Bleb incarceration following Ahmed valve surgery

Globe luxation is a painful and potentially vision-threatening condition in which the globe becomes trapped behind the eyelids requiring physician intervention in the emergency department or eye clinic. On presentation, the patient typically complains of an inability to close their eye, severe forei...

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Autores principales: Gross, Fredric J, DiSandro, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5077236/
https://www.ncbi.nlm.nih.gov/pubmed/27799829
http://dx.doi.org/10.2147/IMCRJ.S119899
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author Gross, Fredric J
DiSandro, Giovanni
author_facet Gross, Fredric J
DiSandro, Giovanni
author_sort Gross, Fredric J
collection PubMed
description Globe luxation is a painful and potentially vision-threatening condition in which the globe becomes trapped behind the eyelids requiring physician intervention in the emergency department or eye clinic. On presentation, the patient typically complains of an inability to close their eye, severe foreign body sensation, decreased vision, and significant eye pain. Although most visual symptoms are reversible and primarily result from exposure keratopathy, optic nerve damage, and permanent vision loss can occur from repeat or prolonged episodes of globe luxation. Risk factors include any congenital or acquired conditions that displace the globe anteriorly in the orbit and increased eyelid laxity that allows the globe to prolapse through the lid aperture. Typically, the precipitating event involves eyelid retraction during ophthalmic examination or an event that increases intraorbital pressure such as coughing or sneezing. Once the globe has luxated, the condition is typically worsened by blepharospasm and patients’ attempts to close the eye that worsen the entrapment. In the current case, the patient had a large superotemporal filtering bleb following Ahmed valve surgery for uncontrolled glaucoma. While instilling her glaucoma medication, she retracted her eyelids sufficiently to pull the upper lid over her filtering bleb where it became entrapped causing a similar presentation to globe luxation. Traditional methods of repositioning the globe were unsuccessful. Bleb needling was ultimately required to return the globe to a normal position.
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spelling pubmed-50772362016-10-31 Bleb incarceration following Ahmed valve surgery Gross, Fredric J DiSandro, Giovanni Int Med Case Rep J Case Report Globe luxation is a painful and potentially vision-threatening condition in which the globe becomes trapped behind the eyelids requiring physician intervention in the emergency department or eye clinic. On presentation, the patient typically complains of an inability to close their eye, severe foreign body sensation, decreased vision, and significant eye pain. Although most visual symptoms are reversible and primarily result from exposure keratopathy, optic nerve damage, and permanent vision loss can occur from repeat or prolonged episodes of globe luxation. Risk factors include any congenital or acquired conditions that displace the globe anteriorly in the orbit and increased eyelid laxity that allows the globe to prolapse through the lid aperture. Typically, the precipitating event involves eyelid retraction during ophthalmic examination or an event that increases intraorbital pressure such as coughing or sneezing. Once the globe has luxated, the condition is typically worsened by blepharospasm and patients’ attempts to close the eye that worsen the entrapment. In the current case, the patient had a large superotemporal filtering bleb following Ahmed valve surgery for uncontrolled glaucoma. While instilling her glaucoma medication, she retracted her eyelids sufficiently to pull the upper lid over her filtering bleb where it became entrapped causing a similar presentation to globe luxation. Traditional methods of repositioning the globe were unsuccessful. Bleb needling was ultimately required to return the globe to a normal position. Dove Medical Press 2016-10-20 /pmc/articles/PMC5077236/ /pubmed/27799829 http://dx.doi.org/10.2147/IMCRJ.S119899 Text en © 2016 Gross and DiSandro. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Report
Gross, Fredric J
DiSandro, Giovanni
Bleb incarceration following Ahmed valve surgery
title Bleb incarceration following Ahmed valve surgery
title_full Bleb incarceration following Ahmed valve surgery
title_fullStr Bleb incarceration following Ahmed valve surgery
title_full_unstemmed Bleb incarceration following Ahmed valve surgery
title_short Bleb incarceration following Ahmed valve surgery
title_sort bleb incarceration following ahmed valve surgery
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5077236/
https://www.ncbi.nlm.nih.gov/pubmed/27799829
http://dx.doi.org/10.2147/IMCRJ.S119899
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