Open Access Case study

Isolated Medial Orbital Wall Fracture: A Rare Presentation

Raşit Kılıç, Abdi Bahadır Çetin, Gülay Çetin

Ophthalmology Research: An International Journal, Page 104-107
DOI: 10.9734/OR/2015/19799

Aim: The aim of this study was to evaluate the clinical course and treatment of a case that developed right orbital medial wall fracture following the rare etiological factor of nose blowing.

Presentation of Case: A 20-year-old male patient presented with suddenly developing swelling of the right eye following strong nose blowing the same day. The examination revealed swelling of the right eye and mild pain with eye movements. The visual acuity was full with normal anterior and posterior segments in both eyes. Computed tomography revealed an ethmoid bone fracture and medial rectus muscle and orbital contents had prolapsed inside the sinus. The eyelid swelling had decreased and the pain with eye movements had disappeared at the 2-week follow-up. Complete recovery without any sequel was seen in the 3-month follow-up.

Discussion: Considering the complications that may develop after surgical treatment, the cases should be thoroughly evaluated at presentation with surgery only being considered in appropriate cases. Small fractures with no or minor herniation, or cases with diplopia recovering quickly can be monitored without treatment. Our patient was followed-up without treatment as the bone defect was small, and there was no enophtalmus, eye movement limitation or diplopia. Full recovery was seen without sequel at the end of the short-term follow-up of our patient.

Conclusion: Small fractures with no enophtalmus, eye movement limitation or diplopia can be followed-up without treatment, as in the presented case.


Open Access Case study

Phenothiazine Group Drug Induced Corneal and Lenticular Deposits in a Patient of Severe Depression – A Case Report

Ojha Sushil, Tandon Anupama, Saraswat Neeraj, Shukla Dipendra

Ophthalmology Research: An International Journal, Page 108-111
DOI: 10.9734/OR/2015/19765


A 50-yr-old man, who had been taking medication for severe depression with psychosis, presented to eye OPD of UPRIMS & R with a chief complaint of visual disturbance of 8 months duration. He was continuously taking chlorpromazine unsupervised in double the dose and doubles the frequency. Slit-lamp examination revealed fine, discrete, and brownish deposits on the posterior cornea. In addition, bilateral star-shaped anterior sub capsular lens opacities, which were dense, dust-like granular deposits, were noted. Best-corrected visual acuity was 6/36 in the right eye and 6/24 in the left eye. Other ocular findings were normal. Dark pigmentation on face was present. The deposition was not reversible even after stopping the drug.


Open Access Case study

Wolfram Syndrome: Report of Three Siblings with Early Vision Loss and Documented Lesion of the Entire Visual Pathway

Brunella Maria Pavan Taffner, Patricia Grativol Costa Saraiva, Fábio Petersen Saraiva

Ophthalmology Research: An International Journal, Page 131-137
DOI: 10.9734/OR/2015/20537

Objective: Report and document in images the presence of WFS1 in three of four siblings, with loss of visual acuity as the initial clinical presentation.

Design: Case series study.

Participants: Three of four siblings with WFS born to consanguineous parents.

Methods: All patients had diagnostic imaging with contrast-enhanced brain magnetic resonance imaging (MRI) and digital retinography.

Results: The patients and their father reported vision loss since before the age of seven, backed up by reports of multiple unsuccessful prescriptions for glasses and poor first-grade school performance due to visual deficit. Diabetes mellitus was diagnosed at seven years of age. All patients presented bilateral neurosensory deafness, atrophy of the posterior pituitary lobe, cerebellum, nerve, chiasma, optic tract and optic disc (bilateral), as well as urological changes and gait and balance disorders. One patient is epileptic and another suffers from a combination of anxiety and depression.

Conclusion: Three unique cases of WFS due to early loss of visual acuity, lesion of the entire visual pathway documented in images, and an unusually high level of familial penetrance.


Open Access Original Research Article

Ocular Involvement in Patients with Rheumatoid Arthritis

Artur Zoto, Brikena Selimi

Ophthalmology Research: An International Journal, Page 99-103
DOI: 10.9734/OR/2015/18637

Aim: The aim of this study was to find out the prevalence of various ocular involvements in patients with rheumatoid arthritis and to asssess the relation to immunological alterations.
Methods: This is a cross-sectional study involving 70 patients with rheumatoid arthritis. All patients fulfill the criteria of American College of Rheumatology and the European League against Rheumatism for the diagnosis of rheumatoid arthritis. Serum samples for rheumatoid factor and anti-cyclic citrullinated peptide antibody were obtained. The lacrimal secretion was measured in all patients by Schirmer’s test. The patients were referred to the Ophthalmologist for examination of the eyes and interpretation of the related findings.

Results: Ocular manifestations were identified in 13 (19%) of patients with rheumatoid arthritis. Keratoconjunctivitis sicca was identified in 9 (13%) patients, episcleritis in 2 (3%) patients and scleritis in 2 (3%) patients. Patients with positive rheumatiod factor and anti-cyclic citrullinated peptide antibody, were 42 (100.0%) of whom 10 (23.8%) represent ocular lesions, while in the other group of 28 (100.0%) patients seronegative only 3 (10.7%) patients have ocular lesions.
Ocular involvement are common in rheumatoid arthrits. Keratoconjunctivitis sicca, episcleritis and scleritis are ocular manifestations that occur in rheumatoid arthritis. The most common ocular manifestation was keratoconjunctivitis sicca. Immunological alterations are important factors in ocular manifestations.


Open Access Original Research Article

Evaluation of Tear Secretion in Thyroid Patients in Relation to the Thyroid Status and Previous I131 Treatment for Thyroid Cancer

Athanasios Karamitsos, Lampros Lamprogiannis, Kyriakos Gougoulias, Konstantinos Stamoulas, Diamantis Almaliotis, Athanasia Skriapa-Manta, Theofanis Vaseiliadis, Aikaterini Raptou, Vasileios Karampatakis

Ophthalmology Research: An International Journal, Page 112-118
DOI: 10.9734/OR/2015/19236

Aims: To evaluate tear secretion of thyroid patients with no clinical evidence of thyroid ophthalmopathy in relation to thyroid status and history of I131 treatment by the use of the 2-minute Schirmer test I (test without topical anesthesia).

Study Design: Prospective study.

Place and Duration of Study: 1st University Eye Clinic, AHEPA Hospital, Thessaloniki, Greece and Laboratory of Experimental Ophthalmology, Aristotle University of Thessaloniki, Greece, between June 2013 and July 2014.

Methodology: 128 consecutive thyroid patients, 111 females and 17 males, aged from 18 to 82 years 49.48±14.61 (mean±sd) were recruited for this study. None of the thyroid patients had clinical signs or symptoms of thyroid ophthalmopathy. 49 of them had history of I131 treatment for thyroid carcinoma. The 2-min Schirmer test I was performed on the same day the patients underwent the routine exams for thyroid hormones. As abnormal were considered Schirmer test I values <10 mm.

Results: Out of 49 thyroid patients with history of I131 therapeutic treatment, 35 (71.4%) had 2-minute Schirmer test I values <10 mm. However there was no statistically significant difference in relation to their thyroid status. Regarding patients, with no previous I131 treatment, 55 out of 79 patients (71.4%) had Schirmer test I values <10 mm and there was no statistically significant difference in relation to their thyroid status. There was no statistically significant difference in Schirmer test I values between patients who received I131 and those who did not.

Conclusion: Thyroid patients without clinical evidence of thyroid ophthalmopathy have impaired Schirmer test I scores irrespective of the thyroid status and previous I131 exposure and thus they more likely to develop ocular surface abnormalities. Patients with previous I131 treatment had no statistically significant differences in the tear secretion values as compared with the non-irradiated thyroid patients.


Open Access Review Article

Rasayana Pills in Cataract- An Integration of Ancient Knowledge and Scientific Evidences

Amandeep Kaur, Vikas Gupta, Ajay Francis Christopher, Parveen Bansal

Ophthalmology Research: An International Journal, Page 119-130
DOI: 10.9734/OR/2015/20285

Introduction: Cataract is a principal cause of blindness in the world. Surgery, the major prevailing therapeutic approach for cataract is laced with various complications that include iris prolapse, raised intraocular pressure, infection, cystoid macular oedema and posterior capsular opacification. So world is looking towards more robust and natural ways to prevent cataract.

Aim: Rasayana therapy (specially Caksusya Rasayana) have been known to play an important role in prevention and cure of eye disorders. This manuscript intends to highlight hypothesis along with the scientific evidences in favour of role of Rasayanas in prevention and cure of cataract

Methodology: Extensive internet search and literature search related to Ayurvedic texts on Rasayana was conducted. Local Ayurveda experts were contacted to know about commonly used Rasayana preparations in cataract. Based on that, Rasayana components of these single preparations/polyherbal preparations were searched for their antioxidant, aldose reductase inhibitor and antiglycating activity.

Results: Metadata analysis and perusal of ancient texts on Ayurveda and scientific studies on the evidences in favour of some Rasayanas and some specific Caksusya Rasayana show ability of Rasayana to act as anticataract agents by acting through one or the other molecular mechanism. It is also important to note that some of these Rasayanas like Yashthimadhu, Shunthi, Haridra, Amalaki, Tulsi, Pippali and Triphala Rasayana are very common component of daily kitchen use and can be a better therapy for patient compliance.

Conclusion: From the metadata analysis it may be concluded that most of the Rasayanas possess antioxidant, antiglycating and aldose reductase inhibitory activity, either singly or simultaneously and thus they can prevent or revert changes responsible for cataract pathogenesis. So it is pertinent to mention here that use of Rasayana therapy have the potentials to work against the development of cataract and should be explored for scientific evidences for mechanism of action.