Biomedical subjects

S T Berger

Publications and source records attributed to S T Berger.

5 recordsLinked to original sources

PubMed1991

Macroscopic pigmentation in a dematiaceous fungal keratitis.

The diagnosis of fungal keratitis can be difficult and is often delayed. The distinction between moniliaceous and dematiaceous (pigmented) keratomycoses is not commonly possible on clinical examination. We report a case of a Curvularia lunata fungal keratitis in a 40-year-old patient who presented with diffuse brown pigmentation throughout the ulcer bed. Histologic staining and growth on Sabourad's dextrose agar demonstrated the brown pigmentation characteristic of this pigmented fungus. We call attention to this clinical pigmentation as a helpful clue in the detection of dematiaceous fungal keratitis.

Adult↗

PubMed1991

Scleritis and Streptococcus pneumoniae.

We retrospectively review our experience with four patients with Streptococcus pneumoniae scleritis. Two of the patients had been exposed to beta irradiation after pterygium removal 4 and 13 years previously. One patient had a 3-year history of chronic anterior nodular scleritis, and one patient had severe rheumatoid arthritis. All were treated with intensive i.v. and topical fortified antibiotics. In two of the cases, the infection was controlled and visual acuity returned to 20/30 and 20/60. In one patient, infectious scleritis progressed to endophthalmitis. This eye ultimately became phthisical and required enucleation because of chronic pain. In the remaining patient, infectious scleritis led to perforation, which required a corneal-scleral patch graft. This patient had a final visual acuity of counting fingers. An infectious etiology should be suspected in cases of necrotizing scleritis associated with a purulent discharge, and appropriate smears and cultures should be obtained. Infectious scleritis can be caused by streptococcal organisms. Appropriate topical and intravenous antibiotic treatment is effective in some cases.

Aged↗

PubMed1990

Successful medical management of Acanthamoeba keratitis.

Seven patients with documented Acanthamoeba keratitis were treated with prolonged and intensive triple antiamoebic therapy consisting of topical neomycin-polymyxin B-gramicidin, propamidine isethionate 0.1%, and miconazole nitrate 1%. Additionally, five patients were treated with topical corticosteroids. Six of seven patients were cured of Acanthamoeba keratitis with medical therapy alone, one patient required therapeutic penetrating keratoplasty to eradicate the infection. Two patients underwent penetrating keratoplasty to improve their vision after medical therapy. Our series differs from previous reports in that triple antiamoebic therapy was used in all seven patients and was successful in both early and advanced cases of Acanthamoeba keratitis. Prolonged and intensive topical therapy with these three antiamoebic drugs may be an effective mode of therapy for Acanthamoeba keratitis.

Administration, Topical↗

PubMed1990

Ocular trauma caused by exploding glass bottles containing dry ice and water.

We treated three patients with severe ocular injuries caused by exploding glass bottles containing a mixture of dry ice chips and water. One patient had a corneal laceration and traumatic cataract with several retained intraocular glass fragments. The second had a scleral laceration without corneal or lenticular involvement. The third suffered a corneal-scleral laceration, with a total retinal detachment. Following surgery, two patients recovered 20/20 vision; the third patient regained only light perception.

Adolescent↗

PubMed1988

Epidemic keratoconjunctivitis and lacrimal excretory system obstruction.

Epiphora is a common symptom associated with the acute phase of epidemic keratoconjunctivitis (EKC). Reflex lacrimal secretion occurs secondary to conjunctival or corneal inflammation. Acquired obstruction of the lacrimal excretory system may account for persistence of tearing after resolution of the acute inflammatory phase of the viral infection. Three cases of lacrimal excretory system obstruction after EKC are reported. Multifocal obstruction of the canaliculi and nasolacrimal duct is characteristic. Dacryocystorhinostomy (DCR) was required to relieve obstruction in all cases. Probing and corticosteroid irrigation may avoid the need for silicone intubation or conjunctivodacryocystorhinostomy in the management of canalicular obstruction. Persistent epiphora after EKC should raise clinical suspicion of acquired dacryostenosis. Early recognition may allow for optimal management.

Adult↗