Chlamydial infection producing keratoconjunctivitis of the corneoscleral limbus.
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Chlamydia Infections↗
Biomedical subjects
H D Perry
Publications and source records attributed to H D Perry.
Systemic tetracycline hydrochloride as adjunctive therapy in the treatment of persistent epithelial defects.
Recent evidence shows tetracyclines have anticollagenolytic activity that may be clinically effective in disease treatment. This led us to use systemic tetracycline (oral tetracycline hydrochloride 1 g daily divided into 4 doses) as adjunctive therapy in treating 18 patients with persistent corneal epithelial defects. Fourteen of 18 patients healed their defects; within 48 hours (9 patients) and within two weeks (the other 5 responding patients). Two patients showed no effect and two showed disease progression.
Adolescent↗
Serious corneal complications associated with extended-wear soft contact lenses for myopia.
Three patients wearing extended wear contact lenses for correction of myopia presented with severe corneal complications including corneal ulcers and corneal infiltrates. All cases were assembled over a four-month period, reflecting the alarming rise in severe corneal complications related to increased usage of these lenses. We feel indiscriminate dispensing and lack of proper follow-up care are primary contributing factors in the near epidemic rise in severe corneal problems related to this usage. Two of our three patients had significant permanent visual loss following resolution of their contact lens problems.
Adolescent↗
Retinal arteriolar occlusion in multiple sclerosis.
A 25-year-old white man presented with acute multiple sclerosis manifested by right blindness, difficulty urinating, and paresthesias and weakness of both legs. Retinal examination revealed a distal occlusion of the descending branch of the superior temporal arteriole leading to an area of retinal ischemia of the right eye. The optic disc was edematous, and there were focal areas of periphlebitis. All retinal signs resolved in three weeks, and the only abnormality that persisted was a pale right optic disc. The finding of small arteriolar disease is unusual and may represent another possible pathogenetic mechanism in multiple sclerosis.
Adult↗
Reis-Bücklers dystrophy: a study of eight cases.
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Adult↗
Factors related to corneal epithelial complications after closed vitrectomy in diabetics.
In a series of 30 vitrectomy patients, postoperative corneal complications developed in 14 (47%). Thirteen (92%) of the 14 patients with complications were diabetic. Other factors that were positively correlated with the development of corneal complications included decreased corneal sensitivity, intraoperative lensectomy, and intraoperative epithelial debridement. The corneal complications involved the epithelium in 11 (78%) of the 14 complicated cases, with involvement of the endothelium (as manifested by stromal edema) in five (35%) cases. The diabetic human corneal epithelium contains considerable levels of sorbitol and fructose, which indicates the probable presence of the sorbitol pathway. As in the lens, this pathway may lead to osmotic changes that make the diabetic corneal epithelium more vulnerable to damage intraoperatively. Postoperatively, reepithelialization is delayed because of a probable failure of adhesion of cells to the underlying basement membrane.
Cornea↗
Schirmer test after topical anesthesia and the tear meniscus height in normal eyes.
The height of the inferior tear meniscus was measured in 86 normal eyes. A value greater than 0.1 mm was obtained in 93% of the eyes that were studied. However, attempts to correlate meniscus height with subsequent Schirmer test results showed that these measurements varied randomly. Schirmer tests that were conducted on 265 eyes without instillation of 0.5% proparacaine hydrochloride and on 466 eyes with proparacaine showed that topical anesthesia reduced mean test values by 40%. When proparacaine was used prior to testing, no decrease in tear production with advancing age was demonstrated, nor were results significantly different in males and females. Schirmer test values, ranging from 0 to 3 mm, were obtained in 15% of the normal volunteers when the test was performed after instillation of topical anesthesia and after blotting of the tear lake from the inferior cul-de-sac.
Adult↗
Iris involvement in granulocytic sarcoma.
A 6-year-old boy with a diagnosis of acute myeoblastic leukemia in remission developed iris infiltration accompanied by uveitis, hypopyon, and vitreous hemorrhage, which was initially unilateral, later becoming bilateral. Pathologically, the eyes showed leukemic infiltrates in the conjunctiva, episclera, sclera, ciliary body, trabecular meshwork, canal of Schlemm, choroid, vitreous, and the iris. Leder stain studies showed positive esterase activity, indicating granulocytic sarcoma. Granulocytic sarcoma may appear intraocularly as iris nodules. These iris nodules may be the initial manifestation of granulocytic leukemia.
Antineoplastic Agents↗
Oversize corneal donor grafts in penetrating keratoplasty.
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Aged↗
Reversible blindness in optic neuritis associated with influenza vaccination.
A patient is reported in whom bilateral optic neuritis developed following an influenza vaccination. From complete blindness (absence of light perception) in one eye, the patient's vision returned to normal following steroid treatment.
Blindness↗
Sustained release of BCNU for the treatment of intraocular malignancies in animal models.
Sustained release of 1,3-bis(2)chloroethyl)-1-nitrosourea (BCNU) via an episcleral implanted silicone device was used to treat Brown-Pearce epithelioma in the anterior chamber of rabbit eyes. One group of test eyes received BCNU dissolved in sesame oil; a second group received BCNU in pure ethanol. Control eyes received only the diluent, sesame oil or pure ethanol. The effectiveness of the various dosages and diluents was compared by clinical observation, by weight of the enucleated eyes, and by histopathologic examination. Sustained release of BCNU via an episcleral implanted silicone device delayed the growth of Brown-Pearce epithelioma in rabbit eyes of both test groups. The most effective action resulted from administration of BCNU in pure ethanol.
Animals↗
An illuminated grid for macular testing.
The status of the macula should be included in the preoperative evaluation of patients about to undergo keratoplasty or cataract extraction. Frequently, corneal opacities or cataracts preclude visualization of macular details. In such cases, the Amsler grid is useful in assessing macular function. This study evaluated 15 patients with opaque media. In 13 patients, the opacity was too dense to allow the patient to see the Amsler grid. However, all 13 patients could see the illuminated version of the grid. Of the three abnormal responses detected by the use of the illuminated grid, two were caused by macular pathology and one by amblyopia.
Adult↗
Cysticercosis of the eyelid.
A 14-year-old girl had a four-month history of a painless, enlarging mass in the right upper eyelid. Histopathologic examination revealed the cystic mass to be Cysticercus cellulosae, the larval form of Taenia solium. This patient had been in Vietnam and Laos several years previously and, while there, developed a flu-like syndrome. Despite the fact that she was asymptomatic for the two years preceding her clinical examination, the histopathologic diagnosis of C cellulosae prompted an extensive medical and neurologic work-up to rule out the possibility that the patient harbored the adult tapeworm or other larval forms. Fortunately, the results of this survey were negative.
Adolescent↗
Corneal complications after closed vitrectomy through the pars plana.
A retrospective study of 150 patients who underwent closed vitrectomy through the pars plana evaluated the incidence and character of postoperative corneal complications. Corneal changes developed in 43% of patients. Thirty patients had significant corneal complications, half of which resolved with treatment. Fourteen patients had complications that necessitated corneal surgery or resulted in loss of useful vision. Diabetic patients were at greatest risk for corneal problems, particularly postoperative epithelial defects. Intraoperative lensectomy was the only other factor that increased the corneal complication rate. The importance of early recognition and therapy for corneal changes after vitrectomy becomes apparent.
Corneal Diseases↗
Corneal donor material selection.
Histologic study of eyes used as donor material for corneal transplant revealed one instance of massive leukemic infiltration with leukemic keratic precipitates on the fellow eye. In another eye, microabscesses composed of acute and chronic inflammatory cells containing Crytococcus neoformans were present. In a third patient metastatic anaplastic cells were present in the choroid. We think donor eyes are absolutely unacceptable if death was caused by any chronic neurologic disorder, unless clearly secondary to trauma. Eyes from patients with septecimia, hepatitis, jaundice and any evidence of any active viral infection, syphilis, and positive serology are also unacceptable. Extreme caution should be used in selecting eyes of patients with ocular or systemic malignancy, long-term diseases, particularly if immunosuppressive agents were used, where a history of eye disease exists, including corneal disease or dystrophy, iritis, absolute glaucoma or acute glaucoma, and eyes with a history of previous intraocular surgery.
Bacterial Infections↗
Direct delivery of anticancer agents: experimental treatment of intraocular malignancy.
Two anticancer agents, one lipophilic, 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), and one hydrophilic, 5-(3,3-dimethyl-1-triazeno) imidazol-4-carboxamide (DTIC), were used to treat Brown-Pearce epithelioma in the anterior chamber of rabbit eyes. The BCNU test animals were divided into three groups: one treated by direct injection of the drug into the subconjuntival space or the anterior chamber, the second by both direct injections and intravenous administration, and the third by intravenous injection alone. The DTIC test animals were treated with only local injection into the subconjunctival space or anterior chamber. Dosage, delivery system, and effectiveness were compared following clinical observation and histopathologic examination. Direct delivery of BCNU or DTIC in subconjuntival space or anterior chamber delayed the growth of Brown-Pearce epithelioma in rabbit eye. The effectiveness of this treatment was significnatly enhanced by combining direct injection with systemic administration of a lower dose of BCNU.
Animals↗
Hemorrhage from isolated aneurysm of a retinal artery: report of two cases simulating malignant melanoma.
Isolated retinal arterial aneurysms or macroaneurysms of the retinal arteries may be the cause of hemorrhage in the retina or vitreous. Two cases are reported in which hemorrhages from isolated retinal arterial aneurysms clinically simulated malignant melanoma of the choroid. Previous studies of lesions simulating malignant melanoma of the uvea have shown that vitreous and retinal hemorrhage may easily mislead the clinician. It is stressed that careful prolonged observation does not materially decrease the patient's chance for survival if he does have a malignant melanoma and may prevent an unnecessary enucleation.
Aged↗
Chorioretinitis sclopetaria: choroidal and retinal concussion injury from a bullet.
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Adult↗