Eddie F. Kadrmas

Coxsackievirus B4 as a cause of adult chorioretinitis.

PURPOSE To describe the clinical manifestation and course of chorioretinitis presumed to be secondary to coxsackievirus infection in an adult. METHOD Case report documented by fundus photography and fluorescein angiography. RESULTS Ophthalmoscopic examination of a symptomatic 34-year-old woman showed several cream-colored parafoveal spots at the level of the retinal pigment epithelium and similar, multiple confluent spots in the midperiphery of both eyes. Titers for coxsackievirus B4 demonstrated a fourfold rise between acute and convalescent sera. CONCLUSION Coxsackievirus B4 is apparently a rare cause of chorioretinitis but nevertheless should be considered in the appropriate clinical setting.

Vitreous hemorrhage and retinal vein rupture

PURPOSE/METHODS We examined a 23-year-old woman who had a sudden onset of floaters after self-induced emesis. RESULTS/CONCLUSIONS Examination showed a dense vitreous hemorrhage originating from a rupture site in the wall of the superotemporal branch vein. We postulate a preexisting weakness in the retinal vein wall as a predisposing factor to rupture. This mechanism may explain some cases of vitreous hemorrhage associated with a Valsalva maneuver.

Visual Problems of the Aging Musician

The presbyopic musician presents the ophthalmologist with an often demanding set of visual needs. Many modalities, some necessarily creative, are available to aid older musicians in their vision-dependent art.

Superior Limbic Keratoconjunctivitis

PURPOSE To study superior limbic keratoconjunctivitis in a relatively large group of patients and to determine whether a relation exists with thyroid dysfunction. METHODS The medical records of 57 patients with superior limbic keratoconjunctivitis who were examined between 1980 and 1993 were reviewed. RESULTS Thirty-seven patients (64.9%; 95% confidence interval, 51.1-77.1) had objective evidence of thyroid dysfunction. Of patients with superior limbic keratoconjunctivitis and thyroid disease, 33 (89.2%) had ophthalmopathy, which in 16 patients (48.5%) was sufficiently severe to require orbital decompression. CONCLUSION Superior limbic keratoconjunctivitis is associated with thyroid dysfunction and appears to be a prognostic marker for severe Graves ophthalmopathy.