Autologous serum eye drops for the treatment of persistent corneal epithelial defects

A series of 10 patients at Armed Forces Institute of Ophthalmology, Rawalpindi, from September 2009 to August 2010 is reported. Follow-up of patients were done till February 2012. Patients with persistent corneal epithelial defects [PED] of minimum 2 weeks duration, in whom conventional therapy had failed, were included in the study. They were prescribed 100% autologous serum eye drops on hourly basis. When PED healed within 02 weeks, it was labeled as effective and when it healed within one month, it was labeled as partially effective. Six weekly follow-up was done for 18 months for all patients to document any recurrence of PED. Eight out of 10 patients had successful outcome i.e. 80% of PED healed within one month, out of which 7 patients had 'effective' outcome. Autologous serum eye drops are safe, effective and minimally invasive modality in treating PED

Amniotic membrane transplantation in primary pterygium compared with bare sclera technique

To compare the excision of primary pterygium by bare sclera technique and excision combined with amniotic membrane transplantation [AMT]. An experimental study. Eye Department, Military Hospital, Rawalpindi, presently known as Armed Forces Institute of Ophthalmology, Rawalpindi, from May 2007 to July 2008. A pilot study of 70 patients was conducted. Patients were divided in two groups. In group I, pterygium excision was done by bare sclera technique while in group II, AMT was done after excision. Patients were followed for 6 months. Proportion of recurrence of pterygium was noted in each group and compared with chi-square test with significance at p < 0.05. Number of patients who presented with recurrence of pterygium in group-I were 12 [37.5%] and in group-II were 4 [12.9%]. Chi-square tests showed that there was a statistically significant difference in frequency of recurrence between the two groups [p = 0.025]. AMT after excision of pterygium appeared to be safe and effective way of treating primary pterygium as compared to bare sclera technique due to lesser recurrence at 6 months

Interferon associated retinopathy

Interferon is an immunomodulating cytokine which is used to treat different diseases. Nowadays it is being commonly used for the treatment of chronic hepatitis C. Few patients develop ocular complications secondary to the use of Interferon. We report here a case in which a young soldier with no other risk factors developed retinopathy changes after five months of interferon alpha 2b therapy which included cotton wool spots at the posterior pole and dot-blot haemorrhages in both fundi. These changes gradually started resolving after cessation of treatment and completely disappeared after six months

Frequency of ocular manifestations of chronic graft versus host disease

With the advancement of techniques for haematopoietic cell transplantation, the number of transplant survivors is increasing rapidly and so are the chances of chronic graft versus host disease [cGVHD]. The ocular manifestations of this disease have not been explored in our local population. This study was conducted to determine the frequency of ocular complications in cases of cGVHD following successful bone marrow transplantation. Twelve diagnosed cases of cGVHD were evaluated from June 2008 to March 2009 and there ocular manifestations were noted especially the ocular surface disorders, using double staining method with fluorescein and rose-bengal. Nine patients [75%] were having dry eyes, 7 [58.3%] with mebomian glands dysfunction, 4 [33%] with acute conjunctivitis, 2 [16.7%] with bilateral lacrimal canalicular occlusion, and 1 [8.3%] each of bilateral posterior subcapsular cataract, unilateral sterile corneal epithelial defect, anterior uveitis, retinal haemorrhages and disc oedema. The higher frequency of dry eyes along with other ocular manifestations in patients of cGVHD suggests the need of close ophthalmic monitoring in all such cases

Spontaneous resolution of direct carotid cavernous fistula

Proptosis due to carotid cavernous fistula is rare sequelae of head injury. We report a case of post-traumatic, direct high flow carotid cavernous fistula that resolved spontaneously 06 weeks after carotid angiography. It however, resulted in loss of vision due to delay in early treatment. In the cases of post-traumatic proptosis, carotid cavernous fistula should be kept in mind

Bilateral lacrimal bicanalicular obstruction in chronic graft versus host disease

Bone Marrow transplantation has been increasingly used for the treatments of various blood cancers for last two decades. As a complication, a variable number of patients develop Chronic Graft Verses Host Disease [cGVHD] six to eight months later. Ocular involvement occurs in 60 to 80% of patients with cGVHD. Though dry eye sensation is the most common ocular symptom of cGVHD we report here a case of excessive watering due to bilateral lacrimal bicanalicular obstruction secondary to ocular involvement in cGVHD along with onset of dry eye features

Phthiriasis Palpebrarum

Phthiriasis palpebrarum [lice infestation of palpabrae] is a rarely reported disorder and may present as blepharo-conjuctivitis. It is usually seen in lower socioeconomic groups and spreads through either sexual contacts or directly through linen or clothing. We report a family with phthiriasis palpebrarum in which the primary source of infestation was the paternal uncle of two children. Mechanical removal proved to be quite effective in treating the disease and preventing its recurrence