An unusual intracerebral foreign body associated with eye trauma

A case report is presented of penetrating orbital trauma in the driver of a motor vehicle which collided with a kangaroo. A tooth fragment from the kangaroo traversed the orbit, lodging intracranially. Management of the case is described and appropriate choice of antibiotic regime discussed.     

Hexokinase distribution in the ocular lens

Background: Normal lens function is dependent on phosphorylation of glucose by the enzyme hexokinase. Age-related decreases in the activity of this enzyme could significantly alter the capacity of the lens to cope with stress and might lead to cataract formation. However, insufficient information is available to assess this possibility. Methods: The activity of hexokinase was measured in extracts from concentric tissue layers removed from baboon, chicken, fish, human, kangaroo and lion lenses. Results: A gradient of hexokinase activity was observed in all lenses tested. Activity was highest in the peripheral fibre cells and decreased rapidly to less than 10 per cent of the maximum one-third of the way into the lens. Conclusions: Hexokinase activity is only associated with cells capable of protein synthesis and is virtually absent from mature fibre cells. This suggests that there is very little need for carbohydrate metabolism in the central regions of the lens. It is concluded that disruptions in nuclear metabolism do not play a role in cataract development. (Clin Exp Optom 1995: 78: 4: 149–153)     

Development of the area centralis and visual streak in the grey kangaroo Macropus fuliginosus

To further our understanding of area centralis and visual streak formation we have investigated the distribution and number of the total cell population in the retinal ganglion cell layer of the western grey kangaroo Macropus fuliginosus using adults and young from 7-200 days postnatal. This species was chosen since, as we describe, the adult possesses a particularly prominent area centralis and visual streak. By studying the total cell population we were able to compare cell distributions in immature retinae, in which cell types could not be distinguished, with topography in the adult. By 57 days postnatal a weak visual streak was apparent; a pronounced area centralis and visual streak were seen by 84 days although densities across the retina, particularly in the far periphery, were still considerably higher than in the adult. Dying cells were also observed up to 160 days, but not at 188 days or in the adult. The fall of approximately one third in the total cell number as the area centralis and visual streak developed is presumably related to cell death. Furthermore, at 57 days, dying cells were seen preferentially in retinal regions outside the immature visual streak and may therefore play a part in refining density gradients to their mature form. As the area centralis and visual streak developed, the relative lengths of the dorso-ventral and naso-temporal axes remained similar, suggesting that differential radial growth cannot underlie the changing live cell density gradients.     

Malignant melanoma of the choroid in a naevus of Ota.

A rare case of choroidal malignant melanoma in a naevus of Ota is described. This is the first reported case from Asia outside the Japanese population. This case illustrates the need for close observation of all pigmented lesions of the eye.     

Combined coliform and anaerobic infection of the lacrimal sac

A case is reported of combined coliform and anaerobic bacterial infection of the lacrimal sac, a condition of which there is only one other published case report. In addition, a literature review is presented of the bacteriology of acute dacryocystitis as it applies to this case. Recommendations for the microbiological investigation and management of acute dacryocystitis are made.     

Sellar spine associated with endocrine and neuro-ophthalmological manifestations

A case of sellar spine, associated with neuro-ophthalmological and endocrine abnormalities, is reported. The case described is a rare malformation, of which the authors found only six cases in the literature.     

Role of Botulinum Toxin A in Diplopia following Orbital Decompression

Diplopia following orbital decompression is a common complication in Graves' ophthalmopathy. Strabismus surgery is often required to treat the persistent diplopia. The author presents a successful treatment with botulinum toxin A injection in a case of diplopia following orbital decompression. Treatment with botulinum toxin A in the management of new-onset diplopia following orbital decompression has been suggested in a case that is not amenable to prism treatment and may eliminate strabismus surgery in some cases.     

Role of botulinum toxin A in diplopia following orbital decompression

Diplopia following orbital decompression is a common complication in Graves' ophthalmopathy. Strabismus surgery is often required to treat the persistent diplopia. The author presents a successful treatment with botulinum toxin A injection in a case of diplopia following orbital decompression. Treatment with botulinum toxin A in the management of new-onset diplopia following orbital decompression has been suggested in a case that is not amenable to prism treatment and may eliminate strabismus surgery in some cases.     

Primary tuberculosis of the retina.

A case of pseudoglioma diagnosed on histopathology to be retinal tuberculosis is presented with a general review of the literature on ocular tuberculosis. The case is peculiar in that retinal tuberculosis occurred without concomitant involvement of the choroid.     

Pseudomonas-induced bilateral endophthalmitis with corneal perforation in a neonate.

Neonatal endophthalmitis is a rare entity that may be exogenous or endogenous. Pseudomonas aeruginosa is a ubiquitous gram-negative rod that may appear as a nosocomial source of infection in the neonatal intensive care unit. A case of bilateral Pseudomonas-induced endophthalmitis is presented, and a discussion of the case and of the relevant literature follows.     

Primary choroidal malignant melanoma occurring in a New Zealand Maori

Purpose/Method: A case of a 28-year-old Maori with an aggressive primary choroidal malignant melanoma is presented. Results/Conclusion: Melanoma and particularly intraocular melanoma is very rare in pigmented races. This is the first reported case in the Maori.     

Trabeculectomy for Traumatic Hyphema in Sickle Cell Trait

Abstract

A case report of a traumatic hyphema in a patient with sickle cell trait is presented. A review of the published literature in PubMed was performed and medical management strategies and surgical treatment indications for traumatic hyphema are discussed. We support the case for temporary trabeculectomy in patients with traumatic hyphema and sickle cell disease.     

Bilateral primary choroidal melanoma.

A case of bilateral primary choroidal melanoma is described in a 51-year-old white male. Histological confirmation followed enucleation of the left eye and local excision in the right. A careful systemic evaluation failed to demonstrate any other primary or secondary melanomata. This case is the first bilateral primary choroidal melanoma reported in the United Kingdom and the first to be described in which histological confirmation was obtained as a result of local excision of one of the tumours.     

Retinopatía anular externa aguda asociada al virus de la inmunodeficiencia humana

A case of acute annular outer retinopathy (AAOR) is presented in a patient that was later proved to be positive for the human immunodeficiency virus (HIV).The aetiology of AAOR remains unknown, although a viral infection or an autoimmune mechanism has been suggested. The case presented here is noteworthy because it is the first case described in a patient with HIV positive serology. Even so, the precise role played by HIV infection or secondary immunosuppression in the development of the AAOR is not known.     

Orbital tuberculoma masquerading as an orbital malignancy

Background: Orbital tuberculosis is exceedingly rare in areas where tuberculosis is non-endemic. A case of childhood orbital tuberculosis is reported, which the authors believe to be the first reported case of orbital tuberculosis in the Australasian region. Methods/Results: The patient, a 6-year-old boy, presented with proptosis and was initially mistaken to have an orbital malignancy. Treatment with antituberculous drugs resulted in resolution of the condition. Conclusion: This case served as a timely reminder of the need to keep awareness of the extrapulmonary manifestations of tuberculosis alive even in developed countries. A high index of suspicion for this eminently treatable disease in the appropriate clinical situation is particularly important when migrant communities from high-prevalence areas are involved.     

PTERYGIUM LEADING TO BLINDNESS: A CASE REPORT

A case report is presented of an aboriginal woman with a pterygium that covered the entire cornea, resulting in blindness. This case illustrates the fact that pterygia do not necessarily regress in eyes with deterioration of visual acuity.     

Bilateral subepidermal calcified nodules of the eyelid

A subepidermal calcified nodule (SCN) is an uncommon benign lesion, which usually develops in early childhood and is typically solitary. A rare form of this lesion has been reported in the eyelid. We report here a case of a 12-year-old girl with bilateral nodules of the right upper eyelid and a left lower eyelid simulating epidermal cyst. The histopathologic examination of the excised nodule confirmed the diagnosis. To our knowledge, this may be the first bilateral case of eyelid SCN reported in the literature.     

Congenital double lacrimal fistula

A case of congenital double lacrimal fistula is herein reported. Both fistulae were noted at the time of surgery to connect to the common canaliculus. To the best of our knowledge, this is the only case of a double fistula that has been reported.     

Oestrus ovis ophthalmomyiasis acquired in the UK: case report and scanning electron microscopic study.

A case of external ophthalmomyiasis acquired in the UK is reported. Oestrus ovis infestation of the external conjunctiva is described and a scanning electron microscopic study made of the first stage larvae. To our knowledge this represents only the third case reported of UK acquisition of ophthalmomyiasis.     

Germinoma of the Corpus Callosum

A case is described of a young man presenting with diabetes insipidus and a junctional scotoma. A diffuse infiltrating mass centred in the corpus callosum and suprasellar area is found, which on pathological examination proved to be a primary intracranial germinoma. The case illustrates that rarely the corpus callosum can be involved by this tumour and that diagnosis may be delayed in atypical presentations.KEYWORDS: collosal mass, corpus collosum, germinoma