Retina
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Posttraumatic endophthalmitis is a rare complication of penetrating eye injuries that results in blindness in potentially salvageable eyes. ⋯ Prompt diagnosis and early treatment with intraocular and systemic antibiotics are important in the successful management of posttraumatic endophthalmitis. The use of pars plana vitrectomy was associated with a good visual outcome when used in select cases.
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Orbital emphysema is radiologically apparent in 50% of cases of orbital fractures, but it is generally a benign, self-limited condition. However, visual loss may occur if a fracture produces orbital compression via a ball-valve effect, allowing air to enter but not leave the orbit. A case of compressive orbital emphysema complicated by ischemic optic neuropathy is reported. Intraorbital needle aspiration relieved the compression with improvement of visual acuity and normalization of intraocular pressure.
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Giant retinal tears may arise spontaneously, but approximately 25% occur in association with ocular trauma. The clinical findings and results of surgical management in 38 cases of traumatic giant retinal tear seen at Moorfields Eye Hospital in London during a 10-year period are presented. Patients were young (mean age = 29 years) and mostly men (n = 36; 95%). ⋯ Raised intraocular pressure was an associated problem that required treatment in 12 (32%) eyes. Visual acuity at final follow-up examination ranged from 6/6 to no perception of light (NPL; mean = 6/36). These results compare favorably with published figures for the treatment of spontaneous giant retinal tears.
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Ocular fundus abnormalities associated with the Klippel-Trenaunay-Weber syndrome are uncommon and include retinal vascular tortuosity and diffuse choroidal hemangioma. A case involving a young girl with Klippel-Trenaunay-Weber syndrome who had unusual bilateral, exudative, outer retinal vascular masses involving the peripheral fundus in one eye and the foveal area in the other eye is reported. ⋯ The fundus lesions appear to represent vascular tumors of the retina that differ clinically from previously reported retinal vascular tumors and Coats disease. The simultaneous retinal and renal involvement suggest that Klippel-Trenaunay-Weber syndrome may be associated with more widespread vascular malformations than previously realized.