scholarly journals Submacular Cysticercosis Successfully Treated through Conservative Management: Case Report

2020 ◽  
Vol 11 (2) ◽  
pp. 315-321
Author(s):  
Renata García Franco ◽  
Alejandro Arias Gómez ◽  
Juvenal Guzman Cerda ◽  
Marlon García Roa ◽  
Paulina Ramirez Neria
Keyword(s):  
Visual Acuity ◽  
Medical Management ◽  
Central Nervous System Involvement ◽  
Vitreoretinal Surgery ◽  
Visual Outcome ◽  
Clinical Findings ◽  
Ophthalmological Examination ◽  
Blurred Vision ◽  
Elevated Lesion ◽  
The Right

Appropriate medical management can be an alternative in those patients with submacular cysticercosis in whom achieving good visual outcome with vitreoretinal surgery is not possible. We report the case of a 25-year-old female who presented complaining of blurred vision in her left eye associated with photopsias and metamorphopsias of 3 months duration. Initial visual acuity in the right eye was 20/20 and 20/100 in the left eye. Upon indirect ophthalmoscopy in the left eye, a yellow-white, dome-shaped, elevated lesion with foveal involvement was observed. The rest of the ophthalmological examination proved normal. With clinical findings and images, submacular cysticercosis was diagnosed, and vitreoretinal surgery was suggested. Nevertheless, the patient did not accept the treatment; therefore, medical management was initiated. Central nervous system involvement was ruled out, and treatment with praziquantel and systemic prednisolone was initiated. Cysticercosis was resolved with significant improvement of her symptoms and visual acuity.

scholarly journals Ambliopia anisometropia

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Laya Rares
Keyword(s):  
Ophthalmological Examination ◽  
Blurred Vision ◽  
Anisometropic Amblyopia ◽  
Main Complaint ◽  
Maddox Rod ◽  
The Right ◽  
Test Cover ◽  
Myopic Astigmatism ◽  
Distance Fixation ◽  
Cover Test

Abstract: Anisometropic amblyopia is blurred vision due to refractive anomaly without any anatomical disorders of the eyes. It is frequently found among children in their growth and development periods. The prognosis depends on the ambylopia severity, management, patient’s obedience to the management, and age. We report a case of anisometropic amblyopia in a 8-year-old boy with his main complaint was blurred vision of both eyes. The ophthalmological examination showed the visual acuity of both eyes 6/40, PH 6/9. Several tests that showed normal results were as follows: eyeball movements to all directions; pupil responses to light; Hischberg test; cover test dan cover uncover test at near and far distance fixation; alternate cover test; and worth four dots and Maddox rod tests. Cyclopegical refraction with streak retinoscopy at 50 cm distance resulted in right eye S-4.00 C-3.00 x1800 6/9 and left eye S-1.25 C-3.25 x1800 6/7.5; autorefraction of right eye S-4.50 C-3.25 x70 and of left eye S-1.25 C-4.25 x1710. Anterior and posterior segments of both eyes were normal. Conclusion: In this case, the diagnosis was confirmed as anisometropic amblyopia and compound myopic astigmatism of the right and left eyes. The prognosis was dubia ad bonam. The patient was treated with maximal correction glasses and observed for the first four weeks, and then would be evaluated continuously untill the vision was normal. Keywords: amblyopia anisometropia, vision, refraction anomalyAbstrak: Ambliopia anisometropia merupakan gangguan penglihatan akibat kelainan refraksi tanpa disertai adanya kelainan anatomik pada mata yang sering terjadi pada masa perkembangan anak. Prognosis sangat tergantung pada derajat ambliopia, penanganan, kepatuhan pasien terhadap penanganan, dan usia pasien. Kami melaporkan kasus ambliopia anisometropia pada seorang anak berusia 8 tahun, dengan keluhan utama penglihatan kedua mata kabur. Dari pemeriksaan oftalmologik didapatkan visus ODS 6/40, PH 6/9. Beberapa pemeriksaan yang dilakukan memperlihatkan hasil normal, yaitu: pergerakan bola mata ke segala arah; respon pupil terhadap cahaya; Hischberg test; cover test dan cover uncover test pada fiksasi jarak dekat dan jauh; alternate cover test; serta worth four dots test dan Maddox rod test. Pemeriksaan refraksi sikloplegik dengan streak retinoscopy pada jarak 50 cm didapatkan mata kanan S-4,00 C-3,00 x1800 6/9 dan mata kiri S-1,25 C-3,25 x1800 6/7,5 dan pemeriksaan autorefraksi mata kanan S-4,50 C-3,25 x70 dan mata kiri S-1,25 C-4,25 x1710. Pemeriksaan segmen anterior dan posterior mata kanan dan kiri dalam batas normal. Simpulan: Diagnosis pada kasus ini ialah ambliopia anisometropia ODS dan astigmatisma miopikus kompositus ODS, dengan prognosis dubia ad bonam. Terapi yang diberikan ialah kacamata koreksi maksimal dan diobservasi selama 4 minggu pertama, dan akan dievaluasi terus sampai ketajaman penglihatan normaL. Kata kunci: ambliopia anisometropia, ketajaman penglihatan, kelainan refraksi

Bilateral fungal infection inducing a serpiginous-like picture

2020 ◽  
pp. 112067212090872
Author(s):  
Alvaro Fernández-Vega González ◽  
Carlos Fernández-Vega González ◽  
Beatriz Fernández-Vega Sanz ◽  
María Teresa Peláez ◽  
Jesús Merayo-Lloves
Keyword(s):  
Visual Acuity ◽  
Fungal Infection ◽  
Inflammatory Diseases ◽  
Histopathological Examination ◽  
Clinical Findings ◽  
Blood Analysis ◽  
Retinal Pigmented Epithelium ◽  
Pigmented Epithelium ◽  
Laboratory Investigations ◽  
The Right

Purpose: To report the clinical findings of a patient who presented with an atypical bilateral fungal retinitis that was established by retinochoroidal biopsy. Methods: Case report. Results: A 56-year-old systemically healthy man presented with progressive visual loss in his left eye for 3 weeks. Visual acuity was 20/40 in the left eye, and 20/20 in the right eye and fundus examination showed macular retinal pigmented epithelium changes in his left eye. Over the following four months, his lesions progressed to serpiginous-like widespread retinal pigmented epithelium atrophy and his visual acuity decreased to 20/100, but no signs of ocular inflammation were found. Treatment with oral corticoids, valganciclovir and trimethoprim/sulfamethoxazole showed no efficacy. Blood analysis and cultures, laboratory investigations, and imaging tests were carried out looking for infectious and inflammatory diseases, but all tests were negative. Two months later, the patient presented with the same kind of lesions in the other eye (right eye), so he was subjected to retinochoroidal biopsy. Histopathological examination of specimen revealed the presence of intraretinal and choroidal fungal hyphae. Oral voriconazole was initiated achieving clinical remission, but no visual improvement was obtained. The source of the infection remains unknown since all tests results were negative. However, his profession as brewmaster might be related to the origin of the infection. Conclusion: Diagnosis of intraocular fungal infection can be challenging. Retinochoroidal biopsy may be useful to establish the diagnosis in those atypical cases with nonrevealing workup and inflammation localized to the retina.

Neuro-ophthalmological manifestations of Behçet’s disease

2018 ◽  
Vol 103 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Ammr Alghamdi ◽  
Bahram Bodaghi ◽  
Chloé Comarmond ◽  
Anne Claire Desbois ◽  
Fanny Domont ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Behçet’S Disease ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Visual Outcome ◽  
Ophthalmological Examination ◽  
Behcet's Disease

BackgroundThe neuro-ophthalmological manifestations of Behcet’s disease (BD) are rare, and data regarding their characteristics and outcome are lacking.ObjectiveTo report prevalence, main characteristics and outcome of neuro-ophthalmological manifestations in BD.Patients and methodsThis is a retrospective monocentric study of 217 patients diagnosed with neuro-Behçet’s disease (NBD), of whom 29 (13.3%) patients presented with neuro-ophthalmological manifestations (55% of men and mean±SD age of 26±8 years). All patients underwent a detailed ophthalmological examination and were followed up in the internal medicine and the ophthalmology departments.ResultsNeuro-ophthalmological manifestations were the first presentation of BD in 45% of patients and developed later in the course of the disease in 55% of patients. They are divided into parenchymal (PM) and non-parenchymal (NPM)-related manifestations in, respectively, 13 patients (45%) and 16 patients (55%). PM included papillitis in seven patients (53.8%), retrobulbar optic neuritis in four patients (30.8%) and third cranial nerve palsy in two patients (15.4%). NPM included papilloedema related to cerebral venous thrombosis in all 16 patients, of whom 6 patients (37.5%) had sixth cranial nerve palsy. At initial examination, 93.1% of patients had visual alterations, including mainly decreased visual acuity visual field defects and/or diplopia. All patients were treated with corticosteroids and 79% of patients received immunosuppressive agents. After treatment, the visual outcome improved or stabilised in 66.7% of patients while it worsened in 33.3. The mean±SD logarithm of the minimum angle of resolution visual acuity improved from 0.4±0.3 at diagnosis to 0.2±0.3 after therapy. 10.3% and 3.4% of patients were legally blind at diagnosis and after therapy, respectively.ConclusionNeuro-ophthalmological manifestations of BD represented 13% of NBD. They could be potentially severe and disabling. Prompt treatment is the key factor in improving visual outcome.

scholarly journals Clinical features and treatment outcomes of endogenous Klebsiella endophthalmitis: a 12-year review

2020 ◽  
Vol 13 (12) ◽  
pp. 1933-1940
Author(s):  
Chun Yue Mak ◽  
Lawrence Pui-leung Iu ◽  
Helena Pui-yee Sin ◽  
Li Jia Chen ◽  
Grace Lui ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Prognostic Factors ◽  
Treatment Outcomes ◽  
Clinical Features ◽  
Visual Outcome ◽  
Ophthalmological Examination ◽  
Poor Visual Outcome ◽  
Ocular Symptoms ◽  
Clinical Records ◽  
High Index Of Suspicion

AIM: To identify the clinical features and treatment outcomes of endogenous Klebsiella pneumoniae endophthalmitis and investigate prognostic factors of poor visual outcome. METHODS: The clinical records of all patients diagnosed with endogenous Klebsiella endophthalmitis between January 2007 to December 2018 in Prince of Wales Hospital, Hong Kong, China were retrospectively reviewed. Thorough ophthalmological examination findings were recorded in the case note, including visual acuity testing, slit-lamp examination, indirect ophthalmoscopy and B-scan ultrasonography if media opacity precluded fundus viewing. RESULTS: A total of 18 eyes in 14 patients were identified. Bilateral involvement was noted in 4 patients (28.6%). Hepatobiliary sepsis was the source in 9 patients (64.3%). Culture of intraocular fluid was positive in 5 out of 18 eyes (27.8%). Mortality was noted in 2 patients (14.3%). Mean final visual acuity was 20/1500. Six out of 16 eyes had total loss of sight (37.5%) and 3 eyes required evisceration (18.8%). Multivariate linear regression revealed poor presenting visual acuity (P=0.031) and lack of fundus view due to vitritis (P=0.02) as prognostic factors of poor visual outcome. CONCLUSION: Visual outcome of endogenous Klebsiella endophthalmitis is poor. Poor presenting visual acuity and lack of fundus view predict poor visual outcome. High index of suspicion for endophthalmitis is important in Klebsiella sepsis patients with complaints of ocular symptoms. Ophthalmological screening is recommended in non-communicable patients with Klebsiella sepsis.

scholarly journals EMERGENCY TREATMENT FOR CENTRAL RETINAL ARTERY OCCLUSION ( CRAO )

2021 ◽  
Vol 1 (2) ◽  
pp. 7-8
Author(s):  
Nida Farida
Keyword(s):  
Visual Acuity ◽  
Emergency Treatment ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Blurred Vision ◽  
Retinal Artery ◽  
Ocular Chamber ◽  
The Right

Central retinal artery occlusion (CRAO) is a blinding event but not considered as a common emergency problem. Since awareness of the case is low, patients usually come to the ophthalmologist later than the golden period and havingthe worst prognosis. We report the case of patient with a central retinal artery occlusion that had visual improvement after emergency treatment.A 47-year-old woman with no comorbidities presented with symptoms of a sudden blurred vision, no pain or redness in the right eye (RE). Best-corrected visual acuity in the RE was 1/60. A relative afferent pupillary defect was observed in the RE. Ocular fundus examination of RE was suggestive of CRAO. Emergency treatment were performed, including rebreathing of expired CO2, ocular massage and ocular chamber paracentesis. One week later, the visual acuity was improved.This case highlights that fast and accurate response in acute management of CRAO should be conducted, especially within the golden hours which is less than 6 hours after the accident, to prevent permanent visual loss of thepatient.

scholarly journals A Case of Neurosarcoidosis with Labyrinthine Involvement

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Peter B. Johnson ◽  
Roxanne Melbourne-Chambers ◽  
Amit Manohar Saindane ◽  
Nilesh Desai ◽  
Myrton Smith
Keyword(s):  
Cranial Nerves ◽  
Central Nervous System Involvement ◽  
Visual Disturbance ◽  
Clinical Findings ◽  
Imaging Findings ◽  
Pituitary Dysfunction ◽  
First Case ◽  
Cranial Neuropathies ◽  
The Right ◽  
Temporal Bones

Sarcoidosis is a chronic granulomatous disease of unknown aetiology, which may involve any organ system. It most commonly occurs in adults with childhood involvement being rare. Central nervous system involvement is seen in up to 25% and typically involves meningeal disease resulting in multiple cranial neuropathies. Other common clinical findings include seizures, headache, dementia, and pituitary dysfunction. Imaging plays a central role in the diagnosis with typical findings including pachymeningeal and leptomeningeal enhancing lesions. Other imaging findings include lacunar and major territory infarcts, hypothalamic and infundibular thickening, hydrocephalus, and cranial nerve enhancement. We present a case of an eight-year-old male patient with progressive headache, visual disturbance, unilateral sensory hearing loss, and multiple cranial neuropathies. Imaging findings demonstrated the classic pachymeningeal and leptomeningeal enhancement along much of the skull base, as well as enhancement of the right and left second and eighth cranial nerves. Extensive inflammatory changes were noted in the temporal bones and paranasal sinuses. There was also enhancement of the right and left labyrinths. Sinus biopsy confirmed sarcoidosis. We present the first case to our knowledge of sarcoid labyrinthitis.

Active iris vascular tufts bleeding successfully treated with argon laser photocoagulation

2018 ◽  
Vol 28 (2) ◽  
pp. 241-242 ◽  
Author(s):  
Ambreen Sarmad ◽  
Fadi Alfaqawi ◽  
Monali Chakrabarti ◽  
Arijit Mitra ◽  
Bushra Mushtaq
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Case Report ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Active Bleeding ◽  
Blurred Vision ◽  
Argon Laser Photocoagulation ◽  
The Right ◽  
Effective Use

Purpose: Iris vascular tufts (IVT) are rare biomicroscopic capillary outgrowths from the pupillary margins. Patients are usually asymptomatic until presenting with blurred vision due to spontaneous hyphema or with raised intraocular pressure. Case report: A 61-year-old woman presented to eye casualty with left eye (LE) blurred vision and discomfort for 1 day. Her external ocular examination was unremarkable and visual acuity was 6/6 in the right eye (RE) and 6/9 in the LE. Biomicroscopic examination revealed a 2-mm hyphema in her LE and bilateral multiple small IVT and active bleeding from IVT at the pupillary margin of the LE at the 5 o’clock position. Diagnosis of LE active bleeding from IVT was made and she underwent argon laser photocoagulation directed at the source of bleeding. The bleeding stopped immediately after the second burn. She was followed up for 3 months; her visual acuity was 6/5 and 6/6 in the RE and LE, respectively, with no further problems. Conclusions: Iris vascular tufts are benign and recurrent hemorrhages are unlikely. Therefore, definitive argon laser photocoagulation or surgical treatment are reserved to arrest further episodes of hyphema. Our case demonstrates the effective use of argon laser photocoagulation to completely arrest active bleeding from IVT and excellent recovery of hyphema with no further problems for 5 years.

scholarly journals Optic neuropathy due to allergic fungal rhinosinusitis

2011 ◽  
Vol 02 (02) ◽  
pp. 180-182 ◽  
Author(s):  
Jiji Tresa Cyriac ◽  
Tambi Cherian ◽  
Wasna Ali Hadi ◽  
Joyce Jose
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Anterior Segment ◽  
Sinus Surgery ◽  
Automated Perimetry ◽  
Blurred Vision ◽  
Eye Color ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
The Right

ABSTRACTAn uncommon case of allergic fungal rhinosinusitis presented to the ophthalmology outpatient department of our hospital with complaints of blurred vision in the right eye of a few days duration and vague complaints of pain around the eyes. The visual acuity on examination was grossly reduced in the right eye and normal in the left eye. Color vision was normal. Anterior segment examination including pupils was normal. Dilated fundus examination was normal except for temporal pallor in the right optic disc. Automated perimetry and magnetic resonance imaging (MRI) scan of brain and orbit were done. The imaging report showed a bilateral pansinusitis with pressure on the right optic nerve. Perimetry showed a superior field defect on the right side. ENT consultation and computed tomography (CT) with contrast helped to diagnose this as a case of allergic fungal rhinosinusitis. The patient was started on systemic steroids under the care of the ENT surgeon. After a few days, pre-operative assessment showed a gross improvement of visual acuity. Endoscopic sinus surgery was done to remove the polyps and thick mucus material. Histopathologic examination confirmed allergic fungal mucin. Days after surgery, the visual acuity improved further and repeat perimetry showed gross improvement in the visual field. Good history taking and a detailed ophthalmic examination, keeping in mind the probable causes of loss of vision of few days duration with no findings other than a decreased visual acuity and a suspicious disc, were key to the early diagnosis and investigation in this case. This helped in early referral and management of the case before permanent damage and irreversible visual loss occurred. The optic nerve is a cranial nerve which, once damaged permanently, will not regenerate. The amount of sinus involvement was extensive on both sides and invariably the left optic nerve would have been involved in a few days, if intervention was delayed.

scholarly journals Pachymeningitis in a Patient With Granulomatosis With Polyangiitis; A Case Report

2021 ◽  
Vol 6 (2) ◽  
pp. 80-82
Author(s):  
Gholam Hossein Alishiri ◽  
Ehsan Rahmanian ◽  
Mahsa Ramezanpour
Keyword(s):  
Visual Acuity ◽  
Granulomatosis With Polyangiitis ◽  
Rare Complication ◽  
Brain Mri ◽  
Blurred Vision ◽  
Orbital Mass ◽  
Autoimmune Antibodies ◽  
Finger Counting ◽  
Nerve Paresis ◽  
The Right

Introduction: Granulomatosis with polyangiitis (GPA) is a systematic and necrotizing vasculitis with positive autoimmune antibodies. Some studies have reported the prevalence of eye involvement between 40%-50% of cases. Retro orbital granuloma is a rare complication of GPA which should be treated by surgical involvements, while pachymeningitis can be diagnosed by MRI and treated by medical management. In this study, we tried to present a case of GPA with optic neuritis and typical central nervous system (CNS) involvement, while there were no definite features of sinusitis or kidney injuries. Case Presentation: A 15-year-old girl was admitted because of blurred vision in her left eye. She was a known case of GPA three years ago with initial features, including left facial nerve paresis due to pan-sinusitis and pulmonary cavity. Neurologic evaluations, including sensory and motor features, were normal, too. Ophthalmologic examinations showed that visual acuity of the right eye was good, while the visual acuity in the left eye decreased to the point of finger counting at a distance of 20 cm. The left eye Marcus gunn test was positive (3+); anterior and posterior eye segments were normal. The patient was evaluated by brain MRI with gadolinium and a pathologic enhancement in the left cavernous was seen which had a pressure effect on the optic nerve. She was treated by intravenous methylprednisolone followed by rituximab. Conclusion: Reporting orbital mass in a patient who had GPA can be supposed as granuloma which needs a biopsy to confirm a diagnosis. In our case, the imaging manifestation was heterodox for granuloma, while neurosurgical consultation recommended drug treatment for pachymeningitis.

scholarly journals A case report of visual outcome in keratoconus with retinitis pigmentosa

2018 ◽  
Author(s):  
Chiun-Ho Hou ◽  
Yun-Wen Chen ◽  
Ken-Kuo Lin ◽  
Jiahn-Shing Lee ◽  
Lai-Chu See ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Retinitis Pigmentosa ◽  
Contact Lens ◽  
Contact Lenses ◽  
Life Quality ◽  
Visual Outcome ◽  
Visual Aids ◽  
Blurred Vision ◽  
Visual Rehabilitation

Abstract Background: It is uncommon to see retinitis pigmentosa in keratoconus patients. The main difficulty of visual rehabilitation for this is restricted visual field. We presented the treatment and gene screen of visual system homeobox 1 (VSX 1) gene in this case. Case presentation: A 24-year-old man with retinitis pigmentosa presented with progressively blurred vision. Slit lamp examination revealed Vogt’s striae over both eyes, and corneal topography indicated bilateral keratoconus. We had tested 5 exons of VSX 1 gene from him and the did not find mutation on direct sequence. To improve visual acuity, we prescribed keratoconus rigid gas permeable (RGP) contact lens for him with good efficacy. However, lens dislocation occurred occasionally. He could not find dislocated lens easily due to visual field restriction, so he asked for more stable visual aids. Therefore, we instead prescribed scleral lens (SL), which were more stable on the ocular surface and led to more stable vision. Visual acuity was also gained with SL, but the tolerance time for SL was shorter compared to that of keratoconus RGP contact lens. To compare the efficacy of these two lenses, we surveyed life quality using the National Eye Institute Visual Functioning Questionnaire – 25 in three situations: baseline, with keratoconus RGP contact lens, and with SL. Conclusion: The patient used the two lens types according to his needs, and benefited from vision rehabilitation with both keratoconus RGP contact lens and SL. Keywords: keratoconus; retinitis pigmentosa; rigid gas permeable contact lenses; scleral lenses.

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