Corneal tattooing with Chinese ink is a simple, effective outpatient procedure for treating painful BK in eyes with no visual potential.
Rationale:Canaliculitis is a frequently overlooked and misdiagnosed disease. Concurrent corneal ulceration with canaliculitis is uncommon. We report such a case.Patient concerns:An 87-year-old woman complained of swelling and pain of the right eye after acute angle closure glaucoma attack. Slit-lamp examination was compatible with the features of infectious keratitis, and the cultures from corneal scrapings grew Streptococcus anginosus later. Hourly topical vancomycin (25 mg/ml) was instilled, then the corneal ulceration improved initially but became stationary after 1-week treatment.Diagnosis:Discharge from the upper punctum was noted subsequently and canalicular concretions were found through curettage. The cultures from canalicular discharge and concretions also revealed the presence of S. anginosus. Thus, infectious keratitis secondary to canaliculitis was diagnosed.Interventions:Canaliculotomy was performed to remove the large concretion and vancomycin was injected locally.Outcomes:The corneal ulceration resolved after canaliculitis was appropriately treated.Lessons:Canaliculitis could be a reservoir for organisms that may make compromised corneas liable to infections. Only the appropriate diagnosis and aggressive treatment of canaliculitis leads to the eradication of associated corneal infections.
Purpose To report six cases of Klebsiella pneumoniae orbital cellulitis without preceding endophthalmitis. Method Retrospective chart review. Results We reported four females and two males admitted to our hospital for Klebsiella pneumoniae orbital cellulitis proven by computed tomographies and bacterial cultures from May 1995 to March 2017. Proptosis, conjunctival congestion, and chemosis and limitation of ocular motility were present in all six patients. Four patients had decreased visual acuities, and three of them recovered completely after treatment. The origin of the infection was sinus in four patients, skin wound in one patient, and sepsis presumably caused by a dental procedure in one patient. Three of all six patients had underlying diabetes mellitus. Two patients had orbital cellulitis before they were diagnosed of diabetes during hospital stay. Conclusion Diabetes may be a risk factor of Klebsiella pneumoniae orbital cellulitis, especially for those of nonsinus origin.
BACKGROUND: A smartphone microscope adapter is an alternative to a permanently mounted camera, which often requires a specially designed light path as well as a computer system for data storage and network connectivity. A common disadvantage of these adapters is that they need to be repeatedly mounted and dismounted; this is inconvenient during serial observations. PURPOSE: The study purpose is to develop and test a semi-permanent microscope adapter. METHODS: Our prototype was designed using three-dimensional (3D) computer-aided design software and was 3D printed for testing. Two tests were designed to quantify the workflow improvement by measuring the time required to complete specific movements, which simulated the actions of capturing photographs by using an adapter and a slit-lamp biomicroscope. Our prototype was the experimental adapter, and two commercially available products were used as references. A single-shot test measured the average time required to complete a photographing cycle, in which a single photograph was recorded. A multiple-shot test measured the time required to complete cycles in which a different number of photographs were captured; thus, the time required specifically for the preparation phase of photographing was determined. Both tests were performed by 4 researchers. RESULTS: The average time required to complete a cycle using our prototype in single-shot test was significantly shorter than that using one of the references. For the other reference, significances were shown in 2 testers’ results. In the multiple-shot test, the linear regression analysis also showed that the preparation phase of our prototype was significantly shorter than the preparation phase of the two commercially available products ( P < 0.001). CONCLUSIONS: The semi-permanent design may improve the workflow of photography using smartphone adapters, thereby reducing the time and effort required for preparing devices, particularly when making multiple consecutive observations or when the targets disappear fast.
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