Direct carotid cavernous sinus fistula in a 14 years old Malay boy / 国际眼科杂志(Guoji Yanke Zazhi)

A fourteen years old Malay boy was involved in a motor vehicle accident and suffered multiple injuries. The patient was referred to ophthalmology for right periorbital haematoma, ocular examination was normal but proptosis of right eye was detected which was later associated with increase in the intraocular pressure (IOP). Direct carotid cavernous sinus fistula (CCF) was diagnosed by angiography and treated with embolization.

A humongous intraorbital foreign body in a "possessed"patient / 国际眼科杂志(Guoji Yanke Zazhi)

A 39 years old gentleman presented with red painful right eye.He had self-inflicted an injury to his right eye with a wooden stick and he saw a vision of an old man indicating him to do so.Clinically,the right eye was moderately proptosed,complete ophthalmoplegia and the periorbital skin was severely swollen.Imaging showed right orbital cellulitis with inferior ophthalmic vein thrombosis,bilateral cavernous sinus syndromeandimpending cavernous sinus thrombosis.No intraorbital or intraocular foreign body was reported.Despite aggressive intraven ous antimicrobials,the patient's condition was not improved.Exploration done under anesthesia exposed a huge wooden stick at the inferior fornix.Patient showed a remarkable recovery after the removal of the foreign body may occur in psychiatry patient that a possibility of selfinflicted injury.A detailhistory,examinationand appropriate investigations are mandatory to reveal the correlated clinical findings with imaging studies are the most helpful guide in managing intraorbital foreign body could potentially prevent further serious morbidity or

Successful combined treatment in vernal shield ulcer / 国际眼科杂志(Guoji Yanke Zazhi)

A 21-year-old and an 11-year-old patients presented with severe,resistant shield ulcers failed to respond to medical treatments which included topical steroids,mast cell stabilizers and antihistamines. Both of them were treated with surgical debridement of the ulcer,supratarsal injection of triamcinolone acetonide,topical cyclosporine 0.5g/L and ketotifen fumerate 0.25g/L. The ulcers healed well after three weeks. Topical cyclosporine was discontinued after two months in both patients. They were symptom free with no recurrence for six months. Combination of surgical debridement of the ulcer,supratarsal injection of triamcinolone acetonide,topical cyclosporine 0.5g/L and ketotifen fumerate 0.25g/L are effective as the treatment option in managing patients with severe vernal shield ulcer.KEYWORDS: vernal shield ulcer; surgical debridement; supratarsal injection of triamcinolone acetonide; cyclosporine; ketotifen fumerate

A staged penetrating keratoplasty following limbal stem cells allograft in severe chemical injury leading to successful restoration of the ocular surface anatomy / 国际眼科杂志(Guoji Yanke Zazhi)

A 62-year-old man presented with severe bilateral ocular surface chemical injury and history of failed penetrating keratoplasty of right eye in 1996. Visual acuity was hand movement in right eye and light perception in left eye. Staged procedures of limbal stem cells allograft followed by penetrating keratoplasty have been done and resulted in good ocular surface restoration and rehabilitation of vision in right eye.