Klinische Monatsblätter für Augenheilkunde
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Klin Monbl Augenheilkd · May 2004
Case ReportsPosterior ischemic optic neuropathy: case report of a rare complication after general surgery.
Posterior ischemic optic neuropathy (PION) is a rare cause of bilateral severe and bilateral visual loss. Three mechanisms for posterior ischemic optic neuropathy are recognized: arteritic, non-arteritic, and peri- or postoperative. We report a case of bilateral postoperative posterior ischemic optic neuropathy. ⋯ Peri- and postoperative posterior ischemic optic neuropathy is a rare but devastating complication of surgery performed at distance from the visual pathways and its vascularization. Risk factors include: spine surgery, peri-operative hypotension, anemia, facial edema. Early recognition of posterior ischemic optic neuropathy and rapid correction of hypotension and/or anemia might improve outcome of posterior ischemic optic neuropathy, which usually is poor.
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Klin Monbl Augenheilkd · Jan 2004
Case Reports[Nosocomial pseudomonas aeruginosa-associated keratitis in soft contact lens wearer].
Pseudomonas aeruginosa is the most common cause of bacterial-associated keratitis in soft contact lens wearers, due to wrong use of soft contact lenses. Problems are often severe corneal ulcers and even corneal perforations. We report on a soft contact lens wearer with credibly correct use of soft contact lenses and nosocomial Pseudomonas aeruginosa-associated keratitis. ⋯ Previous reports on Pseudomonas aeruginosa-associated keratitis in soft contact lens wearers demonstrate corneal problems due to extended or overnight wear or unsuccessful contact lens cleaning. We present a case of nosocomial corneal infection after soft contact lens wearing and nosocomial infection because of contact with a partner working in an intensive-care unit. Hygienic rules should be strictly followed by patients and staff using soft or hard contact lenses for visual correction or for therapeutic reasons.
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In the past few years, there have been many changes in ophthalmic anaesthesia. Application of drugs in general anaesthesia with excellent controllability enhances patient safety and allows a more efficient OR-management. Regional anaesthesia is gaining widespread use for ophthalmic surgery, especially topical anaesthesia for cataract surgery. ⋯ Postoperative nausea and vomiting (PONV) remains a distressing and common problem after strabismus repair in particular in children. The incidence of PONV depends on the type of ophthalmic surgery and drugs applied. To reduce PONV in ophthalmic surgery, application of long-lasting opiates should be avoided, and non-opiate analgesics and, depending on the kind of operation, antiemetic prophylactics are recommended.
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Klin Monbl Augenheilkd · Nov 2003
Case Reports[Spontaneous, bifocal rupture of the limbus in secondary angle closure glaucoma after open globe injury].
To report on a case of bifocal rupture of the limbus that developed in a young male with secondary angle closure glaucoma 7 months after penetrating eye injury. ⋯ This is first reported case of delayed, spontaneous, bifocal rupture of the corneoscleral limbus after primary open globe injury. It may be speculated that severe contusion of the eye with structural damage of the corneoscleral limbus preceded the penetrating injury and that the later limbal rupture was caused by a marked elevated IOP due to epithelial ingrowth.