Klinika oczna
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Review Case Reports
[Posterior ischemic optic neuropathy following bilateral radical dissection of cervical lymph nodes].
Visual loss is a rare and potentially devastating complication of surgery under general anesthesia. We present a case of blindness after simultaneous bilateral neck dissection and discuss the perioperative circumstances and the possible causes. We also compare and contrast other such cases described in the literature and remind the clinical criteria for the diagnosis of perioperative type of posterior ischemic optic neuropathy.
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Examination of the pupils' light reaction and estimation of the pupils' diameter are the components of the routine physical examination of a patient. Disturbances in pupils' light reaction, unequal size of the pupils indicate damage of the nervous system and require careful diagnosis, both neurological and ophthalmological. Different aspects of anatomy, physiology and the most common pathological syndromes associated with disturbed pupils' light reaction and unequal diameters of the pupils were presented in the article. Early diagnosis and proper treatment can allow to improve prognosis in the analyzed patient group.
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Intraocular foreign bodies (IOFBs), are the major cause of penetrating ocular trauma and the most serious problem is the resulting impairment of visual function. In this paper, based on published reports and their clinical experience, authors discuss questions of pathogenesis, epidemiology and clinical features of IOFB injuries. Special attention was paid on primary and secondary complications, which include mechanical lesions of the ocular tissues, metallosis and endophthalmitis.
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To present two cases of neuroretinitis in cat scratch disease We present two girls treated in Department of Ophthalmology of Poznai University of Medical Sciences because of unilateral, painless decrease of vision. Both patients presented following cat exposure fever and lymph nodes swelling. Ophthalmoscopic findings was neuroretinitis (optic disc edema with the macular star). ⋯ One of our patients received treatment which included oral antibiotic (macrolides) and steroid. The second patient was left without treatment. In our case--the duration of visual loss was longer in patient who was not treated.
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Review
[Perioperative posterior ischemic optic neuropathy--pathogenesis and clinical characteristics].
Posterior ischemic optic neuropathy (PION) is an uncommon cause of perioperative visual loss. It has been most frequently reported after spinal surgery and radical neck dissection. This type of PION occurs in the setting of profound hypotension and severe anemia during the perioperative period. ⋯ Diagnosis of PION can be made only after other causes of the optic neuropathy have been excluded. The prognosis for visual recovery is generally poor. Although correction of hemodynamic derangements may be beneficial, no treatment has proven to be effective.