eyes). The main indications included severe corneal ectasia followed by post-keratoplasty eyes, post-traumatic corneas and patients with ocular surface disease. The average duration of scleral lens wear was 6 months, and the average wearing time was 12hours per day. BCVA increased from 0.8 to 0.2±0.5 LOGMAR. The average scores on the NEI-VFQ 25 of patients after scleral lens fitting were significantly higher, 80.5 versus 42.6 before wearing scleral lenses, thus an increase of 38.1. DISCUSSION: Quality of life has become a major issue in the healthcare field, which has seen a renewed interest in ophthalmology lately. The results of our study support the data from previous studies regarding the impact of scleral lenses on the quality of life of patients. CONCLUSION: High oxygen permeability scleral lenses are a satisfying therapeutic alternative, allowing a significant improvement in the quality of life of patients for whom the usual therapeutic means are limited.