Posner-Schlossman syndrome induced laser in situ keratomileusis keratectasia–a case report

Letter to the editor     

Periocular thelaziasis presenting as an orbital mass – a case report

Thelazia callipaeda is a rare parasitic infestation caused by spiruroid nematode of the genus Thelazia. We report a case of a 74-year-old gentleman who presented with a painless swelling of left lower lid since 15 days. Examination revealed a firm mobile mass along the inferior orbital rim. Magnetic Resonance Imaging showed a well-defined preseptal cystic lesion and Ultrasound screening revealed multiple mobile worms within. Patient underwent cyst excision in toto under local anesthesia. Four long refractile worms were isolated from within the cyst cavity. Species identification confirmed the parasite as Thelazia callipaeda. Periocular thelaziasis usually presents as free floating worms in the conjunctival sac, anterior chamber or vitreous cavity. It is important to be aware of this rare entity which should be considered as a differential diagnosis in endemic areas.     

Bilateral retinal detachment in Hallermann-Streiff-François syndrome: a case report

We report the case of a patient with Hallermann-Streiff-Fran?ois syndrome, with typical presentation of white bilateral cataract. The surgical treatment showed morphological retinal abnormalities, which resulted in an exudative retinal detachment. This case underscores the importance of paying special attention during surgical treatment of cataract in this type of patient.     

Bilateral neuro-retinitis following chick embryo cell anti-rabies vaccination – a case report

Background  

The Optic nerve is rarely involved after sheep brain anti-rabies vaccination in the form of retrobulbar neuritis or papillitis. Bilateral neuroretinitis after chick embryo cell antirabies vaccination has not been reported.     

Coats’ disease and bilateral cataract in a child with Turner syndrome: a case report

Purpose To report the first case in which Coats’ disease was observed with infantile cataract in a girl with Turner syndrome (TS). Materials and methods We examined a 4-year-old female infant with TS who was referred with a diagnosis of leukocoria in the left eye. Results and discussion Examination under anaesthesia revealed a bilateral punctate cataract and left eye fundus showed vascular retinal abnormalities typical of Coats’ disease. Cryotherapy was performed on the telangiectatic vessels and the child was followed up for a period of 12 months. Despite cryotherapy resulting in regression of the peripheral exudates, an exudative maculopathy persisted with poor visual outcome. We suggest that Coats’ disease should be considered as a rare ocular manifestation in TS.     

Metastatic malignant teratoid medulloepithelioma – a case report and review of the literature

Medulloepitheliomas are rare congenital tumours arising from the epithelium lining the medullary tube. They are usually detected in the first decade of life. They may be teratoid or non-teratoid. Regional and distant metastases are rare. Extraocular extension of disease appears to be the most important prognostic feature. Surgical resection is the usual mode of treatment. The role of other adjuvant modalities is as yet unclear.     

【In Press】 Late onset acute Vogt Koyanagi Harada syndrome – challenges on the way

Letter to the editor     

Exudative retinal detachment in macular hole surgery using platelet concentrates – a case report

INTRODUCTION: Retinal detachment after macular hole surgery is a rare complication, usually occurring because of small, peripheral holes. We present a patient with a high bullous exudative retinal detachment following pars plana vitrectomy. CASE REPORT: A healthy 69-year-old patient presented with a macular hole stage III of the left eye. Corrected visual acuity was 20/200. Pars plana vitrectomy was performed without peeling of the internal limiting membrane or an epiretinal membrane, a few drops of platelet concentrate were instilled onto the hole, and the bulbus was filled subtotally with a non-expanding SF6/air mixture. On the 3rd postoperative day a small retinal detachment of the inferior half of the retina was noticed that increased over the next 3 days until it reached the inferior vascular arcade. During the following 3 days a spontaneous remission occurred with complete reattachment of the retina. Six weeks after operation the retina was completely reattached, the macular hole was closed, and the visual acuity was 20/200 with a slight cataract. CONCLUSION: Retinal detachments after macular hole surgery are not always of rhegmatogenous nature but may also be exudative and related to an inflammatory reaction caused by adjuvants. When a retinal detachment occurs immediately after macular hole surgery without detectable holes it may be advisable to wait for some days before reoperation.     

Multifocal Rosai Dorfman disease of periorbital tissues spanning 15 years – a case report

The authors report a rare case of Rosai Dorfman disease with multifocal involvement of periorbital tissues, beginning in a young girl at the age of 3 and spanning 15 years. Surgical treatment was successful.     

Glaucoma secondary to trabecular meshwork precipitates: a case report of Grant’s syndrome

AIM: To quantify intraoperative and postoperative complications in complex phacoemulsification cataract extraction (phacoemulsification) with iris manipulation compared to non-complex and complex phacoemulsification without iris manipulation. METHODS: All phacoemulsification cases at the University of Colorado between January 1, 2014, and June 30, 2017 were included. Exclusion criteria for the primary outcome of intraoperative complications were planned combination surgery and eyes with less than 28d follow-up. Exclusion criteria for the secondary outcomes of postoperative complications were unplanned additional surgery, and chronic steroid eye drop use prior to surgery. Data including sex, race/ethnicity, surgery length, visual acuity, intraoperative and postoperative complications, and intraocular pressures (IOP) were collected and analyzed utilizing general linear and Logistic regression modeling. RESULTS: The medical records of 5772 eyes were reviewed (500 complex without iris manipulation, 367 with iris manipulation). The number of any intraoperative complication in the complex with iris manipulation and complex without iris manipulation groups was 15 (4.1%) and 26 (5.2%), respectively, compared to 41 (0.8%) in the non-complex group. Postoperative inflammation was found in 135 (2.8%) non-complex cases, 20 (4.1%) complex cases without iris manipulation, and 20 (5.6%) complex cases with iris manipulation. The adjusted odds ratio of postoperative inflammation in phacoemulsification with iris manipulation compared to non-complex was 2.3 (95%CI: 1.3-4.0, P=0.005). The rate of IOP spikes >10 mm Hg was significantly greater in cases with iris manipulation (P=0.001). CONCLUSION: Complex cases have more intraoperative complications. However, only complex cases with iris manipulation led to increase rates of postoperative inflammation and IOP spikes >10 mm Hg.     

Glaucoma secondary to trabecular meshwork precipitates: a case report of Grant’s syndrome

AIM: To describe a via pars plana anterior iris enclavation IOL fixation technique. METHODS: A total of 35 consecutive aphakic vitrectomised patients (average age 71±7.14y) underwent pars plana vitrectomy (PPV) and via pars plana anterior iris enclavation IOL fixation. RESULTS: The mean preoperative best corrected visual acuity (BCVA) was 0.11±0.14 logMAR, the mean post-operative BCVA was 0.07±0.11 logMAR. The preoperative mean spherical equivalent was 7.22±4.21. The final mean spherical equivalent was -0.25±0.15. No eyes had hypotony, retinal or choroidal detachment or endophthalmitis. CONCLUSION: This technique may be a safe and useful in the case of aphakia, and a prospective study would be useful to confirm this findings.     

Primary tubercular dacryocystitis – a case report and review of 18 cases from the literature

Tuberculosis is an airborne communicable disease primarily affecting lungs. Primary tuberculosis of the lacrimal sac is very rare. A 15-year-old girl presented with bilateral epiphora for 8 months. Examination revealed bilateral nasolacrimal duct obstruction. During dacryocystorhinostomy, bone over lacrimal sac was found partially eroded. Lacrimal sac was found filled with caseous white material. Biopsy from the lacrimal sac revealed tubercular granulomas. Patient improved after anti-tubercular therapy.

Abbreviations: PCR: polymerase chain reaction; NAAT: nucleic acid amplification test     

Intraconal gauze mass: An unusual complication of orbital fracture repair – a case report

Gossypiboma and textiloma are terms used to describe tumor-like masses caused by retained gauze or surgical sponges after any operation. It is a rare surgical complication, usually difficult to diagnose due to its variable clinical presentation and nonstandard radiological appearance. We describe here a rare case of orbital gossypiboma in a child after surgical correction of an orbital blowout fracture.     

Bilateral multiple primary iridociliary cysts – A rare case report

Iridociliary cysts are often found in patients as an incidental finding during a routine ophthalmic evaluation and if asymptomatic do not require any treatment per se. However, these are often mistaken as iris melanoma and the patient is managed accordingly causing a great deal of inconvenience to the patient as well as the doctor.Case presentationA 69 year old male presented to the ophthalmic out-patients department for routine ophthalmic evaluation. On examination, he is best corrected visual acuity was 6/9, N6 in both eyes. Post-mydriasis evaluation showed a Grade II nuclear cataract in both eyes. There was a smooth, pigmented mass with a rounded surface projecting from behind the iris resembling an iris melanoma. On further evaluation, he was found to have multiple ciliary body cysts.ConclusionUltrasound biomicroscopy is a valuable technique in diagnosing iridociliary cysts.     

Retinal pigment epithelium detachment associated with vitreomacular traction syndrome—case report

Purpose To report the unusual association of vitreomacular traction syndrome (VMT) with retinal pigment epithelium (RPE) detachment and describe the outcomes of successful surgery. Methods An 84-year-old man was referred with 6-month history of blurred vision in his RE. Best-corrected visual acuity (BCVA) was “counting fingers.” Slit-lamp examination revealed VMT overlying a RPE detachment. The above findings were confirmed by optical coherence tomography (OCT). Pars plana vitrectomy and internal limiting membrane (ILM) peeling were performed. OCT was carried out at 3, 6, 9, and 11 months postoperatively. Results Eight weeks postoperatively BCVA improved to 6/60. Slit-lamp examination and OCT showed relief of the vitreomacular traction, however the underlying RPE detachment remained unchanged and progressively regressed during the following 11 months. Visual acuity did not improve above 6/36 at the last follow-up visit. Conclusion Retinal pigment epithelium detachment could be associated with VMT. Although the incidence is rare, it may compromise the outcomes of successful surgery.     

2005 ESCRS Ridley Medal Lecture: Will keratectasia be a major complication for LASIK in the long term?

The literature on keratoconus and progressive post-laser in situ keratomileusis ectasia (PPLK) was studied after a retrospective review of 137 highly myopic eyes (mean -15.58 diopters) 5 to 9 years after LASIK. Only 2 eyes developed keratectasia, 1 after automated lamellar keratolasty for myopia and 1 after myopic LASIK. In neither case was intraoperative pachymetry carried out. In the PPLK case, a residual stromal bed thickness (RSBT) of 120 microm was discovered when a retreatment was attempted on lifting the flap. The PPLK developed 2 years later. The obvious discrepancy between reported cases of PPLK and the expected rate from the incidences in larger retrospective studies and our own 15-year experience suggests that PPLK is not a significant complication provided the standard rules applying to the preoperative total corneal thickness and RSBT are observed. However, newer techniques for the study of posterior corneal changes and those involving corneal biomechanics should be used in the future to study the long-term effects of LASIK on the cornea.