All patients had stable visual acuity with low rates of PCO 2.5 years after surgery. The PCO rate with the Akreos IOL was similar to that with other acrylic IOLs reported in the literature.
Although infrequent, this complication has poor outcomes. The definitive management is removal of the weight. Information regarding implanted gold, and previous reactions should be elicited pre-operatively. Type IV hypersensitivity should be considered in patients with persistent inflammation that do not respond to antibiotic or steroid therapy.
A patient with typical rheumatoid arthritis is presented. After a short period of the disease a hypereosinophilic syndrome (HES) developed with vasculitis, pulmonary fibrosis, and thrombosis, and the disease took a malignant course. The patient died within a year after the diagnosis of HES. High titres of rheumatoid factor were manifested and total complement (CH50) was very low, indicating an active immune disease. As HES has been suggested to have an autoimmune aetiology, these findings are interesting, as positive rheumatoid serology has very rarely been reported in patients with this syndrome.
Purpose: To report the first case of cavernous sinus thrombosis (CST) due to methicillin-resistant Staphylococcus aureus (MRSA) infection. Also, to emphasise that MRSA infection may be acquired in the community. Method: Single observational case report. Results: CST has a very high mortality and morbidity and has been reported as a rare complication of localised and systemic infection. We present the case of a 35-year-old female intravenous (IV) drug user presenting with septicaemia and heroin overdose. Following initial resuscitation, she gained consciousness but remained confused with Glasgow Coma Scale (GCS) of 8/15. The patient was febrile and there was a marked bilateral proptosis, eyelid swelling with erythema, and conjunctival chemosis. Pupils were pinpoint. Ocular movements appeared limited. In view of the high index of suspicion of CST, the patient was intubated for an urgent CT scan of the brain and orbits, which confirmed the disorder's diagnosis. Highdose IV ceftazadime, metronidazole, and flucloxacillin was commenced. Blood cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA). The patient had not had any prior hospital contact. The source of infection was not identified, but the subsequent CT scan indicated multiple intracerebral abscesses and multiple cavitating abscesses of the lungs with a large pleural effusion. The patient died nine days after admission to hospital. Conclusion: MRSA infection can be acquired in the community and should be borne in mind by ophthalmologists when dealing with infections. To the authors' knowledge, this is the first case of CST secondary to MRSA sepsis.
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