Presentation
A 10 years old girl presents to our eye clinic with a chief complaint of watering from right eye and for the evaluation of two small holes present inferonasal to the medial canthus since birth. [medcraveonline.com]
A family with 3 affected members is presented in this series with similar incomplete punctal canalization and nasolacrimal duct obstructions. [unboundmedicine.com]
We suggest a genetic basis of this disorder through presenting our case series. CASE PRESENTATION We present two cases of bilateral congenital dacryo- cystoceles occurring in a set of identical twins. [archive.org]
Mean age at presentation was 1.7 years (range 8-48 months). Discharge and matting of eyelashes were the presenting symptoms in 22 out of 25 (88%) cases, whereas the only epiphora was the presenting symptom in three (12%) cases. [ncbi.nlm.nih.gov]
Email: [email protected] Previous presentation: The information in this article was originally presented at the Combined Sections Meeting of the Triological Society; Feb. 4-7, 2010; Orlando, Fla. [thefreelibrary.com]
Entire Body System
- Lymphadenopathy
Physical examination may show pallor (80%), petechial (50%), lymphadenopathy (35%) or splenomegaly (50-60%) Investigation: Initial: CBE with peripheral blood film (blast cells, with no aeur rods). WCC will often be raised. [aimted.com]
[…] lacrimal gland deficiencies that may impair aqueous production include the following: Lacrimal gland infiltration Sarcoidosis Lymphoma AIDS Graft vs host disease Amyloidosis Hemochromatosis Lacrimal gland infectious diseases HIV diffuse infiltrative lymphadenopathy [emedicine.medscape.com]
- Myxedema
NOS hereditary sporadic 334.3 Other cerebellar ataxia Cerebellar ataxia NOS Use additional E code to identify drug, if drug-induced 334.4 Cerebellar ataxia in diseases classified elsewhere Code first underlying disease, as: alcoholism (303.0-303.9) myxedema [theodora.com]
Associated features include a hoarse cry,umbilical hernia, dry and cold extremities, myxedema, mottledskin, and mental retardation. [quizlet.com]
- Camping
IL-2 also binds to the delta opioid receptor and inhibits cAMP production and neuronal function. This loss of neuronal function diminishes normal neuronal tone, leading to sensory isolation of the lacrimal gland and eventual atrophy. [emedicine.medscape.com]
Gastrointestinal
- Abdominal Pain
Forty-year-old patient with highly acute lower abdominal pain (rightsided) five days after taking amoxicillin. Mucosal hemorrhaging in ascending colon. Fig. 17.7 CMV colitis. [rrnursingschool.biz]
pain, vomiting Investigation: Abdominal ultrasound. [aimted.com]
pain (1) Abdominal pain, chronic (1) Celiac disease (1) Crohn's disease (1) Cystic fibrosis (3) Digestive system disorders (1) Digital rectal examination (3) Functional gastrointestinal disorders (1) Gastroesophageal reflux disease (2) Gastrointestinal [innovations.ahrq.gov]
pain, related diseases and genetic alterations [mendelian.co]
Symptoms, due to the impaired function of nerve or enteric smooth muscle, include nausea, vomiting, bloating, constipation, abdominal distention, abnormal digestive and intestinal mobility (peristalsis), abdominal pain, malnutrition. [chginc.org]
- Blood in Stool
Based on combination of clinical features and workup Typical workup should include CBE (anemia), blood smear (schistocytes), EUC (GFR), stool cultures (Positive for E. coli O157:H7). [aimted.com]
Cardiovascular
- Hypertension
October 02, 2018 Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. October 01, 2018 Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. October 01, 2018 [medscape.org]
[…] including the collaborative ocular melanoma study age related eye disease study diabetic retinopathy study early treatment diabetic retinopathy study advanced glaucoma intervention study optic nerve sheath decompression trial idiopathic intracranial hypertension [beaumont.edu]
Atypical HUS without prodromal diarrhea has tendency to relapse and is often associated with high risk of long-term hypertension and chronic renal failure. [aimted.com]
Double blind randomized clinical trial in subjects affected by open angle glaucoma or intraocular hypertension. Medical condition: Subjects affected by glaucoma or intraocular hypertension. [clinicaltrialsregister.eu]
Some of these children had underlying congenital heart defects and/or pulmonary hypertension. [medicalhomeportal.org]
Musculoskeletal
- Fracture
" "LE FORT'S FRACTURE---inv's ZYGOMA, MAXILLA, & NASAL BONES," "Oblique & Horizontal Fracture of nasal septum--- is called asJARJAVAL FRACTURE,"- "GLOBUS HYSTERICUS---lump in throat not interfering with swallowing,"- " GROMMET INSERTION---is done in [mypgnotes.com]
Fractures and dislocations should receive prompt attention. Cardiac anomalies may require surgical correction. [disorders.eyes.arizona.edu]
Trauma[edit] Naso-orbital fractures may involve the nasolacrimal duct. Early treatment by fracture reduction with stenting of the entire lacrimal drainage system should be considered. [en.wikipedia.org]
(2) Hip fractures (1) Hip replacement (6) Injury of cervical spine (disorder) (1) Joint replacement surgery (4) Knee replacement (5) Musculoskeletal diseases (5) Osteoarthritis (4) Osteonecrosis (1) Osteopenia (1) Osteoporosis (13) Physical therapy [innovations.ahrq.gov]
Intervention in Congenital Nasolacrimal Duct Obstruction. ( 30178001 ) Sathiamoorthi S...Mohney BG 2018 27 Timing of Simple Probing for Congenital Nasolacrimal Duct Obstruction: Not So Simple. ( 30178002 ) Repka MX 2018 28 The Role of Inferior Turbinate Fracture [malacards.org]
Eyes
- Dry Eyes
Dry eye disease may be subdivided into 2 main types as follows: Dry eye disease unassociated with SS (non-SS KCS) Dry eye disease can also be subdivided into pure aqueous deficiency dry eye and evaporative dry eye. [3] Eighty-six percent of patients with [emedicine.medscape.com]
eye patients Medical condition: Dry eye syndrome (DES) Disease: Version SOC Term Classification Code Term Level 16.0 10015919 - Eye disorders 10013777 Dry eye syndrome LLT 16.0 10015919 - Eye disorders 10013774 Dry eye PT Population Age: Adults, Elderly [clinicaltrialsregister.eu]
• DRY EYE IS A CONTINUUM OF DISEASE 13. [slideshare.net]
CHAPTER 3 The Dry Eye Applied physiology 57 Causes 57 Clinical features 58 Special investigations 59 Treatment 60 56 The Dry Eye 57 Applied physiology The main lacrimal glands produce about 95% of the aqueous component of tears and the accessory lacrimal [archive.org]
Prevalence of dry eye among an elderly Chinese population in Taiwan: the Shihpai Eye Study. Ophthalmology. 2003;110:1096–101. PubMed CrossRef Google Scholar 7. Paulsen FP, Thale AB, Maune S, Tillmann BN. [link.springer.com]
- Photophobia
The classic symptoms of epiphora, photophobia, and blepharospasm are secondary to corneal edema and opacification and breaks in Descemet’s membrane. [entokey.com]
• Photophobia. • Tearing. • Amblyopia. INTRODUCTION In this chapter, an overview of the various forms of glaucoma that occur in infants and young children is given. [medtextfree.wordpress.com]
Macular degeneration Diplopia Brisk reflexes Slurred speech Ankle clonus Progressive gait ataxia Slow saccadic eye movements Posterior embryotoxon Bilateral cleft lip and palate Dysmetric saccades Drusen Esotropia Pendular nystagmus Rod-cone dystrophy Photophobia [mendelian.co]
CLINICAL MANIFESTATION Irritation Redness Burning/ Stinging Tearing Contact lens intolerance Increased frequency of blinking Itchy eyes foreign body sensation Blurred vision Photophobia (less frequent symptom) Thick sticky mucous discharge [slideshare.net]
renal agenesis, urethral atresia, and hydronephrosis), conductive or sensorineural hearing loss, choanal atresia, mammary gland or nipple hypoplasia, ophthalmological findings (i.e. nasolacrimal duct [NLD] obstruction, lower lid punctal stenosis, photophobia [ijo.in]
- Visual Impairment
impairment, often accompanied by short stature (summary by Martin et al., 2014 ). [mendelian.co]
Familial exudative vitreoretinopathy (FEVR) ( English pronunciation: /ˈfēvər/, US dict: fēvər ) is a genetic disorder affecting the growth and development of blood vessels in the retina of the eye. [1] This disease can lead to visual impairment and sometimes [ipfs.io]
One eye: moderate impairment; other eye: normal vision 369.8 Unqualified visual loss, one eye 369.9 Unspecified visual loss ---------------------------------------------------------------------- | | Additional Classification | LEVELS OF VISUAL IMPAIRMENT [theodora.com]
Enlarged cornea/eye Elevated IOP Poor vision Visual impairment Asymptomatic Myopia/astigmatism Irritability Optic nerve cupping Infants are most likely to present with subtle corneal enlargement and diffuse corneal opacification, which is often recognized [entokey.com]
Management of visual impairment may be complicated by the child's ability to tolerate glasses, patching, or other intervention. [medicalhomeportal.org]
- Blurred Vision
CLINICAL MANIFESTATION Irritation Redness Burning/ Stinging Tearing Contact lens intolerance Increased frequency of blinking Itchy eyes foreign body sensation Blurred vision Photophobia (less frequent symptom) Thick sticky mucous discharge [slideshare.net]
Look for: Excessive tearing Watery eyes Recurrent eye inflammation (conjunctivitis) Recurrent eye infections (dacryocystitis) Painful swelling of the inside corner of the eye Eye mucus discharge Blurred vision Bloody tears When to see a doctor If your [sites.google.com]
(264.5) 368.63 Abnormal dark adaptation curve Abnormal threshold of cones or rods Delayed adaptation of cones or rods 368.69 Other night blindness 368.8 Other specified visual disturbances Blurred vision NOS 368.9 Unspecified visual disturbance 369 Blindness [theodora.com]
Herpes Simplex Keratitis Clinical Features: Redness, photophobia Watery discharge Blurred vision Swollen opaque epithelial cells, dendritic ulcer, decreased corneal sensation, subepithelial haze, mild anterior activity Investigation: Diagnostic: Based [aimted.com]
- Diplopia
Tremor Cerebellar atrophy Intellectual disability, mild Fatigue Gait ataxia Dysmetria Progressive cerebellar ataxia Intention tremor Limb ataxia Bilateral cleft lip Fasciculations Truncal ataxia Horizontal nystagmus EMG abnormality Macular degeneration Diplopia [mendelian.co]
Periorbital and orbital cellulitis - signs Proptosis Ptosis Chemosis Lid erythema/edema Motility restriction Ocular/periorbital pain Decreased vision - Diplopia Nasal discharge Worsening pain on eye movement Nasal tenderness periorbital and orbital cellultitis [quizlet.com]
New onset diplopia: 14 years after retinal detachment surgery with a hydrogel scleral buckle. Br J Ophthalmol 2005;89(5):640. ( Letter to the Editor) Sheikh I, Leibovitch I, Selva D, Daya S, Malhotra R. [drleibovitch.com]
[…] polyopia Visual halos 368.16 Psychophysical visual disturbances Visual: agnosia disorientation syndrome hallucinations 368.2 Diplopia Double vision 368.3 Other disorders of binocular vision 368.30 Binocular vision disorder, unspecified 368.31 Suppression [theodora.com]
Neurologic
- Headache
(3) Ischemic stroke (3) Memory disorders (3) Mental status changes (1) Migraine headaches (1) Movement disorders (1) Multiple sclerosis (5) Neurologic examination (2) Neuropathic pain (1) Olfaction disorders (1) Pain management (2) Parkinson disease [innovations.ahrq.gov]
Redness, pain, pulsation, epiphora, and tightness in the medial lid angle, along with a severe headache, will cause the patient to seek medical advice.[17] If the obstruction does not resolve, mucous membrane inflammation may become chronic and acute [statpearls.com]
These included headaches (29% to 50%), mental retardation (13%), and seizures (11.5%). 7, 16, 23 In addition to synostosis of the calvarial sutures, the cranial base sutures and midface sutures of the orbits and maxilla display premature fusion. 16, 31 [entokey.com]
Severe sore throat, earache, or headache not relieved by Tylenol or ibuprofen. History of tuberculosis, rheumatic fever, kidney disease, or heart disease. Severe chest pain or shortness of breath. You are coughing up thick, green or bloody sputum. [quizlet.com]
Then proceed to management: > 2 mo: ceftriaxone + dexamethasone < 2 mo: cefotaxime + amoxycillin > 2 mo: ceftriaxone + dexamethasone ICU management may be necessary Mumps Clinical features: Non-specific prodrome of fever, headache, malaise and myalgia [aimted.com]
- Peripheral Neuropathy
[…] nerve sheath tumor Malignant peripheral nerve sheath tumor with perineurial differentiation Malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differenciation Malignant peripheral neuroectodermal tumor of the cervix uteri Malignant peripheral [orpha.net]
neuropathy 356.0 Hereditary peripheral neuropathy Déjérine-Sottas disease 356.1 Peroneal muscular atrophy Charcot-Marie-Tooth disease Neuropathic muscular atrophy 356.2 Hereditary sensory neuropathy 356.3 Refsum's disease Heredopathia atactica polyneuritiformis [theodora.com]
[…] myelin protein 22) CHROMOSOMAL LOCATION: 17p11.2 MODE OF INHERITANCE: autosomal dominant This disorder is a demyelinating peripheral neuropathy with combined distal muscle weakness and atrophy with sensory loss and slow nerve conduction. [chginc.org]
Workup
In patients with atypical presentations, including younger age and male gender, further workup is appropriate. Bloody punctual discharge or lacrimal sac distension above the medial canthal tendon is also highly suggestive of neoplasm. [en.wikipedia.org]
Based on combination of clinical features and workup Typical workup should include CBE (anemia), blood smear (schistocytes), EUC (GFR), stool cultures (Positive for E. coli O157:H7). [aimted.com]
Bilateral nasal endoscopy is essential in the workup of infants presenting with clinical findings suspicious for a dacryocystocele and often will show a cystic mass in inferior meatus. [archive.org]
[…] tear breakup time (TBUT) The Schirmer test Tear meniscus height Quantification of tear components through analysis of tear proteins Impression cytology to monitor progression of ocular surface changes Additional tests that may be used in a research workup [emedicine.medscape.com]
In patients with atypical presentations, including younger age and male gender, further workup is appropriate. Bloody punctual discharge or lacrimal sac distension above the medial canthal tendon is highly suggestive of neoplasm. [wikivisually.com]
Treatment
The mean age of treatment was 26.25±10.08mo (range, 13-49mo) for MCI and 26.85±12.25mo (range, 16-68mo) for PMCI. [ijo.cn]
More recently, pushed MCI (PMCI) has treatment was 26.25依10.08mo (range, 13-49mo) for MCI been introduced as another potential treatment option in and 26.85依12.25mo (range, 16-68mo) for PMCI. Treatment CNLDO. [docksci.com]
Treatment: The definitive treatment is surgery with pin fixation Prompt treatment is required to prevent avascular necrosis. [aimted.com]
Treatments and drugs The cause of your blocked tear duct will determine which treatment is right for you. Sometimes, more than one treatment or procedure is needed before a blocked tear duct is completely corrected. [sites.google.com]
1 conservative treatment ineffective children. 2 for newly diagnosed older children of lacrimal duct obstruction (> 5 months), The 3 had failed history with lacrimal probing. 4 willing to undergo intubation treatment to repeated lacrimal passage of the [nasalcyst.net]
Prognosis
The book features more than 150 4-color illustrations throughout and a short, succinct format which includes: Epidemiology and Etiology, History, Physical Examination, Differential Diagnosis, Laboratory and Special Examinations, Diagnosis, Prognosis, [r2library.com]
In general, the prognosis for visual acuity in patients with dry eye disease is good. Patients with SS or prolonged untreated dry eye represent a subgroup with a worse prognosis, requiring a longer course of treatment. [emedicine.medscape.com]
Prognosis The prognosis for resolution of nasolacrimal duct obstruction by one or more surgical procedures is quite good. The success rate of simple probing is excellent. [eyewiki.aao.org]
When surgery is needed, the prognosis depends on the technique and associated conditions. Success rates of external and internal DCR are similar and reported to be more than 90% in most studies in the literature. [statpearls.com]
Treatment: Typical diarrhoea associated HUS has good prognosis if given early supportive therapy, including dialysis. [aimted.com]
Etiology
We report here two female siblings with congenital dacryocystocele, and review the etiology and potential inherited predisposition to this comparatively rare entity. Published by Elsevier Ireland Ltd. [ncbi.nlm.nih.gov]
Acquired lacrimal drainage obstruction: an etiologic classification system, case report, and a review of the literature. Part 3. Ophthal Plast Reconstr Surg. 1993;9(1):11–26. PubMed CrossRef Google Scholar 30. [link.springer.com]
The book features more than 150 4-color illustrations throughout and a short, succinct format which includes: Epidemiology and Etiology, History, Physical Examination, Differential Diagnosis, Laboratory and Special Examinations, Diagnosis, Prognosis, [r2library.com]
Log out Cancel Table of Contents From Cochrane database of systematic reviews (Online) 2018 - 10 Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. [medscape.org]
Etiology Depending on the etiological factors, dacryostenosis can be classified into the following two broad categories: Congenital Dacryostenosis The most common cause of congenital dacryostenosis is a mechanical obstruction located in the distal part [statpearls.com]
Epidemiology
The book features more than 150 4-color illustrations throughout and a short, succinct format which includes: Epidemiology and Etiology, History, Physical Examination, Differential Diagnosis, Laboratory and Special Examinations, Diagnosis, Prognosis, [r2library.com]
History of the Rochester Epidemiology Project. Mayo Clin Proc. 1996;71:266–274. [PubMed] [Google Scholar] 10. Schwarz M. Congenital atresia of the nasolacrimal canal. Arch Ophthalmol. 1935;13:301–302. [Google Scholar] 11. Cassady JV. [ncbi.nlm.nih.gov]
The epidemiology and genetics of congenital heart disease. Clin in Perinatol 2001; 28 : 1–10. 3. Kohner EM, Allen EM, Saunders KB, Emery VM, Pallis C. [nature.com]
Epidemiologically, congenital dacryocystoceles is relatively uncommon and is estimated to occur in 1 of 3884 births.'' It has been reported to be more common in female*'^ and non-Hispanic white patients. [archive.org]
Clinical studies indicate that nasal disease is sporadic in patients undergoing DCR.[9] Familial predisposition and osteoporotic changes have also been suggested as being predisposing factors.[9] Epidemiology Congenital dacryostenosis is quite common [statpearls.com]
Pathophysiology
New insight into the pathophysiology of primary acquired dacryostenosis. Ophthalmology. 2001;108(12):2329–36. PubMed CrossRef Google Scholar 8. Burns JA, Cahill KV. Modified Kinosian dacryosystorhinostomy: a review of 122 cases. [link.springer.com]
Ophthalmic plastic and reconstructive surgery. 1992; [PubMed PMID: 1554647] [9] Paulsen FP,Thale AB,Maune S,Tillmann BN, New insights into the pathophysiology of primary acquired dacryostenosis. [statpearls.com]
The exact cause and pathophysiology that underlies primary infantile glaucoma remains unknown. [medtextfree.wordpress.com]
Pathophysiology of Infantile Glaucoma Very little information is known pertaining to the causes of the impaired outflow in each of the primary childhood glaucomas. [entokey.com]
A major understanding of the underlying pathophysiology of autoimmune diseases has been the application of genome wide association scans that have identified a degree of genetic sharing among the autoimmune diseases. [wikivisually.com]
Prevention
Log out Cancel Table of Contents From Cochrane database of systematic reviews (Online) 2018 - 10 Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. [medscape.org]
[…] care processes (977) Fall prevention (46) Immunizations (98) Prenatal care (68) Primary prevention (596) Secondary prevention (425) Tertiary prevention (10) ► Patient Population ► Age (662) Adolescent (13-18 years) (260) Adult (19-44 years) (77) Aged [innovations.ahrq.gov]
Special antiviral eye drops or ointments are used for herpes infections of the eye Opthalmia Neonatorm - Complications and prevention Complications: (most from herpes) Blindness, inflammation of the iris, scar or hole in the cornea Prevention: screening [quizlet.com]
The final part of the operation is meticulous closure of the skull base defect so as to prevent a postoperative CSF leak. [myslide.es]