Open Access Case study

Non-surgical Management of Bilateral Ectropion in a 5 hours Old Collodion Baby: A Case Report

Kehinde Fasasi Monsudi, Abdulkabir Ayansiji Ayanniyi, Teslim Olatunde Lawal

Ophthalmology Research: An International Journal, Page 227-232
DOI: 10.9734/OR/2014/9533

Congenital bilateral upper eyelids eversion is rare clinical condition. However it is known to be associated with collodion baby, Down syndrome and children of black race. This condition responds well to early active conservative management. We reported a case of congenital bilateral upper eyelids eversion in a collodion neonate delivered by 21 year old lady at home through a spontaneous vaginal delivery. This case was successful managed with lid reposition, topical antibiotic and eye patching.

 

Open Access Case study

Parinaud Syndrome in Association with Thalamic Infarct in a Young Person

Priscilla Xinhui Wang, Srinivasan Sanjay

Ophthalmology Research: An International Journal, Page 241-249
DOI: 10.9734/OR/2014/9343

Aim: We report a case of Parinaud syndrome secondary to an acute left posteromedial thalamic infarct in a young person.

Presentation of Case: Patient's main presenting complaints were blurring of vision and diplopia. The main clinical manifestations were that of a severe restriction in upward gaze, and convergence-retraction nystagmus.

Discussion: Vertical gaze palsies have been well associated with midbrain lesions but more rarely associated with seemingly isolated thalamic lesions.  This case report further supports current limited literature that suggests that thalamic lesions may also manifest as vertical gaze palsies. In addition, cases of cerebrovascular events are usually first seen in the Emergency Department where diagnoses are made and acute management is given. In this case, the patient was referred to the Eye clinic from the Emergency Department for visual symptoms. Parinaud syndrome was promptly recognised by the ophthalmologist upon examination and the decision for urgent brain imaging with referral to the neurologist was quickly made. Timely management of patient likely contributed to his favourable outcome.

Conclusion: This is a case of Parinaud syndrome secondary to an acute left posteromedial thalamic infact in a young person without obvious midbrain involvement. This case highlights the important role of ophthalmologists in the early recognition of Parinaud syndrome, which can allow for prompt diagnosis and management. Timely diagnosis of Parinaud syndrome can be crucial to patient’s outcome.

Open Access Original Research Article

Surgical Outcome of Exotropic Patients' Management; One Year Follow-up

Mohammad Reza Besharati, Masoud Reza Manaviat, Mohammad Hassan Lotfi, Mohammad Reza Shoja, Maryam Forouhari, Elahe Abbasi Shavazi, Samira Salimpur

Ophthalmology Research: An International Journal, Page 219-226
DOI: 10.9734/OR/2014/7042

Purpose: To find the surgical success rate and frequency of complications among patients with exotropia.

Methods: This is a case series study on 102 exotropic patients who were managed surgically. They were followed up for 1 year post operation. Surgical techniques consisted one of the following bilateral rectus (BLR) recession, bimedial rectus (BMR) resection, Recession & resection (R&R), MR advancement and lateral rectus (LR) recession. Deviation measured by Alt. Prism- cover test at far and near. Data was analyzed by SPSS (ver. 16) using descriptive statistics and chi square test.

Results: Mean age of the patients was 18.2±11.4 years. Most cases were infants. Myopic astigmatism was the most frequent refractive error. The most frequent method of surgery was BLR recession in 75 cases (61.5%). Overall Post-operative success rate was 67.6%. The most frequent complication after surgery was misalignment.

Conclusion: BLR recession is a surgical method with acceptable success rate for treatment of exotropia and misalignment is most frequent complication.

 

Open Access Original Research Article

Visual Pathway Tumor Presenting as Visual Disturbances without Extraocular Signs

Sangyoun Han, Ungsoo Samuel Kim

Ophthalmology Research: An International Journal, Page 233-240
DOI: 10.9734/OR/2014/9724

Purpose: To evaluate visual pathway tumor presenting as visual disturbances without extraocular signs and assess the usefulness of various examinations.

Methods: Only 35 patients with intracranial tumors (22 males and 13 females) who were initially diagnosed at our hospital and confirmed by magnetic resonance imaging were enrolled, and previously known intracranial tumor patients and patients with strabismus or proptosis were excluded. Best corrected visual acuity (BCVA), pupillary reflex test, fundus examination, color vision test and visual field test were done to evaluate visual impairments. We investigated the incidence of intracranial tumors and sensitivity of tests.

Results: The most common tumors were pituitary tumors (60.0%), followed by meningioma (20.0%) and optic nerve glioma (5.7%). The BCVA ranged from 1.0 to no light perception and the visual acuity of 3 patients was 1.0 in both eyes. Positive relative afferent pupillary defect was seen in 71.4% and abnormal disc findings were found in 58.8% of patients. The color vision test was more specific (sensitivity: 76.6%), and all patients had abnormal visual field defects.

Conclusions: Pituitary tumor is the most common intracranial tumor. Among tests, a visual field test is a more sensitive test than other tests for detecting compressive optic neuropathy.

 

Open Access Original Research Article

A Retrospective Case Study of the Incidence of Endogenous Fungal Endophthalmitis in Patients with Positive Blood Cultures for Systemic Fungemia: Review of the Literature

Juner Colina, Katherine Chen, Laura Snyder, Seenu M. Hariprasad

Ophthalmology Research: An International Journal, Page 250-258
DOI: 10.9734/OR/2014/10274

Aims: To determine the incidence of fungal ocular involvement, manifesting as chorioretinitis or endophthalmitis, in patients with positive fungal blood cultures in a tertiary care center.

Study Design: Retrospective case series and literature review.

Place and Duration of Study: Department of Surgery–Section of Ophthalmology and Visual Science, University of Chicago Pritzker School of Medicine, Chicago, Illinois. August 2006 to October 2009.

Methodology: Ophthalmology was consulted for evaluation of 100 adult and pediatric patients (47 men, 53 women; age range 10 days–84 years) with fungemia.

Results: Of 100 patients, blood cultures most frequently grew Candida albicans (42%), followed by Candida parapsilosis (22%), and Candida glabrata (16%). One patient had clinical signs of fungal ocular involvement (1/100, 1%) but no ocular symptoms.  Blood cultures in this case were positive for Candida glabrata, and the patient clinically improved after switching antifungal therapy to PO voriconazole.  Two other patients (2%) had nonspecific fundus lesions that were not consistent with chorioretinitis or endophthalmitis.

Conclusions: The incidence of ocular involvement in patients with fungemia is 1%, which is consistent with recent trends in literature.  We believe that guidelines for screening criteria in at-risk inpatients for fungal chorioretinitis and endophthalmitis should be updated.