Sudden Painless Loss Of Vision Research Articles

Delayed Vitreous Hemorrhage After Placement of a Ganciclovir Implant for Cytomegalovirus Retinitis

To report a massive vitreous hemorrhage in a 26-year-old woman that occurred approximately 6 weeks after she received a ganciclovir implant. Case report. The cytomegalovirus retinitis was inactivated after uncomplicated insertion of a ganciclovir implant. Approximately 6 weeks later, the patient was examined for sudden painless visual loss caused by a dense vitreous hemorrhage. Sustained-release ganciclovir implants may be associated with delayed vitreous hemorrhage.

OPHTHALMOMYIASIS INTERNA POSTERIOR

The prognosis for patients with ophthalmomyiasis Interna posterior is variable. In many patients the larva remains in the eye for years without inducing inflammation or loss of vision. Sometimes, however, the migrating larva involves the macula and optic nerve and results in permanent visual loss or even blindness. Our patient presented with sudden painless loss of vision in the right eye that was caused by ophthalmomyiasis interna posterior. Hemorrhage of the optic nerve head suggested that the fly larva had entered the vitreous cavity from the optic nerve head. Subretinal tracts were sequelae of the subretinal migration of the organism. Sequential photographs documented the fly larva migration into the optic nerve head head from the vitreous cavity. The organism was removed by pars plana vitrectomy and retinectomy. In spite of the successful removal of the first stage fly larva, the visual acuity remained poor because of optic nerve atrophy. We suggest early removal of fly larvae to prevent damage and visual loss in cases of ocular myiasis interna posterior.

Varicella-zoster-Virus-Infektionen der Netzhaut bei Patienten mit und ohne Immunsuppression

Infections of the retina with the varicella-zoster virus can lead to severe visual impairment. Patients with immunodeficiency are particularly predisposed to viral infections, and the alterations of the immune system may lead to a modified clinical picture. Two cases of infections of the retina with the varicella-zoster virus in an immunocompromised and an immunocompetent patient are presented. The first otherwise healthy patient showed the typical clinical picture of the "acute retinal necrosis syndrome" with orbital pain and decrease of vision. He had inflammatory infiltration of the vitreous and the anterior chamber, retinal vasculitis, optic disc edema and whitening of the peripheral retina with full thickness retinal necrosis. The second patient with AIDS presented with a history of sudden painless loss of vision in one eye. He had a swollen optic disc, inflammatory infiltrates in the choroid and virtually no cellular infiltration of the vitreous or the anterior chamber. The diagnosis of varicella-zoster virus infection of the retina was confirmed in both patients by polymerase chain-reaction of aqueous and vitreous humor, by determination of intraocular antibody titers and immunohistochemistry on retinal biopsy material, respectively. In both patients no inflammation in the fellow eye developed under therapy with aciclovir. The first patient regained full vision after vitrectomy with membrane dissection. Varicella-zoster virus infections of the retina can present with different clinical pictures in immunocompromised and immunocompetent patients. Early diagnosis and adequate medical and surgical therapy can significantly improve visual prognosis.

Ophthalmology

A comprehensive textbook of ophthalmology, which presents all the relevant information needed for examinations. The authors have produced a coherent summary of this often demanding speciality, the text is well-expressed, logically organized and uses clear diagrams, photographs and lists of key points to make complex issues easier to understand and revise. The authors explain, step-by-step, the practical ophthalmological procedures that all GPs and Casualty Officers need which, with the practical checklist, makes this a useful everyday reference. Following a concise description of anatomy and physiology assessment and refraction, the book takes a problem-solving approach to the major ophthalmological signs and symptoms: squint or strabismus, glaucoma, red eye, sudden painless loss of vision, gradual painless loss of vision, neuro-ophthalmological problems, diabetes, trauma. Supplementing these core clinical problems are comprehensive chapters on tropical ophthalmology, genetics and the epidemiology of visual loss.

Anterior Ischemic Optic Neuropathy as a Complication of Hemodialysis

Hypotension is a common and sometimes difficult to manage occurrence during hemodialysis. The consequences of dialysis-induced hypotension are unpredictable. Anterior ischemic optic neuropathy is an entity associated with many systemic processes, including shock. Anterior ischemic optic neuropathy presents as sudden painless loss of vision. This is the first report of anterior ischemic optic neuropathy as a result of hemodialysis-associated hypotension.