Clinical presentation of vernal keratoconjunctivitis in an immunocompromised patient: a case report

Vernal keratoconjunctivitis(VKC)is a chronic bilateral inflammation of the conjunctiva, commonly associated with a personal or family history of atopy. It is characterized by severe itching, foreign body sensation, thick ropy discharge, photophobia and conjunctival injection. VKC has palpebral, limbal and mixed forms. The classical conjunctival sign in palpebral VKC is the presence of giant papillae, which are predominantly seen on the superior tarsal conjunctiva. The limbal form occurs in dark skinned individuals and the papillae tend to occur at the limbus and have a thick gelatinous appearance. Clinical findings and laboratory investigations support the presence of IgE mediated type1 hypersensitivity reaction. Involvement of CD4 T helper (Th2) driven type IV hypersensitivity has also been confirmed. There has been an increase in the prevalence of allergic disorders in recent years and exaggerated manifestations of these diseases have been recognized in patients living with Human immunodeficiency virus

Severe Ocular Surface abnormalities in a child and Ectodermal Dysplasia: A Case Report.

Ectodermal Dysplasia is a disorder that occurs due to abnormal development of at least two major ectodermal derivatives in the developing embryo. Author report the case of a 10 year old male child who was referred to our department with complaints of absent sweating, foreign body sensation and watering in both eyes for past few months. The family history could be traced to four generations and there was an observed trend of increase in severity of signs and symptoms occurring at younger age.  The purpose of this case report is to create awareness in the Ophthalmic community about the diagnosis and clinical manifestations of the disorder. This case highlights the role of multidisciplinary approach for management of systemic disease, genetic evolution of affected individual and carriers and genetic counseling.

Pattern of mechanical ocular injuries in patients visiting a rural referral centre / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To study the pattern of mechanical ocular injuries in patients visiting a rural referral center.·METHODS:The study was conducted in the department of Ophthalmology, Dr. Rajendra Prasad Government Medical College ( RPGMC ) , Kangra ( Himachal Pradesh ) for a period of 12mo from 1st Jan 2013-31st Dec 2013 which included data collection, data organization, presentation, data analysis and data interpretation followed by a period of follow up extending to a period of 1mo. A total of 200 patients were studied which included all patients of mechanical ocular injuries that visited our department either directly or were referred from other public or private institutions during the study period. It was a prospective study in which all the patients were interviewed with the aid of a questionnaire and underwent a detailed ocular examination. The injuries were classified according to the international ocular trauma classification into open globe and closed globe injuries. The injuries of the lid and adnexa and the cranial nerve palsies were considered as separate entities and data analysis was done with MS Excel 2007 worksheet using the Epi info7 software.·RESULTS: A total of 21,710 patients attended the out-patient department( OPD) during the study period out of which 200 patients were of mechanical ocular trauma which formed 0. 921% of the total OPD attendance. The patients ranged in age from 1-80y with a mean age and standard deviation of 33. 12 ± 20. 48y. In those patients 151 patients ( 75. 5%) were males and 49 ( 24. 5%) were females. The male to female ratio was 3:1. Out of the 200 patients studied, 100 were injured at home, 19 in the playground, 29 had occupational injuries, 38 were injured in road side accidents, 10 were injured due to assault, 3 at school and 1 patient was injured during a stampede that occurred in a religious camp. The visual acuity at presentation was upto 6/12 in 47%, <6/12 to 6/36 in 13. 5%, <6/36-1/60 in 6%, <1/60 to PL ( perceive light ) positive in 22% and PL negative in 4 % patients. In 7. 5 %patients the visual acuity could not be assessed on the Snellen's chart. Most of the patients had closed globe injuries (54. 5%) followed by involvement of the lid and adnexa (23%). And 19. 5% had open globe injuries and 3% had involvement of the cranial nerves.· CONCLUSION: Ocular injuries are common and preventable causes of monocular blindness.