Open Access Case Report

Fluoxetine, a Selective Serotonin Reuptake Inhibitor Overdose Resulting in a Central Retinal Vein Occlusion

Satish G. Agraharam, Gangaprasad Amula, Arjun Srirampur, Aruna Kumari Gadde

Ophthalmology Research: An International Journal, Page 1-3
DOI: 10.9734/OR/2017/35199

Aim: We present a rare case of Central retinal vein occlusion after prolonged use of Fluoxetine.

Case Presentation: A 28 year old patient presented with clinical picture of Central retinal vein occlusion after prolonged use of Fluoxetine. Discontinuation of the offending drug resulted in resolution of the venous occlusion.

Discussion and Conclusion: Young patient presenting with central retinal vein occlusions require drug history to be elicited to identify the cause.


Open Access Case Report

Mechanical Pupil Dilatation Using Oasis Ring versus Non-mechanical Device Pupil Dilatation for Phacoemulsification in Eyes with Narrow Pupil

Mohammad Khater, Ahmed M. Ghoneim

Ophthalmology Research: An International Journal, Page 1-6
DOI: 10.9734/OR/2017/35985

Purpose: to compare using Oasis ring for mechanical dilatation of the pupil during phacoemulsification in cases of narrow pupil with non-mechanical dilatation.

Methods: this study included 80 eyes of 67 patients of cataract with narrow pupil divided into 2 groups each of them included 40 eyes. In one group, Oasis ring was used to achieve adequate pupillary dilatation while in the other group, non-mechanical methods as bi-manual stretching, visco-mydriasis and partial sphincrotomies were used. Both groups were compared regarding achieved pupil size, additional time for dilatation, intra-operative difficulties and post-operative pupil characters after one month.  This study was conducted at Tanta University Hospital in Egypt.

Results: We found that the mean pupil size was 6.00±0.00 mm Oasis ring group while was 4.26±0.48 mm in the other group. Dilatation needed longer time with Oasis ring where it ranged from 83- 117 seconds. There was more liability for intra-operative difficulties as iris prolapse, minimal bleeding and iris trauma in the non-mechanical group. Post-operative pupil characters were rounded, central and reactive in the first group while oval pupil was found in 17.5% and minute tears in 12.5% of cases of non-mechanical group.

Conclusion: Oasis ring offered more pupil dilatation with less liability for intra-operative complications and preservation of pupil characters. It added more cost and time to achieve adequate pupil dilatation.


Open Access Case study

Acute Unilateral Intraocular Pressure (IOP) Elevation in the Emergency Room (ER): A Case Report

A. Lopes, D. Silva, M. Mota, C. Vendrell, M. Lisboa, F. Vaz

Ophthalmology Research: An International Journal, Page 1-6
DOI: 10.9734/OR/2017/35617

Aim: To present a clinical case of acute unilateral intraocular pressure (IOP) elevation in the emergency room (ER) that required a complex differential diagnosis, including acute angle closure, trauma, hypertensive uveitis, Posner-Schlossman Syndrome (PSS) or Glaucomatocyclic Crisis and Pigmentary Dispersion Syndrome (PDS).

Presentation of Case: A 15-year-old myopic female presented in the ER with two acute episodes of IOP elevation in the right eye - OD (40-50 mmHg), with mild discomfort and red eye and mild blurred vision in both episodes. Slit lamp evaluation of the OD revealed in the first episode mild pigment in the inferior portion of the endothelium and anterior chamber (AC), white and thin keratic precipitates in the second episode and tyndall in both episodes. Gonioscopy performed in the first episode revealed a thick pigmented trabecular meshwork and ultrasound biomicroscopy (UBM) revealed a mild anterior concavity of the peripheral iris. A laser iridotomy was performed in the first episode and an association of steroids and hypotensive medication was performed in both episodes.

Discussion: After a differential diagnosis analysis, a diagnosis of PDS was made in the first episode and a diagnosis of PSS was made in the second episode.

Conclusion: This clinical case recalls the complexity of some clinical cases, questioning us about the presence of two different pathologies in the same eye, or whether it is the same pathology. Thus, it highlights the need of integration of clinical signs and symptoms to allow a correct differential diagnosis, treatment and follow-up.


Open Access Case study

Successful Treatment for Methicillinn Resistent Staphylococcus aureus Conjunctivitis Using 1% Povidone Iodine Eye Drop: Two Cases

Kazuki Matsuura, Yuki Terasaka, Ryu Uotani, Yoshitsugu Inoue

Ophthalmology Research: An International Journal, Page 1-4
DOI: 10.9734/OR/2017/36471

Purpose: Long-term bedridden patients frequently present with refractory chronic conjunctivitis. Multidrug-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), are often isolated; infections caused by such bacteria are treated with vancomycin, although refraining from overuse of this drug is recommended. Bacterial resistance to povidone-iodine (PI) has not been observed; hence, it can be effectively used for treating bacterial infections. However, it has not been popularly used for treating ocular surface infections. We report two cases of multidrug-resistant bacterial conjunctivitis treated with PI.

Methods: Case 1: A 90-year-old male hospitalized for pneumonia caused by multidrug-resistant Pseudomonas aeruginosa. Case 2: A 56-year-old male hospitalized for brainstem hemorrhage. In both patients, there were signs of conjunctivitis and MRSA was cultured. To avoid overuse of vancomycin, we started 1% PI instillation thrice daily.

Results: Clinical signs of the patients remarkably improved within a week of PI treatment. There were no distinct complications from PI treatment in either case.

Conclusions: PI has a wide spectrum, does not induce bacterial resistance, is cheap, and can be obtained worldwide. Though further studies are necessary for wider practical use in clinical settings, PI ocular instillation is a reasonable option for treating ocular surface infections caused by multidrug-resistant bacteria, which are overseen by many general ophthalmologists.


Open Access Original Research Article

Prevalence of Congenital Colour Vision Deficiency in Nigerians Living in Ugep, Cross River State

R. N. Ativie, R. E. Ubom, A. A. Aigbiremolen, O. E. Mukoro, O. M. Odigie, J. C. Igweh

Ophthalmology Research: An International Journal, Page 1-6
DOI: 10.9734/OR/2017/30848

Colour vision deficiency and colour vision blindness are synonymous terms describing poor colour discrimination by the visual senses. Nowadays, screening for these disorders is an established practice, so that those affected can be advised about occupational preclusions. Since population based study on the broader impact of colour vision defects is limited, this study was undertaken in Ugep, a rural community in cross river state of Nigeria. Using the cluster sampling technique, a convenient sample of 1500 males and females (of between 10-60 years) were selected. Plates 1-17 of the 2008 edition of the Ishihara’s colour album were then administered to the subjects in rooms brightly illuminated by day light. Subjects were then screened with Plates 1, 3, 5, 13 and 15. Study reveals that, the prevalence of congenital colour vision deficiency in Nigerians living in Ugep is 1.8% (28 of every 1500 subjects), while that of total colour blindness was barely 0.2%. Gender distribution of colour blindness appeared in about 2.8% of sampled male subjects, and 0.7% of sampled female subjects, indicating a significantly greater frequency in males than the females. Distribution of colour blindness by age revealed no sequence between age and the defect as p < 0.001, df=1. Population based screening for colour vision deficiency is recommended for helpful prevocational counselling.