RESUMO
Sudden onset nonaxial proptosis and diplopia is alarming and orbital haemorrhage or a rapidly expanding orbital tumour should be excluded. We present a case of a young man aged 15 years who attended the Accident and Emergency Department with a 6-h history of sudden onset proptosis and diplopia in whom the aetiology was orbital emphysema.
Assuntos
Enfisema/etiologia , Seio Frontal/diagnóstico por imagem , Mucocele/complicações , Doenças Orbitárias/etiologia , Doenças dos Seios Paranasais/complicações , Adolescente , Diplopia/diagnóstico , Enfisema/diagnóstico por imagem , Enfisema/fisiopatologia , Exoftalmia/diagnóstico , Seio Frontal/fisiopatologia , Humanos , Masculino , Mucocele/diagnóstico por imagem , Mucocele/fisiopatologia , Doenças Orbitárias/diagnóstico por imagem , Doenças Orbitárias/fisiopatologia , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/fisiopatologia , Tomografia Computadorizada por Raios XRESUMO
AIM: To investigate the safety and efficacy of alcohol delamination of the corneal epithelium for recalcitrant recurrent corneal erosion syndrome (RCE) in a prospective non-comparative interventional case series. METHODS: Patients with RCE who remained symptomatic despite topical lubrication and 3-month use of an extended wear (bandage) contact lens were included. The intensity of pain on a scale of 1 to 10, and duration and frequency of attacks were recorded. Patients were treated with alcohol delamination and followed up at 1 week, 1 month and then at 12 months, which was the minimum follow up time. Success was defined as a resolution of symptoms after 1 month of treatment, and partial success as a significant reduction in symptoms manageable with topical lubricants, and failure where symptoms were unchanged or worsened. RESULTS: 20 eyes of 20 patients with RCE caused by trauma (n = 14), anterior basement membrane dystrophy (n = 5) or idiopathic (1) were studied. The mean age of patients was 44 years and mean follow-up 24 months. Two eyes were lost to follow-up. 15 (83%) eyes were qualified as successes, 3 as partial successes and no failures were seen. No intraoperative complications were observed. 1 patient developed transient subepithelial haze that resolved with topical steroid, 1 had a change in refraction and 1 developed herpetic stromal keratitis 2 months postoperatively, which was successfully treated. No loss of vision was observed in any of the patients. CONCLUSION: Alcohol delamination of the corneal epithelium is a safe and effective method for treating patients with recalcitrant RCE.
Assuntos
Doenças da Córnea/tratamento farmacológico , Epitélio Corneano/efeitos dos fármacos , Etanol/uso terapêutico , Adulto , Idoso , Lentes de Contato de Uso Prolongado , Doenças da Córnea/etiologia , Doenças da Córnea/patologia , Lesões da Córnea , Etanol/administração & dosagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Medição da Dor , Estudos Prospectivos , Recidiva , Índice de Gravidade de DoençaRESUMO
Scedosporium prolificans is an unusual infection, especially following pterygium surgery. A 63-year-old man who developed an uncomfortable, red right eye 10 years after pterygium surgery with adjunctive mitomycin C is described. To the best of the authors' knowledge, this is the first reported case of S. prolificans sclerokeratitis following pterygium surgery with adjunctive mitomycin C.
