Congenital corneal annaesthesia a case report

Congenital corneal anaesthesia [CCA] is a rare clinical entity which can occur as an isolated anomaly or can be associated with some systemic disorders, usually the latter. CCA was diagnosed in a 2 1/2 year old girl from the history of self-inflicted ocular injuries and non-healing corneal ulceration, and evaluation of the corneal sensations

Anterior capsulectomy in cataract surgery: local experience in Sharjah, United Arab Emirates

Anterior capsulotomy is a key step in cataract surgery. Here we report our experience with two techniques, namely can-opener capsulotomy [COC] and continuous curvilinear capsulorhexis [CCC]. Which technique is chosen is partly influenced by the type of cataract present: it was mature in 52.1%, immature in 42.2%, and associated with pseudoexfoliation in 5.8% of cases. Posterior capsular tears occurred in 7% of all operations [7.8% of all 90 cases of COC, and 5.8% of all 52 cases of CCC]. Five of the total of 10 posterior capsular breaks occurred in eyes with mature cataract [a rate of 6.8%], 2 in eyes with immature cataract [a rate of 3.3%], and 3 in eyes with pseudoexfoliation [a rate of 37.5%]; this stresses the significance of local population factors among the causes for the relatively high rate of capsular rupture experienced by us. Of all posterior capsular breaks, 70% happened during the phase of irrigation and aspiration of cortical material. This step was most dangerous in the group operated using the COC technique. Six out of seven cases [85.7%] of posterior capsular rupture in this group happened during irrigation and aspiration of cortex. While in the group operated using the CCC technique, the risk of posterior capsular rupture was equally divided between nucleus delivery, irrigation/aspiration and intra -ocular lens implantation [one case for each step]

Peripheral retinal examination in pseudophakia

Peripheral retinal examination in pseudophakia is a challenge for the posterior segment surgeon. We have studied 62 cases of planned extracapsular cataract extraction [ECCE] and intraocular lens implantation [IOL] regarding three factors: the type of anterior caps-ulotomy, the size of optic of the implant and the method of examination. We compared three methods of examination the Goldmann three mirror lens, the Volk quadraspheric lens and the indirect opthalmoscopy. We found that in cases implanted with 5.5 mm optic IOL the equator was the most difficult area to examine with the Goldmann lens. Only in 26.6% of our cases the equator was visible with this method. The Volk quadraspheric lens can cover this area. With the 7 mm optic IOL the problem was in visualizing the periphery of the retina. This was seen in 68% by using the three mirrors lens and in none by using the Volk lens. The best method for examining the retinal periphery in both sizes of optic was the indirect opthalmoscopy. The anterior capsule did-not impose any difficulty in fundus examination in our cases. We recommend, in case of potential retinal pathology, to implant a wide optic lens at least 7 mm and to perform a large capsulorhexis opening of the same size of the implant in order to give the best chances of peripheral retinal visualization for the posterior segment surgeon

Idiopathic parafoveal telangiectasia

Idiopathic parafoveal telangiectasis is a rare disease that may cause visual loss. Ten cases were reviewed, eight were included in the study and grouped on the basis of their clinical and fluorescein findings according to an international classification, and two cases were excluded due to the presence of diabetes. From the results obtained it was concluded that some degree of visual loss starting in adulthood characterized all patients. Categorization is important in order to know the line of treatment and long-term prognosis. Photocoagulation is probably beneficial in patients group 1 and not for groups 2 and 3. Visual prognosis in at least one eye is good

Ophthalmic manifestations in cases of occlusion of posterior cerebral artery

Twelve cases were included in the study. For each case the following was done: Visual and non-visual history taking, routine ophthalmological examination, plotting of visual fields. All cases were examined neurologically. A computerized tomography [CT] scan confirming the diagnosis of occipital lobe infarction was required as an inclusion criterion. Follow up for at least 3 months was done. The most frequent ophthalmic finding was the presence of field defect in 83% of cases. This was in form of homonymous hemianopia in 41.7% of cases, double hemianopia with macular sparing in 25% of cases. The occipital lobe infarction was unilateral in 58.3% of cases and bilateral in 41.7% of cases. Amnestic aphasia was the most common non-ophthalmological finding [25%]. The ophthalmologist must be aware of findings in cases of occlusion of posterior cerebral artery. The two most important investigations required are plotting of the visual fields and performing a brain CT scan

Microsporidial keratoconjunctivitis in an HIV-infected patient: case report and literature review

We describe an HIV-seropositive patient who presented with bilateral superficial epithelial keratitis due to protozoal infection by the microsporidia Encephalitozoon cuniculi. Diagnosis was made by clinical and cytological examination of conjunctival and corneal scrapings and was further confirmed by light and electron microscopy

Development of corneo-scleral necrosis and calcification after pterygium excision and beta irradiation

We report the findings in an of eye a patient who, in 1980, underwent excision of a pterygium three times in the one year. The second and third operation were followed by beta irradiation. The 3600 cGy applied in two overlapping fields during the second of these irradiations had resulted in 7200 cGy being applied near the nasal limbus, which is where the most severe changes were seen. These consisted of corneal thinning [thickness estimated to be < 40% of normal] near the limbus at 3 o'clock, and scleral necrosis adjacently, permitting uveal tissue to shine through. A large, elevated and calcified plaque covered the nasal part of the rest of the sclera, right up to the caruncle. Vision in this eye was reduced to hand movements, mainly due to corneal scarring and immature senile cataract

Ocular complications in kleeblattschadel [cloverleaf skull] syndrome

We report a case of Kleeblattsch

Clinical study of vernal keratoconjunctivitis in the united Arab emirates [East coast]

A clinical study of 112 cases of vernal keratoconjunctivitis in the Eastern coastal region of the United Arab Emirates was carried out during a twelve-month period, starting from September of 1990. The disease manifested predominantly in the limbal form, with a majority of the patients suffering from active disease throughout the year, and only a small percentage of cases giving typical atopic and family histories. The predominance of the limbal form of vernal keratoconjunctivitis, especially in persons of dark complextion, provides evidence that genetic factors may play a role in the development of this disease, though environmental factors do influence the severity of it. A combination therapy of sodium cromoglycate and aspirin was effective in relieving symptoms and minimizing recurrences

Vitrectomy for diabetic traction retinal detachment

The results of pars plana vitrectomy for diabeitc retinal detachment were analysed in 38 eyes of 33 patients. The technique used in all cases was vitrectomy, mebranectomy, segmentation and delamination. As an adjunct to vitrectomy, scleral was performed in 13% of eyes. Intra-ocular gas injection was performed in 68.4% of eyes. Anatomical reapplication of the retina was achieved in 71% of eyes. Functionally 61.3% of eyes regained ambulatory visual acuity. The preoperative as well as intraoperative factors associated with a poor visual outcome were analysed; the most important being the presence of iris neovascularization, aphakia, vitreous hemorrhage, the absence pf properly timed panretinal photocoagulation and the occurrence of iatrogenic retinal breaks. The complications were mentioned and discussed