A 41-year-old man presented for evaluation of a widespread eruption. The eruption started six months beforehand as bumps within pre-existing black tattoos over his trunk and arms. One month later, the patient developed eye pain and the diagnosis of a uveitis was made. A different eruption soon followed, which the patient described as patches of rough skin. Finally, the patient developed discrete patches of hair thinning. The clinical examination, history, skin biopsy findings, and elevated angiotensin-1 converting enzyme and immunoglobulin levels supported the diagnosis of systemic sarcoidosis, which manifested as a sarcoidal tattoo granuloma, perifollicular cutaneous sarcoidosis, and uveitis. (+info)
Pain management in blind, painful eyes: clinical experience with retrobulbar alcohol injection in 4 cases.
(3/15)
Ocular pain is often difficult to treat and may be caused by many eye diseases. The first step in pain management is medical therapy combined with analgesics; however, severe and resistant cases may require neurolytic eye blocks or definitive surgery. Retrobulbar block with neurolytic agents such as alcohol may be preferred, if the eye is cosmetically normal or the patient is medically or psychologically unsuitable for enucleation or evisceration. Here, we present our successful and efficient pain management using retrobulbar alcohol injection in 4 patients with painful blind eyes. Patients with neovascular glaucoma presenting with painful blind eyes were accepted to our clinic for pain management. The patients had continuous pain with an increasing severity in the recent months. We planned to perform retrobulbar alcohol injection as the pain of the patients was resistant to medical therapy. We noted measurement of verbal analogue scale for pain (VAS) before the block (7, 9, 9 and 10, respectively), after retrobulbar lidocaine and alcohol injection, at the postoperative 1st day, 1st, 2nd 3rd and 4th weeks, and 3rd, 4th, 5th, 6th and 12th months. Early and late complications were also recorded. On the first day after injection, no patient required additive analgesic therapy and their VAS scores were 0, 0, 0, and 3, respectively. Except for one patient who underwent enucleation because of a bacterial infection, the other three patients' VAS scores were 1, 0 and 1 at the 12th month assessment. We suggest that neurolytic retrobulbar block is an efficient pain management strategy in blind painful eyes. (+info)
Assessment of vision-related quality of life in dry eye patients.
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Topical nonsteroidal anti-inflammatory drugs for corneal abrasions in children.
(5/15)
QUESTION: Corneal abrasion from minor injury to the eye is common in both adults and children. Some of my colleagues prescribe topical nonsteroidal anti-inflammatory drugs (NSAIDs) for analgesia. How safe is this practice? ANSWER: Topical ophthalmic NSAIDs are a short-term effective treatment of the pain associated with corneal abrasions in children. Rare but serious complications have been reported in adult case-study series. Children with corneal abrasions should have follow-up appointments within 24 to 48 hours to assess healing, complications, and side effects of treatment, particularly if they are using topical NSAIDs. (+info)
We report a 74-year-old woman who presented with recurrent isolated abducens nerve paresis. Cranial magnetic resonance imaging revealed that the right abducens nerve was sandwiched between the right internal carotid artery and a persistent trigeminal artery (PTA) variant, which might have led to neurovascular compression of the abducens nerve, resulting in abducens nerve damage. Normal variants of PTA, which are cerebellar arteries originating from a precavernous portion of the internal carotid artery, must be carefully observed as such variants can potentially cause a neurovascular compression of the abducens nerve. (+info)
Spontaneous hemorrhage from orbital cavernous hemangioma resulting in sudden onset of ophthalmopathy in an adult--case report.
(7/15)
A 61-year-old woman presented with a very rare case of spontaneous bleeding from an orbital cavernous hemangioma manifesting as sudden onset of ophthalmic pain, proptosis, diplopia, and nausea. Magnetic resonance (MR) imaging and computed tomography (CT) revealed an intraconal, well-demarcated cystic mass with hemorrhage. The mass was immediately removed through a transcranial approach. Histological examination showed that the mass was a cavernous hemangioma. Ophthalmopathy was resolved by surgery. Orbital cavernous hemangioma is very common in adults, but spontaneous bleeding is extremely rare relative to intracranial cavernous hemangiomas. This rare case emphasizes the importance of careful neuroimaging evaluation with MR imaging and CT for diagnosing orbital cavernous hemangioma associated with spontaneous bleeding. (+info)
Recurrent symptomatic intraocular pressure spikes during hemodialysis in a patient with unilateral anterior uveitis.
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