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        תוצאת חיפוש

        אוקטובר 2001

        גיא בן-סימון, אירינה ברקת
        עמ'

        גיא בן-סימון, אירינה ברקת

         

        מכון העיניים מוריס וגבריאלה גולדשלגר, מרכז רפואי שיבא, תל-השומר

         

        זיהום ראשוני בשלבקת פשוטה (ש"פ) (HSVherpes simplex) הוא זיהום שכיח במדינות המערב, וניתן למצוא נוגדנים לנגיף ב-90% מהאוכלוסייה בקירוב. שיאי הזיהום הראשוני מתרחשים בגיל הילדות והבגרות המוקדמות, אם כי לעתים מאובחנים מקרים אקראיים בתקופת הינקות ובגיל המבוגר. ברוב החולים הזיהום הראשוני הוא אי-תסמיני וחולף עצמונית (אם כי במקרים נדירים התוצאות הרסניות). לאחר הזיהום הראשוני נותר הנגיף לצמיתות בגוף בצורה כמוסה (latent), ושיפעול (reactivation) המחלה מתרחש בעתות מועקה גופנית או נפשית.

        שלבקת ראשונית של העיניים (primary ocular herpes) מתהווה בד"כ כדלקת לחמית זקיקית (follicular) עם נפיחות קשריות-לימפה אזוריות ודלקת שלפוחיתי של העפעפיים. בחלק מהחולים מתהווה צורה של דלקת קרנית אפיתלית, הנמשכת זמן רב יותר מזיהום בלחמית. לעתים נדירות מעורבת גם המשתית (stroma) בקרנית.

        ינואר 2001

        דוד ישראלי, יאיר הוד וארנה גייר
        עמ'

        Retinal Injury Induced by Laser Pointers

         

        D. Israeli, Y. Hod, O. Geyer

         

        Eye Dept., Carmel Medical Center, Haifa

         

        Laser pointers originally designed for use during presentations are ubiquitous and are even sold as toys (such as pens or on key chains) in drug stores. Though reported as safe, the laser pointers still carry the risk of potential damage to the eye. We report a 16-year-old boy with bilateral retinal injury caused by 20-30 seconds of exposure to a laser pointing-device. Immediately thereafter, vision was blurred bilaterally and he noted a central red scotoma in each eye. Symptoms resolved spontaneously within 2 days but the retinal scars remained all during the 10 months of follow-up.

        It is clear from our report and 3 other publications that retinal damage can develop from misusing laser pointers. Laser hazards and safety should be stressed for the general public. We recommend that laser-pointers should not be available as toys to children and teenagers.

         
         

        אוקטובר 2000

        י' דומניץ, ר' אבישר וח' סביר
        עמ'

        Corneal Infection in Wearers of Contact Lenses

         

        Y. Domniz, R. Avisar, H. Savir

         

        Assaf Harofeh Medical Center, Zerifin; and Hasharon Hospital, Petah Tikva

         

        This is a 5-year retrospective survey of corneal infection in wearers of optical contact lenses (OCL). 23 of the 61 patients (38%; Hasharon Hospital) with positive cultures wore OCL. Visual acuity improved in 15 (65%), no change was noted in 4 (17.5%) and there was deterioration in 4 (17.5%), as compare with status on admission.

         

        Pseudomonas aeruginosa was the most common cause of infections among OCL wearers. The improvement in visual acuity expected due to wearing OCL was affected by infections. After Staphylococcus albus infections had the highest rate (100%) of improvement in visual acuity and after Ps. aeruginosa the lowest rate (57.2%) of improvement, as well as the highest rate of deterioration (42.8%) found following recovery.

         

        OCL wearers are at higher risk for damage to visual acuity following corneal infection, and highly virulent infections in OCL wearers are responsible for a high risk of damage to visual acuity.

        פברואר 2000

        עדי רון, שמחה מיזל, מיירה שפירו-פיינברג וצבי קליין
        עמ'

        Cortical Blindness Following Coronary Angiography 


        Addie Ron, Simcha Meisel, Myra Shapiro-Feinberg,Herman O. Klein

         

        Depts. of Medicine, Cardiology and Diagnostic Imaging,Meir Medical Center, Kfar Saba

         

        Cortical blindness has been occasionally reported as a complication after cerebral angiography, but is rare after coronary angiography. The contrast agent is believed to be responsible for the sudden development of blindness. Although the exact mechanism is unknown, it appears that the contrast agent disrupts the blood brain barrier, mostly in the occipital areas.

        We report a 77-year-old man who suddenly developed transient, bilateral cortical blindness 4 hours after coronary angiography. Using contrast enhancement, the CT scan showed typical, symmetrical involvement of both occipital lobes. There were no other neurological deficits. Vision and CT findings returned to normal within 48 hours.

        יאיר הוד, יוסף קורסיה, יובל יסעור וארנה גייר
        עמ'

        Causes of Blindness in Israel 


        Y. Hod, Y. Corcia, Y. Yassur, O. Geyer

         

        Depts. of Ophthalmology, Carmel Medical Center, Haifa and Rabin Medical Center, Petah Tikva; Israel Ministry of Labor and Social Affairs, Jerusalem; and Rehabilitation Services Administration, Services for the Blind

         

        Of the world population, 38 million are blind and another 110 million are visually impaired. Even in the developed countries there are 3.5 million who are blind.

        This study of blindness in Israel is based on the National Blind Registry. At the end of 1998, 15,937 were registered as blind, 0.3% of the total population; 776 (5%) of them were 18 years old or younger; 6,426 (40%) 18-65 years old; and 8,735 (55%) 65 years or older.

        The leading causes of blindness in Israel are glaucoma (2,074, 13%), macular degeneration (1,954, 12%) and diabetes mellitus (1,680, 11%). Since glaucoma and diabetes, and to a lesser extent glaucoma, respond to treatment, blindness could have been avoided in most cases. National screening programs for early diagnosis and treatment of these diseases would reduce prevalence of the newly blind.

        שמעון קורץ, מרדכי גולדנפלד ושלמה מלמד
        עמ'

        Early Detection of Glaucoma by a Mobile Unit

         

        S. Kurtz, M. Goldenfeld, S. Melamed

         

        Sam Rothberg Glaucoma Center, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer

         

        Glaucoma, the third leading cause of blindness in the western world, is characterized by painless, gradual loss of visual fields which may lead to severe visual impairment or even blindness. In 4 years of operation of a mobile glaucoma unit for screening and early diagnosis of glaucoma, 10,037 subjects aged 18-95 years were screened (4504 women, 45%); 55% were under 50 years (Graph 1).

        Ocular hypertension was diagnosed in 8.0%; primary open angle glaucoma (POAG) in 0.8%, with 2/3 already under treatment, the rest newly diagnosed. Pseudo-exfoliative glaucoma was diagnosed in 0.2%; only 2 cases had closed angle glaucoma; 91% of those screened were normal (Fig. 4; age stratification, Graph 3).

        POAG increased with age, from 0.2% in those under 40 years to 10% in those over 80; POAG was more common in men, but OHT was similar in both sexes (6.0% vs. 5.3%). There was no correlation between incidence of POAG and place of work except in the Sorek Nuclear Center (1.9% vs. 0.8%, p=0.11). Other conditions significantly more frequent in POAG than normals were diabetes mellitus (x 2.5), systemic hypertension (x 4), myopia (x 2) and history of intraocular surgery (x 6).

        ינואר 2000

        בן-עמי סלע, יוסף זלוטניק, תמר משוש, גליה יבלונסקי ופביאן אברהם
        עמ'

        Gyrate Atrophy of Choroid and Retina, and Hyperornithinemia 


        B-A. Sela, J. Zlotnik, T. Masos, G. Yablonski, F. Abraham

         

        Institute of Chemical Pathology and Goldschlager Eye Institute, Sheba Medical Center, Tel Hashomer; and Sackler Faculty of Medicine, Tel Aviv University

         

        Gyrate atrophy of the choroid and retina is a rare degenerative disease, characterized biochemically by a marked increase in blood ornithine levels, due to deficiency of ornithine S-amino transferase. 4 men aged 35, 36, 48 and 62 years are described with different stages of myopia, night blindness and loss of peripheral vision, which progressed to tunnel vision and partial blindness. Onset of the disease was at ages 3, 10 and 15 years, respectively, while in the 4th patient there was delayed expression starting at about age 50. Most had posterior subcapsular cataracts, and the ocular fundus exhibited demarcated circular areas of chorioretinal degeneration. So far the only patients described in Israel have been of Iraqui origin. Our fourth patient originated from Istanbul, and he may represent a hitherto undescribed variant with a much delayed expression of the disease.

        י' דומניץ, ר' אבישר וח' סביר
        עמ'

        Corneal Infection - Causes and Effects on Vision

         

        Y. Domniz, R. Avisar, H. Savir

         

        Ophthalmology Depts., Assaf Harofeh Medical Center, Zerifin, and Hasharon Hospital, Petah Tikva

         

        We conducted a retrospective 5-year survey of corneal infections treated in the ophthalmology ward of Hasharon Hospital. The most frequent type of corneal infection was corneal abscess; the most frequent cause was Staphylococcus albus, although this bacterium is not reported as a frequent cause of corneal infections.

        There was improvement in visual acuity in 69.2% and no change in 15.4%. Corneal infection by Pseudomonas aeruginosa was the most frequent cause of worsening of corneal acuity (23.08%). The greatest improvement of visual acuity was in those with corneal ulcers. The worst visual acuity was in those with corneal abscesses. Pseudomonas aeruginosa was the main cause of infection in contact-lens wearers.

        In the world medical literature, Staphylococcus albus is considered of very low virulence. This bacterium was the most frequent cause of corneal infections in our study so it may have greater virulence in Israel.

        נובמבר 1999

        אירנה קרסניץ, יצחק בירן ובנימין מילר
        עמ'

        Retinal Lesion due to Excessive Exposure to Sunlight

         

        Irene Krasniz, Itzchak Beiran, Benjamin Miller

         

        Dept. of Ophthalmology, Rambam Medical Center and Bruce Rappaport Faculty of Medicine, Technion, Haifa

         

        Retinal damage caused by direct exposure to the sun's rays is well recognized by the ophthalmic community. Although functional ability in solar retinopathy is usually regained within weeks, some suffer long-term visual impairment. Anatomic damage to the retina, even in those who regain full vision, is permanent. We describe 2 cases of solar retinopathy, 1 of which remained with permanent loss of vision. The role of medical education in preventing damage from solar retinal hazards is stressed.

        נובמבר 1998

        ארנה גייר
        עמ'

        Nonpenetrating Deep Sclerectomy

         

        Orna Geyer

         

        Ophthalmology Dept., Tel Aviv-Sourasky Medical Center

         

        This is the first report from Israel of nonpenetrating deep sclerectomy (DS), a new operation for the surgical management of glaucoma. It facilitates ocular fluid drainage without entering the eye. It involves performance of a conjunctival flap and creation of a 565 mm superficial scleral flap. A deeper scleral flap is dissected off the scleral bed together with the roof of the canal and corneal stroma, leaving behind the wall of the canal and membrane. Aqueous will flood the dissected area. A collagen device is then sutured to the scleral bed, the superficial scleral flap sutured into position and the conjunctiva closed. With this procedure, the surgeon can avoid the common complications of conventional glaucoma surgery.

         

        We report a 6-month follow-up of 15 patients after DS. Mean preoperative intraocular pressure was 26.7+2.5 mm Hg, which decreased to 15.5+4.7. After 6 months there was no change in visual acuity after surgery. DS is associated with good middle-term intraocular pressure control and a low rate of postoperative complications. It is therefore a good alternative to standard glaucoma surgery.

        אוקטובר 1998

        מרים וייל בן הרוש, הדסה גולדברג, אברהם קוטן, יוסף גילבורד ורונית אלחסיד
        עמ'

        Optic Glioma in Children with Type 1 Neurofibromatosis

         

        M. Ben-Arush, H. Goldberg, A. Kuten, J. Guilbord, R. El-Hassid

         

        Pediatric Hematology-Oncology Unit, The Northern Israel Oncology Center, and Division of Neurosurgery, Rambam Medical Center; and Technion School of Medicine, Haifa

         

        During the period 1985-95 we treated 5 girls and 13 boys with optic glioma associated with Type 1 neurofibromatosis (median age 3 years, range 2-10 years). 6 were treated with radiotherapy alone, 1 with surgery and radiation therapy and 1 with chemotherapy in order to postpone irradiation to an older age; 1 is being followed with no therapy. All children are alive, 2-10 years from diagnosis (mean follow-up time 5.4 years). 3 had improvement of vision following therapy and in 4 visual ability stabilized, including the child being followed without treatment. In 1 vision deteriorated despite therapy.

        אפריל 1998

        רינה רייזין, אהוד ליבוביץ ושמואל לברטובסקי
        עמ'

        Toxic Optic Neuropathy caused by Methanol Poisoning

         

        Rina Reisin, Ehud Liebovitz, Shmuel Levartovsky

         

        Dept. of Ophthalmology, Barzilai Medical Center, Ashkelon

         

        A 40-year-old woman attempted suicide by drinking methanol. Her visual acuity began to deteriorate 36 hours later and was found to be 6/60 in her right eye with no light perception in the left. No systemic manifestations other than the eye symptoms were found. In the following months visual acuity improved without specific therapy. 2 months following the methanol, visual acuity was 6/6 in the right eye and finger-counting at 1 meter in the left eye. There was pronounced optic atrophy in the left eye, as well as a central defect in the left visual field due tothe methanol toxicity.

        מרץ 1998

        דני געתון, עדיאל ברק, שלמה שגב, יובל יסעור וגיורא טרייסטר
        עמ'

        Prevalence of Pigmentary Dispersion Syndrome in Israel

         

        D. Gaton, A. Barak, S. Segev, Y. Yassur, G. Treister

         

        Ophthalmology Dept., Beilinson Medical Center, Petah Tikva and Ophthalmology Dept. and Institute for Medical Screening and Assessment, Sheba Medical Center, Tel Hashomer

         

        Pigmentary dispersion syndrome is a precursor of pigmentary glaucoma whose prevalence in the urban population of USA was found to be 2.45%. We evaluated its prevalence during ocular screening examinations among normal Israelis. We screened for excessive pigmentation on the corneal endothelium with the slit-lamp and determined in each patient best corrected visual acuity, intra-ocular pressure (after mydriasis), condition of the anterior segment, cup-disk ratio, posterior segment abnormalities and questioned about history of any ocular disease and family history of glaucoma. 374 patients (mean age 49±11) were examined on 10 consecutive days. In 5.9% excessive corneal endothelial pigmentation was found. Intra-ocular pressure (after mydriasis) averaged 15.52±1.93 mm Hg as compared to 14.73±2.04 among the rest of our study population, (p=0.01). The prevalence of suspected pigmentary dispersion syndrome among young adults in Israelis is high.

        ינואר 1998

        יהודית רניאל, יהודה טייכנר וצבי פרידמן
        עמ'

        Progression of Diabetic Retinopathy after Cataract Extraction

         

        Y. Raniel, Y. Teichner, Z. Friedman

         

        Annette and Aron Rozin Dept. of Ophthalmology, Bnai-Zion Medical Center and Bruce Rappaport Faculty of Medicine, The Technion, Haifa

         

        A prospective study of the effect of cataract extraction with intraocular lens implantation on the course of diabetic retinopathy (DR) in 44 patients (59 eyes) was carried out. It showed that in the 1-3 years following surgery, there was progression of DR (including development of newly formed retinopathy) in 35% of the patients (28.8% of eyes). Progression was more marked in patients with pre-operative bilateral DR compared to those without bilateral DR (77% and 16% respectively). Insulin dependence did not play a role in progression. Final visual acuity was better in patients without pre-operative DR, as well as in eyes without progressive retinopathy.

        דצמבר 1997

        מורקוס מועלם וחנא גרזוזי
        עמ'

        Airbag-Associated Ocular Trauma

         

        Marcus Muallem, Hanna Garzozi

         

        Ophthalmology Dept., HaEmek Medical Center, Afula

         

        Airbags have received widespread recognition as an effective means of enhancing automobile safety. They are particularly effective in frontal and front angle collisions which otherwise would be fatal or cause serious injuries. Inflation of the bag helps protect the driver and front-seat-passenger from hitting the steering wheel, dashboard or windshield. In frontal crashes airbags have reduced driver deaths, hospital admission rates, and incidence of brain injury. On the other hand, an increasing variety of airbag-associated organ injuries has been reported, including blunt ocular and chemical trauma. 2 cases of ocular trauma due to airbags which resulted in choroidal rupture with disastrous outcome in terms of visual acuity are presented. Since the very first report in May 1991 of airbag-associated ocular trauma until June 1996, there has apparently been only 1 case of choroidal rupture due to airbag-associated trauma, presented in 1 sentence of a brief report. Although airbag-related eye trauma may be relatively infrequent, the severity of the injuries incurred, especially when the posterior segment of the eye was involved, warrants research on new airbag design that minimizes the risk of ocular injury. Meanwhile all cases of airbag-associated ocular trauma should be reported, so that medical staff, the general population and car manufacturers will become more aware of this medical issue.

        הבהרה משפטית: כל נושא המופיע באתר זה נועד להשכלה בלבד ואין לראות בו ייעוץ רפואי או משפטי. אין הר"י אחראית לתוכן המתפרסם באתר זה ולכל נזק שעלול להיגרם. כל הזכויות על המידע באתר שייכות להסתדרות הרפואית בישראל. מדיניות פרטיות
        כתובתנו: ז'בוטינסקי 35 רמת גן, בניין התאומים 2 קומות 10-11, ת.ד. 3566, מיקוד 5213604. טלפון: 03-6100444, פקס: 03-5753303