Spontaneous Unilateral Anterior Corneal Mosaic in Orbital Apex Syndrome: A Case Report
| Autor: | Harshita Moond, Twinkle Gupta, Neha K Sethi, Ashu Dihana, Neeru Bhutta |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Journal of Clinical and Diagnostic Research, Vol 18, Iss 08, Pp 01-02 (2024) |
| Druh dokumentu: | article |
| ISSN: | 2249-782X 0973-709X |
| DOI: | 10.7860/JCDR/2024/69937.19771 |
| Popis: | Cornea is the transparent, avascular, outermost fibrous coat of the eyeball. Fluorescein dye is used to detect epithelial discontinuities in the cornea. In a normal cornea, there is no uptake of stain after fluorescein instillation. However, a distinct honeycomb or mosaic pattern is often observed after massaging the cornea through the lids with fluorescein staining. This pattern is known as Anterior Corneal Mosaic (ACM) and is characterised by a polygonal/honeycomb pattern on the cornea. Present case is the first case of spontaneous unilateral ACM in an eye with orbital cellulitis and orbital apex syndrome, displaying a ‘guitar-pick’ sign on Magnetic Resonance Imaging (MRI) and B-scan. In this case, a 65-year-old female patient complained of a sudden onset of decreased vision in her left eye that began one week ago. Slit lamp examination revealed chemosis and a spontaneous mosaic pattern on the cornea. Pus culture from an upper lid abscess identified Methicillin Resistant Staphylococcus aureus (MRSA). Treatment with intravenous antibiotics, abscess drainage, and topical antibiotics resulted in clinical improvement, although vision remained poor after one month. Authors hypothesise that the ACM was spontaneously induced in the absence of external pressure from the eyelids. It was likely caused by pressure on the cornea from lid swelling and increased posterior pressure due to orbital soft-tissue inflammation. Thus, it may serve as a clinical indicator of elevated orbital pressure. |
| Databáze: | Directory of Open Access Journals |
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