Can J Ophthalmol
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Perthes syndrome, or traumatic asphyxia syndrome, results from a severe crush injury of the thorax. It manifests itself with facial and upper chest petechiae, subconjunctival hemorrhages, cervical cyanosis, and occasionally neurological symptoms. A patient who had been incarcerated under a block of marble presented with severe traumatic asphyxia syndrome complicated by pulmonary contusion, fractures of the right clavicle and the 8th and 9th ribs, minimal right hemothorax, liver contusion, and bilateral optic disc edema. ⋯ To our knowledge, we present the first case of Perthes syndrome with bilateral optic disc edema.
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To report a case with an intracranial foreign body in the setting of a globe-perforating injury. A 53-year-old man experienced a sudden pain in his right eye while he was breaking a stone with a sledgehammer. Upon examination, a 1.5 mm superomedial corneoscleral perforation site was noted. Cranial sections of axial orbital computed tomography (CT) revealed a foreign body at the middle cranial fossa. ⋯ A high index of suspicion is required to detect an intracranial foreign body in ocular injuries. Orbital CT must be included in preoperative evaluation of these patients and cranial sections must also be examined carefully.
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We report a rare case of hypersensitivity in a 63-year-old man who received subconjunctival lidocaine, cefazolin, and gentamicin for corneal abscess. Significant palpebral swelling and erythema were observed several hours after the injection. Nine months later, he received subconjunctival lidocaine, vanco-mycin, and ceftazidime for a new corneal abscess. After several hours, the eyelids were red and swollen, with mild blistering and scaling of the cheek. Two patch tests for lidocaine were negative. During follow-up, lateral tarsorrhaphy was performed under local anesthesia with lidocaine; erythema and swelling of eyelids and cheek appeared, resolving after several days. ⋯ Sensitivity to lidocaine can appear after subconjunctival injection. Patch tests may be negative, but the allergy suspected by the recurrence of clinical signs after rechallenge with lidocaine. Ester anesthetics can be used for local anesthesia.
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Despite equalization of the ratio of men and women among matriculating medical students, it is possible that different rates of success for applicants at the level of resident selection in the annual residency match may occur on the basis of sex. As part of a larger project, we examined this issue across the medical specialties. In the current article, the effect of sex on resident selection within the specialty of ophthalmology is explored. ⋯ Our data suggest that discrimination on the basis of sex does not occur at the level of residency selection. The lower level of female recruitment may be due to decreased interest in this specialty among women. Nonetheless, the proportion of female ophthalmologists within the Canadian workforce continues to increase.
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To correlate vision-limiting complications of open-globe trauma with anatomical zone and mechanism of injury. ⋯ Traumatic cataracts were the most common vision-limiting factor in all subcategories of open-globe injuries. Injuries in zones II and III and blunt-force ruptures were associated with increased rates of retinal detachments, phthisis, and enucleation, contributing to the poorer visual prognosis in these patients.