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Keratopathy


Presentation

  • PURPOSE: To present an atypical case of herpes simplex virus (HSV) endotheliitis.[ncbi.nlm.nih.gov]
  • A similar deep stromal lesion appeared in the right eye 2 years after initial presentation. We present an unusual case of paraproteinemic keratopathy with a uniquely asymmetric presentation that resulted in a diagnosis of multiple myeloma.[ncbi.nlm.nih.gov]
  • Deposits were also present in the wing cell layer. In the anterior stroma these deposits were rare. Atypically shaped and branched nerves were also present in the anterior stroma.[ncbi.nlm.nih.gov]
  • Visual acuity and anterior segment examination at presentation and follow-up; local therapy; systemic diagnosis and management; and histopathologic, immunohistochemical, in situ hybridization, and ultrastructural findings.[ncbi.nlm.nih.gov]
  • RESULTS: A 15-year-old female contact lens wearer presented complaining of eye pain and redness in the left eye.[ncbi.nlm.nih.gov]
Corneal Opacity
  • A systemic work-up, including serologic tests like serum protein or cholesterol levels, is needed in patients with unexplainable corneal opacity.[ncbi.nlm.nih.gov]
  • Ophthalmologists who encounter corneal opacities may order the appropriate diagnostic studies to determine the presence of occult systemic disease.[ncbi.nlm.nih.gov]
  • The 7-year follow-up of case 2 showed a reduction of lattice-like opacity to moderate diffuse corneal opacity.[ncbi.nlm.nih.gov]
  • Literature review revealed 72 patients with bilateral PPK (34 male, mean age 57; 38 female, mean age 58) in 51 studies of MGUS published from 1934 to 2015 and disclosed six additional corneal opacity patterns.[ncbi.nlm.nih.gov]
  • West Indian punctate keratopathy (WIPK) is characterized by stable, asymptomatic, white superficial corneal opacities. We examined this patient's lesions with in vivo confocal microscopy.[ncbi.nlm.nih.gov]
Corneal Irritation
  • irritation stimulated an intense eye rubbing with epithelial trauma.[eyewiki.org]
Periorbital Rash
  • Previously reported ocular adverse reactions of erlotinib include trichomegaly, periorbital rash, ectropion, blepharitis, persistent corneal epithelial defect, corneal ulcer and perforation.[ncbi.nlm.nih.gov]
Facial Swelling
  • He complained of ocular and facial pain, facial swelling, and transient blurred vision. First aid by the beach included a hot shower and methoxyflurane for the pain.[ncbi.nlm.nih.gov]
Facial Pain
  • He complained of ocular and facial pain, facial swelling, and transient blurred vision. First aid by the beach included a hot shower and methoxyflurane for the pain.[ncbi.nlm.nih.gov]
Agitation
  • We also recorded Acute Physiology and Chronic Health Evaluation II score, daily Sequential Organ Failure Assessment score, mechanical ventilation, Richmond Agitation-Sedation Scale, and level of eye care.[ncbi.nlm.nih.gov]

Workup

  • Hematologic workup resulted in a diagnosis of IgG kappa multiple myeloma. Histopathology was significant for semicrystalline deposits in the posterior stroma. The patient's visual acuity improved to 20/50 7 months after penetrating keratoplasty.[ncbi.nlm.nih.gov]
  • Band-shaped keratopathy presenting without an obvious etiology merits a complete systemic and ophthalmic workup.[ijo.in]
  • Clinical examination: A general medical workup is advisable in patients with systemic association of the disease. Examination of eyes should be carried out under slit lamp (bio-microscopy) by an eye specialist.[aimu.us]

Treatment

  • New potential treatments include collagen cross-linking (CXL), cultured endothelial cell injection, and topical treatment with Rho-associated kinase (ROCK) inhibitor.[ncbi.nlm.nih.gov]
  • Surgical treatment using EDTA is safe and effective treatment for band keratopathy.[ncbi.nlm.nih.gov]
  • After proper diagnosis, the first step of treatment is the cessation of drug abuse. In addition to medical treatment, early AMT has an advantage of early pain relief and consequential elimination of the need for topical anesthetic instillation.[ncbi.nlm.nih.gov]
  • Cessation of IVIG and treatment with topical and systemic corticosteroids reversed the finding. At final follow-up, vision in both eyes was normal.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: The CXL efficiently relieved pain due to BK for 1 year after treatment.[ncbi.nlm.nih.gov]

Prognosis

  • CONCLUSIONS: Kpro-1 is associated with an excellent prognosis for graft retention, acceptably low prevalence of sight-threatening complications, and highly satisfactory visual improvement in eyes with HSV keratopathy, but not in eyes with HZV keratopathy[ncbi.nlm.nih.gov]
  • Amniotic membrane transplant may be considered as a longer-term treatment for bullous keratopathy patients, especially in patients with poorer visual prognosis, but it may also be used as an interim measure for patients awaiting corneal transplant.[ncbi.nlm.nih.gov]
  • Patients with familial idiopathic BSK could be cases with poor prognosis for treatment with EDTA due to an early recurrence of the disease.[ijo.in]
  • Prognosis Mild EK has an excellent prognosis, with most if not all patients making a full recovery if the cornea remains intact without erosion, ulceration, or microbial infection. [18] Severe cases can lead to scarring, perforation and permanent vision[eyewiki.aao.org]
  • The prognosis for visual improvement and relief of symptoms is excellent following PTK for band keratopathy (5-9). More than 95% of patients experience partial or complete symptomatic relief.[webeye.ophth.uiowa.edu]

Etiology

  • There was no evidence of infectious or systemic etiologies. Genetic testing for the UBIAD1 gene for Schnyder corneal dystrophy was negative.[ncbi.nlm.nih.gov]
  • BACKGROUND: Bullous keratopathy (BK), a severe sight-threatening disorder can have a variety of etiologies such as prophylactic laser iridotomy, intraocular surgery, trauma, and other ocular disorders.[ncbi.nlm.nih.gov]
  • […] of inflammatory cells within the cornea or anterior chamber, central stromal necrosis, and corneal opacification, with an onset of 3 to 9 days after refractive surgery; This case report reviews the clinical findings, differential diagnosis, possible etiologies[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Cross-linking associated with sterile keratitis is an unusual entity of unknown etiology, which can lead to stromal scarring.[ncbi.nlm.nih.gov]
  • Abstract Climatic droplet keratopathy (CDK) is a degenerative corneal disease of unknown etiology. We described CDK for the first time in Latin America in the Argentinean Patagonia (El Cuy).[ncbi.nlm.nih.gov]

Epidemiology

  • The Epidemiology of Eye Disease. Johnson GJ, Minassian DC, Weale RA and West SK: 58:(3rd). Singapore: World Scientific Publishing Company. 82012. 6.[spandidos-publications.com]
  • A.Congenital upper eyelid coloboma: embryologic, nomenclatorial, nosologic, etiologic, pathogenetic, epidemiologic, clinical, and management perspectives.[eyewiki.aao.org]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of this condition remains elusive and requires further investigation. No author has a financial or proprietary interest in any material or method mentioned.[ncbi.nlm.nih.gov]
  • The pathophysiology of this condition remains elusive to date and highlights the challenges of noninvasive diagnostic techniques and yet the utility of molecular genetic analysis in elucidating the etiology of this unique clinical presentation.[ncbi.nlm.nih.gov]
  • Future confocal microscopy at different stages will help clarify the pathophysiologic condition of this rare syndrome.[ncbi.nlm.nih.gov]
  • A discussion of the causes, pathophysiology, and treatment of interstitial keratitis is also undertaken. The differential diagnosis and appropriate laboratory tests for patients with interstitial keratitis is given.[morancore.utah.edu]
  • Pathophysiology The cornea has a high density of nerve endings from the long posterior ciliary nerves and is 100 times more sensitive than the conjunctiva.[aao.org]

Prevention

  • FINDINGS: The use of poly ethylene cover (0.59 0.665) was significantly more effective in prevention of keratopathy than other methods (P 0.001).[ncbi.nlm.nih.gov]
  • To the best of our knowledge, this is the first report of successful use of ASEs in treating and preventing recurrence of ulcers in the context of bullous keratopathy.[ncbi.nlm.nih.gov]
  • Ephx2 depletion had no detectable effects on STZ-induced hyperglycemia but prevented the development of tear deficiency. Ephx2 -/- mice showed an acceleration of hyperglycemia-delayed epithelium wound healing.[ncbi.nlm.nih.gov]
  • OBJECTIVES: To compare the effectiveness of bandage contact lenses and punctal plugs with ocular lubricants in preventing corneal damage in mechanically ventilated and sedated critically ill patients.[ncbi.nlm.nih.gov]
  • Whatever you’re doing to prevent DLK should be good at preventing this as well.” Editors’ note : All of the physicians interviewed have financial affiliations with Advanced Medical Optics (Santa Ana, Calif.).[eyeworld.org]

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