角膜后弹力层脱落复位一例

1病例患者女,31岁。双眼患葡萄膜炎16年。后因双眼继发青光眼,于1999年9月在我院行右眼小梁切除术。2005年3月于他院行左眼抗青光眼术。术前视力0.15。术后自觉左眼视物模糊,畏光溢泪,视力0.03。角膜水肿,治疗无好转。于2005年4月21日来我院。眼部检查:右眼:0.03,左眼:0.03。右眼眼压     

急性视网膜坏死综合征一例报告

患者 ,男 ,40岁 ,因“右眼红痛 ,视物模糊 ,伴眼前黑影飘动 2月”入院。曾在外院诊为“右眼葡萄膜炎” ,给予静滴抗生素、抗病毒药物及皮质类固醇治疗。右眼红痛症状缓解 ,视物模糊逐渐加重。入院查体 :全身检查无异常 ,化验检查正常。右眼视力光感 ,眼压 11ｍｍＨｇ(1ｍｍＨｇ =0 133ｋＰａ)。右眼轻度睫状充血 ,角膜透明 ,角膜后少许细小灰白色点状沉着物 ,前房深度正常 ,Ｔｙｎｄａｌｌ征弱阳性 ,瞳孔大小、光定位正常 ,无后粘连 ,晶状体透明 ,玻璃体灰白色絮状浑浊 ;眼底视盘色淡 ,边界模糊 ,全视网膜浅脱离 ,黄斑区受累 ,动脉呈串珠状…     

玻璃体切割术治疗眼内玻璃异物存留十年1例

患者 ,男 ,2 1岁。主诉 :右眼红、痛、视物不见 ,门诊拟诊“右眼内异物、色素膜炎”10天 ,于 2 0 0 2年 10月 12日入院。十年前患者右眼不慎被爆炸的灯泡炸伤 ,即在当地医院眼科就诊 ,经眼部及 B超检查提示 :右眼玻璃体异物。 X线拍片 :未见金属异物。诊为 :右眼角膜穿通伤、右眼外伤性白内障、眼内异物 ,并行角膜穿通伤清创缝合术及白内障摘除术。因当地医院条件有限 ,未行眼内异物取出 ,术后右眼视力 0 .0 2。十年来右眼无明显不适 ,未予进一步诊治。全身检查未见异常。眼部检查 :视力右眼数指 /眼前 ,左眼 0 .2 (- 2 .2 5 DS→1.0 )。…     

真性晶状体囊膜剥脱

患者男性,85岁.因双眼视物模糊30年,于2011年5月4日来广东省汕头市中心医院眼科就诊.既往无眼外伤史,否认葡萄膜炎等疾病史,否认糖尿病、高血压病等全身疾病史,否认高温环境工作史.全身体检未见异常.眼部检查:双眼视力均为0.25,角膜透明,房水清,晶状体混浊.诊断:双眼老年性白内障.行右眼超声乳化白内障吸除及人工晶状体植入术后2d,左眼视力下降,眼部检查:左眼视力为0.15,眼压为26.7 mm Hg(1 mm Hg=0.133 kPa),瞳孔区晶状体前囊膜透明膜状物附着,约2 mm×2 mm.左眼相干光断层成像术检查:晶状体前囊膜层状剥脱(精粹图片1).诊断:左眼老年性白内障;左眼真性晶状体囊膜剥脱.     

节段状视网膜动脉周围炎1例

患者男性，31岁。因右眼视物模糊4d来我院门诊就诊。患者既往体健，否认风湿、结核及其他病史。眼部检查：视力右眼0．1，左眼1．0，右眼结膜充血，角膜透明，房水闪辉（＋＋），眼压右眼14mmHg（1mmHg=0．133kPa），左眼13mmHg，眼底窥不清。考虑为葡萄膜炎，     

信息动态

例1,女,72岁.因右眼视物模糊6个月就诊于内蒙古自治区人民医院眼科.患者1年前曾在内蒙古自治区人民医院眼科行右眼白内障超声乳化联合人工晶状体植入术,术中植入亲水性丙烯酸酯人工晶状体(intraocular lens,IOL),术后3d术眼矫正视力1.0.6个月前患者自觉右眼视物模糊,无明显诱因,未治疗.眼科检查:右眼视力0.2,矫正后视力不提高,眼压16 mmHg(1 mmHg=0.133 kPa).右眼外眼未发现异常,角膜透明,前房深度中等,晶状体前囊膜皱缩,囊袋口缩小,IOL襻蜷缩,IOL偏心、移位,眼底隐约可见视盘边界清,色泽正常,视网膜平伏,余窥不清(图1,2).左眼检查未见明显异常.初步诊断:右眼晶状体囊袋皱缩综合征(capsule contraction syndrome,CCS).行右眼晶状体前囊膜环形剪除术,解除IOL的蜷缩及偏心、移位(视频).术后3d患者右眼视力1.0,眼部手术伤口愈合,出院(图3,4).     

睫状体无色素上皮腺瘤一例

患者女性,51岁,右眼无痛性视力下降1年.患者于1年前无明显外因出现右眼视物模糊,无红痛、视物变形,无头痛、恶心、呕吐等不适,未引起重视,未诊治.近1年来,视物模糊进行性加重,无其他眼部不适.于2010年8月18日来温州医学院附属第一医院门诊,行眼部B超检查示右眼鼻侧睫状体占位(图1),拟诊"右眼睫状体部肿瘤,右眼白内障",建议手术治疗.     

人工晶状体植入术后致角膜穿孔一例

患者,男,73岁。右眼老年性白内障于1997年9月在当地医院行白内障囊外摘出联合人工晶状体植入术。术后一直感右眼胀痛,视物模糊,用药不详。1998年5月来我院门诊,眼部检查:右眼视力强光感/眼前,角膜雾状浑浊,大泡样改变,角膜中央穿孔,人工晶状体下襻脱出眼外(图1),眼内结构窥不清。入院后,全身检查,未见异常。局麻下行右眼人工晶状体取出联合前段玻璃体切除及角膜板层移植术,术中发现虹膜萎缩,玻璃体溢入前房。术后3月随访植片成活,视力强光感/眼前。眼压正常。讨论:人工晶状体植入术后,几乎每例均可发生不同程度的眼内炎症反应。但致角膜穿孔…     

水凝胶人工晶状体混浊一例

患者女．70岁。因右眼视物模糊3个月，于2001年12月来我院就诊。患者曾因双眼葡萄膜炎，屈光不正，并发性白内障，分别于2000年10月和12月在我院行左、右眼超声乳化白内障摘除后房型人工晶状体（intraocular lens,IOL)植入术。右眼术中使用美国Alcon公司的BSS和正大福瑞达     

准分子激光原位角膜磨镶术后眼外伤致角膜瓣下上皮植入一例

患者女性,46岁。因右眼视物模糊、视力明显下降半年到内蒙古医科大学附属医院就诊。患者10年前曾行准分子激光原位角膜磨镶术（laserinsitukeratomileusis,LASIK）,术后双眼视力均为1.0。患者自述一年前曾因羽毛球击伤右眼后畏光、流泪伴视物不清半天,于外院治疗。治疗期间,患者未向其经管医师表明曾在10年前行LASIK,经管医师遂按照常规角膜炎处理。本院此次眼部检查的结果为,     

Anterior uveitis in the absence of scleritis in a patient with rheumatoid arthritis: case report

Rheumatoid arthritis is the most common collagenosis and affects almost 0.6% of Brazilian population. It is an important cause of articular deformities. The main ocular manifestation of rheumatoid arthritis is dry eyes (secondary Sj?gren's syndrome), followed by scleritis, peripheral ulcerative keratitis and uveitis. The aim of this paper is to present a case of anterior uveitis in the absence of scleritis in a patient with rheumatoid arthritis, a very rare presentation in this type of patient. Female patient, 55 years old, with rheumatoid arthritis, presenting suddenly ocular pain and low vision in the right eye. Her exam showed anterior chamber reaction with hypopion, peripheral corneal keratitis and intraocular pressure of 32 mmHg. She was diagnosed with hypertensive anterior uveitis and peripheral corneal keratitis and treated with systemic and topical corticosteroids, topical antibiotic, topic and systemic ocular hypotensive and mydriatic drops. Anterior uveitis is common in rheumatological diseases, especially in those seronegative arthropathies related to HLA B27. In this paper we present a patient with rheumathoid arthritis and anterior uveitis in the absence of scleritis, a rare presentation in actual medical literature.     

Recurrent bilateral retinal vasculitis as a manifestation of post-streptococcal uveitis syndrome

We report a case of post-streptococcal uveitis mainly presenting with bilateral recurrent retinal vasculitis in Korea. A 14-year-old Asian female presented with decreased visual acuity of 20 / 30 in the right eye and 20 / 25 in the left eye. The patient had a history of glomerulonephritis nine months before onset of uveitis. The manifestation of uveitis was predominantly retinal vasculitis. We presumed post-streptococcal uveitis because probable streptococcal infection was confirmed by anti-streptolysin O titer elevation. With topical and oral steroid treatments, the patient experienced complete vision recovery. Post-streptococcal uveitis occurs rarely and mostly involves young patients in the form of non-granulomatous anterior uveitis. However, as this case shows, it may primarily involve the posterior uvea without anterior inflammation and may recur.     

Juvenile xanthogranulomatosis with bilateral and multifocal ocular lesions of the iris, cornealscleral limbus, and choroid

A 14-month-old boy with juvenile xanthogranuloma skin lesions presented with increased intraocular pressure, hyphema, anterior uveitis, iris mass, and a subconjunctival limbal mass of the right eye. He subsequently developed a subretinal mass in the left eye. The anterior uveitis resolved after 2 periocular injections of triamcinolone in addition to the administration of topical prednisolone and oral prednisone and methotrexate. The subretinal mass in the left eye also resolved during the course of 1 year. He developed a cataract in the right eye and underwent lensectomy with anterior vitrectomy. This is the first published case in which methotrexate was used as an adjunctive treatment of juvenile xanthogranuloma in a child.     

Hypotony Maculopathy in a Patient with HLA-B27-associated Uveitis

Purpose: To describe a patient with HLA-B27-associated anterior uveitis who developed hypotony maculopathy. Methods: Visual acuity, biomicroscopic slit-lamp examination, and fluorescein angiogram. Results: Following an episode of acute anterior nongranulomatous HLA-B27-associated uveitis, the patient developed decreased vision, choroidal folds, optic disc edema, and a serous exudative detachment characteristic of hypotony maculopathy. The intraocular pressure was noted to be 4 mmHg. Following therapy with topical 1% prednisolone acetate and 5% homatropine, both the intraocular pressure and retinal anatomy normalized. Conclusions: Hypotony maculopathy may be seen in patients with HLA-B27-associated uveitis and should be considered as a cause of vision loss in patients with this condition.     

Intralenticular metallic foreign body

Background: Intralenticular metallic foreign bodies may be well tolerated for many years.
Case Report: A 24-year-old Caucasian man was referred with an intralenticular metallic foreign body present in the left eye for five days. Following initial treatment with topical steroid and antibiotic, the lens remained clear and visual acuity normal. Two years later the left eye developed an anterior uveitis, with reduced vision. A left phacoemulsification lens extraction with removal of the intralenticular foreign body and insertion of a posterior chamber intraocular lens was performed.
Conclusion: Management of intralenticular metallic foreign bodies may be conservative till intraocular inflammation or cataract develops.     

Chronic postoperative endophthalmitis due to pseudomonas oryzihabitans

PURPOSE: To report a case of chronic postoperative endophthalmitis caused by the gram-negative bacterium Pseudomonas oryzihabitans.DESIGN: Interventional case report.METHODS: A 77-year-old man was referred to our service for nonpainful uveitis in the right eye accompanied by increased intraocular pressure of 2 years' duration with onset 4 months after uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens implantation. The uveitis partially responded to topical corticosteroid therapy but was recurrent with tapering of steroids. An anterior chamber tap and vitreous biopsies sent for cultures were negative. Owing to the persistence of inflammation despite intraocular vancomycin injection, the lens implant and capsule were removed and culture of the latter revealed the bacterium P. oryzihabitans.RESULTS: There was no recurrence of inflammation after removal of the lens implant and capsule.CONCLUSIONS: Unlike other gram-negative organisms, which are associated with poor outcomes, P. oryzihabitans may masquerade as chronic uveitis because of its low virulence.     

晶状体内金属异物1例

我们报道1例45岁晶状体内残留铁片伴轻微前葡萄膜炎症状患者。局部使用睫状肌麻痹剂和皮质类固醇后视力改善。6mo后由于白内障形成,视力严重恶化。而晶状体囊外切除联合异物取出术联合后房型人工晶状体植入术后视力明显恢复。本研究说明白内障人工晶状体植入手术能使保守治疗无效的白内障所导致的低视力获得良好的视力。     

Intraocular involvement as initial symptoms of non-Hodgkin lymphoma

BACKGROUND: The diagnosis of a intraocular lymphoma is often delayed because of a symptomatic pseudouveitis. CASE REPORT: We report on a 68-year-old female patient, who was referred because of a tumor of the optic disk in her right eye and bilateral uveitis with secondary glaucoma. The painful blind right eye was enucleated. The assumed diagnosis of a pseudouveitis as an initial manifestation of a B-cell lymphoma was confirmed histologically. She developed systemic extension and recurrence in the second eye despite polychemotherapy. The patient died from complications of her systemic tumor disease 15 months after initial symptoms. CONCLUSIONS: An initially unilateral and later bilateral uveitis in elderly patients which does not respond to steroid therapy could also be suspicious for an intraocular lymphoma. If the conjunctiva is not involved, the confirmation of the diagnosis requires a diagnostic viteous biopsy.     

Tubulointerstitial nephritis and uveitis with bilateral multifocal choroiditis

PURPOSE: To report a case of bilateral multifocal choroiditis secondary to tubulointerstitial nephritis and uveitis. METHODS: Case report. A 16-year-old women with an 11-month history of tubulointerstitial nephritis and uveitis and bilateral anterior uveitis developed bilateral multifocal choroiditis. After initial unsuccessful treatment with topical steroids, treatment was augmented by a 2-week course of systemic prednisone. RESULTS: Intensive steroid treatment resulted in steroid-induced glaucoma, which required bilateral trabeculectomies, but the uveitis became inactive. Two years after uveitis onset, bilateral intraocular pressure was normal, there were occasional (12+) anterior chamber cells, and inactive depigmented chorioretinal lesions on topical steroid drops. See also pp. 764-768, 798-799. CONCLUSIONS: Tubulointerstitial nephritis and uveitis usually involves only the anterior uvea, although a few cases of posterior uveitis have been described. This article reports a case of multifocal choroiditis associated with tubulointerstitial nephritis and uveitis. It is important for ophthalmologists to be aware of possible posterior uveal involvement in tubulointerstitial nephritis and uveitis so they can choose the most appropriate immunosuppressive therapy for the uveitis.     

Optic Disc Atrophy in Patient with Posner-Schlossman Syndrome

A 32-year-old man with blurred vision in the right eye and headache presented with anterior uveitis, an intraocular pressure (IOP) of 60 mmHg, an open angle, no visual field defects, and normal optic nerve. He had a history of five previous similar attacks. In each of the previous instances, his anterior uveitis and high IOP were controlled with antiglaucoma medications and topical steroids. However, at the fifth attack, his optic disc was pale and a superior paracentral visual field defect was shown. Brain magnetic resonance image studies were normal. This case represents that a recurrent Posner-Schlossman syndrome (PSS)-induced optic disc atrophy likely due to ocular ischemia caused by a recurrent, high IOP. Although PSS is a self-limiting syndrome, we should manage high IOP and prevent ischemia of the optic nerve head by treating with ocular antihypertensive medications.