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Biomedical subjects

H D Perry

Publications and source records attributed to H D Perry.

At least 91 records · Page 5Linked to original sources
PubMed1982

Isolated episcleral neurofibroma.

A 22-year-old white woman presented with an epibulbar tumor of the right eye first noted seven years previously. Clinical examination showed a 6 x 8 mm lobulated yellowish white tumor rising 3-4 mm off the inferior bulbar surface. An excisional biopsy revealed the tumor to be free of conjunctival attachments and be firmly fixed to the sclera. Smaller nodules were noted away from the main tumor and posterior to the equator. The histopathologic evaluation revealed the tumor to be an isolated episcleral neurofibroma. Although rare, isolated episcleral neurofibromas should be thought of in the differential diagnosis of epibulbar tumors and treated conservatively.

Adult↗
PubMed1981

Subconjunctival lymphoma: a review of six suspected cases and the use of immunologic surface markers.

Six cases of subconjunctival tumor clinically compatible with the appearance of subconjunctival lymphoma were evaluated. Two of the patients, Cases 1 and 2, were under treatment with either prednisone or gold therapy for severe rheumatoid arthritis. Patient 3 manifested further evidence of systemic disease (auxillary lymph node). Of the remaining cases, patient 4 had no further evidence of systemic involvement, whereas patient 5 was suspected of having a gastrointestinal tumor. The last case, a patient known to have pulmonary lymphoma, presented with dry eye and multiple subconjunctival lymphomatous masses. Immune surface marker studies demonstrated a B-cell monoclonal subconjunctival lymphoma, suggestive of an improved survival when compared to null cell-type lesions. Immune surface marker studies offer a new commercially available method for classifying and prognosticating subconjunctival lymphomas.

Aged↗
PubMed1980

Subcutaneous dirofilariasis of the eyelid and ocular adnexa. Report of six cases.

Six cases of subcutaneous dirofilariasis are reported, three located in the eyelid, two in the periorbital region, and one in the subconjunctival tissues. Three patients lived in Florida, two in North Carolina, and one in Mississippi. All patients were adults, ranging from 27 to 69 years of age (median age was 58 years). Most patients experienced an inflamed painful nodule that contained portions of a nematode. The morphologic features for identification of the worm as belonging to the genus Dirofilaria are outlined.

Adult↗
PubMed1980

Round and oval cones in keratoconus.

In advanced keratoconus, there are two cone types. The more common round or nipple shaped cone is limited in diameter but may reach any degree of conicity. The cone center lies mostly in the lower nasal quadrant. The oval or sagging cone, is often larger and lies more commonly in the inferotemporal quadrant close to the periphery. The oval cone is usually associated with more episodes of corneal hydrops, scarring and difficulty in fitting contact lenses. Histopathologic review of 23 cases (10 round, 13 oval), revealed that the oval group had more breaks in Bowman's membrane, 10.1 versus 5.0, (P smaller than 0.01), and a tendency toward greater pannus formation with more ruptures in Descemet's membrane. We hope this clinicopathologic correlation may allow a more logical approach to patient care based on recognizing two different cone types in advanced keratoconus.

Cornea↗
PubMed1980

Conservative treatment of chalazia.

Recently, several authors have revived interest in intralesional corticosteroid therapy of chalazia. Most ophthalmologists use surgical excision to treat these lesions. We feel that before either method is advocated as definitive, a more conservative therapeutic approach should be evaluated. In an attempt to determine the effectiveness of conservative therapy, we studied consecutive patients with chalazia treated only by lid hygiene. The study consisted of 37 patients, 19 men and 18 women, ages 14 to 62 with a total of 47 chalazia. Thirty-six chalazia resolved with conservative therapy; 4 chalazia remained the same, and in two patients, small pyogenic granulomas developed. These figures indicate that conservative therapy was approximately 80% effective in treating chalazia.

Adolescent↗
PubMed1980

Superficial reticular degeneration of Koby.

A 36-year-old white man with congenital ichthyosis and a history of a posterior uveitis beginning at age 8 presented with an unusual corneal opacity. At age 26 bilateral central corneal opacities were noted consisting of fine interlacing white lines forming a reticulum at the level of Bowman's membrane. A faint brown background tint of the basal epithelium was also present. Over the next 10 years the opacity progressed only slightly, with some mild superficial scarring of the underlying corneal stroma. The visual acuity remained good. This corneal pattern appeared virtually identical to the superficial reticular degeneration of Koby. As described by Koby in 1927, this rare corneal degeneration is characterised as a painless, slow, progressive development of a central fine, white reticulum at the level of Bowman's membrane. This rare corneal degeneration probably represents an atypical form of band keratopathy.

Adult↗
PubMed1980

Tolerance of normal rabbit eyes to the antineoplastic carmustine.

Various dosages of the anticancer agent 1,3-bis(2-chloroethyl)-1-nitrosourea (carmustine, BCNU) were administered to 28 normal rabbit eyes. Single injections and series of injections were given to determine the tolerance and toxicity levels of this drug when injected directly into the vitreous cavity, the anterior chamber, or the subtenon-retrobulbar space. During a follow-up period of 3 weeks to 4 months, no significant ocular changes were noted following a single injection of BCNU into the vitreous (0.002--0.50 mg) or anterior chamber (0.001--0.250 mg), or 10 daily subtenon-retrobulbar injections (0.5--1.0 mg each). When the daily dosage was increased to 1.5--2.0 mg, corneal damage with stromal infiltration, edema, and vascularization were found after the course of the 10 subtenon-retrobulbar injections in 3 of 6 test animals.

Animals↗
PubMed1979

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↗
PubMed1979

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↗
PubMed1979

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↗
PubMed1979

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↗
PubMed1978

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↗
PubMed1978

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↗
PubMed1978

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↗
PubMed1978

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↗