A simple method for lacrimal intubation.
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Biomedical subjects
Publications and source records attributed to I Sternberg.
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As court-appointed medical advisors in the speciality of ophthalmology for the Israeli Labour Courts, we are called upon to assist in making decisions on work-related eye injuries or illnesses. In this report we present seven cases of eye injuries which workers claimed were caused by work accidents. Each case helps to illustrate the various guidelines we use in making a medical judgement as to whether or not a specific ocular problem was, indeed, the result of a work accident.
Patients with poor or total absence of levator function require correction of their ptosis by a sling procedure. The aim of the procedure is to utilize the action of the frontalis muscle, innervated by the seventh nerve, to mechanically raise the droopy eyelid. The most common materials used for the sling are autogenous or preserved fascia lata and synthetic products such as nylon or dacron sutures. We introduce a new material for the sling procedure--preserved placental umbilical vein modified for the use as a sling. Two cases are presented in which this material was used with excellent results.
We present our experience in using artificial skin (Omniderm) in the prevention of early healing of a raw lid margin. The material is inert and acts properly for this procedure.
Trichoepithelioma histologically resembles basal cell epithelioma, but only rarely do the two lesions coexist. The case reported here documents a patient with hereditary trichoepithelioma who presented with a basal cell epithelioma of the medial canthus invading the lower eyelid. The clinical and histologic features of both entities will be discussed, as well as the possibility of malignant transformation of a trichoepithelioma to a basal cell epithelioma.
In 17 cases of recurrent retinal tears occurring after successful retinal detachment surgery, the new tears developed on or near the treated primary tear in seven cases and away from the treated tear in ten cases. It took an average of 25.6 months for the second tears to develop, and almost all of the recurrent tears were the same distance from the limbus as the primary tear. The benefit of the 360 degree encircling band and the relationship of the thermal injury to production of a second tear is discussed.
A method of repositioning extruding silicone tubes is described by reintubation with a second Crawford intubation set. The method and indications are described.
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Five cases of orbital varices are presented, demonstrating a surgical approach with the use of vascular clips. Three of four cases were clipped at the apex of the orbit, with no recurrence. A fourth case was clipped two-thirds of the way back in the orbit, with no progression of the varix and significant improvement of the patient's symptoms. A fifth case failed because of extensive hemorrhaging. Follow-up ranged from 2 to 9 years.
An osteoma is a slow growing, bony tumor which forms in the sinuses of the skull. Presenting complaints include headaches, cerebral symptoms, or visual disturbances, depending upon the location of the tumor. This paper describes an unusual case of ethmoid sinus osteoma, with epiphora as the primary symptom; it also caused the failure of a previous dacryocystorhinostomy. This case illustrates the need for thorough evaluation of epiphora, including sinus x-rays.
In ten cases of nontraumatic retinal tears with initial vitreous hemorrhages so dense that all retinal detail was obscured, medical management included hospitalization, sedation, and binocular patching. It took an average of 4.3 days for the vitreous to clear so that the tears could be examined. All the tears were on or anterior to the equator, and all were in the superior quadrants. Surgery was performed promptly once the tears were visible even though much of the retina was still covered with hemorrhage. After total clearing of the vitreous, no additional retinal tears were found in any of the ten cases. Postoperative complications included hemorrhages in three cases, macular pucker in one case, and a paramacular star in one case.
The therapeutic effect of human fibroblast interferon (HFIF) was studied in 33 patients. Seven had ophthalmic lesions (three due to adenovirus Type 8, four to herpes simplex virus, and one to herpes zoster) and were treated with HFIF. In the four patients with herpes simplex keratitis, HFIF was given in addition to standard therapy or together with other antiviral agents. Ten other patients, 8 with herpes simplex or herpes zoster skin or mucous membrane lesions, were treated with HFIF. HFIF was incorporated into an ointment as well as into a solution for subconjunctival infections. Although the number of cases was small, our results showed that HFIF was effective in shortening the course of the disease.
Mandibulofacial dysostosis is a syndrome caused by delay in the development of the first visceral arch. This report describes a case which had fusion of the gums and temporomandibular joint, together with coloboma of both lids. This variant has not previously been reported.
A family affected with pituitary dwarfism transmitted probably as an X-linked recessive or autosomal recessive condition, is described. The propositus had globular-like changes in his cornea, this latter as a sequela of endocrine disturbances, is suggested and discussed.
A method of opening an opacified, retrolental, intrapupillary membrane in a pseudophakic eye, using the argon laser, is presented. The procedure was safe, and the membrane remained retracted one year after treatment.
Werner's syndrome is believed to be an autosomal-recessive inherited disorder. Among other manifestations of premature aging, patients with Werner's syndrome frequently develop chronic leg ulcers that heal poorly. We present a patient who suffered from this rare syndrome and developed typical leg ulcers. We wish to alert physicians to this syndrome so that its attendant problems can be considered when treatments are being planned for patients with chronic leg ulcers.
A case of total eversion of both upper eyelids of late onset is reported. There were no associated ocular or general anomalies. No apparent cause was found. The treatment was directed toward diminishing the swelling of the lids and preventing corneal involvement, secondary infections, and epidermalization of the conjunctiva. Within the first week, the eyelids returned to their normal position. In a three-month follow-up period, no complication or other anomalies were found.