Ophthalmology Commons^™

Treatment Challenges In An Atypical Presentation Of Tubulointerstitial Nephritis And Uveitis (Tinu), S Caplash, S Gangaputra, S Kodati, Shamir Tuchman, Hemalatha Srinivasalu, H Sen

Pediatrics Faculty Publications

Purpose: To describe an atypical presentation of Tubulointerstitial Nephritis and Uveitis (TINU), with challenges in treatment course. Observations: A 12-year-old Hispanic female presented to the National Eye Institute's Uveitis clinic with bilateral blurred vision, red eyes and photophobia, not responsive to topical steroids. On exam, she had bilateral severe panuveitis with areas of subretinal fluid. During her evaluation, she was noted to have elevated serum creatinine. A kidney biopsy confirmed the presence of severe tubulointerstitial nephritis and interstitial fibrosis. She was treated with oral steroids with excellent resolution of symptoms and subretinal fluid. She continued to have anterior segment flares …

Corneal Edema And Keratitis Following Selective Laser Trabeculoplasty, E T. Liu, L S. Seery, A Arosemena, Tania Lamba, C J. Chaya

Ophthalmology Faculty Publications

Purpose

To describe three cases of keratitis following Selective Laser Trabeculoplasty(SLT).

Observations

Three females with a history of glaucoma presented with corneal edema, keratitis (endothelial, epithelial) and decreased visual acuity shortly after SLT. There was variable resolution of symptoms after starting treatment with oral antiherpetics and topical steroids.

Conclusions and importance

With the increase in usage of SLT as a treatment for glaucoma and subsequent reports of keratitis, it is imperative for ophthalmic surgeons to be aware of herpes simplex as a possible risk factor. Prompt treatment with antivirals and steroids can potentially prevent scarring and permanent …

Medical Resource Utilization Of Outpatient Care For Children With Neurofibromatosis Type 1, Rabia Idrees, Michael Fisher, Rachel Hachen, Brian Callaghan, Robert A. Avery

GW Research Days 2016 - 2020

Background:

Neurofibromatosis Type 1 (NF1) is an autosomal dominant syndrome with manifestations affecting the central nervous system, musculoskeletal system, peripheral nervous system, and cognitive/behavioral functions. Many of these manifestations persist throughout life and require medical/surgical interventions.

The resource utilization and economic burden of caring for children with NF1 is unknown. Prior research has inherent selection bias and does not accurately reflect the incidence/resource utilization of morbidities. In order to identify which disease manifestations are in the most need of improved clinical algorithms and novel therapeutics, the frequency/type of resources utilized (i.e., diagnostic imaging and specialty visits) must be determined.

The …

Antibiotic Prophylaxis In Orbital Fractures., Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz

Ophthalmology Faculty Publications

Purpose:

To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection.

Design:

Retrospective cohort study.

Participants:

All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics.

Main Outcome Measures:

Development of orbital infection.

Results:

One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria. No orbital infections were documented. Twenty subjects (12%) received no prophylactic antibiotic, and two (1%) received only one dose of antibiotics pre-operatively for surgery. For primary antibiotic, 136 subjects (79%) received oral antibiotics, and 14 (8%) received …

Amaurosis Fugax Due To Pleomorphic Sarcoma, Sheila Pabon, Katherine Williams, Marena Patronas

Ophthalmology Faculty Publications

Purpose

This report describes a case of amaurosis fugax due to a rare primary cardiac sarcoma.

Observations

A patient who was recently diagnosed with left atrial pleomorphic sarcoma presented with a chief complaint of multiple episodes of intermittent vision loss in the right eye during the course of radiation therapy.

Conclusions and importance

The authors postulate emboli from the left atrial sarcoma entered systemic circulation and subsequently caused brief episodes of transient occlusion to retinal, ophthalmic and/or ciliary arteries leading to momentary retinal hypoxia. We believe this is a novel finding, previously unreported in the literature, of transient embolic occlusion …

Iris Abscess A Rare Presentation Of Intravenous Drug Abuse Associated, Jonathan Pierce, Nisha Warrier, Christina Antonopoulos, Nicole Siegel, Deeba Husain

Ophthalmology Faculty Publications

Purpose: To describe an unusual case of intravenous drug abuse associated endogenous endophthalmitis presenting with an iris abscess.

Observations: A 30-year old female with history of intravenous drug use presented with a two-week history of redness and blurry vision in the right eye. An initial diagnosis of anterior uveitis was made. However, she worsened on topical steroids and mydriatics. She was found to have a hypopyon and an iris abscess. She received broad spectrum antibiotic and antifungal treatment with voriconazole, this lead to significant clinical improvement. She was discharged on oral fluconazole and lost to follow up. The patient was …