New perspectives on old diseases.
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Biomedical subjects
Publications and source records attributed to E M Perlman.
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PURPOSE: To report a case of Arthrographis kalrae keratitis and to note that its clinical manifestation resembles Acanthamoeba corneal infection. METHODS: Case report. RESULTS: The patient's keratitis was caused by A kalrae, a very rare soil fungus. CONCLUSIONS: Arthrographis kalrae can cause a keratitis that manifests with severe photophobia and a slowly progressive corneal infiltrate whose symptoms can mimic Acanthamoeba. Our patient most likely acquired the fungus from exposure to soil and not from her contact lenses.
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Pterygium and pseudopterygium have long been known to induce astigmatism and may do so without entering the visual axis. We present a case report of a 34-year-old man with a traumatic pseudopterygium which produced a "dynamic" astigmatism, varying in different fields of gaze. Due to the pseudopterygium's attachment to the lateral canthus, it produced a tethering effect with markedly decreased vision and wrinkling of Descemet's membrane when the eye was directed away from the anchoring point. This model may apply to other ocular diseases where perilimbal attachments and adnexal adhesions to the corneal surface may occur; such connections should be looked for in cases with unexplained low levels of visual acuity.
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A simple mechanical binary search device is described that can be used to perform the Parks' three-step test. Instructions to make the device from light cardboard are provided.
Despite advances in microsurgical techniques, astigmatism after penetrating keratoplasty is still a perplexing problem. In this paper, using retrospective studies, experiments, and observations, the factors that seem most significant in creating excessive postoperative astigmatism are delineated. The difficulty of creating a circular recipient hole of the same size and shape as the donor button appears to be a prime area for clinical research and technical development.
Phacoanaphylaxis (lens-induced uveitis) is a potentially curable ocular inflammation secondary to lens truma. Recently we have seen three clinically undiagnosed enucleation specimens in our eye pathology laboratory with this entity. Our observations add an argument to the recent concept that early lens removal in cases of traumatic cataract with lens capsule rupture would ultimately lead to better visual results.
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In this article, a small series of cases is presented in which large refractive errors inadvertently result from a change in the brands of trephine used for corneal transplantations. From these experiences, it is evident that the corneal surgeon should be very cautious if he chooses to interchange various brands and types of trephines.