Search

Between February 1988 and May 1990, the authors treated 12 perforating ocular injuries caused by anesthetic injections around the eye. All 12 injections were performed by nonophthalmologists. Eleven were performed by anesthesiologists and one by a certified nurse anesthetist. Five were caused by blunt needles and seven by sharp needles. Two of the eyes had multiple posterior exit wounds. The five eyes that had sharp needle, single perforations (i.e., one entrance wound and one exit wound) were easily managed with cryopexy, laser, or observation. All five of these eyes have a visual acuity of 20/40 or better. Six vitrectomies were performed on the five patients with single perforations caused by blunt needles; three of these eyes have a visual acuity of counting fingers or worse. The two patients who had multiple posterior exit wounds required a total of four procedures. The visual acuity in these eyes is 20/400 and light perception. Anesthesia personnel should be well trained before attempting ocular anesthesia. The use of blunt needles does not prevent ocular penetration.

The case of a 29-year-old former parenteral drug abuser who presented with a 3rd nerve palsy and contralateral ataxia is reported. The patient was found to have a positive HLTV-III titer and acquired immune deficiency syndrome was diagnosed. Computed tomography demonstrated two ring-enhancing lesions in the brain which were presumed to be due to Toxoplasma gondii.

The development of subretinal neovascularization as a complication of retinochoroidal coloboma has been reported in only three cases, in only one of which was the patient treated with laser photocoagulation. We report an additional case of subretinal neovascularization associated with retinochoroidal coloboma in a 57-year-old man that was treated with laser photocoagulation. The patient's visual acuity has remained stable at 20/50.

We describe a 39-year-old man in whom progressive pulsatile proptosis developed 2 days after he suffered a head injury. Computed tomography revealed an isolated blow-in fracture of the orbital roof with herniation of the left frontal lobe into the orbit. Neurosurgical intervention to repair the orbital defect led to full recovery.

Silicone oil is used with increasing frequency to treat complex vitreoretinal disorders. We report our results in 48 consecutive cases (50 eyes) with at least 6 months' follow-up. Postoperatively the retina was completely attached in 76% of eyes. A final visual acuity of 5/200 or better was achieved in 66% of eyes. Complications seen with silicone oil injection include recurrent detachment, corneal decompensation, cataract formation and increased intraocular pressure. The use of sophisticated vitreoretinal surgical techniques in addition to silicone oil injection allowed successful management in eyes that would otherwise have had a poor prognosis.