Significant Ocular Damage Research Articles

Repeated-dose toxicity and toxicokinetic study of isobutylparaben in rats subcutaneously treated for 13weeks.

Parabens have historically served as antimicrobial preservatives in a range of consumables such as food, beverages, medications, and personal care products due to their broad-spectrum antibacterial and antifungal properties. Traditionally, these compounds were believed to exhibit low toxicity, causing minimal irritation, and possessing limited sensitization potential. However, recent evidence suggests that parabens might function as endocrine-disrupting chemicals (EDCs). Consequently, extensive research is underway to elucidate potential human health implications arising from exposure to these substances. Among these parabens, particular concerns have been raised regarding the potential adverse effects of iso-butylparaben (IBP). Studies have specifically highlighted its potential for inducing hormonal disruption, significant ocular damage, and allergic skin reactions. This study aimed to evaluate the prolonged systemic toxicity, semen quality, and estrus cycle in relation to endocrine disruption endpoints, alongside assessing the toxicokinetic behavior of IBP in Sprague-Dawley rats following a 13-week repeated subcutaneous administration. The rats were administered either the vehicle (4% Tween 80) or IBP at dosage levels of 2, 10, and 50mg/kg/day for 13weeks. Blood collection for toxicokinetic study was conducted on three specified days: day 1 (1st), day 30 (2nd), and day 91 (3rd). Systemic toxicity assessment and potential endocrine effects were based on various parameters including mortality rates, clinical signs, body weights, food and water consumption, ophthalmological findings, urinalysis, hematological and clinical biochemistry tests, organ weights, necropsy and histopathological findings, estrus cycle regularity, semen quality, and toxicokinetic behavior. The findings revealed that IBP induced local irritation at the injection site in males at doses ≥ 10mg/kg/day and in females at 50mg/kg/day; however, systemic toxicity was not observed. Consequently, the no-observed-adverse-effect level (NOAEL) for IBP was determined to be 50mg/kg/day in rats of both sexes, indicating no impact on the endocrine system. The toxicokinetics of IBP exhibited dose-dependent systemic exposure, reaching a maximum dose of 50mg/kg/day, and repeated administration over 13weeks showed no signs of accumulation.

No Pain, No Gain – Topical Anesthesia-Induced Keratopathy

Topical anesthesia is an indispensable element of modern ophthalmic practice, most valuable during minor procedures and ocular examinations. However, regularly applied and prolonged use of local anesthetics may cause significant ocular damage. The spectrum of adverse effects is heterogeneous, ranging from mild conjunctival injection with superficial punctate keratopathy to persistent corneal epithelial defects, endothelial decompensation, ulcer formation, secondary infectious keratitis, and possible corneal perforation [1], [2]. Hence, timely identification of the underlying cause is essential to initiate targeted therapeutic measures. However, as topical anesthesia-induced keratopathy is a rare entity in Switzerland and its clinical picture may resemble infectious keratitis [3], the ophthalmologistʼs initial diagnosis poses a challenging task. This case report aims to further raise awareness about topical anesthetic abuse keratopathy.

Incidence of Visual Improvement in Uveitis Cases with Visual Impairment Caused by Macular Edema

Among cases of visually significant uveitic macular edema (ME), to estimate the incidence of visual improvement and identify predictive factors. Retrospective cohort study. Eyes with uveitis, seen at 5 academic ocular inflammation centers in the United States, for which ME was documented to be currently present and the principal cause of reduced visual acuity (<20/40). Data were obtained by standardized chart review. Decrease of ≥ 0.2 base 10 logarithm of visual acuity decimal fraction-equivalent; risk factors for such visual improvement. We identified 1510 eyes (of 1077 patients) with visual impairment to a level <20/40 attributed to ME. Most patients were female (67%) and white (76%), and had bilateral uveitis (82%). The estimated 6-month incidence of ≥ 2 lines of visual acuity improvement in affected eyes was 52% (95% confidence interval [CI], 49%-55%). Vision reduced by ME was more likely to improve by 2 lines in eyes initially with poor visual acuity (≤ 20/200; adjusted hazard ratio [HR] 1.5; 95% CI, 1.3-1.7), active uveitis (HR, 1.3; 95% CI, 1.1-1.5), and anterior uveitis as opposed to intermediate (HR, 1.2), posterior (HR, 1.3), or panuveitis (HR, 1.4; overall P = 0.02). During follow-up, reductions in anterior chamber or vitreous cellular activity or in vitreous haze each led to significant improvements in visual outcome (P <0.001 for each). Conversely, snowbanking (HR, 0.7; 95% CI, 0.4-0.99), posterior synechiae (HR, 0.8; 95% CI, 0.6-0.9), and hypotony (HR, 0.2; 95% CI, 0.06-0.5) each were associated with lower incidence of visual improvement with respect to eyes lacking each of these attributes at a given visit. These results suggest that many, but not all, patients with ME causing low vision in a tertiary care setting will enjoy meaningful visual recovery in response to treatment. Evidence of significant ocular damage from inflammation (posterior synechiae and hypotony) portends a lower incidence of visual recovery. Better control of anterior chamber or vitreous activity is associated with a greater incidence of visual improvement, supporting an aggressive anti-inflammatory treatment approach for ME cases with active inflammation.

Prévalence des ruptures de la capsule dorsale du poignet chez 100 patients ayant une arthroscopie pour douleur de poignet

Button batteries can cause local tissue necrosis within 2 h of exposure due to hydrolysis of tissue fluid and generation of hydroxide ions. Tissue damage resulting from battery exposure has been associated with acute and chronic complications via several routes, however, previous experience with ocular battery exposures is predominantly limited to batteries that have exploded or penetrated the eye.A case is presented of an intact battery causing significant damage after ocular exposure without penetrating the eye.An 18-year-old woman presented to the Emergency Department after a toy balloon propelled a button battery into the patient's eye. The battery did not penetrate the orbit and was intact upon removal from the inferior fornix in the operating room 4 h later. The patient had severe conjunctival ulceration, subconjunctival hemorrhage, vitreous opacification, and a partially dilated pupil, with the greatest area of injury adjacent to the negative pole of the battery. The eye was extensively irrigated and the patient was treated with topical antibiotics, steroids, and a daily rodding procedure to prevent conjunctival adhesions. The eye ultimately healed over the subsequent 6 months, with normal visual acuity on follow-up.Prolonged ocular exposure to an intact battery can cause significant tissue necrosis, which may threaten sight. Early removal is critical to prevent significant ocular damage and visual compromise.

Severe Ocular Injury after Button Battery Exposure

BackgroundButton batteries can cause local tissue necrosis within 2h of exposure due to hydrolysis of tissue fluid and generation of hydroxide ions. Tissue damage resulting from battery exposure has been associated with acute and chronic complications via several routes, however, previous experience with ocular battery exposures is predominantly limited to batteries that have exploded or penetrated the eye. ObjectivesA case is presented of an intact battery causing significant damage after ocular exposure without penetrating the eye. Case ReportAn 18-year-old woman presented to the Emergency Department after a toy balloon propelled a button battery into the patient's eye. The battery did not penetrate the orbit and was intact upon removal from the inferior fornix in the operating room 4h later. The patient had severe conjunctival ulceration, subconjunctival hemorrhage, vitreous opacification, and a partially dilated pupil, with the greatest area of injury adjacent to the negative pole of the battery. The eye was extensively irrigated and the patient was treated with topical antibiotics, steroids, and a daily rodding procedure to prevent conjunctival adhesions. The eye ultimately healed over the subsequent 6 months, with normal visual acuity on follow-up. ConclusionProlonged ocular exposure to an intact battery can cause significant tissue necrosis, which may threaten sight. Early removal is critical to prevent significant ocular damage and visual compromise.

Diffuse retinal injury from a non-penetrating TASER dart

To describe a non-penetrating TASER gun injury resulting in a small exudative retinal detachment but significant visual acuity and retinal function loss as demonstrated by electroretinography (ERG). A 39-year-old man presented to the emergency department with a TASER barb embedded in his right lower lid. A complete clinical ophthalmologic examination and surgical extrication were performed, as well as radiologic imaging and Ganzfeld electroretinography. No scleral penetration was observed on surgical exploration. Retinal examination showed a peripheral exudative detachment. Subsequent follow-up revealed progressive resolution of the detachment and improvement in visual acuity. The ERG showed a 63-70% decrease in rod a- and b-waves, while isolated cone responses were reduced by only 10%, with a minimal increase in implicit time. This case shows that periocular TASER injuries, even if apparently superficial, may result in significant ocular damage. ERG may be useful in the diagnosis of visual loss attributed to disturbance in photoreceptor function, in the absence of anatomically evident damage.

Ocular findings following trauma from paintball sports

To raise awareness of potential significant ocular damage and visual loss secondary to paintballs in those not wearing ocular protection and to report high incidence of chorioretinitis sclopetaria from paintball contusion. We reviewed cases of eye injury presenting to a single institution from 2000 to 2005. Those cases in which the injury was attributed to paintballs were identified and evaluated to determine ocular findings and visual prognosis. Ocular paintball injuries occurred in eight male subjects and one female subject (nine eyes) with an average age of 16 years (range, 11-26). None had ocular protection at the time of ocular injury. On initial examination, vitreous haemorrhage was present in six eyes (67%), maculopathy, hyphema, cataract, and commotio retinae were each present in four eyes (44%). Two eyes suffered retinal detachment and one eye an optic nerve avulsion. Chorioretinitis sclopetaria occurred in four eyes (44%). The final visual acuity was > or =20/40 in three eyes, 20/50 to 20/150 in two eyes, and < or =20/200 in four eyes. Injuries owing to paintballs can result in severe ocular damage and visual loss. Increased awareness and need for proper ocular protection should be emphasized by ophthalmologists. Chorioretinitis sclopetaria occurs with a high frequency and its presence should be recognized, as its management is different from retinal tear or detachment.

Severe Orbitopalpebral Emphysema after Nose blowing Requiring Emergency Decompression

Orbital emphysema is a frequent condition associated with medial wall fractures after blunt trauma. It is usually a benign, self-limited phenomenon. The authors are unaware of previous reports of severe orbital emphysema needing emergency decompression with no evidence of any previous significant trauma such as the case presented herein. A 51-year-old woman had painful swelling of the left orbital region that prevented her from opening her eyelids. She complained of a coincident cold with abundant mucous rhinorrhea. She had blown her nose vigorously several times. A computed tomography scan revealed a left proptosis, an extensive orbitopalpebral emphysema, and a blowout fracture of the medial wall of the left orbit. A complete ophthalmic examination was only possible after a needle decompression. No significant ocular damage was observed, so outpatient treatment was provided. Twenty-eight hours later, the swelling had almost disappeared, and the ocular assessment was normal. A forceful expiratory effort raising intranasal pressure may cause a medial wall orbital fracture. If the airway hyperpressure episodes are repeated, a severe orbitopalpebral emphysema may develop. Should there be any suspicion of vascular compression, it must be drained to allow the assessment of visual function and theoretically prevent a potentially irreversible ischemic visual loss.

Profile of Trauma-related Residual Periorbital Deformities in Indian Children

To describe the profile of periorbital trauma in Indian children less than 10 years of age. Thirty two children with periorbital injuries were evaluated, over a period of 1 year. Demographic features, mechanism and type of injury were noted. Detailed ophthalmic examination and investigations, including X-ray, ultrasonography, and CT scan were done as needed. Patients requiring secondary intervention were followed-up up to 6 months after surgery. Among the 32 children seen, 20 (63%) were males, 25 of 32 (78%) were between 4 and 7 years of age. Fall was the cause of injury in 31% (10/32) and assault in 28% (9/32). Medial canthal injury was the commonest of all periorbital injuries manifesting as lacrimal drainage obstruction and telecanthus. Associated fractures of the naso-orbital bones were present in 7 patients (22%) and ocular injuries were seen in 18 patients (56%). Secondary intervention was performed in 20 patients and lacrimal drainage procedure was the commonest surgery, performed in 15 out of 20 (75%). Periorbital injuries in children not only lead to midfacial deformities and lacrimal drainage obstruction but are associated with significant ocular damage also.

Predictive factors for the development of rubeosis following proton beam radiotherapy for uveal melanoma

AIMS/BACKGROUNDProton beam radiotherapy can effectively treat primary uveal melanomas of any size. Some patients, however, develop adverse late effects following treatment and the purpose of this study was to determine...

Ocular effects of UV-B exposure.

Although an association between UV-B exposure and ocular damage has been long suspected, this relationship is still not well quantified. Cataract is the most significant ocular damage associated with UV-B exposure. Initial studies of the association between UV-B exposure and cataract were hampered by a lack of precision in the assessment of cataract and a failure to separate cataract types. With a few exceptions, most studies have not assessed individual ocular UV-B exposure but have used ambient levels or isolated behaviours. Ecologic studies show there is more cataract in sunny areas, but whereas ambient UV-B fluxes may change by a factor of 3 or 4 over the globe, individual behaviour can change ocular exposure in a given location by 20-fold or more. The Chesapeake Bay Watermen studies assessed individual ocular UV-B exposure and have shown a consistent relationship between exposure to UV-B and the risk of both cortical and posterior subcapsular cataract. However, further work to refine these findings is sorely needed.