Primary Sjögren's syndrome is an autoimmune disorder that is characterized by lymphocytic infiltration of salivary and lacrimal glands. The extra-glandular manifestations might be arthritis, myalgia, glomerulonephritis, skin rashes, and neurologic involvement. One of the uncommon neurologic manifestations is neuromyelitis optica spectrum disorder (NMOSD). In the present case, an older woman is reported that was diagnosed with NMOSD secondary to keratoconjunctivitis sicca, which is rare in geriatric practice.
- MeSH
- Humans MeSH
- Neuromyelitis Optica * diagnosis complications etiology MeSH
- Aged MeSH
- Sjogren's Syndrome * complications diagnosis MeSH
- Keratoconjunctivitis Sicca etiology diagnosis MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
Mezi komorbidity atopické dermatitidy patří postižení očního povrchu, především atopická keratokonjunktivitida (jejímž signálem může být ekzém víček a pruritus), keratokonus, katarakta, glaukom a odchlípení sítnice, jež mohou vést k vážnému a trvalému poškození zraku. Dermatolog může být prvním, kdo u svých pacientů s atopickou dermatitidou na oční komorbidity pomyslí. Včasná detekce očního postižení umožňuje včasnou léčbu, a tak může zabránit progresi a vzniku komplikací. V textu je podrobně probrána role dermatologa. Mezioborová spolupráce dermatologa a oftalmologa, případně alergologa, je velmi žádoucí.
Atopic comorbidities include ocular surface involvement, especially atopic keratoconjunctivitis (eyelid eczema and pruritus can be it ́s signal), keratoconus, cataracta, glaucoma and retinal detachment, which can lead to severe and permanent visual impairment. Dermatologist may be the first to think of ocular comorbidities in his patients with atopic dermatitis. Early detection of ocular involvement allows for early treatment and can prevent progression and complications. The role of dermatologist is discussed in detail in the text. Interdisciplinary collaboration of dermatologist and ophtalmologist, eventually allergologist, is highly dessirable.
Chemické poleptania sú zrak ohrozujúce poranenia, vyžadujúce okamžitú liečbu. Hlavným cieľom počiatočnej terapie je intenzívny a výdatný výplach spojovkového vaku, za účelom neutralizácie a eliminácie pôsobiacej chemikálie. Ďalšie terapeutické postupy, či už konzervatívne, alebo chirurgické, závisia od klinického nálezu. Cieľ: V kazuistike popisujeme priebeh a liečbu pacientky s poleptaním oboch očí zásaditou látkou. Kazuistika: V práci uvádzame kazuistiku 35-ročnej ženy, s chemickým poleptaním oboch očí alkalickým činidlom. Do troch týždňov nastala úplná reepitelizácia oboch rohoviek. Vzhľadom k tomu sme predpokladali uspokojivú prognózu hojenia, avšak na ľavom oku došlo s odstupom času k lýze rohovky. Stav sa podarilo zvládnuť, ale následne došlo na ľavom oku zrejme v súvislosti s infekciou COVID-19 k závažnej keratouveitíde s hypopyonom a lýzou rohovky, čo v konečnom dôsledku viedlo k eviscerácii postihnutého oka. Výsledky a záver: V kazuistike popisujeme management ľahkého poleptania na pravom oku a komplikovaného stredne ťažkého poleptania ľavého oka zásaditou chemikáliou. Obe oči boli do troch týždňov kompletne prehojené, no nález na ľavom oku sa skomplikoval, čo dospelo v konečnom dôsledku až k eviscerácii postihnutého oka. Ochorenie COVID-19 mohlo prispieť k zhoršeniu nálezu na rohovke alebo mohlo ísť iba o koincidenciu dvoch ochorení a keratouveitída mala závažný priebeh z dôvodu predchádzajúceho ťažkého priebehu hojenia a mnohých komplikácií po chemickom poleptaní oka.
Chemical burns are sight-threatening injuries that require immediate management. The main goal of the initial treatment is prompt and copious irrigation to neutralize and eliminate the chemical, followed by various therapeutic options (conservative and surgical) according to the individual patient’s postinjury findings. Purpose: In this case report, we describe the course and treatment of a patient with chemical alkali burns of both eyes. This study reports the outcomes of an ocular alkali burn patient who became infected with COVID-19 and where severe keratouveitis with corneal graft melting and hypopyon occurred, ultimately resulting in evisceration of the eye. Observations: We report the case of a 35-year-old woman, after an alkali burn of both eyes. Complete re-epithelialization of both corneas occurred within three weeks. Due to this observation, we assumed a satisfactory healing prognosis. However, corneal lysis occurred in the left eye over time. The condition was managed, but subsequently severe keratouveitis with hypopyon and corneal lysis occurred in the left eye, apparently in connection with the COVID-19 infection, which ultimately led to the evisceration of the affected eye. Conclusions and Importance: In the case report, we describe the management of a mild chemical alkali burn of the right eye and a complicated moderate burn of the left eye with an alkaline chemical. Both eyes were completely healed within three weeks. However, the findings on the left eye became complicated, which ultimately led to the evisceration of the affected eye. The disease of COVID-19 could have contributed to the deterioration of the findings on the cornea, or it could have just been a coincidence of two diseases, with the keratouveitis having a serious course due to the previous difficult course of healing and many complications after the chemical burn.
- Keywords
- lýza rohovky,
- MeSH
- Amnion transplantation MeSH
- Burns, Chemical * diagnosis etiology complications therapy MeSH
- COVID-19 complications virology MeSH
- Adult MeSH
- Eye Evisceration MeSH
- Sodium Hydroxide adverse effects MeSH
- Keratoconjunctivitis etiology MeSH
- Keratoplasty, Penetrating MeSH
- Humans MeSH
- Eye Injuries * diagnosis etiology complications therapy MeSH
- Cornea surgery physiopathology pathology MeSH
- Corneal Transplantation MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Keywords
- dupilumab,
- MeSH
- Dermatitis, Atopic * drug therapy complications MeSH
- Cyclosporine pharmacology therapeutic use MeSH
- Glucocorticoids pharmacology therapeutic use MeSH
- Antibodies, Monoclonal, Humanized * pharmacology therapeutic use MeSH
- Janus Kinase Inhibitors pharmacology therapeutic use MeSH
- Keratoconjunctivitis * drug therapy therapy MeSH
- Humans MeSH
- Adolescent MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- MeSH
- Spondylitis, Ankylosing diagnostic imaging complications physiopathology MeSH
- Behcet Syndrome complications MeSH
- Cogan Syndrome complications MeSH
- Diagnosis, Differential MeSH
- Hypertensive Retinopathy drug therapy MeSH
- Arthritis, Juvenile diagnosis complications therapy MeSH
- Keratitis diagnosis drug therapy MeSH
- Humans MeSH
- Eye Manifestations MeSH
- Polyarteritis Nodosa complications MeSH
- Uveitis, Anterior epidemiology etiology therapy MeSH
- Arthritis, Psoriatic diagnosis drug therapy complications MeSH
- Arthritis, Reactive diagnosis drug therapy complications MeSH
- Retinal Arterial Macroaneurysm MeSH
- Arthritis, Rheumatoid diagnosis complications therapy MeSH
- Sjogren's Syndrome diagnosis complications therapy MeSH
- Scleritis MeSH
- Keratoconjunctivitis Sicca diagnosis therapy MeSH
- Dry Eye Syndromes drug therapy physiopathology MeSH
- Scleroderma, Systemic complications physiopathology therapy MeSH
- Lupus Erythematosus, Systemic diagnosis drug therapy complications physiopathology MeSH
- Takayasu Arteritis diagnosis complications physiopathology MeSH
- Uveitis drug therapy classification MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Dermatitis, Atopic classification complications therapy MeSH
- Pemphigoid, Benign Mucous Membrane diagnosis classification complications pathology therapy MeSH
- Blepharitis diagnosis drug therapy MeSH
- Diagnosis, Differential MeSH
- Keratoconjunctivitis diagnosis drug therapy MeSH
- Conjunctivitis drug therapy classification MeSH
- Humans MeSH
- Eyelid Diseases etiology therapy MeSH
- Corneal Diseases MeSH
- Conjunctival Diseases etiology drug therapy MeSH
- Eye Manifestations * MeSH
- Rosacea diagnosis complications physiopathology therapy MeSH
- Stevens-Johnson Syndrome drug therapy classification complications physiopathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Dermatitis, Atopic * complications drug therapy MeSH
- Antibodies, Monoclonal, Humanized MeSH
- Interleukin-13 MeSH
- Keratoconjunctivitis * MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Letter MeSH
Autoři prezentují kazuistiky dvou žen, které byly na přelomu roku 2018/2019 hospitalizované na Oční klinice FN Hradec Králové pro oční projevy rosacey. Vstupně byl objektivní nález na předním segmentu očí obou pacientek poměrně závažný. V obou případech jsme se setkali se zašednutím rohovek a povrchovou i hlubokou vaskularizací rohovky. Obličeje obou pacientek jevily více či méně typické známky celkového onemocnění. Jednalo se především o papulopustule s krustou v případě pacientky z první kazuistiky. Subjektivně pacientky popisovaly typické příznaky suchého oka. Po konzultaci s dermatologem byla nastavena cílená protizánětlivá lokální a celková léčba s postupným zlepšením stavu v obou případech. V obou případech jsme používali jiných vzorců celkové terapie rosacey dle literatury (Azitromycin x Doxyhexal). U jedné z pacientek jsme se setkali v následné ambulantní péči s výraznou non-compliace se závažnými následky. Cílem sdělení je upozornit na problematiku očních komplikací v souvislosti s celkovým onemocněním rosacea a zdůraznit důležitost mezioborové spolupráce v léčbě této choroby, která může vést k trvalému poškození předního segmentu oka a k výrazné ztrátě zrakové ostrosti.
The authors present case reports of two women, who were hospitalized in Department of Ophthalmology, University hospital Hradec Králové for ocular symptoms of rosacea. In the beginning there were relatively severe objective findings in the anterior segment of the eye in both cases – significant cornea graying with superficial and deep cornea vascularization in both eyes. On faces of both patients there were more or less typical sings of general illness. Especially in the first case there were severe papulopustules with crust all over the face. Subjectively Patients describe characteristic symptoms of dry eye. After dermatological consultation local and general anti-inflammatory treatment was set with consequent condition improving in both cases patients. In both cases we use two different general therapy formula according to literature (Azitromycin x Doxyhexal). In one case report, we found distinctive non-compliance during aftercare on our department with serious consequences.The purpose of our report is to point out ocular complications of rosacea and importance of oftalmologist ́s and dermatologist ́s cooperation during therapy of this illness with can lead to permanent damage of front segment of the eye and significant loss of visual acuity.
- MeSH
- Anti-Bacterial Agents administration & dosage therapeutic use MeSH
- Anti-Inflammatory Agents administration & dosage therapeutic use MeSH
- Antipruritics administration & dosage therapeutic use MeSH
- Administration, Topical MeSH
- Keratitis drug therapy MeSH
- Keratoconjunctivitis drug therapy MeSH
- Humans MeSH
- Young Adult MeSH
- Eye Diseases * drug therapy MeSH
- Rosacea * drug therapy complications MeSH
- Aged MeSH
- Dry Eye Syndromes drug therapy MeSH
- Treatment Outcome MeSH
- Lubricant Eye Drops administration & dosage therapeutic use MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Flykténová keratokonjunktivitida (phlyctenular keratoconjunctivitis) je neinfekční zá-nětlivé onemocnění spojivky a rohovky zprostředkované imunopatologickou reakcíIV. typu. Postihuje nejčastěji děti nebo mladé dospělé.
Phlyctenular keratoconjunctivitis is a non infective inflammatory disorder of conjunctivaand cornea caused by type 4 immunopathological reactions. It mostly affects childrenand young adults.
- MeSH
- Abscess diagnosis drug therapy MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Diagnosis, Differential MeSH
- Adrenal Cortex Hormones therapeutic use MeSH
- Keratoconjunctivitis * diagnosis drug therapy MeSH
- Conjunctiva pathology MeSH
- Humans MeSH
- Child, Preschool MeSH
- Recurrence MeSH
- Staphylococcus aureus pathogenicity MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Documentation * methods utilization MeSH
- Corneal Edema diagnosis etiology pathology MeSH
- Photography * methods veterinary MeSH
- Herpesviridae Infections diagnosis complications pathology MeSH
- Keratitis diagnosis genetics classification MeSH
- Limbus Corneae pathology MeSH
- Melanoma diagnosis complications pathology MeSH
- Cat Diseases MeSH
- Dog Diseases MeSH
- Corneal Diseases * diagnosis physiopathology pathology MeSH
- Corneal Injuries diagnosis pathology MeSH
- Carcinoma, Squamous Cell diagnosis complications pathology MeSH
- Statistics as Topic MeSH
- Keratoconjunctivitis Sicca diagnosis genetics classification MeSH
- Corneal Endothelial Cell Loss diagnosis complications pathology MeSH
- Animals MeSH
- Check Tag
- Animals MeSH
