Quiste de iris. A propósito de un caso / Iris cysts. About a case

Introducción: Los quistes de iris son lesiones benignas encapsuladas de contenido líquido que se pueden localizar en el epitelio pigmentario del iris o en su estroma, se clasifican de acuerdo con su etiología en primarios cuando no tienen una causa conocida y secundarios cuando se forman como consecuencia de traumatismos, fármacos, tumores malignos, uveítis, parásitos o trastornos sistémicos.Los síntomas incluyen obstrucción del eje visual, visión borrosa e incluso descompensación corneal, el diagnóstico se realiza mediante la observación directa a través de la lámpara de hendidura y con estudios de imagen como la ultrasonografía, una vez establecido el diagnóstico su tratamiento sigue siendo controversial e incluyen iridectomía, drenaje del conteni-do quístico, uso de láser argón y YAG láser.Presentación del caso: Paciente femenina de 28 años con antecedente de traumatismo ocular derecho, posteriormente presenta lesión quística en iris, valorada mediante biomicroscopía y estudios de imagen (ultrabiomicroscopía), confirmando el diagnóstico de quiste de iris, para lo cual se realiza drenaje quirúrgico con evolución favorable. Conclusión: Los quistes de iris son lesiones poco frecuentes que podrían comprometer el campo visual dependiendo de su localización y tamaño por lo que el drenaje quirúrgico del contenido quístico iridiano es una opción terapéutica eficaz.

Introduction: Iris cysts are benign encapsulated lesions of liquid content that can be located in the pigment epithelium of the iris or in its stroma, they are classified according to their etio-logy as primary when they do not have a known cause and secondary when they form as a consequence from trauma, drugs, malignant tumors, uveitis, parasites or systemic disorders.Symptoms include visual axis obstruction, blurred vision and even corneal decompensation. The diagnosis is made by direct observation through the slit lamp and with imaging studies such as ultrasonography. Once the diagnosis is established, its treatment remains contro-versial and include iridectomy, drainage of cystic contents, use of argon laser and YAG laser.Case presentation: A 28-year-old female patient with a history of right ocular trauma, subse-quently presenting a cystic lesion in the iris, assessed by biomicroscopy and imaging studies (ultrabiomicroscopy) confirming the diagnosis of iris cyst, for which surgical drainage was performed with a favorable evolution.Conclusion: Iris cysts are rare lesions that could compromise the visual field depending on their location and size, which is why surgical drainage of the iris cyst content is an effective therapeutic option.

Ophthalmic adverse effects of nasal decongestants on an experimental rat model / Efeitos oftálmicos adversos de descongestionantes nasais em modelo experimental com ratos

ABSTRACT Purpose: To investigate the potential effects of chronic exposure to a nasal decongestant and its excipients on ocular tissues using an experimental rat model. Methods: Sixty adult male Wistar rats were randomized into six groups. The first two groups were control (serum physiologic) and Otrivine® groups. The remaining four groups received the Otrivine excipients xylometazoline, benzalkonium chloride, sorbitol, and ethylene diamine tetra acetic acid. Medications were applied into both nostrils twice a day for 8 weeks. Before the rats were sacrificed, epithelial staining, the Schirmer test, and intraocular pressure measurements were performed under ketamine/xylasine anesthesia (50 and 5 mg/kg, respectively). Results: Epithelial defects and dry eye were common findings in all study groups. Cataracts developed in two cases clinically. Histopathological evaluation revealed many different pathological alterations in all parts of the ocular tissues such as corneal edema, polypoid proliferation and hyalinization of the vessel wall, cystic formation of the lens, retinal nerve fiber layer degeneration, and corpora amylacea formation of the lacrimal gland. Conclusions: Prolonged usage of the nasal decongestant xylometazoline and its excipients may cause ophthalmic problems such as dry eyes, corneal edema, cataracts, retinal nerve fiber layer, and vascular damage in rats. Although these results were obtained from experimental animals, ophthalmologists should keep in mind the potential ophthalmic adverse effects of this medicine and/or its excipients and exercise caution with drugs containing xylometazoline, ethylene diamine tetra acetic acid, benzalkonium chloride and sorbitol for patients with underlying ocular problems.

RESUMO Objetivo: Investigar os possíveis efeitos da exposição crônica de descongestionante nasal e seus excipientes em tecidos oculares, utilizando um modelo experimental com ratos. Métodos: Sessenta ratos Wistar adultos machos foram divididos aleatoriamente em seis grupos. Os primeiros dois grupos foram controle (soro fisiológico) e Otrivina®. Os quatro grupos restantes receberam os excipientes de Otrivina, tais como Xilometazolina, Benzalcônio, Sorbitol e Ácido Etilenodiamino Tetracético (EDTA). Os medicamentos foram aplicados em ambas as narinas dos ratos, duas vezes ao dia, durante 8 semanas. Antes que os ratos fossem sacrificados, a coloração epitelial, o teste de Schirmer e a medida da pressão intraocular foram realizados sob anestesia com Ketamina/Xilasina (50 e 5 mg/kg, respectivamente). Resultados: Defeitos epiteliais e olho seco foram achados comuns nos grupos de estudo. A catarata desenvolveu-se clinicamente em dois casos. A avaliação histopatológica revelou a existência de alterações em todas as partes dos tecidos oculares, tais como edema de córnea, proliferação polipoide e hialinização da parede vascular, formação cística da lente, degeneração da camada de fibra nervosa da retina (RNFL) e formação de corpos amiláceos da glândula lacrimal. Conclusões: O uso prolongado do descongestionante nasal Xilometazolina e seus excipientes pode causar vários problemas oftalmológicos, como olho seco, edema de córnea, catarata, RNFL e dano vascular em ratos. Embora esses resultados tenham sido obtidos a partir de animais experimentais, os oftalmologistas devem ter em mente os potenciais efeitos oftalmológicos adversos desse medicamento e/ou de seus excipientes.

Ocular findings in patients with cholestatic disorders of infancy: a single-centre experience

Background and study aims: Neonatal cholestasis can be associated with ocular findings that might aid in its diagnosis, e.g., Alagille syndrome [AGS] and Niemann Pick disease [NPD]. We aimed to investigate the frequency of ocular manifestations in infants with cholestasis

Patients and methods: This cross-sectional study included cholestatic infants presenting to the Paediatric Hepatology Unit, Cairo University Paediatric Hospital, Cairo, Egypt. All infants underwent examination of lid, ocular motility, anterior and posterior segments and measurement of intraocular pressure, cycloplegic refraction, ocular ultrasonography and vision

Results: The study included 112 infants with various cholestasis; 73 [65.2%] were males. The median age was 2 months. Diagnosis was reached in 39 cases: 14 had AGS, 14 had biliary atresia [BA], 4 had NPD, 4 had post-haemolytic cholestasis, 2 had cytomegalovirus neonatal hepatitis, and one case had hepatorenal tyrosinaemia. Thirteen cases were probably having progressive familiar intrahepatic cholestasis [PFIC] type 1 or 2 considering their persistent cholestasis in the presence of normal gamma-glutamyl transpeptidase; 28 were left with a diagnosis of "idiopathic neonatal hepatitis" [INH], and 32 [28.6%] had no definite diagnosis. Ophthalmologic abnormalities were found in 39 cases [34.8%]. The commonest finding was unilateral/bilateral optic nerve drusen in 12 [10.7%], followed by posterior embryotoxon in 11 [9.8%]. Ocular findings were observed in 64.3% patients with AGS, 50% patients with NPD, 30.8% cases with suspected PFIC type 1or 2, 28.6% infants with INH, and 14.3% patients with BA

Conclusion: Ophthalmologic findings are not uncommon among cholestatic infants. Ophthalmologic examination should be routinely performed, including assessment of anterior segment, fundus examination, and ocular ultrasound

Kabuki make-up syndrome with genitourinary anomalies, ophthalmologic features and hyperpigmentation in an Egyptian child

We report a 3.5 year old male child, first in order of birth of healthy consanguineous Egyptian parents with typical characteristics of Kabuki make-up syndrome. The patient had microcephaly, high arched sparse eyebrows, hypertelorism, long palpebral fissures with eversion of the lateral third of the lower eyelids, bilateral ptosis, long eyelashes, blue sclera, depressed nasal bridge, broad nose with everted nares, and low set small deformed ears, thin lips, low post hair line, short neck, persistent fingertip pads, dysplastic nails, hypermobile joints, pigmented nevus on the back, lateral side of right foot and right leg and mild hypertrichosis over the lower back. Our patient had also a non-functioning left kidney, multiple chalazions in upper eyelids, enlargement of the glans penis, which were not reported previously, and moderate mental retardation

Patología traumática ocular / Eye traumatic pathology

Resumen:La intoxicación se considera como una manifestación patológica definida por los signos y síntomas que secundarios a la acción de una o varias dosis de un agente tóxico y su evolución puede llevar al sujeto a un estado irreversible e incluso a la muerte. Cada año mueren alrededor de un millón de personas a consecuencia de diversos envenenamientos. La intoxicación alcohólica es causada por alcoholes, compuestos orgánicos que se derivan de los hidrocarburos y están formados por grupos hidroxilos. El etanol es el alcohol que con más frecuencia produce intoxicaciones ya que es el más común y el que más al alcance de la población se encuentra, este produce múltiples alteraciones a nivel del sistema nervioso y de otros sistemas del organismo.

Abstract:Often the medical examiner has to assess possible eye injuries and sequelae of a patient who has been the victim of an assault or some kind of accident (traffic, work, sport), which may have civil responsibility by the aggressor. The ocular pathology occurs for most forensics, not specialists in it, a major problem in establishing the etiology of injuries and their subsequent monitoring, given their complexity and specificity. Therefore in this article we try to make a review of the generalities of the anatomy, physiology and the most important variants of eye injuries that can lead to a trauma so that the forensic can make the assessment of injury with ophthalmological condition and have the information necessary so that you can interpret the ophthalmic report to provide the specialist in ophthalmology,dist inguish the offending box and interpreta previous state, if applicable, the final consequences.

Anti-inflammatory effect of lycopene on endotoxin-induced uveitis in rats / Efeito anti-inflamatório do licopeno na uveíte induzida por endotoxina em ratos

ABSTRACT Purpose: We evaluated the efficacy of lycopene, a dietary carotenoid and potent antioxidant, against ocular inflammation and oxidative stress in an experimental uveitis model. Methods: Endotoxin-induced uveitis (EIU) was induced in Sprague-Dawley rats by a single subcutaneous injection of 200 μg lipopolysaccharide (LPS). Induction of EIU was preceded by daily intraperitoneal injection of 10 mg/kg lycopene for three consecutive days (Lycopene + LPS group) or equivolume vehicle (Vehicle + LPS group). A positive control group received 1 mg/kg dexamethasone pretreatment (DEX + LPS), and a negative control group received daily vehicle injection but no LPS (Vehicle Control). Twenty-four hours after LPS or final vehicle administration, eyes were enucleated, and aqueous humor was collected for measurement of the number of infiltrating cells, total protein concentration, and levels of nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and oxidative stress markers. Inflammatory response severity was compared among groups clinically and histopathologically. Results: Infiltrating cell number, total protein concentration, and NO, TNF-α, and IL-6 levels were significantly elevated in the aqueous humor of Vehicle + LPS group rats compared to Vehicle Controls. Compared to the Vehicle + LPS group, lycopene pretreatment significantly reduced aqueous humor concentrations of oxidative stress markers, NO (0.29 ± 0.1 μM vs. 0.19 ± 0.1 μM, p=0.003), TNF-α (71.0 ± 22.3 ng/ml vs. 50.1 ± 2.1 ng/ml, p=0.043), and IL-6 (121.6 ± 3.0 pg/ml vs. 111.1 ± 5.6 pg/ml, p=0.008). Inflammatory score was also reduced (2.0 ± 0.0 vs. 0.4 ± 0.5, p=0.001). Lycopene reduced the infiltrating cell count and protein concentration, but differences did not reach significance. Most lycopene effects were equivalent to dexamethasone. Conclusions: Lycopene may aid in the clinical management of uveitis by suppressing inflammation and oxidative stress.

RESUMO Objetivo: Avaliamos o efeito do licopeno, um carotenóide dietético e um potente anti-oxidante, sobre a inflamação ocular e estresse oxidativo em modelo de uveíte experimental. Métodos: Uveíte foi induzida por endotoxina (EIU) em ratos Sprague-Dawley por uma única injeção subcutânea de 200 ug de lipopolissacárido (LPS). A indução de EIU foi precedida por injeção intraperitoneal de licopeno em uma dose de 10 mg/kg (grupo LPS + Licopeno) ou veículo de mesmo volume (grupo LPS + Veículo), durante 3 dias consecutivos. O grupo controle positivo recebeu uma dose de 1 mg/kg de Dexametasona (grupo DEX + LPS) e o grupo controle negativo recebeu doses diárias de veículo mas sem LPS (grupo Controle Veículo). Vinte e quatro horas após a administração do LPS, os olhos foram enucleados, humor aquoso foi recolhido, e o número de células infiltrativas, a concentração de proteína, assim como os níveis de óxido nítrico (NO), fator de necrose tumoral α (TNF-α), interleucina-6 e marcadores de estresse oxidativo foram determinados no humor aquoso. Além disso, a resposta inflamatória foi avaliada clinicamente e histologicamente. Resultados: As células infiltrativas, concentração de proteína, o NO, TNF-α, interleucina-6 foram significativamente elevados no humor aquoso de ratos do grupo Grupo LPS + Veículo quando comparados ao Grupo Controle Veículo. O tratamento com licopeno diminuiu significativamente estes aumentos. Comparado ao Grupo LPS + Veículo, o licopeno reduziu significativamente as concentrações no humor aquoso dos marcadores de estresse oxidativo e NO (de 0,29 ± 0,1 μM para 0,19 ± 0,1 μM, p=0,003), o TNF-α (de 71,0 ± 22,3 ng/ml para 50,1 ± 2,1 ng/ml, p=0,043), interleucina-6 (de 121,6 ± 3,0 pg/ml para 111,1 ± 5,6 pg/ml, p=0,008). Do mesmo modo, o aumento do número de células infiltrativas no tecido uveal em seções histológicas foi significativamente inibido pelo licopeno, a pontuação inflamatória diminuiu de 2,0 ± 0,0 para 0,4 ± 0,5, p=0,001. Embora, não tenha sido estatisticamente significativo, o licopeno reduziu a contagem de células infiltrativas e a concentração de proteínas no humor aquoso. Conclusões: Estes resultados sugerem que o licopeno pode ter efeitos benéficos no tratamento da inflamação ocular, através dos seus efeitos anti-inflamatórios e antioxidantes.

Guidelines proposal for clinical recognition of mouth breathing children

INTRODUCTION: Mouth breathing (MB) is an etiological factor for sleep-disordered breathing (SDB) during childhood. The habit of breathing through the mouth may be perpetuated even after airway clearance. Both habit and obstruction may cause facial muscle imbalance and craniofacial changes.OBJECTIVE: The aim of this paper is to propose and test guidelines for clinical recognition of MB and some predisposing factors for SDB in children.METHODS: Semi-structured interviews were conducted with 110 orthodontists regarding their procedures for clinical evaluation of MB and their knowledge about SDB during childhood. Thereafter, based on their answers, guidelines were developed and tested in 687 children aged between 6 and 12 years old and attending elementary schools.RESULTS: There was no standardization for clinical recognition of MB among orthodontists. The most common procedures performed were inefficient to recognize differences between MB by habit or obstruction.CONCLUSIONS: The guidelines proposed herein facilitate clinical recognition of MB, help clinicians to differentiate between habit and obstruction, suggest the most appropriate treatment for each case, and avoid maintenance of mouth breathing patterns during adulthood.

INTRODUÇÃO: a respiração bucal (RB) é um fator etiológico para os distúrbios respiratórios do sono (DRS) na infância. O hábito de respirar pela boca pode ser perpetuado mesmo depois da desobstrução das vias aéreas. Tanto o hábito quanto a obstrução podem causar desequilíbrios da musculatura facial e alterações craniofaciais. O objetivo deste trabalho é propor e testar uma diretriz para o reconhecimento clínico da RB e de alguns fatores predisponentes aos DRS em crianças.MÉTODOS: entrevistas semiestruturadas foram realizadas com 110 ortodontistas, com relação aos seus procedimentos para avaliação clínica da RB e aos seus conhecimentos sobre DRS na infância. A partir daí, com base nas respostas obtidas, uma diretriz foi desenvolvida e testada em 687 crianças, com 6 a 12 anos, oriundas de escolas de ensino fundamental.RESULTADOS: não existe padronização para o reconhecimento clínico da RB pelos ortodontistas. Os procedimentos mais comumente realizados foram ineficientes para reconhecer a diferença entre a RB por hábito e a por obstrução.CONCLUSÕES: a diretriz proposta facilita o reconhecimento clínico da RB, diferencia entre RB por hábito e por obstrução, sugere o tratamento mais adequado para cada caso, e evita a manutenção do padrão de respiração bucal na idade adulta.

Ophthalmic manifestations of Linear Nevus Sebaceous/Organoid Nevus Syndrome

Linear Nevus Sebaceous Syndrome [LNSS] is a rare sporadic oculoneurocutaneous disorder, also classified as Organoid Nevus Syndrome. It consists of a triad of midline facial linear nevus sebaceous, central nervous system and ocular abnormalities. To the best of authors' knowledge ophthalmic features of LNSS have never been reported in Pakistani population. We report two cases of LNSS, associated with multiple cutaneous nevus sebaceous lesions, complex ocular choristomas and rare bilateral presentation in one patient. Ocular choristomas included limbal dermoids, dermolipomas at superior fornices and chroidal choristoma. Ocular surface was successfully reconstructed by excision of limbal dermoids, partial keratectomy and amniotic membrane transplant

Biometria no crescimento do olho alto míope na infância / Biometry in the growth of the high myopic eye in childhood

OBJETIVO: Determinar se o crescimento do globo ocular mensurado através da biometria óptica e ultrassônica em uma população pediátrica de altos míopes é significante, assim como variação significante da espessura do cristalino, profundidade da câmara anterior, curvatura corneana e achados fundoscópicos durante o acompanhamento. MÉTODOS: Uma população pediátrica (idade média: 8,7anos), 11 olhos de crianças portadoras de alta miopia (refração média inicial: -11,28D) foi submetida a avaliação seriada num período de nove meses incluindo-se biometria óptica (IOLMaster, Zeiss) e ultrassônica (Ultrascan, Alcon; técnica de contato), refratometria estática, oftalmoscopia indireta e retinografia. RESULTADOS: No período de nove meses, o crescimento do olho foi estatisticamente significante em 64% (7 olhos) e não ocorreu em 36% (3 olhos), com modificação do comprimento axial médio (pré=26,76 mm; final=26,98 mm). Neste período, o equivalente esférico refracional aumentou em 45% (5 olhos), não apresentou variação em 27% (3 olhos), com modificação da refração média (pré=-11,28 D; final=-11,69 D). Não houve variação estatisticamente significante da espessura do cristalino, profundidade da câmara anterior, curvatura corneana e do aspecto fundoscópico. CONCLUSÃO: No grupo de crianças com alta miopia acompanhadas num período de nove meses, demonstrou-se o crescimento do globo ocular com variação do comprimento axial tanto pela técnica de biometria óptica quanto ultrassônica, e com aumento da refratometria média. Outros parâmetros estudados como espessura do cristalino, profundidade da câmara anterior e curvatura da córnea não demonstraram variação no período de tempo do estudo.

PURPOSE: To determine if the growth of the axial length measured by optical and ultrasound biometry in a pediatric population of high myopes is significant, as well as significant variation of lens thickness, anterior chamber depth, corneal curvature and ophthalmoscopic findings during follow-up. METHODS: A pediatric population (mean age: 8.7 years old) of 11 high myopic eyes (mean initial refractive error: -11.28 D) was submitted to serial evaluation over a 9-months period including optical (IOLMaster, Zeiss) and ultrasound biometry (Ultrascan, Alcon, contact technique), cycloplegic refraction, indirect ophthalmoscopy and fundus photography. RESULTS: During a 9-months period, eye growth was significant in 64% (7 eyes) and did not occur in 36% (3 eyes), with change in the mean axial length (pre=26.76 mm; final=26.98 mm). During this period, refractive spherical equivalent increased in 45% (5 eyes), did not show variation in 27% (3 eyes), with a change in mean refraction (pre=-11.28 D; final=-11.69 D). There was no statistically significant variation of lens thickness, anterior chamber depth, corneal curvature and ophthalmoscopic findings. CONCLUSION: Ocular globe growth (axial length) measured by optic and ultrasound biometry was significant in the high myopic pediatric population examined. The findings suggest that axial length variation preceded variation of other structures in the sample examined. In a group of children with high myopia followed during a 9-months period, ocular growth was demonstrated with variation of axial length either with optical or ultrasound biometry techniques, and change in mean refraction. Other parameters studied as lens thickness, anterior chamber depth and corneal curvature did not demonstrate variation during the time of the study.

Assessment of ocular surface toxicity after topical instillation of nitric oxide donors / Avaliação da toxicidade na superfície ocular após instilação tópica de doadores de óxido nítrico

PURPOSE: To evaluate the ocular surface toxicity of two nitric oxide donors in ex vivo and in vivo animal models: S-nitrosoglutathione (GSNO) and S-nitroso-N-acetylcysteine (SNAC) in a hydroxypropyl methylcellulose (HPMC) matrix at final concentrations 1.0 and 10.0 mM. METHODS: Ex vivo GSNO and SNAC toxicities were clinically and histologically analyzed using freshly excised pig eyeballs. In vivo experiments were performed with 20 albino rabbits which were randomized into 4 groups (5 animals each): Groups 1 and 2 received instillations of 150 µL of aqueous HPMC solution containing GSNO 1.0 and 10.0 mM, respectively, in one of the eyes; Groups 3 and 4 received instillations of 150 µL of aqueous HPMC solution-containing SNAC 1.0 and 10.0 mM, respectively, in one of the eyes. The contralateral eyes in each group received aqueous HPMC as a control. All animals underwent clinical evaluation on a slit lamp and the eyes were scored according to a modified Draize eye test and were histologically analyzed. RESULTS: Pig eyeballs showed no signs of perforation, erosion, corneal opacity or other gross damage. These findings were confirmed by histological analysis. There was no difference between control and treated rabbit eyes according to the Draize eye test score in all groups (p>0.05). All formulations showed a mean score under 1 and were classified as "non-irritating". There was no evidence of tissue toxicity in the histological analysis in all animals. CONCLUSION: Aqueous HPMC solutions containing GSNO and SNAC at concentrations up to 10.0 mM do not induce ocular irritation.

OBJETIVO: Avaliar a toxidade na superfície ocular de dois compostos doadores de óxido nítrico em modelos ex vivo e in vivo: S-nitrosoglutationa (GSNO) e S-nitroso-N-acetilcisteína (SNAC), em uma matriz de hidroxipropil metilcelulose (HPMC) nas concentrações finais de 1,0 and 10,0 mM. MÉTODOS: As toxicidades de GSNO e SNAC foram avaliadas clinicamente e histologicamente em modelo ex vivo usando globos oculares porcinos recém excisados. Experimentos in vivo foram realizados com 20 coelhos albinos que foram randomizados em 4 grupos (5 animais em cada): Os grupos 1 e 2 receberam instilações de 150 µL de solução aquosa de HPMC contendo GSNO 1,0 e 10,0 mM, respectivamente, em um dos olhos; Os grupos 3 e 4 receberam instilações de 150 µL de solução aquosa de HPMC contendo SNAC 1,0 and 10,0 mM, respectivamente, em um dos olhos. Os olhos contralaterias em cada grupo receberam solução aquosa de HPMC como controle. Todos os animais foram clinicamente avaliados em lâmpada de fenda e os olhos foram pontuados de acordo com o teste de Draize modificado e analisados histologicamente. RESULTADOS: Os globos oculares porcinos não apresentaram sinais de perfuração, erosão, opacidade da córnea ou outros danos graves. Esses resultados foram confirmados pela análise histológica. Não houve diferença entre os olhos dos coelhos tratados e controles de acordo com a pontuação do teste de Draize em todos os grupos (p>0,05). Todas as formulações apresentaram um escore médio menor do que 1 e foram classificadas como "não-irritantes". Não houve evidência de toxicidade tecidual nas análises histológicas em todos os animais. CONCLUSÃO: Soluções aquosas de HPMC contendo GSNO e SNAC em concentrações até 10,0 mM não induzem irritação ocular.

Frequencies of various ocular pathologies detected on B-scan ultrasonography in patients of ocular trauma

To determine the frequencies of various ocular pathologies detected on B-scan ultrasonography in patients of ocular trauma. A descriptive cross-sectional study. The study was conducted in 162 patients of ocular trauma from 14th September 2011 to 14th march 2012 presenting to the outpatient department of Al-Shifa Trust Eye Hospital in collaboration with the B-scan department of the hospital. All the information was recorded on proformas and data analysis was done using SPSS 13.0. There were 134 [82.7%] males and 28 [17.3%] females. The study showed that age group 1-20 yrs is most commonly affected by ocular trauma. Males are 5 times more commonly affected by ocular trauma than females. Vegetative material [29%], metallic objects [27.2%] and stone material [17.9%] were most common causes of ocular trauma. While plastic objects [8.6%], blast injuries [4.9%], glass [4.9%], hand and finger trauma [3.7%] and animal horn trauma [3.7%] were less common causes. The study showed vitreous hemorrhage to be most common B-scan finding in ocular trauma [31.5%] while 19.8% patients had no abnormality detected on B scan. Retinal detachment was present in 17.9% patients, intraocular foreign body [IOFB] in 9.9% and endophthalmitis in 7.4%. In patients of ocular trauma, most common B-scan finding is vitreous hemorrhage, retinal detachment and intraocular foreign body. Although significant number of trauma patients have normal B-scans as well. In ocular trauma patients B-scan can be an excellent tool to examine posterior segment when anterior segment pathology precludes clinical examination. This study provides a local data base of the burden of posterior segment pathology in ocular trauma patients that requires urgent management by Vitreoretinal specialist for better visual outcome

Mobile phone radiation induced plasma protein alterations and eye pathology in newly born mice

The hazardous health effect of the exposure to 900-1800 MHz radiofrequency electromagnetic fields [RF-EMF] which emitted from mobile phones was investigated on the plasma protein and eye of newly born mice. Twenty one newly born mice were divided into 3 groups, the 1[st] group served as control, the 2[nd] group exposed to mobile phone radiation daily for one month [45 min/day] and the 3[rd] group remained one month following the end of exposure. The results showed deleterious changes in the plasma protein pattern by electrophoretic analysis. Also, the microscopic examination demonstrated numerous histopathological and histochemical changes in the eye mainly represented by degenerated, hemorrhagic areas and detachment in some layers of the eye with alteration in collagen, polysaccharides, total protein and marked increase in amyloid beta [beta] protein contents of newly born mice exposed to RF-EMF from mobile phone [45 min/day] for one month as well as after one month following the end of exposure. It was concluded that the exposure to mobile phone radiation causes plasma proteins alterations and eye pathology in newly born mice

Clinical and Pathological Characteristics of Intraocular Cysticercosis

This study aimed to explore the clinical, radiological, and pathological characteristics of intraocular cysticercosis due to Taenia solium metacestode infection. Total 8 patients diagnosed with intraocular cysticercosis at the Red Cross Hospital of Yunnan Province, China were examined retrospectively. Patients with clear dioptic media had undergone fundus chromophotography. All patients underwent B ultrasonography of the ocular region (CT) successive scanning of the orbit and cerebral tissues. Parasites were extracted surgically and then examined pathologically. The fundus chromophotography showed a white and condensing scolex package in the vesicle. The B ultrasonic examination showed a vesicle-like echogenic mass in the vitreous chamber, in which the high-level echo spot was the cysticercus scolex. The pathological examinations showed that the vesicle wall exhibited hyaline degeneration, inflammatory cell infiltration, neuroglial fiber, and glial cell proliferation layers from the inside to the outside. The scolex is round and is composed of the outer tissue (the body wall) and the inner furrow tissue; these tissues migrated together. Primordially differentiated sucking discs were found in one case, but no hooklets were found. The inner scolex tissue was folded like a paper flower. The severity of intraocular disease is closely correlated with the pathophysiological processes of the cysticercus worm. Pathological examination of the intraocular lesions can help to evaluate the course of the disease as well as to provide a scientific basis for effective antiparasitic medication.

Management of post-operative Nocardia endophthalmitis.

Post-operative Nocardia endophthalmitis has an aggressive course and poor visual prognosis. It often masquerades as severe post-operative uveitis or toxic anterior segment syndrome due to the absence of vitreous involvement resulting in a delay in diagnosis. The poor prognosis in Nocardia endophthalmitis is due to severe intra-ocular inflammation which may lead to phthisis. Therefore, treatment with corticosteroids after appropriate antibiotics have been initiated may improve the outcome. This is an interventional case report highlighting the typical features of Nocardia endophthalmitis, which when diagnosed early and managed medically with antibiotics and steroids, resulted in an excellent visual outcome in our patient.

Patología orbitocraneana de presentación oftalmológica / Orbitocranial pathology with ophthalmologic symptoms

Objetivos. Comunicar la correlación clínico-etiológica de diferentes entidades orbitocraneanas que se presentaron inicialmente con síntomas oftalmológicos y establecer su aporte para la elección del estudio ideal de cada caso particular.Materiales y Métodos. Se analizaron retrospectivamente 36 pacientes con patología orbitaria y/o intracraneal. Las consultas fueron realizadas entre julio de 2007 y enero de 2011, y todos los casos fueron evaluados con examen oftalmológico, Campimetría Visual Computarizada, Tomografía Computada Multislice (TCMS), Resonancia Magnética (RM) y, en algunos casos, con un estudio histopatológico. Resultados. El síntoma inicial más frecuente fue la disminución o alteración de la agudeza visual, presente en 22 pacientes (61%). Otros síntomas fueron: diplopía en 9 pacientes (25%), exoftalmos en 2 (5,5%), hematoma orbitario en 2 (5,5%) y leucocoria en 1 (3%). En el grupo de pacientes que consultó por alteración visual, los diagnósticos etiológicos fueron variados e incluyeron:meningiomas esfenoidales (n=4), enfermedad de Devic (n=2), glioma mesencefálico (n=1), gliomas ópticos en NF-1 (n=2), metástasis de carcinoma de mama (n=4), linfoma cerebral (n=2), ACV (n=4), hipofisitis linfocitaria (n=1) y pseudotumor cerebri (n=2).Entre los que originalmente manifestaron diplopía, se destacaron: un tumor de lámina cuadrigémina, un quiste pineal con hidrocefalia aguda, dos aneurismas de arteria comunicante posterior, dos aneurismas de arteria carótida interna intracavernosa (uno de ellos gigante y disecante), un aneurisma ventral de la arteria carótida interna supraclinoidea y dos mucoceles fronto-etmoidales. Llama la atención que dos meningiomas el nervio óptico se presentaran inicialmente con exoftalmos y disminución de la agudeza visual en forma secundaria y que la manifestación inicial en un paciente con síndrome de West fuera leucocoria. Conclusión. El abordaje interdisciplinario y la adecuada recomendación de estudios por imágenes en...

Assessment of vitreoretinal interface and clinically significant macular edema by OCT and fluorescein angiography

To assess the changes occurring at the vireoretinal interface with clinically significant macular edema using optical coherent tomography [OCT] and fundus fluorescein angiography [FFA]. Ninety nine eyes of 84 patients suffering from macular edema of different etiologies were included in this study. They were divided according to the cause of macular edema into 6 groups. Treatment modalities were done to be evaluated in the follow up. All cases were followed up at regular visits one week, one month, and six months with routine ocular examinations. FFA and OCT changes were determined and evaluated at one month and 6 months after treatment. In diabetic group [40 eyes], there were 22 eyes with different stages of PVD seen by OCT in comparison to 5 eyes only demonstrated by FFA, ERM seen by OCT of different stages in 14 eyes while in FFA 10 eyes only, In the RVO group [15 eyes], there were 6 eyes with different stages of PVD seen by OCT in comparison to no eyes demonstrated by FFA, In the IGS group [10 eyes], there were 3 eyes with different stages of PVD seen by OCT in comparison to no eyes demonstrated by FFA, In the CNV group [17 eyes], there were 4 eyes with different stages of PVD seen by OCT in comparison to no eyes demonstrated by FFA, ERM seen by OCT of different stages in 3 eyes while in FFA one eye only, In the RP group [10 eyes], there were 2 eyes with different stages of PVD seen by OCT in comparison to no eyes demonstrated by FFA. In the TME group [7 eyes], there were 3 eyes with different stages of PVD seen by OCT in comparison to no eyes demonstrated by FFA, ERM seen by OCT and FFA of different stages in 4 eyes. OCT provided us with valuable information on the retinal morphologic changes associated with ME of different etiologies and analyzing vitreomacular relationship and detecting macular SRD undetectable on biomicroscopy and FFA

Measuring normal ocular torsion and its variation by fundus photography in children between 5-15 years of age.

Cycloposition has been measured by various methods; however, fundus photography is the most reliable method to evaluate the torsion objectively. We did a prospective study to find out the disc foveal angle (DFA) and its variation in children without squint. We included 210 eyes of 105 children between the ages of 5-15 years. DFA was calculated using standard technique after taking a fundus photograph. The cycloplegic refraction was done and compared. The mean age was 10.6 ± 2.5 years. Mean DFA in right eye (RE) was 6.49 ± 3.25° (0-13°) and in left eye (LE) was 5.80 ± 3.29° (0-12°). The difference between the RE and LE was statistically not significant (P=0.131) (mean 1.15 ±1.39°). Mean DFA in emmetropic children was 6.1° ± 3.4° (n=112 eyes). DFA varies widely in children. The difference observed in DFA measurement for eyes with various refractive errors were compared with DFA measurements for emmetropic eyes.