Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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Exploding beverage bottles can cause serious ocular injuries. The mechanisms of injury and the consequences were studied retrospectively in 21 patients admitted to the hospital between 1982 and 1992. Most of the patients (76%) were injured by propulsion of the bottle cap. ⋯ About 2% of all eye injuries admitted to hospital are caused by bottle explosions. The consumer can reduce the danger of bottle explosions by storing bottles in a cool place and taking care not to shake then before use. Manufacturing industry is called upon to develop and to use stopper systems connected to the bottles to prevent propulsion of bottle caps.
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We reviewed the conditions leading to the mutilating procedure of orbital exenteration in 24 patients at our institution between 1980 and 1993. In 17 cases, including 16 of 17 patients with malignant tumours of the eyelid, this operation could potentially have been avoided. Three of these 17 patients first saw a doctor at an extremely advanced and otherwise untreatable stage of the tumour. ⋯ In one patient a meibomian gland carcinoma was misdiagnosed as a chalazion and excised without histological examination. In another case of squamous cell carcinoma a cutaneous incisional biopsy 6 months prior to orbital exenteration revealed a papilloma. These results emphasize the necessity of careful histological examination in the treatment of lid tumours.
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Comparative Study
[Cognitive function of geriatric ophthalmology patients after local and general anesthesia].
Since there will be an increase in the number of geriatric patients who undergo surgery and anesthesia over the next few years, studies comparing the effects of general and local anesthesia on cognitive functioning in elderly persons are mandatory. One hundred eleven ophthalmological patients, all over the age of 64 years, were assessed preoperatively, on the first and on the fourth postoperative day using a battery of standardized cognitive tests. Of the initial sample, 47 patients undergoing local and 54 undergoing general anesthesia completed the assessment. ⋯ The performance of patients with general anesthesia decreased transiently and returned to the initial levels within 3 days. We conclude from our results that postoperative cognitive deficits may occur in geriatric patients. However, general anesthesia poses no more risk to cognitive function than local anesthesia.
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We have recently seen a number of patients with angle-closure glaucoma who had been treated for glaucoma simplex (primary open-angle glaucoma). The main cause of this misdiagnosis was gonioscopy, as its findings are subject to the impression of the examiners. For objective examination of the chamber angle and the iris configuration, B-scan ultrasonography was performed using a contact eye cup filled with saline. ⋯ The findings were quite different between eyes. In the eye with a higher IOP, pronounced optic nerve damage and visual field defect, the chamber angle was distinctly more narrow and closed. Most of the patients were treated with beta-blocker drops, which they felt were agreeable.