Optic neuropathy secondary to lymphoma

Optic neuropathy secondary to lymphomatous infiltration of the optic nerve developed in a patient who was in complete remission from treatment of a non-Hodgkin's lymphoma. This is the first reported case of an isolated optic neuropathy occurring in a patient in clinical and laboratory remission of non-Hodgkin's lymphoma. Recognition that such a complication can occur is important in that prompt treatment may lead to reversal of visual loss, as it did in this patient.     

Optic neuropathy secondary to radiotherapy for nasal melanoma

Optic neuropathy is a rare but important complication of radiotherapy used in the treatment of cancers of the head and neck, usually resulting in rapidly progressive blindness in one or both eyes. The case is presented of a 77-year-old woman with bilateral optic neuropathy resulting in blindness, secondary to radiotherapy for a melanoma of the nasal cavity. The onset of optic neuropathy occurred 9 months post-radiotherapy, at a cumulative dose of 6000 rad. The left eye was first involved, with the right eye becoming involved within 2 weeks. Despite treatment with oral anticoagulation and high dose intravenous methylprednisolone, there was progressive deterioration resulting in bilateral optic atrophy, with final visual acuities of perception of light in the right eye and no perception of light in the left eye. This case demonstrates that oral anticoagulation was ineffective in the treatment of progressive radiation-induced optic neuropathy.     

A comparison of sub-tenon block with peribulbar block in small-incision cataract surgery

Purpose:To compare the efficacy and safety of sub-tenon block to peribulbar block with respect to analgesia, akinesia, and complications.Methods:It is an observational study conducted at a government hospital in Karnataka. Seventy patients who came to the ophthalmology OPD for small-incision cataract surgery (SICS) under local anesthesia were included in the study. The participants were divided into two groups of 35 as per the surgeon. The pain was evaluated at the time of administration of the block, during the surgery, and during the postoperative period of 4 h. Akinesia was noted in both the groups and the time of onset of akinesia was noted. Any complications associated with the block such as chemosis or subconjunctival hemorrhage were also noted. Statistical analysis was done using PSS version 25.0, where P < 0.05 was considered significant.Results:The baseline pain score was higher in the peribulbar group (1.57). The onset of akinesia was faster in sub-tenons (90.34 s). Complete akinesia was achieved in 82.9% of patients after peribulbar block. There was no significant difference in complications in both groups.Conclusion:Sub-tenons block is an effective and safer technique of ocular anesthesia for SICS. It can be considered as an alternative to the conventional peribulbar block for SICS.     

白内障术后并发无张力性瞳孔1例

白内障囊外摘除术加人工晶状体植入术后并发无张力性瞳孔临床较为少见 ,而且缺乏有效的治疗方法 ,常被忽略。现将我们遇到的 1例报告如下。患者 ,女 ,6 0岁。因左眼视力下降 2年 ,视物不见 2个月 ,于 2 0 0 0年 10月 19日以左眼老年性白内障住院行手术治疗。既往有糖尿病史 7年     

Optic neuropathy secondary to cat scratch disease: case report

Optic neuropathy due to cat scratch disease is a relatively infrequent occurrence associated with macular star formation and is characterized by sudden painless loss of vision mostly unilateral. Bartonella henselae is well recognized as the etiologic agent in cat scratch disease. Ocular complications of the disease occur in up to 10% of patients and include neuroretinitis. Ocular bartonelosis is usually self-limited with complete or near-complete recovery of vision in otherwise healthy patients. A case of a boy with neuroretinitis caused by B. henselae is reported.     

Change in ocular alignment after topical anesthetic cataract surgery

Background  To report the incidence of, and change in ocular misalignment following topical anesthetic cataract surgery. Methods  Prospectively, 160 consecutive patients who were scheduled for cataract surgery under topical anesthesia were evaluated. All patients had a complete ophthalmic examination, including ocular alignment evaluation, just before and 1 day, 1 week, 3 weeks, and 2 months after cataract surgery. Results  Preoperatively, 26 patients had ocular misalignment. Mean deviation in these preexisting misalignment was 7.2 ± 6.8 prism diopters (PD). Postoperatively, the angle of deviation improved to 5.4 ± 7.4 PD. Acquired ocular misalignment after cataract surgery occurred in 12 of 160 patients (8%) at 1 day, and seven of 131 (5%) at 2 months. None of these seven patients sought medical attention for the diplopia. Conclusions  The overall incidence of topical anesthesia-related change in ocular alignment after uneventful cataract surgery was 5%. However, no patients had symptomatic diplopia. Topical anesthetic cataract surgery could abolish the risk of postoperative diplopia and improve the heterophoric status of preexisting misalignment. None of the authors has any financial interest in this study.     

鼻内镜手术致视神经损伤的临床研究

目的探讨应用鼻内镜行鼻窦手术的眼并发症发生原因及治疗方法。方法回顾性分析3例鼻内镜术后出现不同程度视功能损害者,对其视力、视野、眼电生理、对比敏感度等检查及治疗进行分析。结果鼻内镜手术操作不当可以引起视功能损伤。3例中1例经皮质类固醇冲击等治疗后视力及视野明显改善,另2例经治疗后改善不明显。结论鼻内镜手术因局部解剖位置的原因容易引起视功能损害,对于视力正常但仍主觉视力下降的患者,应行对比敏感度检查。鼻科医生必须熟练掌握相关解剖,对可能发生的眼部并发症予以足够的重视。     

Optic neuropathy secondary to dasatinib in the treatment of a chronic myeloid leukemia case

The drug dasatinib is a new therapeutic option for patients with chronic myeloid leukemia (CML) as well as acute lymphocytic lymphoblastic leukemia (ALL). However, the scientific literature has not reached a consensus regarding the types of secondary ophthalmologic effects that this drug may have. In this study, we present the case of a 36-year-old male patient who was treated with dasatinib. Two and a half months later, this patient began to experience progressive visual loss in the superior visual field of both eyes.After ruling out various diagnostic options and performing extensive complementary tests, the suspected diagnosis was compatible with optic neuropathy secondary to dasatinib. The patient partially improved after stopping this medication and receiving oral corticosteroid treatment.Although secondary ophthalmological effects related to dasatinib are practically non-existent, our case is the first to report optic neuropathy secondary to this drug.     

Optic neuropathy in uremia

We examined three patients who developed optic neuropathies while undergoing chronic hemodialysis. One patient developed severe bilateral deterioration of vision, but recovered totally four weeks after discontinuing deferoxamine chelation therapy. Another patient had bilateral visual loss associated with chronic papilledema of idiopathic increased intracranial pressure. A third showed atypically severe consecutive anterior ischemic optic neuropathy. The latter two patients showed little improvement with high-dose intravenous methylprednisolone therapy combined with more vigorous hemodialysis. These cases, in addition to those previously described, underscore the heterogeneity of optic nerve disease in patients with uremia.     

Natural course of photic maculopathy secondary to uncomplicated cataract surgery

We report on a 36‐year‐old man who developed photic maculopathy in the left eye shortly after uncomplicated cataract surgery. The visual acuity (VA) of the left eye was 6/39 and spectral domain optical coherence tomography (SD‐OCT), performed one week after surgery, revealed a hyporeflective space in the outer retina (a ‘partial‐thickness hole’) at the fovea. Microperimetry showed a relative central scotoma and multifocal electroretinogram (ERG) showed reduced responses within the central 10°. Two months later, VA in the felt eye improved to 6/6 and SD‐OCT showed an almost complete resolution of the ‘partial‐thickness hole’. Microperimetry showed the resolution of the relative scotoma at the fovea and multifocal ERG showed improved responses within the central 10°. SD‐OCT, microperimetry and multifocal ERG are useful tools in the diagnosis and follow‐up of photic maculopathy after uncomplicated cataract surgery. Its natural history may be characterised by resolution of both morphological and functional changes shortly after surgery.     

青光眼白内障联合手术治疗白内障继发青光眼

目的探讨白内障继发青光眼进行白内障青光眼联合手术的效果。方法28例（28只眼）白内障继发青光眼完成了超声乳化吸出及人工晶状体植入联合巩膜瓣下小梁切除术。结果术前视力〈0．1者22只眼,0．1～0．3者6只眼。术后视力〈0．1者13只眼,0．1～1．0者15只眼。术前平均眼压（34．30±9．32）mmHg,术后平均眼压（16．42±5．36）mmHg（1mmHg=0．133kPa）。25眼眼压降至正常范围,3眼经药物治疗达到正常范围。并发症主要是角膜水肿和浅前房。术后随访3～6个月。结论超声乳化吸出及人工晶状体植入联合巩膜瓣下小梁切除术对于白内障继发青光眼是安全和有效的。     

Optic neuropathy and central nervous system disease secondary to Sj?gren's syndrome in a child

The authors describe a 10-year-old girl in whom optic neuropathy and central nervous system (CNS) disease developed in association with primary Sj?gren's syndrome. There was angiographic evidence of cerebral vasculitis and multiple infarcts present on neuroimaging. Results of parotid biopsy, cerebrospinal fluid, and serologic analyses showed abnormalities that were consistent with the diagnosis of Sj?gren's syndrome. Although the patient had optic disc pallor on initial evaluation, her color vision and acuity improved with immunosuppressive therapy, as did her other neurologic symptoms. The authors believe this represents the first reported case of optic neuropathy and CNS disease associated with primary Sj?gren's syndrome in the pediatric population. The possibility of improvement in visual function with early institution of immunosuppressive therapy makes prompt diagnosis essential.     

Optic capture of the AcrySof intraocular lens in pediatric cataract surgery.

PURPOSE: To assess the results of acrylic intraocular lens (IOL) optic capture in children with cataract. SETTING: Department of Ophthalmology, Hospital de Clínicas José de San Martín, and Instituto de la Vision, School of Medicine, University of Buenos Aires, Argentina. METHODS: Eight children had cataract surgery. After lens and cortex aspiration, an AcrySof (Alcon) IOL was implanted in the bag. A primary posterior capsulorhexis was performed. The optic edges were slipped through the posterior capsule leaflets. Clarity of the visual axis, preoperative and postoperative best corrected visual acuities (BCVAs), and refraction were evaluated. RESULTS: The visual axis remained clear in all cases. No case required a secondary procedure. The mean preoperative BCVA was 0.06 +/- 0.06 (SD). Postoperatively, the mean BCVA was 0.88 +/- 0.11 and the mean spherical equivalent, +0.62 +/- 1.31. The mean follow-up was 28.9 +/- 5.3 months. CONCLUSION: Results show that the optic of an acrylic IOL may be captured through a posterior capsulorhexis in pediatric cataract surgery, combining the advantages of optic capture with a smaller incision and a decreased inflammatory response.