Presentation
To present the management of a rare case of persistent pupillary membrane (PPM) associated with high myopia and amblyopia. A 12-year-old boy presented with progressive diminution of vision in the right eye since childhood. [ncbi.nlm.nih.gov]
A 21-year-old woman presented for a routine eye examination. Her visual acuity was 20/25 in the right eye and 20/40 in the left eye, and her pupils were reactive. [nejm.org]
Entire Body System
- Developmental Delay
The patient had associated omphalocele, sensorineural hearing loss, and developmental delay. Magnetic resonance imaging revealed agenesis of the corpus callosum. [ncbi.nlm.nih.gov]
Respiratoric
- Aspiration
The purpose of using Malyugin ring in this case was to avoid intraoperative bleeding caused by cutting blood vessels that might have been present within the pupillary membrane, to secure a wide and stable pupil, to avoid accidental aspiration of the membrane [ncbi.nlm.nih.gov]
The Provisc was removed with a Simco irrigation/aspiration canula. The corneal wounds each required a single 10/0 nylon suture which were removed under anaesthetic 3 months postoperatively. [bjo.bmj.com]
Patients who are unconscious or unable to perform self-care activities should have mouth care as often as needed to keep the mouth clean and moist and avoid aspiration of debris and infectious microorganisms. [medical-dictionary.thefreedictionary.com]
Eyes
- Blurred Vision
We describe a case of bilateral total PPM in a 36-year-old female who presented with complaints of blurred vision in both the eyes. Dense pupillary membranes obscuring the visual axis need early surgical treatment. [ncbi.nlm.nih.gov]
The right eye had no previous treatment and the patient was aware of longstanding blurred vision in the right eye. The PPM in the left eye had been treated with surgical excision at the age of 9 years. [ghrnet.org]
Psychiatrical
- Suggestibility
The presence of a mesodermal pupillary membrane despite absence of the iris suggested a primary neuroectodermal defect as the pathogenetic factor in this case of aniridia. [ncbi.nlm.nih.gov]
This result suggests that more severe occlusion by hyperplastic persistent pupillary membrane in the neonatal period can cause more severe ametropia associated with either a myopic, hyperopic, or cylindrical trend. [healio.com]
Face, Head & Neck
- Broad Nasal Bridge
Facial manifestations included broad nasal bridge, hypertelorism, and downward-slanting of palpebral fissures. The patient had associated omphalocele, sensorineural hearing loss, and developmental delay. [ncbi.nlm.nih.gov]
Treatment
The mean absolute value of anisometropia was greater in the surgical treatment group than in the medical treatment and observation groups (P = .048). [ncbi.nlm.nih.gov]
This treatment appeared to be successful with best-corrected visual acuity (BCVA) of 20/40, although there was now a high degree of myopia (-16 D). [ghrnet.org]
[…] modality: a surgical treatment group, a medical treatment group, and an observation group. [healio.com]
Prognosis
Although visual prognosis for properly managed patients is favorable, close follow-up of VA is needed since there is a chance of deprivation amblyopia. 6 Our case represents a PPM with acceptable pupillay opening in whom appropriate management resulted [academic.oup.com]
Surgery is generally performed in the first weeks or months of life, with good visual prognosis and consists of excision of the pupillary membrane using Vannas or vitreous scissors. [reviewofophthalmology.com]
In this study, we reviewed the medical records of 39 eyes with hyperplastic persistent pupillary membrane not associated with any other ocular anomaly affecting visual outcome and evaluated die visual prognosis and refractive change. [healio.com]
In cases such as this one, tests of macular function like entoptic tests, retina acuity meter (RAM) or laser interferometry can be performed to confirm the status of the macula and the visual prognosis. [djo.harvard.edu]
Etiology
Other etiologic factors include dehydration, mouth breathing, poor oral hygiene, radiation to the head or neck, and antineoplastic agents. [medical-dictionary.thefreedictionary.com]
Prevention
Firstly, the argon laser was used to photocoagulate the part of the membrane adhering to the iris surface and so to prevent any bleeding caused by the YAG laser. [ghrnet.org]
We suggest that early intervention in the first weeks or months of life is necessary to prevent the development of amblyopia. If mydriasis is unsuccessful, surgery is recommended followed by optical correction and occlusion therapy as necessary. [ncbi.nlm.nih.gov]
Teaching Hospital in Karachi Qidwai W, Waheed S, Ayub S, Syed, IA Role of Flax and Flax Gum in Health and Diabetes Mitra A, Bhattacharya D CABG at SKIMS - An Initial Experience Lone RA, Ahangar AG, Zubair H, Hussain Z, Dar AM Does HIV Infection Afford a Prevention [indmedica.com]
[…] pupillary dilation, because of adherences between pupillary membrane and the iris, or posterior synechiae.(7)When the red reflex is no longer visible or severely compromised, surgery should immediately be indicated, with the aim to rescue the view and prevent [docslide.us]
In humans, mucous membranes and the skin prevent the entry of pathogens. [medical-dictionary.thefreedictionary.com]