International ophthalmology
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Comparative Study
Assessment of diagnostic criteria in management of infantile glaucoma. An analysis of tonometry, optic disc cup, corneal diameter and axial length.
Infantile glaucoma is characterized by increased intraocular pressure, enlarged corneal diameters, optic disc cupping and typical anamnesis. The aim of our study was to evaluate the validity of diagnostic criteria in differentiating between manifest infantile glaucoma and glaucoma-suspected eyes (e.g. megalocornea). ⋯ Corneal diameters and axial length were helpful in the diagnosis of infantile glaucoma, but of limited use in the follow-up. The decision to undertake surgery was based upon tonometry and optic disc evaluation.
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Case Reports
Orbito-cranial injury caused by penetrating metallic foreign bodies: report of two cases.
Two cases of orbito-cranial injury caused by foreign bodies (FBs) penetrating the lateral wall and roof of the orbit are described. In the first patient, a long rusted nail acted as a missile and was only detected by X-rays and CT scan. The nail penetrated the orbit, the eyeball, the lateral orbital wall, and the temporal lobe of the brain. ⋯ In the second patient, large metallic FB, having penetrated the orbital roof was lodged intracranially above the chiasma. This was removed via frontal craniotomy. Mechanism of such injuries and appropriate surgical approaches are described as well.
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Onchocerciasis is a devastating blinding disease caused by the parasite Onchocerca volvulus that infects about 80 million people, causing blindness and visual impairment in 1-2 million people. In hyperendemic areas, more than half of the population will become blind from onchocerciasis before they die. ⋯ An annual oral dose of only 150 mg/kg completely suppresses the disease manifestations. Programs for the community-based mass distribution of ivermectin are now being conducted and promise to control this major blinding scourge.
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We report on 17 consecutive cases of retinal detachment due to macular hole surgically treated by one of the authors (S. B.) between the fall of 1982 and 1985. The standard method used was pars plana vitrectomy and intraocular air tamponade. ⋯ Vitrectomy and gas tamponade alone, without coagulation, constitute the safest and most sparing treatment of this type of retinal detachment. Unfortunately, approximately one half of these cases require subsequent additional photocoagulation because of renewed accumulation of subretinal fluid. In about one fourth of macular hole retinal detachments, however, lasting reattachment is achieved only by silicone oil tamponade following initial vitrectomy and air/gas tamponade.