We examined 45 (23 male and 22 female) Japanese patients with paranasal sinus mucopyoceles associated with ophthalmic complications. The patients ranged in age from 31 to 87 years. The patient distribution by the affected sinus was as follows: maxillary sinus alone, 17 patients; ethmoidal sinus alone, 9 patients; frontoethmoidal sinuses, 9 patients; frontal sinus alone, 7 patients, and other multiple sinuses, 3 patients. Thirty-nine mucoceles and 6 pyoceles were identified. Ophthalmic signs and symptoms included lid swelling, ocular pain, pseudoptosis, proptosis, displacement of the eyeball, epiphora, slight blurring of vision, severely decreased visual acuity, visual field abnormality, diplopia, disk edema, retinoichoroidal folds and increased intraocular pressure. Of the 45 patients, 1 had a history of sinus trauma and 29 had a history of sinus surgery.
We treated two patients with herpes zoster ophthalmicus in whom hyphema and hemorrhagic glaucoma occurred. Case 1 complained of facial skin eruption, and was given intravenous acyclovir for 7 days. Hyphema and high intraocular pressure occurred in the left eye 10 days after the onset of the skin eruption. Case 2 had severe pain and blisters on her face, and was given intravenous acyclovir for 7 days. An intracameral hemorrhage and glaucoma developed in the right eye 15 days after the onset of the skin lesion. Intravenous acyclovir may be necessary for longer than 7-day periods if the iridocyclitis remains.
A 2-month-old infant had a retroperitoneal tumor and increased levels of vanillylmandelic acid and homovanillic acid in the urine, indicating an abdominal neuroblastoma. Two whitish masses that were noted on the left iris regressed in synchrony with the primary tumor mass as therapy was administered. We believe that our patient represents the third reported case of iris metastasis from abdominal neuroblastoma.
Delirium was demonstrated after cataract surgery in a 64-year-old man (case 1). The patient struck his head against the floor; thereafter an extradural hematoma was found and extracted. Postoperative delirium was also noted in a 58-year-old woman (case 2) and in a 26-year-old woman (case 3) with rhegmatogenous retinal detachment. All 3 patients recovered from their psychiatric complications within 1 month.
We examined a 52-year-old man with bilateral symmetric lesions of the cornea and fundus. The corneal lesions were compatible with granular dystrophy, and the fundus lesions were consistent with cone dystrophy. The simultaneous occurrence of these dystrophies may be uncommon.
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