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Low-Grade Ocular Infections
LETTERS TO THE JOURNAL
VOL. 98, NO. 4
nary Disease. Washington, D.C., Armed Forces In stitute of Parasitology, 1976, pp. 373-381. 5. Neumann, E., and Gunders, E.: Ocular lesions of onchocerciasis in Liberia. Am J. Ophthalmol. 56:573, 1963. 6. Thylefors, B., Brinkmann, U. K.: The microfilarial load in the anterior segment of the eye. A parameter of intensity of onchocerciasis. Bull. WHO 55:731, 1977.
LOW-GRADE OCULAR INFECTIONS R O B E R T H. G E N T R Y ,
M.D.
Inquiries to Robert H. Gentry, M. D., 2105 White Ave., Knoxville, TN 37916.
For some time I have had trouble with low-grade ocular infections for which I have seen my ophthalmologist on various occasions. The infection generally lasts two three days, is generally controlled relatively well with Neosporin drops, and two out of three times involves my right eye. This particular localization is not surprising because everything seems to get into my right eye. No one has been able to offer me any long-term relief. One night while I was shaving my upper lip with my electric shaver I accidentally snorted powdered whiskers into my right eye, and I was also aware that the imme diate sensation was more intense but oth erwise identical to the feeling of irritation I had experienced at the start of the infections. Since then, as I have shaved around my mouth and nose, I have made it a point to hold my breath and have reduced the frequency of irritation and infection to less than half of what it used to be. I offer this brief case history because I suspect most ophthalmologists do not in quire into the shaving habits of their patients. For chronic eye infections, it might be worthwhile asking whether pa tients use blades or electric shavers.
521
NEODYMIUM-YAG CAPSULOTOMY A N D POTENTIAL BLINDNESS CRAIG BLACKWELL, M.D., L A W R E N C E W. H I R S T , M.D., AND S P E R O J. K I N N A S , M . D .
From the Bethesda Eye Institute, Department of Ophthalmology, St. Louis University School of Medicine. Inquiries to Lawrence W. Hirst, M. D., Bethesda Eye Institute, 3655 Vista Venue, St. Louis, MO 63110.
A 73-year-old woman with a long histo ry of open-angle glaucoma, controlled on timolol maleate and dipivefrin hydrochloride, and background diabetic retinopathy, had a planned extracapsular cat aract extraction in the right eye two years ago. An intracapsular extraction had been performed in the left eye five years previ ously. Postoperatively, visual acuity in the right eye had gradually decreased from 20/20 to 20/60 because of the forma tion of a dense posterior capsular mem brane. A 3-mm capsulotomy was per formed using 45 spots at 4 mj power on a neodymium-YAG laser. One of the laser applications in a particularly dense por tion of the capsule released a fluff of trapped cortical material into the anterior chamber. Thirty minutes after treatment the patients intraocular pressure was 15 mm Hg and the anterior chamber was quiet. The patient was given prednisolone acetate 0.5% eyedrops and timolol and dipivefrin were continued. At her scheduled return 24 hours later, she complained of right-sided headache and decreasing vision of 12 hours' dura tion. Examination disclosed a visual acu ity of light perception, mild corneal edema, 1+ cell and flare in the anterior chamber, an open angle by gonioscopy, and an intraocular pressure in excess of 80 mm Hg by applanation tonometry. The central retinal artery was pulsing.
VOL. 98, NO. 4
nary Disease. Washington, D.C., Armed Forces In stitute of Parasitology, 1976, pp. 373-381. 5. Neumann, E., and Gunders, E.: Ocular lesions of onchocerciasis in Liberia. Am J. Ophthalmol. 56:573, 1963. 6. Thylefors, B., Brinkmann, U. K.: The microfilarial load in the anterior segment of the eye. A parameter of intensity of onchocerciasis. Bull. WHO 55:731, 1977.
LOW-GRADE OCULAR INFECTIONS R O B E R T H. G E N T R Y ,
M.D.
Inquiries to Robert H. Gentry, M. D., 2105 White Ave., Knoxville, TN 37916.
For some time I have had trouble with low-grade ocular infections for which I have seen my ophthalmologist on various occasions. The infection generally lasts two three days, is generally controlled relatively well with Neosporin drops, and two out of three times involves my right eye. This particular localization is not surprising because everything seems to get into my right eye. No one has been able to offer me any long-term relief. One night while I was shaving my upper lip with my electric shaver I accidentally snorted powdered whiskers into my right eye, and I was also aware that the imme diate sensation was more intense but oth erwise identical to the feeling of irritation I had experienced at the start of the infections. Since then, as I have shaved around my mouth and nose, I have made it a point to hold my breath and have reduced the frequency of irritation and infection to less than half of what it used to be. I offer this brief case history because I suspect most ophthalmologists do not in quire into the shaving habits of their patients. For chronic eye infections, it might be worthwhile asking whether pa tients use blades or electric shavers.
521
NEODYMIUM-YAG CAPSULOTOMY A N D POTENTIAL BLINDNESS CRAIG BLACKWELL, M.D., L A W R E N C E W. H I R S T , M.D., AND S P E R O J. K I N N A S , M . D .
From the Bethesda Eye Institute, Department of Ophthalmology, St. Louis University School of Medicine. Inquiries to Lawrence W. Hirst, M. D., Bethesda Eye Institute, 3655 Vista Venue, St. Louis, MO 63110.
A 73-year-old woman with a long histo ry of open-angle glaucoma, controlled on timolol maleate and dipivefrin hydrochloride, and background diabetic retinopathy, had a planned extracapsular cat aract extraction in the right eye two years ago. An intracapsular extraction had been performed in the left eye five years previ ously. Postoperatively, visual acuity in the right eye had gradually decreased from 20/20 to 20/60 because of the forma tion of a dense posterior capsular mem brane. A 3-mm capsulotomy was per formed using 45 spots at 4 mj power on a neodymium-YAG laser. One of the laser applications in a particularly dense por tion of the capsule released a fluff of trapped cortical material into the anterior chamber. Thirty minutes after treatment the patients intraocular pressure was 15 mm Hg and the anterior chamber was quiet. The patient was given prednisolone acetate 0.5% eyedrops and timolol and dipivefrin were continued. At her scheduled return 24 hours later, she complained of right-sided headache and decreasing vision of 12 hours' dura tion. Examination disclosed a visual acu ity of light perception, mild corneal edema, 1+ cell and flare in the anterior chamber, an open angle by gonioscopy, and an intraocular pressure in excess of 80 mm Hg by applanation tonometry. The central retinal artery was pulsing.