Open Access Case Report

Sudden Loss of Vision Associated with Use of Systemic Non-steroidal Anti-inflammatory Drugs

Adeoti Caroline Olufunlayo, Olaopa Adedolapo Olufunke

Ophthalmology Research: An International Journal, Page 80-82
DOI: 10.9734/OR/2015/18295

Non-steroidal anti inflammatory agents have long been used in ocular therapeutics as a result of their effect on infllammation coupled with the undesirable side effects of steroids in Ophthalmology. Bleeding peptic ulcers have been strongly associated with use of oral non-steroidal anti inflammatory drugs. We present the case of a 51 year old male patient who presented with 4 days history of visual loss in his right eye following the use of 400 mg Ibuprofen three times a day for 3 days one week prior to presentation. Fundus examination revealed a pre-retinal hemorrhage. There may be need to be cautious with the use of these drugs.


Open Access Case Report

Conjunctival Foreign Body a Rare Presentation

Tarakeswararao Attada, V. V. L. Narasimha Rao

Ophthalmology Research: An International Journal, Page 93-98
DOI: 10.9734/OR/2015/18395

Aim: Detection of subconjunctival or intra orbital wooden foreign bodies and its retrieval is important, because of severe blinding complications secondary to infection can occur. We describe, a case of post traumatic subconjunctival wooden foreign bodies retained in conjunctival culde-sac of upper fornix, presenting as conjunctival granuloma.

Case Report: A 50 year male patient was accidentally hit by a wooden stick on the right eye 25 days ago, while he was working in the paddy field. On examination, a granulomatous growth was present on the temporal side of the bulbar conjunctiva. Two wooden foreign bodies were removed from the conjunctival granulomatous mass.

Discussion: The superficial foreign bodies of the conjunctiva are common and the ocular protective mechanisms normally extrude superficial foreign bodies. The clinical course of orbital foreign bodies depends upon their composition. The organic foreign bodies like wood if left untreated results in sight threatening complications.

In our case, wooden foreign bodies penetrated subconjunctivally into the upper fornix and presented as conjunctival granuloma. Under topical anaesthesia (xylocaine 4%) two wooden foreign bodies were removed from conjunctival granuloma. The patient recovered uneventfully with antibiotic drops and oral analgesics and anti-inflammatory drugs.

Conclusion: In patients presenting with post traumatic conjunctival granuloma, we should strongly suspect a subconjunctival retained foreign body before initiating treatment.


Open Access Case study

Conjunctiva Histology in Long-standing Esotropia

Miguel Paciuc-Beja, Victor Hugo Galicia-Alfaro, Myriam Retchkiman-Bret, Ryan Phan, Hugo Quiroz-Mercado

Ophthalmology Research: An International Journal, Page 89-92
DOI: 10.9734/OR/2015/18668

Background: Conjunctiva can be restrictive in long-standing strabismus. To date, there are no reports in the literature describing the histology of the conjunctiva in these patients.

Methods: Conjunctiva biopsies over the medial and lateral rectus were taken at the time of strabismus surgery in 3 patients with restrictive large angle long-standing esotropia.

Results: The conjunctiva overlying the medial rectus has a much more condensed, organized lamina propria compared to the conjunctiva of the contralateral lateral rectus. The medial conjunctiva has scattered small-diameter vessels and numerous clusters of plasmatic cells. The lateral conjunctiva has large blood vessels with occasional scattered plasmatic cells and the lamina propria present a lax structure.

Conclusions: These new findings reinforce the clinical understanding that conjunctiva can become more restrictive over the medial rectus in long-standing esotropia.


Open Access Original Research Article

Delayed Removal of Temporary Non-incisional Silk Suture in Senile Entropion; a Simple Method for Long-time Relief

Gholamhossein Yaghoobi, Behrouz Heydari

Ophthalmology Research: An International Journal, Page 74-79
DOI: 10.9734/OR/2015/16173

Purpose: To assess the long standing effects of transverse lid-everting silk suture in senile entropion.

Methods: Eight patients (9 eyelids) who had only senile entropion participated in this prospective study. The lower lid had retractor laxity and upward migration of the pereseptal orbicularis muscle. The two Quickert-Rathbun silk suture is easily placed under local anesthesia. This is achieved with topical administration of tetracaine drops and subcutaneous infiltration of 2% lidocaine. The patient instilled topical bethamethasone and chloramphenicol every six hour for one week. All patients were followed up regularly at 1 week, 8 weeks, 16 weeks and then, every year for eye lid position (suture was removed after 12 weeks).

Results: Except for one patient, the others had good lid position and no symptoms of corneal discomfort during the three months postoperative period. The other patient developed stitch abscess and responded to medical treatment and early removal of the suture.

Conclusion: Although transverse lid everting suture has been used as a temporary measure in treatment of senile entropion, long standing three months silk lid sutures have been shown to have more permanent effect.

The late removal of suture showed long lasting effects and cost-effectiveness as a simple outpatient procedure, especially in debilitated patients.


Open Access Original Research Article

Laser-Assisted Opening of Gold Micro Shunt’s Windows in Glaucoma: Efficacy and Safety

Nicolas Cadet, Paul Harasymowycz

Ophthalmology Research: An International Journal, Page 83-88
DOI: 10.9734/OR/2015/17902

Objective: To determine the intraocular pressure-lowering effect and safety of opening the Gold Micro Shunt Plus’ (GMS+) windows with a titanium-sapphire laser.

Design: Retrospective case series.

Participants: The charts of 5 patients were reviewed. Diagnoses included primary open-angle glaucoma (n=3), aphakic glaucoma (n=1) and neovascular glaucoma (n=1). There were 4 males and 1 female, aged between 56 and 81 (mean age 70±11). They had undergone a mean of 2±1.6 surgeries (range: 0-4) before GMS implantation.

Methods: IOP and number of glaucoma medications were recorded before and after the implantation of the GMS in 5 patients, as well as before and after the opening of the GMS’ windows with a titanium-sapphire (Ti-Sap) laser. Patients were assessed for complications arising from implanting the GMS and opening its windows. Follow-up lasted 17 to 42 months.

Results: The GMS+ had 8 closed windows and one open flow port upon implantation. Four of these windows were opened in all five patients. Mean IOP before GMS implantation was 29.9±8.5 mmHg and it was 18.6±6.5 mmHg after implantation. Hence, implantation of the GMS was associated with an average decrease in IOP of 11.3±4.2 mmHg or 37.0% (p=0.076). The mean IOP before window-opening was 24.9±5.8 mmHg and after window opening, it was 17.6±5.7 mmHg. The IOP thus dropped 7.3±4.6 mmHg or 29.3% (p=0.055) on average after opening the GMS’ windows. The windows were opened an average 6.4±4.5 months after GMS implantation. IOP at follow-ups remained lower than pre-GMS levels in all patients. The IOP reduction post window opening lasted throughout follow-up, i.e. from 17 to 42 months (average 30±10 months). The number of glaucoma drops for each patient did not decrease after opening the GMS’ windows. One patient developed transitory cystoid macular edema after GMS implantation that resolved with a course of NSAID drops. No complications arose from the opening of the GMS’ windows.

Conclusions: In our small case series, opening the GMS’ windows was safe and was associated with a substantial and sustained reduction in IOP.