PurposeWe present two cases of late-onset capsular bag distension syndrome (CBDS).ObservationsTwo female patients were referred with decreased visual acuity and blurred vision. They had both undergone uncomplicated phacoemulsification and intraocular lens implantation into the capsular bag, seven and 13 years prior.Slit-lamp biomicroscopy and anterior segment optical coherence tomography demonstrated milky fluid between the intraocular lens and posterior capsules, consistent with late-onset capsular bag distension syndrome. A 25-gauge pars plana vitrectomy surgery was performed on each patient.This turbid retrolental fluid was successfully aspirated with posterior capsulotomy using 25-gauge pars plana vitrectomy surgery.Conclusions and importanceLate-onset capsular bag distension syndrome may occur up to 13 years following cataract surgery; the longest reported duration of onset. Anterior segment optical coherence tomography is useful in aiding diagnosis. Management with vitrectomy surgery has the advantages of complete clearance of the turbid fluid and microbial and pathological testing.
Systemic parasitic infections can result in intraocular inflammation. They are a major cause of blindness in many parts of the world. Infection usually results from bloodborne transmission of the organism to the eye or ocular adnexal structures. Diagnosis is often made from clinical patterns of disease in the eye, with laboratory investigations and imaging to support the diagnosis. Various local and systemic therapies are available, but may have limited success in preserving vision.
A simple clinical method for detecting the presence of unilateral proptosis or enophthalmos is described. It is important that in a patient with orbital disease, a detailed ophthalmic and orbital history be taken and a careful clinical evaluation be performed. In the clinical assessment of such a patient, it is also essential to determine the presence of any asymmetry of eye position after excluding any asymmetry in eye size or in the skeletal structure of the face. Observation of the patient's head from above and noting the relative positions of the two eyes has been die traditional method in the clinical assessment of proptosis. We believe that this method of assessment of proptosis has not been adequately described or fully exploited in the past. This paper describes an extension of the same technique. It involves the examiner making the observation from above while slowly moving die patient's head passively from a position of neck flexion to one of neck extension, and then noting which eye in a patient comes into view first. We believe that this kinetic technique provides an accurate method of noting any asymmetry in eye position in relation to the supraciliary ridge. It should therefore prove to be a clinically useful method in the initial assessment of a patient with suspected ocular displacement. [Ophtalmic Surg Lasers 2001;32:257-259]
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