Professional Documents
Culture Documents
2011;86(1):2730
ARCHIVOS
DE LA SOCIEDAD
ESPAOLA
DE OFTALMOLOGA
ARCHIVOS DE LA SOCIEDAD
ESPAOLA DE OFTALMOLOGA
Vol. 85
Mayo 2010
Nm. 5
Contenido
Editorial
La retina como marcador biolgico de dao neuronal
Artculos originales
Comparacin de tres instrumentos de tomografa de
coherencia ptica, un time-domain y dos Fourierdomain, en la estimacin del grosor de la capa de
fibras nerviosas de la retina
Idoneidad de tratamiento en sospechosos de glaucoma. Estudio de concordancia con el grupo de estudio RAND
Atrofia de la capa de fibras nerviosas de la retina en
pacientes con esclerosis mltiple. Estudio prospectivo con dos aos de seguimiento
Comunicaciones cortas
Hipercorreccin secundaria a transposicin muscular
aumentada
Crtica de libros, medios audiovisuales y pginas
web oftalmolgicos
Clinical Neuro-Ophthalmology: The Essentials
Seccin histrica
Del mal de la rosa y la queratoconjuntivitis pelagrosa
Seccin iconogrfica
El estrabismo de Rembrandt
Sociedades y Reuniones Cientficas
Ofertas de trabajo
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PubMed/MEDLINE, Scopus, EMBASE/
Excerpta Medica, IBECS, IME, SCIELO,
BIOSIS, SENIOR y COMPLUDOC
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www.elsevier.es/oftalmologia
Short communication
A RT I C L E I N F O R M AT I O N
A B S T R A C T
Article history:
Case report: We present the case of a 29 year-old man who came to the Emergency
Department due to pain in the right eye. There was demonstrated a complete corneal de-
Keywords:
Tarsorrhaphy
Neurotrophic ulcer
Cerebral toxoplasmosis
Palabras clave:
Caso clnico: Se presenta el caso de un varn 29 aos acude a Urgencias de oftalmologa por
Tarsorrafia
dolor en ojo derecho. Se evidenci una desepitelizacion corneal completa. Tras un trata-
lcera neurotrfica
Toxoplasmosis cerebral
vmitos. la tomografa axial computarizada (TAC) evidenci imgenes sugestivas de toxoplasmosis cerebral. Tras la tarsorrafia completa se observ una restitucin ad integrum del
cuadro.
Conclusin: Ante el diagnstico de una lcera corneal neurotrfica por afectacin del trigmino en el contexto de toxoplasmosis cerebral, la tarsorrafia es un procedimiento eficaz a
tener en cuenta ante defectos epiteliales corneales resistentes a otros tratamientos.
2010 Sociedad Espaola de Oftalmologa. Publicado por Elsevier Espaa, S.L.
Todos los derechos reservados.
Presented
0365-6691/$ - see front matter 2010 Sociedad Espaola de Oftalmologa. Published by Elsevier Espaa, S.L. All rights reserved.
28
Introduction
Neurotrophic ulcers consist of a degenerative corneal
condition caused by any noxa that affects corneal sensitivity.
The absence of corneal sensitive trophic effects entails the
impossibility of corneal healing which associates an epithelial
defect, ulceration and even perforation.
Tarsorrhaphy is a simple, efficient and safe procedure
for managing various ocular surface conditions such as
neurotrophic ulcers due to the involvement of the trigeminal
nerve, facial paralysis, lagophthalmos among others, carried
out in isolation or in combination with other ocular plastic
surgical techniques.
Clinical case
African male, 29, who visits the ophthalmological emergency
section due to pain and diminished vision in the right eye (RE).
The exploration revealed a visual acuity (VA) of finger counting
at 3 m in RE which did not improve with the stenopeic hole,
and of 1 in the left eye (LE).
In the anterior biomicroscopy a ciliary injection was
observed with complete corneal de-epithelization, stromal
edema and folds in Descemet membrane (fig. 1), with the
rest of the ophthalmological exploration being normal. It was
decided to initiate an occlusive treatment with cycloplegic
eyedrops comprising antibiotics. Two days later, apart from
not evidencing improvement in the ocular condition, the
patient associated holocranial headache and vomiting. It was
decided to maintain the ophthalmological treatment and to
refer the patient to the internal medicine emergencies for
a full assessment. After a systemic exploration, diminished
facial sensitivity was evidenced in the fourth branch of the
trigeminal, with corneal anesthesia. A computerized axial
tomography (CAT) was taken which evidenced triventricular
hydrocephalia, with two hypodense areas being observed in
Discussion
The cornea is a highly sensitive structure that is able to
perceive different feelings such as pain, heat, cold or touch.
The absence of corneal sensitivity involves a disruption of the
integrity of the corneal surface.
A neurotrophic keratoplasty is a clinical entity which
comprises all the degrees of corneal and conjunctival
degeneration secondary to the loss of the sensitive function
in the pathway of the nasocilliar branch (V1) of the trigeminal
nerve with or without diminished tear production.
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Conflict of interest
None of the authors have declared any conflict of interest.
R e f e r e n c e s