RESUMEN
PURPOSE: Conjunctival adherence of a tick is an uncommon event with few reports previously cited in the literature. We report a unique case of tick penetration, specifically a black-legged deer tick (Ixodes scapularis), into the conjunctiva. OBSERVATIONS: This patient experienced a 3-week history of unilateral mild ocular pain, decreased vision, and pigmented lesion of her right eye. Slit lamp examination demonstrated a tick attached to the conjunctiva. Pathology confirmed the insect exoskeleton. Visual appreciation of the tick demonstrated probable deer tick larval stage given the shape, size, pigmentation pattern and geographic location of the specimen. Polymyxin-trimethoprim eye drops were prescribed for use three times daily and loteprednol twice daily. CONCLUSIONS AND IMPORTANCE: Despite the low risk for Lyme disease, which is endemic to the Adirondack region where the patient was affected, doxycycline was prescribed for prophylaxis. In any case of suspected tick penetration to the ocular surface, immediate ophthalmologic consultation and prompt removal via the method mentioned above is recommended, as well as attention paid to the Infectious Diseases Society of America guidelines regarding prophylaxis.
Asunto(s)
Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Disco Óptico/irrigación sanguínea , Neovascularización Retiniana/diagnóstico , Terapia Combinada , Dasatinib , Angiografía con Fluoresceína , Humanos , Hibridación Fluorescente in Situ , Coagulación con Láser , Leucemia Mielógena Crónica BCR-ABL Positiva/terapia , Recuento de Leucocitos , Leucocitosis , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Inhibidores de Proteínas Quinasas/uso terapéutico , Pirimidinas/uso terapéutico , Neovascularización Retiniana/terapia , Tiazoles/uso terapéutico , Agudeza Visual , VitrectomíaRESUMEN
Congenital simple hamartoma of the retinal pigment epithelium (CSHRPE) is a rare tumor speculated to arise from the retinal pigment epithelium (RPE). A case of CSHRPE is presented herein along with the related literature. A healthy 20-year-old Middle-Eastern man was evaluated for an asymptomatic retinal lesion found on routine examination of his left eye. Fluorescein angiogram, spectral domain optical coherence tomography, and A and B scan ultrasonography confirmed the suspected clinical diagnosis. For the first time high-definition OCT images are shown, which have an RPE origin for this tumor.
Asunto(s)
Hamartoma/diagnóstico , Enfermedades de la Retina/diagnóstico , Epitelio Pigmentado de la Retina/patología , Diagnóstico Diferencial , Angiografía con Fluoresceína , Hamartoma/congénito , Humanos , Masculino , Enfermedades de la Retina/congénito , Tomografía de Coherencia Óptica , Ultrasonografía , Adulto JovenRESUMEN
A 5-year-old Amish boy diagnosed at birth as having a defect in intracellular cobalamin metabolism, cobalamin C disease (cb1C), presented to the pediatric ophthalmology service with severe visual impairment. Ophthalmoscopy showed bilateral bull's eye macular lesions. Visual loss occurs from retinal degeneration in cb1C disease. This report highlights the importance of post-natal metabolic testing and ophthalmic evaluation in cb1C disease, especially in high-risk inbred populations.
RESUMEN
Sturge-Weber Syndrome is a nonheritable congenital syndrome characterized by a "port-wine stain" on the face and angioma of the meninges. Ocular findings include diffuse choroidal hemangioma, retinal detachment, and various types of glaucoma. Management of diffuse choroidal hemangioma is aimed at preserving the affected eye and preventing glaucoma. In the past this has been challenging. Herein, we describe a case of Sturge-Weber Syndrome with diffuse choroidal hemangioma which was successfully treated with low dose lens-sparing external beam radiotherapy.
