Purpose: To report a case of acute bilateral Irvine-Gass syndrome. Methods: This is an observational case report. Results: An 82-year-old man with no significant ocular history developed postsurgical pseudophakic cystoid macular edema (CME; Irvine-Gass syndrome) on consecutive phacoemulsification cataract surgeries. His initial first-eye (left) CME developed 25 days after surgery and was managed with topical preparations of dexamethasone 0.1% and ketorolac 0.4%, in addition to a routine post-cataract surgery drop regime. His left CME resolved completely on optical coherence tomography (OCT) by day 100, and he subsequently (after extensive discussion of CME risks) underwent cataract surgery on his right eye. He was commenced prophylactically on dexamethasone, ketorolac and oral indomethacin 25 mg t.d.s. immediately after surgery; however, he later developed CME (OD) on day 32 postoperatively. Within 6 months, he achieved complete resolution of his CME in both eyes. His clinical course was documented with serial OCT studies. Conclusion: Irvine-Gass syndrome remains an important differential diagnosis in the evaluation of blurred vision after cataract surgery, despite decreasing incidence. Those who experience CME following their first cataract operation should be counseled about the risks of developing the condition in the contralateral eye, despite prophylactic measures.
Fracture non-union in the pediatric population may span the age range from childhood to adolescence. Fracture non-union in children and adolescents is often due to an underlying cause such as affliction with neurofibromatosis or osteogenesis imperfecta. Although less commonly seen, non-union may occur in the otherwise healthy pediatric population. We report three cases of fracture non-union of the distal end of the fibula in the pediatric age group. All three were characterized by persistent local pain and tenderness following injury with radiographic evidence of fracture non-union. All three had undergone conservative treatment with extended periods of immobilization. Following surgery, all three had marked improvement of their local symptomatology. One patient's course was complicated by reflex sympathetic dystrophy syndrome. In two patients, resection of the un-united fragment at the distal fibula resulted in marked relief from pain without any increase in ankle instability. We postulate that the fracture non-union resulted in a fibrotic reaction that was so extensive that ankle stability was maintained even after removal of the fracture fragment.
Purpose: We describe an unusual clinical finding of a free-floating iris cyst in a patient with recurrent iritis. Method: The clinical finding of a free-floating iris cyst was recorded using slit-lamp photography. Results: A 39-year-old male with a 5-year history of recurrent right iritis was found to have a small mobile iris cyst within his right anterior chamber, first identified 3 years ago. The patient did not experience any discomfort or visual symptoms resulting from the cyst. Conclusion: Surgical removal is not indicated for asymptomatic non-progressive free-floating iris cysts. The significance of a free-floating iris cyst in the setting of recurrent iritis remains unknown.
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