#eye loss

[flyingjemsaucer]

Chapter 24 is up!

So what happened to Shouta all those years ago?

⚠CONTENT WARNING⚠

Graphic depiction a car accident, graphic life threatening injuries, hospitals, intense emotional moments, panic and confusion, trauma, death and grief, guilt.  I have included a summary of the chapter at the end of the text for anyone who feels like they might not be up to reading this.

Read it here!

[legolaslovely]

👀👀👀 eyepatch!Fili. He loses his right eye in the BOTFA... Also, I hope you've been having a good week/day/month and I cant wait to read your next story!!! ~cassiabaggins

Hello! I’m excited to hear from you!!! Hope you’re well!! Thank you so much for your well wishes and for being excited with me! I think I will post tomorrow because blah blah blah no patience, blah blah blah instant gratification... :)))))))))

Onto your ask: I’ve seen you post about this! YOU HURT THE BABE! WHY DO YOU HURT THE BABE? I can’t even imagine the pain that’s involved with losing an eye! MUST PROTECC. OUR LION AND HIS BEAUTIFUL BLUES. I have tears, real tears! Fili deserves all the good things.

So would this be an eye patch thing? Or would he have a prosthetic eye? I’m not very educated on this, so I don’t know the proper terms, sorry/tell me please if I offend! 

After the initial pain of this, I think it would just be a part of him, as any war injury/(insert proper name here) is. He definitely tells stories about it when he’s drunk. Everyone admires and swoons over him because he’s the king who lost an eye winning the mountain back for his people (with help, of course). Kili tries to mouth things or motion to someone about Fili from his right side and Fili knows he’s doing it every time even though he can’t see him. “Damn it, Fee! How do you KNOW?” Fili’s little pebble runs around with a wooden sword and an eye patch like his Papa. As I said, Fili deserves all the good things. <3

[abbythegamergirl]

"Negaduck, please!" Quackerjack begs as he struggles futilely against his chains. "Just..Just leave him alone..!" He sobs when Megavolt lets out another pained scream as his eye is gouged out with Negaduck's bare fingers. "MEGAVOLT!!" Negaduck chuckles darkly as he listens to their useless screams and cries for mercy. based off an rp with @psychosistr.

feel free to reblog

[distractedhistotech]

Between MSA + 1: Coming To

Vivi came to driving the van on a long stretch of road.  She instantly realized something was wrong because A:  She was driving.  Arthur and Sydney did everything they could to keep her from driving. B:  She had no memory of how she got here.  She remembered sitting in the passenger seat talking to the others, then suddenly she was driving and…covered in blood?!

She slammed on the brakes as she heard a scream of pain from the back.  “Holy shit!”  She threw the car into park and turned towards the back.  “Do you guys-”  The question died in her throat.

Sydney was hunched over Arthur and rapidly trying to wrap bandages from the first aid kit around where Arthur’s left arm used to be while Mystery was whimpering nearby.  Vivi vaulted over the chairs.  “What happened?!”

“I-I don’t know,” slurred Sydney.  “I’m just here but I wasn’t here, and I dunno how I got from there to here.”

Vivi ripped off her scarf and quickly wrapped it around Arthur’s chest and injury.  Vivi knew it wasn’t clean, but it was a lot more effective.  “What’s going on?!  What happened?!” demanded Vivi.

“I dunno,” murmured Sydney.

Vivi was about ready to demand Sydney try and remember when she noticed blood dripping off Sydney’s face.  The blood pattern on Sydney’s shirt indicated contact transfer rather than being sprayed by the blood.  There shouldn’t be enough of Arthur’s blood to be dripping off of her.  “Sydney, are you okay?”

“…My face hurts,” muttered Sydney, finally looking up.

Vivi nearly lost her lunch (dinner?) when she saw that Sydney’s right eye was gone, and whatever had removed it had made a mess as the skin around the area was badly torn up. Vivi swore she could see bone and even something that she suspected was Sydney’s optic nerve.  “Holy shit!”

Sydney blinked. “Is it bad?”

Vivi chose not to answer, instead ripping open a clean package of gauze, pressing it to the injury, managing to slap a bit of tape on it, and pressing Sydney’s hand to it. “Press down on that!”

Sydney blinked and glanced at Arthur.  “But what about…”

“Try to keep pressure on him too!”  God, Arthur was so pale, and he was barely bleeding.  Was there any blood left in his body?

Vivi climbed back into the driver’s seat, threw the van into drive and slammed the accelerator into the floor.

[playdoughpal]

Speaking of Curly, he recently experienced another identity shift /neu

He started out as his post crash self at formation, and then he shifted to his pre-crash self for months

Now he’s,,,in between? He’s mostly pre-crash but with some mild facial scars and an eyepatch

I wonder if it reflects our system’s Eye Related Trauma(tm) /nav

[freezingwhitefire]

I finally figured out what I want to do with the water temple and Time. Its going to be so much fun someone might lose an eye. 😈

[juniperpublishersophthalmology]

Eye Loss Due to Disseminated Molluscum Contagiosum Skin Infection Involving the Eyelids in an Immune Competent Child- Juniper Publishers

Juniper Publishers- JOJ Ophthalmology

Introduction

Molluscum contagiosum is a viral infection of skin and mucous membranes caused by a double-stranded DNA poxvirus. The virus causes a characteristic skin lesion consisting of a single or multiple round pearly white umblicated papules [1]. Molluscum contagiosum is largely if not exclusively a human disease although there are few reported cases in some animals [2]. Distribution is worldwide, but it is more common in areas with hot climate [3]. The virus is transmitted directly through skin to skin contact with other infected patients or indirectly through contact with contaminated fomites such as bath sponges and towel. The virus can also be transmitted to other areas in the same patient by autoinoculation [4]. Although all age groups can be affected, it commonly occurs in two age peaks: children and adults. Children are usually infected by casual contact and young adults infected by sexual contact [5]. Clinically molluscum contagiosum lesions are usually asymptomatic; however, some lesions may become pruritic or tender due to associated eczema or inflammation. There are no systemic symptoms [6]. In most cases lesions resolve spontaneously without treatment over the course of several months [7]. On examination, the skin lesions are round, dome shaped, pearly, flesh colored, firm papules with central umblication. They are usually 2-5mm in diameter (except for giant molluscum which may reach few centimeters). Beneath the umbilicated center is a white, curd-like core that contains molluscum bodies. Lesions may be single or multiple distributed on the skin of the head- including the eye lids, neck, trunk, the limbs, and around the genital area [8]. Rarely, it may involve the palms, the soles, mucous membranes of the mouth, or conjunctiva [9,10]. Immuno compromised patients - children and adults, such as HIV patients and patients on immunosuppressive therapy, tend to have atypical and more wide spread and persistent lesions [5,11].

The diagnosis of molluscum contagiosum is clinically evident by the characteristic appearance of the skin lesion. In atypical or giant lesions, a biopsy can be done to reach diagnosis. Histopathology reveals characteristic intracytoplasmic inclusion bodies (molluscum or Henderson-Paterson bodies) [12]. Other tests include complement fixation test (CFT) and polymerase chain reaction (PCR) [13]. Treatment in healthy individuals is not always necessary because most cases are self limiting. Indications include: relieving symptoms and discomfort, improving cosmetic appearance, persistent lesions, and reduction of autoinoculation and spread to other contacts [14]. Many modalities exist [15]. Treatments can be divided into three categories: destructive- physical and chemical), immune modulators, and antiviral [16].

    Case Report

A four years old female child presented to the dermatologist with disseminated skin lesions involving the whole body surface area. The lesions were scattered all over the face, neck, trunk and limbs with larger concentrations around the eyelids- both eyes- and the genital region. The lesions were round pearly white umblicated papules typical of molluscum contagiosum. The patient consulted many dermatologists before she was referred to an ophthalmologist for eye examination. On examination, the lesions were more confluent and concentrated around the eyelids skin and eyelid margins making it difficult to open the balpebral fissure for inspection of the conjunctiva and corneal surface, and the condition was associated with secondary pyogenic infection and discharge around the eyelid margin. Examination under general anesthesia to facilitate eyelids opening and subsequent surgical removal revealed infective keratitis on the right side with profuse pus discharge and extensive corneal stromal ulceration and melting.

The treating dermatologist and ophthalmologist started surgical excision of as many lesions as possible. The eye postoperatively was treated with intensive topical antibiotics eye drops and eye ointment for several days until the infection was resolved and healing of the corneal surface took place. The patient was referred to a pediatrician for the investigation of the possible cause of immune deficiency. The patient did not return subsequently for follow-up (Figure 1-3).

    Discussion

Molluscum contagiosum is usually described as a benign and self limiting skin infection that does not always require treatment [17]. However, this may not be the case when the eye is involved [18]. Ocular manifestations may present as a range of complications [1,6,19]. Lesion located on or near the lid margin may give rise to secondary chronic follicular conjunctivitis. Unless the lid margin is examined carefully, the causative molluscum lesion may be overlooked therefore it can be easily misdiagnosed and mistreated. Prolonged follicular conjunctivitis or secondary bacterial infection can result in keratitis usually in the form of fine punctate epithelial erosions or sub epithelial opacities. Corneal vascularisation, scarring and opacification may result in visual acuity loss. Molluscum contagiosum infection commonly involves the face and hands. Itching and scratching facilitate extension of infection to other parts of the same patient; therefore, the disease usually presents as multiple crops and less commonly as a solitary lesion which sometimes becomes a confluent multilobulated giant tumor affecting the eyelid [20,21]. Secondary infection and ulceration can result in permanent scarring.

Molluscum contagiosum is a common pediatric dermatosis in Iraq [22]. Al-Azawi reported a high prevalence of molluscum contagiosum virus (MCV) type I in children age group<10 years [23]. In our clinical practice, molluscum contagiosum infection is wide spread and eye involvement is very common in Iraq. Predisposing factors may include low socioeconomic status, crowding, and low personal hygiene. It affects all age groups especially children in preschool age and primary school age. This highly contagious infection is usually acquired from contact with other infected people. They could be family members or visitors or more commonly other infected children in the neighborhood or schools.

Molluscum contagiosum infections involving the eyelids and periocular area are usually managed by ophthalmologists, and sometimes referred by dermatologists. Although many modalities of therapy are effective in destruction of the virus, the use of substances such as liquid nitrogen or chemicals in the vicinity of the eye may be hazardous [24,25]. Surgical removal by shave excision or curettage is a simple and effective procedure [23]. However, multiplicity of the lesions and young patient age usually necessitate light general anesthesia given by an anesthesiologist in an operation theater and therefore cannot be done as an outpatient office procedure in the minor surgical room. This may result in considerable suffering to the patient and parents and burden on the health care providers [3].

    Conclusion

Molluscum contagiosum is not always a self-limiting benign skin infection, but it can cause serious eye complications especially in the third world. Active treatment is indicated to prevent secondary complications and limit the spread of the disease to other people.

    Disclosure

The author reports no conflicts of interest in this work.

For more Open Access Journals in Juniper Publishers please click on: https://juniperpublishers.com

For more articles in  JOJ Ophthalmology (JOJO) please click on: https://juniperpublishers.com/jojo/index.php

For more Open Access Journals please click on: https://juniperpublishers.com

[juniperpublishersophthalmology]

Eye Loss Due to Disseminated Molluscum Contagiosum Skin Infection Involving the Eyelids in an Immune Competent Child- Juniper Publishers

Juniper Publishers- JOJ Ophthalmology

Abstract

Background: Molluscum contagiosum is a viral infection of skin and mucous membranes caused by a DNA poxvirus. It is a common skin infection in children with numerous ocular manifestations.

Case report: Eye loss due to disseminated molluscum contagiosum infection of the skin involving the eyelids in a 4 years old immune competent female child. The clinical history, exanimation, treatment and follow-up are presented.

Conclusion: molluscum contagiosum is not always a self limiting benign skin infection and can cause serious eye complications especially in the third world. Active treatment is indicated to prevent secondary complications and limit the spread of the disease to other people.

Keywords:   Viral infection; Molluscum contagiosum; Eye loss

    Introduction

Molluscum contagiosum is a viral infection of skin and mucous membranes caused by a double-stranded DNA poxvirus. The virus causes a characteristic skin lesion consisting of a single or multiple round pearly white umblicated papules [1]. Molluscum contagiosum is largely if not exclusively a human disease although there are few reported cases in some animals [2]. Distribution is worldwide, but it is more common in areas with hot climate [3]. The virus is transmitted directly through skin to skin contact with other infected patients or indirectly through contact with contaminated fomites such as bath sponges and towel. The virus can also be transmitted to other areas in the same patient by autoinoculation [4]. Although all age groups can be affected, it commonly occurs in two age peaks: children and adults. Children are usually infected by casual contact and young adults infected by sexual contact [5]. Clinically molluscum contagiosum lesions are usually asymptomatic; however, some lesions may become pruritic or tender due to associated eczema or inflammation. There are no systemic symptoms [6]. In most cases lesions resolve spontaneously without treatment over the course of several months [7]. On examination, the skin lesions are round, dome shaped, pearly, flesh colored, firm papules with central umblication. They are usually 2-5mm in diameter (except for giant molluscum which may reach few centimeters). Beneath the umbilicated center is a white, curd-like core that contains molluscum bodies. Lesions may be single or multiple distributed on the skin of the head- including the eye lids, neck, trunk, the limbs, and around the genital area [8]. Rarely, it may involve the palms, the soles, mucous membranes of the mouth, or conjunctiva [9,10]. Immuno compromised patients - children and adults, such as HIV patients and patients on immunosuppressive therapy, tend to have atypical and more wide spread and persistent lesions [5,11].

The diagnosis of molluscum contagiosum is clinically evident by the characteristic appearance of the skin lesion. In atypical or giant lesions, a biopsy can be done to reach diagnosis. Histopathology reveals characteristic intracytoplasmic inclusion bodies (molluscum or Henderson-Paterson bodies) [12]. Other tests include complement fixation test (CFT) and polymerase chain reaction (PCR) [13]. Treatment in healthy individuals is not always necessary because most cases are self limiting. Indications include: relieving symptoms and discomfort, improving cosmetic appearance, persistent lesions, and reduction of autoinoculation and spread to other contacts [14]. Many modalities exist [15]. Treatments can be divided into three categories: destructive- physical and chemical), immune modulators, and antiviral [16].

    Case Report

A four years old female child presented to the dermatologist with disseminated skin lesions involving the whole body surface area. The lesions were scattered all over the face, neck, trunk and limbs with larger concentrations around the eyelids- both eyes- and the genital region. The lesions were round pearly white umblicated papules typical of molluscum contagiosum. The patient consulted many dermatologists before she was referred to an ophthalmologist for eye examination. On examination, the lesions were more confluent and concentrated around the eyelids skin and eyelid margins making it difficult to open the balpebral fissure for inspection of the conjunctiva and corneal surface, and the condition was associated with secondary pyogenic infection and discharge around the eyelid margin. Examination under general anesthesia to facilitate eyelids opening and subsequent surgical removal revealed infective keratitis on the right side with profuse pus discharge and extensive corneal stromal ulceration and melting.

The treating dermatologist and ophthalmologist started surgical excision of as many lesions as possible. The eye postoperatively was treated with intensive topical antibiotics eye drops and eye ointment for several days until the infection was resolved and healing of the corneal surface took place. The patient was referred to a pediatrician for the investigation of the possible cause of immune deficiency. The patient did not return subsequently for follow-up (Figure 1-3).

    Discussion

Molluscum contagiosum is usually described as a benign and self limiting skin infection that does not always require treatment [17]. However, this may not be the case when the eye is involved [18]. Ocular manifestations may present as a range of complications [1,6,19]. Lesion located on or near the lid margin may give rise to secondary chronic follicular conjunctivitis. Unless the lid margin is examined carefully, the causative molluscum lesion may be overlooked therefore it can be easily misdiagnosed and mistreated. Prolonged follicular conjunctivitis or secondary bacterial infection can result in keratitis usually in the form of fine punctate epithelial erosions or sub epithelial opacities. Corneal vascularisation, scarring and opacification may result in visual acuity loss. Molluscum contagiosum infection commonly involves the face and hands. Itching and scratching facilitate extension of infection to other parts of the same patient; therefore, the disease usually presents as multiple crops and less commonly as a solitary lesion which sometimes becomes a confluent multilobulated giant tumor affecting the eyelid [20,21]. Secondary infection and ulceration can result in permanent scarring.

Molluscum contagiosum is a common pediatric dermatosis in Iraq [22]. Al-Azawi reported a high prevalence of molluscum contagiosum virus (MCV) type I in children age group<10 years [23]. In our clinical practice, molluscum contagiosum infection is wide spread and eye involvement is very common in Iraq. Predisposing factors may include low socioeconomic status, crowding, and low personal hygiene. It affects all age groups especially children in preschool age and primary school age. This highly contagious infection is usually acquired from contact with other infected people. They could be family members or visitors or more commonly other infected children in the neighborhood or schools.

Molluscum contagiosum infections involving the eyelids and periocular area are usually managed by ophthalmologists, and sometimes referred by dermatologists. Although many modalities of therapy are effective in destruction of the virus, the use of substances such as liquid nitrogen or chemicals in the vicinity of the eye may be hazardous [24,25]. Surgical removal by shave excision or curettage is a simple and effective procedure [23]. However, multiplicity of the lesions and young patient age usually necessitate light general anesthesia given by an anesthesiologist in an operation theater and therefore cannot be done as an outpatient office procedure in the minor surgical room. This may result in considerable suffering to the patient and parents and burden on the health care providers [3].

    Conclusion

Molluscum contagiosum is not always a self-limiting benign skin infection, but it can cause serious eye complications especially in the third world. Active treatment is indicated to prevent secondary complications and limit the spread of the disease to other people.

    Disclosure

The author reports no conflicts of interest in this work.

For more Open Access Journals in Juniper Publishers please click on: https://juniperpublishers.com

For more articles in  JOJ Ophthalmology (JOJO) please click on: https://juniperpublishers.com/jojo/index.php

For more Open Access Journals please click on: https://juniperpublishers.com