ABSTRACT
ABSTRACT A 62-year-old woman was admitted to our clinic with the complaints of periorbital ecchymosis and subconjunctival hemorrhage that are visible, especially on the right eye. We noted that her complaints began the day after she underwent leech therapy on the glabella area for headache. On the glabella, 2 leech bites were observed close to the right side. Examination revealed ecchymosis on the bilateral eyelids and subconjunctival hemorrhage on the inferolateral and medial limbus on the right eye. No treatment was initiated, rather control measures were recommended. The follow-up after 1 month revealed that the patient's complaints had disappeared.(AU)
RESUMO Uma paciente de 62 anos procurou nosso ambulatório com queixas de equimose periorbital e hemorragia subconjuntival, visíveis principalmente no olho direito. Descobrimos que suas queixas começaram no dia seguinte a um tratamento para dor de cabeça com sanguessugas na área da glabela. Na glabela, 2 mordidas de sanguessuga foram encontradas próximas ao lado direito. Durante os exames da paciente, foram detectadas equimoses nas pálpebras bilaterais e hemorragia subconjuntival no limbo ínfero lateral e medial do olho direito. Nenhum tratamento foi iniciado, sendo recomendado apenas controle. No acompanhamento, observou-se que as queixas da paciente desapareceram em cerca de um mês.(AU)
Subject(s)
Middle Aged , Eye Hemorrhage/etiology , Conjunctiva/pathology , Leeching/adverse effects , Headache/drug therapy , Orbital Diseases , HematomaABSTRACT
RESUMO Os diagnósticos diferenciais que compõem as proptoses agudas são, muitas vezes, desafiadores. A anamnese e o exame clínico exigem do oftalmologista atenção especial aos detalhes que permitem diferenciar quadros relativamente benignos e autolimitados de quadros que evoluirão com incapacidades permanentes. Relatamos o caso de uma paciente de 49 anos que, durante viagem de avião, apresentou dor ocular, hematoma periorbitário e proptose do olho esquerdo súbitos. Referia diplopia aguda incapacitante. Exames de tomografia e angiorressonância magnética confirmaram diagnóstico de sinusopatia do seio etmoidal esquerdo e hematoma subperiosteal da órbita esquerda, associado ao barotrauma. Apesar de raro, o diagnóstico de hematoma subperiosteal não traumático deve ser considerado diferencial em relação a proptoses agudas, sendo a anamnese fundamental para essa elucidação diagnóstica.
ABSTRACT Differential diagnoses of acute proptosis are often challenging. History and clinical examination require from ophthalmologists special attention to details, which make it possible to differentiate relatively benign and self-limited conditions from those that will progress to permanent disabilities. We report a 49-year-old female patient who had sudden eye pain, periorbital hematoma and proptosis of the left eye during a commercial flight. She also complained of disabling acute diplopia. Computed tomography and magnetic resonance angiography imaging confirmed the diagnosis of subperiosteal hematoma of the left orbit, associated with left ethmoid sinus disease. Although rare, non-traumatic subperiosteal hematoma should be considered in differential diagnoses of acute proptosis, and history taking is fundamental to elucidate the picture.
Subject(s)
Humans , Female , Middle Aged , Orbital Diseases/etiology , Orbital Diseases/diagnostic imaging , Barotrauma/complications , Eye Hemorrhage/etiology , Eye Hemorrhage/diagnostic imaging , Paranasal Sinus Diseases/drug therapy , Paranasal Sinus Diseases/diagnostic imaging , Aviation , Tomography, X-Ray Computed , Exophthalmos , Magnetic Resonance Angiography , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Diplopia , Air TravelABSTRACT
We report an unusual case of an amelanotic melanoma in a 7 year old hispanic child with subclinical globe perforation. Uveal melanoma rarely occurs in children. Young affected patients are mostly light-colored eye Caucasian adolescents. Since they are not common, these tumors are usually not recognized and misdiagnosed. Differential diagnoses and therapeutic options are outlined.
Subject(s)
Corneal Perforation/etiology , Iris Neoplasms/complications , Melanoma, Amelanotic/complications , Child , Diagnosis, Differential , Eye Enucleation , Eye Hemorrhage/etiology , Humans , Iris Neoplasms/diagnosis , Iris Neoplasms/pathology , Iris Neoplasms/surgery , Male , Melanoma, Amelanotic/diagnosis , Melanoma, Amelanotic/pathology , Melanoma, Amelanotic/surgeryABSTRACT
OBJECTIVE: Describe the ophthalmological sequelae of patients diagnosed with blunt eye injury by paintball. MATERIAL AND METHODS: There were a total 14 cases with a diagnosis of blunt trauma by paintball were treated at the ophthalmology emergency department of the Barraquer Clinic in Bogotá, Colombia. All patients underwent a complete ophthalmological examination with their respective controls according to their outcome. RESULTS: The frequency of eye trauma by paintball was 3.01%. Fourteen eyes were evaluated, age range from 9 to 49 years. Cases were unilateral, 1 woman and 13 men, initial visual acuity less than 20/30 in 12 eyes. Only 5 eyes progressed satisfactorily, and 3 were surgically intervened. The cases that did not show any improvement in visual acuity were related to posterior pole problems, with the most frequent being macular alterations, choroidal rupture, choroidal detachment, retinal tear, and retinal folds. In 3eyes, clinical improvement of visual acuity was evidenced secondary to haemorrhagic processes that resolved with medical treatment. One of them underwent surgical treatment of the lens with an intraocular lens implant. In 2eyes, the visual recovery was very satisfactory and 100% in another. CONCLUSION: Paintball has increased as a sport and recreational activity, where paint projectiles are fired with compressed air weapons. It carries risks of suffering various trauma that can lead to catastrophic episodes, in terms of visual health, and repercussions on the quality of life of those affected.
Subject(s)
Athletic Injuries/complications , Eye Injuries/complications , Wounds, Nonpenetrating/complications , Adolescent , Adult , Athletic Injuries/prevention & control , Athletic Injuries/surgery , Child , Choroid/injuries , Eye Hemorrhage/etiology , Eye Hemorrhage/therapy , Eye Injuries/prevention & control , Eye Injuries/surgery , Eye Protective Devices , Female , Humans , Lens Implantation, Intraocular , Male , Middle Aged , Retinal Detachment/etiology , Retinal Detachment/therapy , Rupture/etiology , Rupture/therapy , Treatment Outcome , Wounds, Nonpenetrating/surgery , Young AdultABSTRACT
Resumo O pseudoxantoma elástico é uma doença generalizada do tecido conjuntivo envolvendo a pele, olhos e sistema cardiovascular desencadeando a fragmentação e calcificação das fibras elásticas. Geralmente ocorre após a puberdade, as manifestações características são manchas pequenas, circunscritas, amareladas, localizadas no pescoço, axila e pregas inguinais. Estrias angioides na retina, tendência à hemorragia e insuficiência arterial são as complicações mais comuns. Esta doença pode ser herdada como autossômica dominante ou recessiva. O tratamento das manifestações oculares convencional é através da fototerapia a laser impedindo a ocorrência de hemorragias locais. Entretanto, novas abordagens terapêuticas estão sendo desenvolvidas como a utilização em longo prazo de drogas antiangiogênicas, as quais atuam inibindo a neovascularização ocular. Apesar de não ter ainda efetivamente substituído o tratamento original, pesquisas recentes já evidenciam benefícios da nova técnica. O objetivo deste estudo é relatar sobre o caso de uma paciente de 37 anos, portadora do pseudoxantoma elástico, com estrias angioides e hemorragia ocular, e o tratamento eficaz com a terapia antiangiogênica no ambulatório de oftalmologia em Nova Iguaçu, Rio de Janeiro.
Abstract The pseudoxanthoma elasticum is a generalized disease of the connective tissue involving the skin, eyes and cardiovascular system triggering the fragmentation and calcification of elastic fibers. Usually occurs after puberty, the manifestations characteristics are small spots, circumscribed, yellowish, located on the neck, axilla and inguinal folds. Angioid streaks in the retina, tendency to hemorrhage and arterial insufficiency are the most common complications. This disease can be inherited as autosomal dominant or recessive. The treatment of ocular manifestations is through the conventional phototherapy laser preventing the occurrence of local hemorrhages. However, new therapeutic approaches are being developed as the long-term use of drugs antiangiogenic, which act by inhibiting the ocular neovascularization. Despite not having yet effectively replaced the original treatment, recent research already show benefits of new technique. The objective of this study is to report on a case of a patient of 37 years, the carrier of the Pseudoxanthoma Elasticum, with angioid streaks and ocular hemorrhage, and the effective treatment with antiangiogenic therapy at the clinic of Ophthalmology in Nova Iguaçu, Rio de Janeiro.
Subject(s)
Humans , Female , Adult , Pseudoxanthoma Elasticum/complications , Eye Hemorrhage/etiology , Angioid Streaks/etiology , Ophthalmoscopy , Tonometry, Ocular , Eye Hemorrhage/diagnosis , Eye Hemorrhage/drug therapy , Fluorescein Angiography , Visual Acuity , Angiogenesis Inhibitors/therapeutic use , Intravitreal Injections , Bevacizumab/therapeutic use , Ranibizumab/therapeutic use , Slit Lamp Microscopy , Angioid Streaks/diagnosis , Angioid Streaks/drug therapySubject(s)
Chemoradiotherapy/methods , Neuroblastoma/secondary , Orbital Neoplasms/secondary , Retroperitoneal Neoplasms/pathology , Biopsy, Needle , Bone Marrow Transplantation/methods , Child, Preschool , Combined Modality Therapy , Conjunctiva/physiopathology , Contrast Media , Ecchymosis/diagnosis , Ecchymosis/etiology , Eye Hemorrhage/diagnosis , Eye Hemorrhage/etiology , Follow-Up Studies , Humans , Immunohistochemistry , Male , Neoplasm Invasiveness/pathology , Neoplasm Metastasis , Neoplasm Staging , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/therapy , Neuroblastoma/diagnostic imaging , Neuroblastoma/surgery , Orbital Neoplasms/diagnostic imaging , Orbital Neoplasms/therapy , Retroperitoneal Neoplasms/diagnostic imaging , Retroperitoneal Neoplasms/therapy , Risk Assessment , Tomography, X-Ray Computed/methods , Treatment OutcomeSubject(s)
Anticoagulants/therapeutic use , Cataract Extraction , Eye Hemorrhage/prevention & control , Fibrinolytic Agents/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Postoperative Hemorrhage/prevention & control , Anesthesia/adverse effects , Anesthesia/methods , Anticoagulants/administration & dosage , Cataract/complications , Contraindications , Eye Hemorrhage/chemically induced , Eye Hemorrhage/etiology , Fibrinolytic Agents/adverse effects , Humans , International Normalized Ratio , Platelet Aggregation Inhibitors/adverse effects , Postoperative Hemorrhage/chemically induced , Practice Guidelines as Topic , Risk Assessment , Thrombophilia/complications , Thrombophilia/drug therapyABSTRACT
Relato de um caso de barotrauma ocular bilateral relacionado ao mergulho autônomo, com hemorragia conjuntival e periocular. Alguns conceitos de física e cuidados durante o mergulho são reportados para um melhor entendimento da fisiopatogenia do quadro, de modo que se possa melhor orientar os pacientes quanto à prevenção.
Report of a case of bilateral ocular barotrauma related to scuba diving, with conjunctival and periocular hemorrhage. Some concepts about Physics and caution are provided to better understanding the pathophysiology of the barotrauma, so proper orientation regarding prevention might be provided.
Subject(s)
Humans , Female , Adult , Barotrauma/complications , Barotrauma/etiology , Eye Injuries/etiology , Diving/adverse effects , Diving/injuries , Remission, Spontaneous , Eye Hemorrhage/etiology , Masks/adverse effectsABSTRACT
BACKGROUND: High blood pressure should be symptomless. However, popular knowledge attributes some symptoms such as headache, epistaxis or dizziness to high blood pressure. AIM: To compare the prevalence of headache, epistaxis, subconjunctival hemorrhages and dizziness in people with normal or high blood pressure. SUBJECTS AND METHODS: A representative sample of an urban population in Chile was studied. Each subject with high blood pressure was paired with a non-related individual of the same sex and age. These subjects were interrogated about the presence of symptoms. RESULTS: One thousand forty eight subjects with high blood pressure (481 male) and 1052 individuals with normal pressure (483 male), were studied. In subjects with high or normal blood pressure, the prevalence of headache was 22 and 21.8% respectively, epistaxis was 11.6 and 11% respectively, dizziness was 7.4 and 7.6% respectively, tinnitus was 9.1 and 9.4% respectively and subconjunctival hemorrhage was 2.9 and 3.1% respectively (p = NS). CONCLUSIONS: No differences in the prevalence of symptoms, popularly attributed to hypertension, were observed between subjects with normal or high blood pressure.
Subject(s)
Hypertension/complications , Adult , Aged , Argentina/epidemiology , Chi-Square Distribution , Conjunctival Diseases/epidemiology , Conjunctival Diseases/etiology , Dizziness/epidemiology , Dizziness/etiology , Epistaxis/epidemiology , Epistaxis/etiology , Eye Hemorrhage/epidemiology , Eye Hemorrhage/etiology , Female , Headache/epidemiology , Headache/etiology , Humans , Male , Middle Aged , PrevalenceABSTRACT
Para avaliarmos a alteraçäo da acuidade visual após a cirurgia de trabeculectomia, analisamos 28 pacientes (28 olhos) com glaucoma primário de ângulo aberto que foram submetidos a esta cirurgia na Santa Casa de Säo Paulo. No pré-operatório testamos a acuidade visual e realizamos o campo visual com o programa "macular test". Trinta dias após o procedimento, todos os pacientes foram examinados novamente. Nossos resultados mostram que tanto a acuidade visual e o "foveal threshold" diminuíram após a cirurgia
Subject(s)
Humans , Male , Female , Aged , Cataract/etiology , Retinal Diseases/etiology , Eye Hemorrhage/etiology , Glaucoma, Open-Angle/surgery , Macula Lutea/physiopathology , Trabeculectomy/adverse effectsABSTRACT
Finalidade: relatar o caso de Adiáspiromicose em paciente feminina submetida a retinopexia por DR complicado com hemorragia intra-oclar e oftalmodínia, com perda de visäo. Método: enuclaaçäo de OD revelando-se à histopatologia a presença de esférulas trilaminadas (adiásporos), fortemente coráveis com ácido periódico de Schiff (PAS). Formaçäo de granuloma com infiltraçäo de macrofágos e linfócitos. Resultado: diagnóstico de Adiáspiromicose por Crysosporium parvum, var. crescens. Desconhecemos na literatura, salvo omissäo, qualquer outro caso de Adiáspiromicose intraocular, sendo talvez a primeira descriçäo dessa micose em oftalmologia.
Subject(s)
Humans , Female , Middle Aged , Lung Diseases, Fungal/diagnosis , Retina/surgery , Eye Enucleation/methods , Eye Hemorrhage/etiology , Retinal Detachment/complicationsSubject(s)
Humans , Female , Aged , Anesthesia, Conduction , Cataract Extraction , Eye Hemorrhage/etiology , Ophthalmologic Surgical ProceduresSubject(s)
Humans , Male , Female , Conjunctiva/pathology , Eye Hemorrhage/diagnosis , Eye Hemorrhage/etiology , Eye Hemorrhage/pathology , OphthalmologySubject(s)
Eye Hemorrhage/etiology , Factor XI Deficiency/complications , Maxillofacial Injuries/complications , Orbital Fractures/complications , Zygomatic Fractures/complications , Accidents, Traffic , Adult , Blindness/etiology , Blood Transfusion , Enophthalmos/etiology , Epistaxis/etiology , Eye Injuries/complications , Hematoma/etiology , Humans , Male , Maxillary Sinus/injuries , Optic Nerve Injuries , PlasmaABSTRACT
A study was made of twelve cases with uveitis, glaucoma and hyphema (UGH) caused by rigid intraocular posterior chamber implants. Three of these patients were female and nine were males. The syndrome started in 75% of the cases two years after having been operated. The patients were followed for an average time of 42 months. Four patients responded to medical treatment. Eight patients required surgery. This syndrome is caused by the irritation and escoriation of the ciliary body at the inferior point which supports the hard lens. Serious complications arise from the removal of the lens. The author obtained good results in treating these patients with selective diathermy of the ciliary body under a scleral flap.
Subject(s)
Eye Hemorrhage/etiology , Glaucoma/etiology , Lenses, Intraocular/adverse effects , Uveitis, Posterior/etiology , Aged , Female , Humans , Male , Middle AgedABSTRACT
The authors studied the records of 30 patients who suffered a massive suprachoroidal hemorrhage during cataract surgery. Immediate development of a retinal detachment (RD) is a very bad prognostic sign. In none of 12 such cases could the retina be reattached. Retinal complications developed in five of six patients who had vitreous incarceration and who did not have vitrectomy as opposed to only one of seven who underwent vitrectomy along with drainage of the hemorrhage. If vitreous is incarcerated in the cataract incision, drainage of the hemorrhage without vitrectomy is a dangerous procedure.