RESUMEN
PURPOSE: This report aims to present a case of corneal keloid caused by chronic corneal insult after trauma and Descemet stripping automated endothelial keratoplasty (DSAEK). CASE PRESENTATION: A 35-year-old male with a history of vision loss in the right eye was referred to our hospital. The patient underwent Ahmed Glaucoma Valve Implantation to alleviate elevated intraocular pressure after ocular trauma to the same eye. One year following the procedure, the eye developed endothelial failure, leading to the performance of Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) with repositioning of the shunt tube. Upon initial examination, a well-circumscribed elevated white opaque lesion involving the central corneal surface of the RE was observed. Based on the patient's clinical history, slit lamp examination, and UBM findings, the diagnosis of corneal keloid was established. Superficial keratectomy was performed. Histopathological analysis confirmed the diagnosis of corneal keloid. Following the procedure, BCVA improved slightly. However, 3 months later, the patient underwent a penetrating keratoplasty for visual rehabilitation. CONCLUSION: Corneal keloids should be considered following any form of ocular trauma, particularly in cases involving ocular surgery. Diagnosing corneal keloids can sometimes be challenging due to the variety of potential differentials; however, by carefully evaluating the patient's medical history and clinical presentation, we can effectively narrow down the differential diagnosis of corneal conditions.
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Queratoplastia Endotelial de la Lámina Limitante Posterior , Queloide , Humanos , Masculino , Queratoplastia Endotelial de la Lámina Limitante Posterior/métodos , Queloide/cirugía , Queloide/etiología , Adulto , Enfermedades de la Córnea/cirugía , Enfermedades de la Córnea/etiología , Lesiones de la Cornea/cirugía , Lesiones de la Cornea/etiología , Lesiones de la Cornea/diagnóstico , Agudeza Visual , Lesiones Oculares/cirugía , Lesiones Oculares/complicaciones , Lesiones Oculares/diagnóstico , Complicaciones PosoperatoriasRESUMEN
PURPOSE: To determine the impact on the functionality associated with visual loss (VFIP) in people with severe ocular trauma (SOT) caused by kinetic impact projectiles used in police crowd control through a prioritization tool in people admitted to a rehabilitation program in Santiago de Chile from December 02, 2019, to November 13, 2020. METHODS: A cross-sectional descriptive study of SOT victims (N = 85), average age 31.4 ± 11.9. The data were recorded through a new 9-item screening instrument for assessment and prioritization of rehabilitation created for this emergency scenario. RESULTS: The impact of the use of kinetic weapons resulted in monocular blindness in the majority of those affected (n = 68; 80.0%). The highest VFIP observed was among young men from lower social strata. There were extreme difficulties in the performance of productive tasks (occupational and/or educational) (n = 42; 49.4%) and the pursuit of hobbies and pastimes (n = 23; 27.1%), as well as a high difficulty in adapting to changes in brightness (n = 29; 34.1%) and handling objects accurately (n = 22; 25.9%). CONCLUSION: The use of kinetic weapons for crowd control resulted in high and extreme VFIP and, in most cases, monocular blindness, causing major difficulties in work, study, and development of hobbies and pastimes in the affected population, highlighting the urgent need for effective rehabilitative care, which requires special attention in order to generate an adequate rehabilitation program. The use of kinetic weapons for crowd control contravenes international goals, policies, and plans set by the WHO and the International Agency for the Prevention of Blindness on strategies to prevent avoidable blindness worldwide until 2020. It is essential to ban the use of these weapons in Chile and worldwide, as well as to revise police protocols for crowd control.
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Ceguera , Lesiones Oculares , Masculino , Humanos , Adulto Joven , Adulto , Estudios Transversales , Chile/epidemiología , Ceguera/epidemiología , Ceguera/etiología , Lesiones Oculares/complicaciones , Lesiones Oculares/epidemiología , HospitalizaciónRESUMEN
PURPOSE: The aim of this study was to define risks for corneal transplantation associated with fibrous ingrowth among first-time transplant recipients. METHODS: We performed a retrospective case-control study of patients with a histopathologic diagnosis of fibrous ingrowth between 2002 and 2019. Patients with fibrous ingrowth from a first corneal specimen were included. Those with incomplete records were excluded. A 1:2 case-control ratio was used. Controls were matched using surgical indication, surgery year, transplantation method, sex, and age. RESULTS: Seventy-eight eyes (76 patients) were included and matched with 160 control eyes. The incidence of fibrous ingrowth found on a first corneal transplant was 0.6% per year. The most common keratoplasty indications were pseudophakic corneal edema (n = 25, 32%) and aphakic corneal edema (n = 15, 19%). Cases were more likely to have a history of ocular trauma (odds ratio [OR], 2.94; 95% CI, 1.30-6.30; P = 0.007), uveitis (OR, 2.73; 95% CI, 1.12-6.63; P = 0.022), retinal detachment or previous retinal surgery (OR, 2.40; 95% CI, 1.34-4.30; P = 0.003), glaucoma tube-shunt surgery (OR, 2.70; 95% CI, 1.29-5.65; P = 0.007), aphakia (OR, 3.02; 95% CI, 1.61-5.67; P = 0.0004), or iris derangement (OR, 10.52; 95% CI, 5.45-20.30; P <0.0001). A multivariate logistic regression model using iris derangement, history of ocular trauma, history of uveitis, and history of cataract surgery demonstrated 81% sensitivity and 66% specificity in predicting presence of fibrous ingrowth. CONCLUSIONS: A history of ocular trauma, uveitis, retinal detachment or previous retinal surgery, glaucoma tube-shunt surgery, aphakia, and iris derangement are risks for detecting fibrous ingrowth among first-time keratoplasty recipients. Patients with these conditions should be monitored closely for corneal decompensation.
Asunto(s)
Afaquia , Edema Corneal , Trasplante de Córnea , Lesiones Oculares , Glaucoma , Desprendimiento de Retina , Uveítis , Humanos , Edema Corneal/cirugía , Estudios Retrospectivos , Desprendimiento de Retina/cirugía , Estudios de Casos y Controles , Trasplante de Córnea/efectos adversos , Lesiones Oculares/complicaciones , Factores de Riesgo , Glaucoma/cirugía , Afaquia/cirugía , Uveítis/complicacionesRESUMEN
RESUMO A ceratopigmentação teve seu primeiro registro pelo filósofo Galeno há muitos séculos como uma estratégia utilizada para o tratamento estético de pacientes com leucomas. As córneas com leucoma são patológicas e, muitas vezes, intolerantes a lentes de contato cosméticas ou próteses oculares, sendo comum a queixa de desconforto excessivo, proporcionado pela superfície corneana irregular. Assim, a ceratopigmentação é uma alternativa para a melhora estética de pacientes com opacidades corneanas. Descrevemos o caso de um paciente do sexo masculino, 39 anos, que apresentou despigmentação precoce em caso de ceratopigmentação associado a quadro de ceratite herpética necrotizante. O paciente foi submetido ao tratamento com aciclovir 2g ao dia e doxiciclina 200mg ao dia, evoluindo com melhora do quadro clínico, apesar da má adesão medicamentosa.
ABSTRACT Keratopigmentation was first recorded many centuries ago by the philosopher Galeno, as a strategy used for the aesthetic treatment of patients with leukomas. Corneas with leucoma are pathological and often intolerant of cosmetic contact lenses or ocular prostheses, with complaints of excessive discomfort provided by the irregular corneal surface being common. Therefore, keratopigmentation is an alternative for the aesthetic improvement of patients with corneal opacities. We describe the case of a 39-year old male patient, who presented early depigmentation in a case of keratopigmentation associated with necrotizing herpetic keratitis. The patient was treated with Acyclovir 2g/day and Doxycycline 200mg/day, evolving with clinical improvement, despite poor medication adherence.
Asunto(s)
Humanos , Masculino , Adulto , Tatuaje/métodos , Neovascularización de la Córnea/etiología , Córnea/cirugía , Opacidad de la Córnea/cirugía , Colorantes/efectos adversos , Aciclovir/administración & dosificación , Lesiones Oculares/complicaciones , Técnicas Cosméticas , Satisfacción del Paciente , Queratitis Herpética/tratamiento farmacológico , Doxiciclina/administración & dosificación , Opacidad de la Córnea/etiología , EstéticaRESUMEN
BACKGROUND: Ocular trauma is one of the leading causes of decreased visual acuity and monocular blindness in the pediatric population. Since its occurrence is potentially preventable, it is essential to understand its demographic characteristics and risk factors to alert and implement prevention and health promotion programs. METHODS: We conducted a retrospective study in which we reviewed 187 clinical records of patients ≤ 15 years old with the diagnosis of severe ocular trauma admitted in 2017 to the Hospital Civil de Guadalajara. We analyzed demographic variables, circumstances of the event, type of treatment, and the evolution of visual acuity and complications. RESULTS: In total, 187 patients and 188 eyes were included; the average age was 6.99 ± 4.1 years. Children of 2 to 5 years of age (41%) were the most affected, and a higher occurrence was observed in males (73%). Open ocular trauma was the most common type of injury (72.7%) caused by sharp objects (45.4%). Most injuries occurred at home (78.1%), without adult supervision (48.1%), and during leisure time (74.9%). Most events were accidental (80.4%), although 12.3% were direct aggression. Surgery was required in 179 patients, in whom corneal injury repair (43.2%) was the most commonly used procedure. Final visual acuity was quantified in 132 eyes, and visual acuity < 20/200 was found in 18.1%. Loss of 4.2% of the eyeballs was recorded. CONCLUSIONS: The highest proportion of cases was identified in male patients ≤5 years old, unsupervised by an adult. Many eye injuries are preventable, so it is necessary to implement socio-educational programs in alliance with pediatric organizations that alert the severity of the problem and promote safe environments.
INTRODUCCIÓN: El trauma ocular es una de las principales causas de disminución de la agudeza visual y de ceguera monocular en la población pediátrica. Su ocurrencia es potencialmente prevenible, por lo que es importante entender sus características demográficas y riesgos para alertar e implementar programas enfocados hacia la prevención y la promoción de la salud. MÉTODOS: Estudio retrospectivo en el que se analizaron 187 expedientes de pacientes ≤ 15 años con diagnóstico de trauma ocular grave ingresados en 2017 al Hospital Civil de Guadalajara. Se analizaron variables demográficas, circunstancias del evento y tipo de tratamiento, así como la evolución de la agudeza visual y las complicaciones. RESULTADOS: Se incluyeron 187 pacientes y 188 ojos; el promedio de edad en el momento del trauma fue de 6.99 ± 4.1 años. Los niños de 2-5 años (41%) fueron los más afectados y se observó una mayor ocurrencia en el sexo masculino (73%). El trauma ocular abierto fue el tipo de lesión más común (72.7%), causado por objetos punzantes (45.4%). La mayoría de las lesiones ocurrieron en casa (78.1%), sin supervisión de un adulto (48.1%) y durante el tiempo libre (74.9%). La mayoría de los sucesos fueron accidentales (80.4%), aunque el 12.3% fue por agresiones directas. Se requirió cirugía en 179 pacientes, en quienes la reparación de lesión corneal (43.2%) fue el procedimiento más utilizado. La agudeza visual final se cuantificó en 132 ojos y se encontró < 20/200 en el 18.1%. Se registró la pérdida del 4.2% de los globos oculares. CONCLUSIONES: La proporción más alta de casos se identificó en pacientes de sexo masculino ≤ 5 años, que se encontraban sin supervisión. Una gran proporción de las lesiones oculares son prevenibles, por lo que es necesario implementar programas educativos sociales en coordinación con organizaciones pediátricas que alerten de la gravedad del problema y promuevan entornos seguros.
Asunto(s)
Lesiones Oculares , Adolescente , Adulto , Niño , Preescolar , Lesiones Oculares/complicaciones , Lesiones Oculares/diagnóstico , Lesiones Oculares/epidemiología , Hospitales , Humanos , Masculino , México/epidemiología , Estudios Retrospectivos , Agudeza VisualRESUMEN
ABSTRACT: We describe a case of a young female patient presenting with ocular hypotension (4 mm Hg) secondary to cyclodialysis, and optic disc edema (ODE) after a blunt trauma in the right eye (right eye). MRI showed posterior globe flattening of the right eye, drawing our attention to the pathophysiology behind these findings. The combination of ODE and posterior globe flattening, as observed in the present case of ocular hypotony, is known from other conditions such as intracranial hypertension and space-flight neuro-ocular syndrome, pointing to a common pathophysiological mechanism, possibly resulting from axoplasmic stasis at the level of the lamina cribrosa due to a high translaminar pressure difference.
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Lesiones Oculares/complicaciones , Presión Intracraneal/fisiología , Presión Intraocular/fisiología , Hipotensión Ocular/complicaciones , Papiledema/etiología , Heridas no Penetrantes/complicaciones , Adulto , Lesiones Oculares/diagnóstico , Femenino , Humanos , Imagen por Resonancia Magnética , Hipotensión Ocular/diagnóstico , Hipotensión Ocular/fisiopatología , Papiledema/diagnóstico , Heridas no Penetrantes/diagnósticoRESUMEN
RESUMEN * Introducción: En el Hospital General Docente "Dr. Agostinho Neto" se desconocen las características de los pacientes atendidos por trauma ocular. Objetivo: Caracterizar el trauma ocular en pacientes ingresados en el servicio de Oftalmología del citado hospital en el período de enero de 2014 a julio de 2019. Método: Se realizó un estudio descriptivo, retrospectivo y longitudinal del total de pacientes con este diagnóstico (n=49). Se estudiaron las variables: sexo, edad, procedencia, ocupación, tipo de trauma, diagnóstico y complicaciones, y modificaciones de la agudeza visual de acuerdo al tratamiento que aplicó. Resultados: El 79,0 % de los pacientes fueron hombres, tenían entre 19 y 40 años de edad (43,0 %), procedían de áreas rurales (57,0 %) y se dedicaban a labores agrícolas (45,0 %). El 76,0 % presentó un trauma ocular abierto, la herida corneal fue el más usual (55,1 %). El 95,9 % de los pacientes recibieron tratamiento quirúrgico y reparación de la herida el 83,6 %. Antes y después del tratamiento, el 47,0 % y el 41,0 % respectivamente de los pacientes presentaron agudeza visual y visión cuenta dedos a percepción luminosa. La catarata traumática fue la complicación más frecuente (33,0 %). Conclusiones: El trauma no es un problema de salud, pero sí limita la calidad de vida de los perjudicado al afectar la agudeza visual.
ABSTRACT * Introduction: The characteristics of the patients with eye trauma treated in the General Teaching Hospital Dr. Agostinho Neto remain mostly unknown. Objective: To characterize eye trauma in the patients in the ophthalmology consultation in the mentioned institution, in the stretch of time between January 2014 to July 2019. Method: A descriptive, retrospective and longitudinal study was carried out on the total amount of patients with the diagnosis (n=49). The different variables taken into account were: gender, age, place of origin, occupation, type of trauma, diagnosis and complications, and the modifications in visual acuity according to the treatment given. Results: 79.0 % of the patients were men, with ages ranging between 19 to 40 years old (43.0 %), from rural areas (57.0 %), and involved in agricultural works (45.0 %). 76.0 % were open eye traumas, being corneal wounds the most common one (55.1%). 95.9 % of the patients were surgically treated, and 83.6 % went through wound healing processes. Before and after the treatment, the 47.0 % and the 41.0 % of the patients, respectively, presented visual acuity and good 'counting fingers' and 'visual perception' tests results. Traumatic cataracts were the most common complication (33.0 %). Conclusions: eye traumas are not a significant health issue, but impacts directly in the life quality of the affected, damaging their visual acuity.
Asunto(s)
Humanos , Lesiones Oculares/cirugía , Lesiones Oculares/complicaciones , Lesiones Oculares/diagnóstico , Agudeza Visual , Epidemiología Descriptiva , Estudios Retrospectivos , Estudios LongitudinalesRESUMEN
PURPOSE: To report a novel clinical presentation of corneal biofilms, consisting of formation of superficial and recurrent corneal plaques. METHODS: Interventional case report. A 9-year-old boy presented with subepithelial, whitish, avascular, and recurrent corneal plaques without any clinical manifestations of active corneal inflammation and/or infection. He had a history of minor ocular trauma; otherwise, his medical history was unremarkable. RESULTS: An excisional biopsy was performed under topical anesthesia. Histological analysis identified these plaques as clusters of gram-negative bacilli surrounded by an extracellular matrix. Samples were further evaluated with special stains (calcofluor white, Flamingo fluorescent dye, propidium iodide, and Gomori-Grocott) that demonstrated biofilm structures. CONCLUSIONS: Corneal plaques are a very rare clinical presentation of corneal biofilms that allow prolonged survival of microorganisms even in the absence of prosthetic material and clinical signs or symptoms of corneal active inflammation and/or infection.
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Biopelículas , Enfermedades de la Córnea/microbiología , Infecciones Bacterianas del Ojo/microbiología , Bacterias Gramnegativas/aislamiento & purificación , Niño , Lesiones Oculares/complicaciones , Humanos , MasculinoRESUMEN
Abstract Objective: To identify the main causes of traumatic cataracts in childhood, based on a scientific review. Methods: Review in Lilacs, Pubmed, Cochrane, Bireme and Sciencedirect databases for the keywords: infant cataract, traumatic cataract, child, pediatrics, low vision, blindness, cause, incidence, ocular trauma. Results: Seventy-two (72) articles on traumatic cataract were found. From these, 17 presented tables relating the cause of ocular trauma to the formation of cataract in pediatrics. This article presents the main findings and analysis of the topic in the literature. Conclusion: The traumas etiologies which were most prominent in the studies analyzed were pointed objects such as cuttings, splinters and wood stick. Boys were more affected and there was a relation with practice of internal and external activities of domicile, in rural and urban zones.
Resumo Objetivo: Identificar as principais causas das cataratas traumáticas na infância, baseado numa revisão científica. Métodos: Pesquisa nas bases de dados Lilacs, Pubmed, Cochrane, Bireme e Sciencedirect com as palavras- chave: catarata infantil, catarata traumática, criança, pediatria, baixa visão, cegueira, causa, incidência, trauma ocular. Resultados: Foram encontrados setenta e dois (72) artigos sobre catarata traumática. Destes, 17 apresentaram tabelas relacionando a causa do trauma ocular com a formação de catarata em pediatria. Este artigo apresenta os principais achados e análise do tema na literatura. Conclusão: As etiologias dos traumas que apresentaram maior destaque nos estudos analisados foram com objetos pontiagudos como estaca, lascas e graveto de madeira. Meninos foram mais acometidos e houve relação com prática de atividades internas e externas ao domicilio, em zona rural e urbana.
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Catarata/etiología , Lesiones Oculares/complicaciones , Lesiones Oculares/etiología , Heridas no Penetrantes/complicaciones , Heridas Penetrantes/complicaciones , Catarata/epidemiología , Lesiones Oculares/epidemiologíaRESUMEN
La incidencia y la prevalencia de las uveítis varía alrededor del mundo, así como los agentes causales y el grupo de edad más afectado. De forma general, pueden asociarse a gran número de complicaciones oculares que originan marcada disminución de la visión, a veces de modo irreversible, e incluso pueden llevar a la ceguera de uno o de ambos ojos. Existe una asociación frecuente entre uveítis y glaucoma. La incidencia de glaucoma secundario a uveítis oscila sobre el 10 por ciento, con fluctuaciones relacionadas con su origen y la edad de presentación. Una parte de las uveítis cursa con hipertensión ocular más o menos marcada durante o después del proceso inflamatorio, lo que constituye un reto para el oftalmólogo, quien debe tratar simultáneamente dos entidades con terapéuticas prácticamente antagónicas. El tratamiento de la inflamación ocular está bien establecido; la hipertensión ocular debe ser tratada sobre la base de las características y el origen de cada entidad. Realizamos una revisión del tema por su importancia, así como de los elementos a tener en cuenta para un mejor resultado del tratamiento en estos pacientes. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud(AU)
The incidence and prevalence of uveitis vary around the world, and so do its causative agents and most affected age group. In general terms, these may be associated to a large number of ocular complications which cause marked, at times irreversible vision reduction, and may even lead to vision loss in one or both eyes. An association is often found between uveitis and glaucoma. The incidence of glaucoma secondary to uveitis ranges around 10 percent, with fluctuations related to its origin and presentation age. A form of uveitis develops with more or less marked ocular hypertension during or after the inflammation process. This is a challenge for ophthalmologists, who should treat two conditions simultaneously with practically opposite therapies. The treatment for ocular inflammation is well established, whereas ocular hypertension should be treated according to the characteristics and origin of each condition. Due to its importance, we conducted a review of the topic, as well as of the elements to be borne in mind to obtain better treatment results. Use was made of the platform Infomed, specifically the Virtual Health Library(AU)
Asunto(s)
Humanos , Uveítis/epidemiología , Lesiones Oculares/complicaciones , Glaucoma/epidemiología , Bibliotecas Digitales , Hipertensión Ocular/terapiaRESUMEN
La incidencia y la prevalencia de las uveítis varía alrededor del mundo, así como los agentes causales y el grupo de edad más afectado. De forma general, pueden asociarse a gran número de complicaciones oculares que originan marcada disminución de la visión, a veces de modo irreversible, e incluso pueden llevar a la ceguera de uno o de ambos ojos. Existe una asociación frecuente entre uveítis y glaucoma. La incidencia de glaucoma secundario a uveítis oscila sobre el 10 por ciento, con fluctuaciones relacionadas con su origen y la edad de presentación. Una parte de las uveítis cursa con hipertensión ocular más o menos marcada durante o después del proceso inflamatorio, lo que constituye un reto para el oftalmólogo, quien debe tratar simultáneamente dos entidades con terapéuticas prácticamente antagónicas. El tratamiento de la inflamación ocular está bien establecido; la hipertensión ocular debe ser tratada sobre la base de las características y el origen de cada entidad. Realizamos una revisión del tema por su importancia, así como de los elementos a tener en cuenta para un mejor resultado del tratamiento en estos pacientes. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud(AU)
The incidence and prevalence of uveitis vary around the world, and so do its causative agents and most affected age group. In general terms, these may be associated to a large number of ocular complications which cause marked, at times irreversible vision reduction, and may even lead to vision loss in one or both eyes. An association is often found between uveitis and glaucoma. The incidence of glaucoma secondary to uveitis ranges around 10 percent, with fluctuations related to its origin and presentation age. A form of uveitis develops with more or less marked ocular hypertension during or after the inflammation process. This is a challenge for ophthalmologists, who should treat two conditions simultaneously with practically opposite therapies. The treatment for ocular inflammation is well established, whereas ocular hypertension should be treated according to the characteristics and origin of each condition. Due to its importance, we conducted a review of the topic, as well as of the elements to be borne in mind to obtain better treatment results. Use was made of the platform Infomed, specifically the Virtual Health Library(AU)
Asunto(s)
Humanos , Uveítis/epidemiología , Lesiones Oculares/complicaciones , Glaucoma/epidemiología , Bibliotecas Digitales/estadística & datos numéricos , Hipertensión Ocular/terapiaRESUMEN
Resumo Um traumatismo ocular contuso pode gerar uma vasta gama de lesões intraoculares que são dependentes da quantidade de energia que o objeto transfere ao olho durante o impacto. As lesões da íris, malha trabecular e corpo ciliar podem repercutir na drenagem do humor aquoso. A ocorrência de uma ciclodiálise caracterizada pelo descolamento do corpo ciliar da parede escleral, criando uma comunicação entre a câmara anterior e o espaço supracoroidiano, pode provocar importante redução da pressão intraocular. Esta diminuição pressórica é a responsável pela ocorrência da maculopatia hipotônica que pode cursar com diminuição irreversível da acuidade visual. Não existe consenso na literatura sobre o tratamento das ciclodiálises. Neste relato, descrevemos um caso de ciclodiálise traumática pós impacto com projétil de arma de fogo tratada com aplicação de laser de argônio.
Abstract Blunt eye trauma can generate a wide range of intraocular lesions that are dependent on the amount of energy the object transfers to the eye during the impact. Lesions of the iris, trabecular meshwork and ciliary body may influence aqueous humor drainage. The cyclodialysis which is characterized by the detachment of ciliary body from the scleral wall, creating a communication between the anterior chamber to supracoroid space, can cause a several reduction of intraocular pressure. This pressure decrease is responsible for the occurrence of hypotonic maculopathy which may induce a severe impact on visual acuity. There is no consensus in the literature about cyclodialysis treatment. In this report, we describe a case of traumatic cyclodialysis after impact with a firearm projectile treated with argon laser photocoagulation.
Asunto(s)
Humanos , Femenino , Adulto , Enfermedades de la Retina/etiología , Heridas por Arma de Fuego/complicaciones , Hipotensión Ocular/etiología , Lesiones Oculares/complicaciones , Oftalmoscopía , Retina/diagnóstico por imagen , Enfermedades de la Retina/terapia , Enfermedades de la Retina/diagnóstico por imagen , Hemorragia Vítrea , Agudeza Visual , Hipotensión Ocular/terapia , Cuerpo Ciliar , Ultrasonografía , Coagulación con Láser/métodos , Tomografía de Coherencia Óptica , Párpados/lesiones , Microscopía con Lámpara de Hendidura , Gonioscopía , Mácula Lútea/diagnóstico por imagenRESUMEN
Ocular trauma is a signifcant problem worldwide. The objective of this study was to determine the characteristics of patients younger than 14 years who underwent traumatic cataract surgery at the Unit of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology "Dra. Ana María Illescas Putzeys" of Hospital de Ojos y Oídos "Dr. Rodolfo Robles V." A retrospective, descriptive, and observational study was carried out to review the medical records of patients who underwent cataract surgery between 2010 and 2015. A total of 54 children underwent traumatic cataract surgery; 75% were boys; 68% were in the 6-11-year-old age range. Blunt force trauma was observed in 57.4%. A visual acuity of 20/70 or better was achieved by 68.2% of patients.
El trauma ocular es un problema significativo en todo el mundo. El objetivo de este estudio fue determinar las características de los pacientes menores de 14 años operados de catarata traumática en la Unidad de Oftalmología Pediátrica, Estrabismo y Neurooftalmología "Dra. Ana María Illescas Putzeys", Hospital de Ojos y Oídos "Dr. Rodolfo Robles V.". Se realizó un estudio retrospectivo, descriptivo, observacional, en el que se revisaron expedientes de pacientes operados de catarata de 2010 a 2015. Se operaron 54 niños por catarata traumática, de los cuales 75% eran hombres. El 68% pertenecían al rango de edad de 6-11 años. El tipo de trauma fue cerrado en un 57,4%. Los pacientes que lograron una agudeza visual igual a 20/70 o mayor fueron el 68,2%.
Asunto(s)
Extracción de Catarata/métodos , Catarata/etiología , Lesiones Oculares/complicaciones , Heridas no Penetrantes/complicaciones , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Estudios Retrospectivos , Agudeza VisualRESUMEN
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.
Asunto(s)
Traumatismos en Atletas/complicaciones , Lesiones Oculares/complicaciones , Heridas no Penetrantes/complicaciones , Adolescente , Adulto , Traumatismos en Atletas/prevención & control , Traumatismos en Atletas/cirugía , Niño , Coroides/lesiones , Hemorragia del Ojo/etiología , Hemorragia del Ojo/terapia , Lesiones Oculares/prevención & control , Lesiones Oculares/cirugía , Dispositivos de Protección de los Ojos , Femenino , Humanos , Implantación de Lentes Intraoculares , Masculino , Persona de Mediana Edad , Desprendimiento de Retina/etiología , Desprendimiento de Retina/terapia , Rotura/etiología , Rotura/terapia , Resultado del Tratamiento , Heridas no Penetrantes/cirugía , Adulto JovenRESUMEN
An indoor-only, 5-year-old, spayed female domestic shorthair cat presented for an ophthalmic examination of the left eye. An intraocular tumor with secondary glaucoma and blindness was diagnosed; the globe was enucleated and sent for histopathological examination. Gross examination revealed a solid white mass filling the entire vitreous space and replacing the iris and ciliary body. The lens and retina appeared to be similarly replaced by the neoplasm. Histological examination revealed a complete loss of the internal ocular structures, with a ruptured capsule as the only remnant of the lens within an extensive malignant mesenchymal neoplastic cell proliferation. The cells were polygonal, with well-defined cytoplasmic borders and abundant weakly basophilic cytoplasm, embedded within the islands of chondroid matrix. No neoplastic invasion of the sclera was apparent. The animal died 6 months after the enucleation due to respiratory distress. Gross examination revealed numerous firm, white to tan nodular masses with smooth to mildly irregular surfaces dispersed throughout the parietal pleura, thoracic surface of the diaphragm, tracheobronchial and mediastinal lymph nodes, pericardium, and lungs. On cross-section, the neoplastic nodules were solid and variably translucent, resembling hyaline cartilage. Histologically, these nodules were similar to the neoplasm identified earlier in the left globe. Metastasis of post-traumatic ocular chondrosarcoma has not yet been described in cats. This is therefore believed to be the first report of metastases of this type of neoplasm in cats. This case adds to the limited set of data on the outcome of this type of tumor.
Asunto(s)
Enfermedades de los Gatos/diagnóstico , Gatos/lesiones , Condrosarcoma/veterinaria , Lesiones Oculares/veterinaria , Neoplasias del Ojo/veterinaria , Glaucoma/veterinaria , Neoplasias Pulmonares/veterinaria , Animales , Enfermedades de los Gatos/diagnóstico por imagen , Condrosarcoma/complicaciones , Condrosarcoma/diagnóstico , Condrosarcoma/secundario , Diagnóstico Diferencial , Enucleación del Ojo/veterinaria , Lesiones Oculares/complicaciones , Lesiones Oculares/diagnóstico , Neoplasias del Ojo/complicaciones , Neoplasias del Ojo/diagnóstico , Neoplasias del Ojo/patología , Resultado Fatal , Femenino , Glaucoma/complicaciones , Glaucoma/diagnóstico , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundarioRESUMEN
BACKGROUND: Carotid-cavernous fistula (CCF) is a shunt between the carotid artery and the cavernous sinus. Traumatic CCFs are diagnosed in 0.2% of head traumas being only 4.6% of the pediatric population. Classified by Barrow in 1985, type A CCF is the most frequent, occurring in 75% of cases. Type A is characterized by direct and high-flow CCF that generally can occur as a result of traumatic injury or rupture of an intracavernous aneurysm. CASE PRESENTATION: The subject was an 8-year-old boy with penetrating trauma to his left eye. During the initial evaluation, a computed tomography (CT) scan was unremarkable, and after relief of symptoms, the patient was discharged. Seven days later, he developed grade I proptosis, conjunctival chemosis, ophthalmoplegia (III, IV, and VI cranial nerve palsies), and left-sided ptosis and mydriasis. Arteriography confirmed a post-traumatic CCF, and the patient was treated with an endovascular detachable balloon. CONCLUSION: CCF should be suspected in craniofacial traumas with ocular symptoms. The presence of a skull base fracture on CT is a poor predictor of CCF associated with head trauma. Early diagnosis and treatment can prevent permanent neurological deficits and unfavorable outcomes.
Asunto(s)
Fístula del Seno Cavernoso de la Carótida/cirugía , Traumatismos Craneocerebrales/cirugía , Lesiones Oculares/cirugía , Heridas Penetrantes/cirugía , Fístula del Seno Cavernoso de la Carótida/diagnóstico por imagen , Fístula del Seno Cavernoso de la Carótida/etiología , Niño , Traumatismos Craneocerebrales/complicaciones , Traumatismos Craneocerebrales/diagnóstico por imagen , Procedimientos Endovasculares/métodos , Lesiones Oculares/complicaciones , Lesiones Oculares/diagnóstico por imagen , Humanos , Masculino , Heridas Penetrantes/complicaciones , Heridas Penetrantes/diagnóstico por imagenRESUMEN
Background: The development of Holmes tremor (HT) after a direct lesion of the midbrain has rarely been reported in the literature, although several etiologies have been linked with HT, such as stroke, brainstem tumors, multiple sclerosis, head trauma, or infections. Phenomenology Shown: A 31-year-old male, having been stabbed in the right eye, presented with a rest and action tremor in the left upper limb associated with left hemiparesis with corresponding post-contrast volumetric magnetic resonance imaging T1 with sagittal oblique reformation showing the knife trajectory reaching the right midbrain. Educational Value: Despite the rarity of the etiology of HT in the present case, clinicians working with persons with brain injuries should be aware of this type of situation.
Asunto(s)
Mesencéfalo/lesiones , Temblor/etiología , Heridas Punzantes/complicaciones , Adulto , Lesiones Oculares/complicaciones , Lesiones Oculares/diagnóstico por imagen , Lesiones Oculares/fisiopatología , Humanos , Masculino , Mesencéfalo/diagnóstico por imagen , Mesencéfalo/fisiopatología , Paresia/diagnóstico por imagen , Paresia/etiología , Paresia/fisiopatología , Temblor/diagnóstico por imagen , Temblor/tratamiento farmacológico , Temblor/fisiopatología , Heridas Punzantes/diagnóstico por imagen , Heridas Punzantes/fisiopatologíaRESUMEN
El trauma ocular es una causa importante de morbilidad oftalmológica en el mundo con implicaciones socioeconómicas importantes para el paciente y sus familiares. Ocurre generalmente en adultos jóvenes, con una buena agudeza visual al inicio del evento traumático, la cual se verá comprometida según la severidad del trauma, las estructuras oculares que afecte y las complicaciones que puedan aparecer. Presentamos dos pacientes con rotura escleral posterior secundario a trauma ocular a globo abierto contuso. Se describe el manejo personalizado el seguimiento en cada caso y sus resultados visualesa(AU)
The ocular trauma is an important cause of ophthalmological morbidity in the world with significant socio-economic implications for the patient and its relatives. It generally occurs in young adults, with good visual acuity at the beginning of the traumatic event, which may be affected by the trauma severity, the ocular structures that it affects and the possible complications. This is the report on two patients with posterior scleral rupture secondary to blunt open-globe ocular trauma. The customized management, the follow-up of each case and the visual results achieved were all described(AU)
Asunto(s)
Humanos , Masculino , Adolescente , Adulto , Lesiones Oculares/diagnóstico , Lesiones Oculares/terapia , Lesiones Oculares/complicaciones , Oftalmoscopios , Cámara Anterior/lesiones , Hemorragia Vítrea/diagnóstico , Vitrectomía/métodos , Agudeza VisualRESUMEN
El trauma ocular es una causa importante de morbilidad oftalmológica en el mundo con implicaciones socioeconómicas importantes para el paciente y sus familiares. Ocurre generalmente en adultos jóvenes, con una buena agudeza visual al inicio del evento traumático, la cual se verá comprometida según la severidad del trauma, las estructuras oculares que afecte y las complicaciones que puedan aparecer. Presentamos dos pacientes con rotura escleral posterior secundario a trauma ocular a globo abierto contuso. Se describe el manejo personalizado el seguimiento en cada caso y sus resultados visuales(AU)
The ocular trauma is an important cause of ophthalmological morbidity in the world with significant socio-economic implications for the patient and its relatives. It generally occurs in young adults, with good visual acuity at the beginning of the traumatic event, which may be affected by the trauma severity, the ocular structures that it affects and the possible complications. This is the report on two patients with posterior scleral rupture secondary to blunt open-globe ocular trauma. The customized management, the follow-up of each case and the visual results achieved were all described(AU)