Journal français d'ophtalmologie
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Postoperative pain in retinal detachment surgery is frequent but it is often underestimated. The aim of this study was to determine the incidence of postoperative pain after retinal detachment surgery and to identify its predictive factors in a longitudinal study. We included 106 patients operated for retinal detachment surgery using an endo-ocular or exo-ocular approach with general anesthesia. ⋯ The predictive factors of this pain revealed by bivariate analysis of the data were the type of surgery and vomiting. The incidence and intensity of postoperative pain after retinal detachment surgery remain high. Pain management requires postoperative treatment of vomiting as well as the development of the endo-ocular surgery and locoregional anesthesia techniques.
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Monochromatic light accentuates details of different retinal layers because of its variable absorption and reflectance by structures both within and above these layers. Red-free light is little used, although it is an elementary method. Green-light ophthalmoscopy, with its short wavelength, enhances some fundus and vitreous structures and may make the examination of pathologic conditions (premacular pathology, vascular abnormalities, etc.) easier. Furthermore, it is often more comfortable for the patient.
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The mechanistic view of dry eye disease aims at completing the classic etiological approach that classifies the disease as parallel ocular surface disorders leading to lacrimal film impairment and dry eye. This approach proposes two levels of ocular surface impairment (with standard etiologies, previously validated in the NEI/Industry workshop), which may not be independent diseases but rather risk factors and/or ways to enter a self-stimulated biological process involving the ocular surface. All external disorders proposed in this model, although unlikely to be fully exhaustive, are classical mechanisms considered to be causes of tear film impairment and ocular surface damage, by tear instability and evaporation, tear hyposecretion, or both. ⋯ Clinically, this approach may explain examples of dry eye syndrome occurring after ocular surgery, contact lens wear, chronic allergy or systemic or topical drugs, and the long-lasting effect even though all causal factors have been removed or have disappeared. This model should be considered as a basis for further reflection on biological mechanisms that could be even more complex but individually constitute potential leads for targeting therapeutic strategies to allow patients to leave the loop even though the triggering factors are still present or can only be attenuated, such as in Sjögren syndrome or ocular rosacea. It also should be considered a complement to more classic etiological and severity classifications aimed at understanding and classifying the large number of diseases that may cause dry eye disease and better assessing the major impairment it causes on the patient's quality of life.
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Retinal vein occlusions (RVOs) are a common cause of severe or total loss of vision. Although the disease entity has long been known, its management is still controversial. We report five patients (six eyes) who experienced RVO even though they were taking anticoagulants or antiplatelet agents. ⋯ Anticoagulants and platelet aggregation inhibitors must only be used to treat systemic factors or thromboembolic disorders associated with RVO. These five case reports illustrate that anticoagulants and platelet aggregation inhibitors cannot guarantee that a severe RVO will not occur. A prospective study would be useful to analyze their advantages in RVO management.
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To report a rare case of primary pulmonary hypertension (PPH) revealed by a relapsing chemosis, exophthalmos, and subacute myopia. ⋯ The association of chemosis, exophthalmos, and subacute myopia is unusual in PPH. We recommend keeping in mind the PPH as a differential diagnosis in those cases, especially in patients who suffer from high blood pressure.