ABSTRACT
PURPOSE: We studied patients who had mottled cyan-colored opacities of the cornea to better understand the cause and prognosis of this entity. METHODS: We reviewed examinations of patients who had a mottled cyan opacification of the cornea. Risk factors, including contact lens wear and exposure to heavy metals, were analyzed. Clinical findings, pachymetry specular microscopy, and progression of the abnormality were noted. RESULTS: Six patients who had a mottled cyan opacification at the level of Descemet's membrane were identified. These opacities were located in the peripheral and midperipheral cornea. All patients had bilateral findings, had visual acuities of 20/20 or better, and were asymptomatic. All patients had worn soft contact lenses bilaterally for periods ranging from seven to 14 years. CONCLUSION: All patients had the similar clinical appearance of a mottled cyan opacification at the level of Descemet's membrane in the peripheral cornea. Long-term contact lens wear appears to be associated; however, the exact cause is unclear.
Subject(s)
Contact Lenses, Extended-Wear/adverse effects , Contact Lenses, Hydrophilic/adverse effects , Corneal Opacity/etiology , Corneal Opacity/pathology , Descemet Membrane/pathology , Adult , Female , Humans , Male , Risk Factors , Visual AcuityABSTRACT
Orbital emphysema is radiologically apparent in 50% of cases of orbital fractures, but it is generally a benign, self-limited condition. However, visual loss may occur if a fracture produces orbital compression via a ball-valve effect, allowing air to enter but not leave the orbit. A case of compressive orbital emphysema complicated by ischemic optic neuropathy is reported. Intraorbital needle aspiration relieved the compression with improvement of visual acuity and normalization of intraocular pressure.
Subject(s)
Emphysema/diagnostic imaging , Orbital Diseases/diagnostic imaging , Adult , Emergencies , Emphysema/etiology , Emphysema/surgery , Eye Injuries/complications , Humans , Male , Orbital Diseases/etiology , Orbital Diseases/surgery , Orbital Fractures/complications , Radiography , Skull Fractures/complicationsABSTRACT
A number of causes need to be considered in the patient with acute, nontraumatic visual loss at or below the 20/200 level. Etiologic factors include several anterior segment diseases, as well as posterior segment (vitreoretinal) and retrobulbar (optic nerve) conditions. Normal slit-lamp and funduscopic findings make identification of the true cause of decreased visual acuity more difficult. The physician must not rush immediately to the diagnosis of functional disease without first ruling out the other causes.
Subject(s)
Eye Diseases , Vision Disorders/etiology , Eye Diseases/diagnosis , Eye Diseases/therapy , HumansABSTRACT
Many types of ocular trauma can be diagnosed and treated in the primary care office, particularly if a slit lamp is available. Treatment for corneal abrasions consists of applying a cycloplegic medication, antibiotic ointment, and a patch (unless a corneal ulcer is suspected). Iritis can be treated with cycloplegics and topical corticosteroids; the prescribing physician should be familiar with the potential ocular side effects and complications. Hyphemas are treated with bed rest, topical atropine sulfate drops and topical corticosteroids, as well as measures to prevent rebleeding. A slit lamp, topical anesthesia, and a foreign-body spud greatly facilitate the removal of foreign bodies from the cornea. Acid and alkali burns should be irrigated until the pH is normal and then should be treated like a corneal abrasion. Lid lacerations must be repaired with care to preserve proper functioning of the lid. Ruptures of the globe are serious injuries requiring surgical repair and long-term follow-up.