Resolution of chicken pox neuroretinitis with oral acyclovir: A case report

It is usual to consider chicken pox as a benign infectious disease with a few anterior segment ocular complications like conjunctivitis, keratitis, episcleritis, scleritis, iridocyclitis, and glaucoma. The retinal manifestations are necrotising retinitis, vitritis, neuroretinitis, and retinal detachments. We report a case of neuroretinitis following chicken pox in a 23-year-old male. The complication was resolved by treatment with oral acyclovir in combination with systemic steroids. This report highlights the necessity for fundus examination in cases of chickenpox exhibiting visual symptoms.     

Followup of chicken pox keratitis. Anatomic-clinical case report

Chicken pox is a very common infectious disease in children. Its corneal involvement is less serious than with measles, which may lead to blindness in numerous developing countries. However, with occasional cases occur. A case of a 59-year-old male patient whose left cornea was involved during a chicken pox infection at the age of 7 is reported. More recently, the vision of the right eye was normal at 20/20 and reduced to visual perception in the affected left eye. Corneal sensitivity was maintained in the left eye, which, however exhibited a central epithelial defect. A central round opacity of the left corneal stroma was believed to be the scar resulting from a previous disciform keratitis. The left central cornea was thinned and there was neither an anterior chamber flare nor new corneal vessels. This corneal condition required a corneal allograft, performed quickly because of the potential risk of perforation. Histopathological study of the corneal button showed a central corneal thinning with an increase in epithelial thickness. The corneal stroma was disorganized, with irregular collagen bundles. No inflammatory cells could be observed, however. All the histopathological changes observed were those of a corneal scar.     

Acute retinal necrosis complicating chicken pox in a healthy adult

We report a case of unilateral acute retinal necrosis (ARN) with marked vitritis and retinal necrosis leading to retinal breaks following chicken pox successfully treated with intravenous acyclovir followed by oral acyclovir, orbital floor triamcinolone injections to contain the inflammation, and barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity and the novel use orbital floor triamcinolone therapy to contain ARN inflammation. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Perform A Death-Defying act- Check your Patient's Blood Pressure!

The addition of a minimal time involved technique—blood pressure measurement—to the optometrlc test and screening battery allows (or early recognition of hypotension and hypertension and glaucoma when additionally linked with ophthalmoscopy and applanation tonometry.     

Choosing your mentor

Sketchy and biased as the foregoing review may be, it brings out two factors conductive to the “birth” of handbooks: sharp accelerations in the progress of medicine and the presence on the scene of unusual human minds with the gift of recognizing a system in a mass of data.The review also shows that the information explosion of the last 30 years has not been a deterrent to the thought of a new handbook. Nor has the realization of the thought been made impossible by the enormous growth in informational material. Fortunately, the work force in science has increased at the same or even greater rate than the size of its product so that experts in the various fields are more easily found. The quality of the handbook has become critically dependent on the persons whom the physiologists call the section editors, i.e., scientists with a broad background of settled, well-organized knowledge, a calm disposition and a critical eye as Gmelin seems to have had. These qualifications need not be defined any further since they have been clearly recognized by English-speaking ophthalmologists all over the world in the structure and composition of the System of Ophthalmology. What remains to be said here is, “Thank you, Sir Stewart, from the bottom of our hearts!”     

Vitiligo iridis and glaucoma: a rare sequelae of small pox

Purpose

Vitiligo iridis refers to focal areas of iris atrophy as sequelae of small pox infection. We report a series of patients with unilateral vitiligo iridis, some of whom presented with secondary open-angle glaucoma.

Methods

Three patients with vitiligo iridis underwent a comprehensive ophthalmic examination including intraocular pressure (IOP) measurement, slit lamp biomicroscopy, gonioscopy, and fundus evaluation. Patients'' facial features were also documented and photographed.

Results

All patients were in their sixth decade. Two out the three had elevated IOP (52 mm Hg and 36 mm Hg) in the same eye as vitiligo iridis, at initial presentation. Gonioscopy showed patchy iris hyperpigmentation and fundus evaluation showed glaucomatous optic disc changes in the involved eye. One patient responded favourably to topical antiglaucoma medications, whereas the other was taken up for combined phacoemulsification–trabeculectomy with good results. The third patient had normal IOP in the involved eye. All three patients gave a history of small pox in childhood and had pitted facial scars typical of previous small pox infection.

Conclusions

Vitiligo iridis may be associated with the secondary glaucoma as a long-term sequelae of small pox. It may be prudent to periodically follow-up such patients for development of raised IOP in the future.     

Resolution of chicken pox neuroretinitis with oral acyclovir: a case report

It is usual to consider chicken pox as a benign infectious disease with a few anterior segment ocular complications like conjunctivitis, keratitis, episcleritis, scleritis, iridocyclitis, and glaucoma. The retinal manifestations are necrotising retinitis, vitritis, neuroretinitis, and retinal detachments. We report a case of neuroretinitis following chicken pox in a 23-year-old male. The complication was resolved by treatment with oral acyclovir in combination with systemic steroids. This report highlights the necessity for fundus examination in cases of chickenpox exhibiting visual symptoms.