Epidemic retinitis during the COVID-19 pandemic

Purpose: To study the impact of the novel coronavirus disease?2019 (COVID?19) pandemic on incidence, seasonal variation, clinical presentation, and disease outcome of epidemic retinitis (ER) and to compare clinical outcomes with positive and negative COVID?19 serology. Methods: This is a retrospective, observational study conducted at a tertiary eye care hospital from August 2020 to June 2022. A graph of ER cases against the month of presentation was compared with the graph of the COVID?19 pandemic in the same region. Cases presented before COVID?19 vaccination, with positive COVID?19 serology (Group 1) were compared with cases with negative serology (Group 2). Results: One hundred and thirty?two cases of ER were seen. The least number of cases were seen during and immediately after the peak of the pandemic (May 2021–August 2021). COVID?19 serology was positive in 13 (22 eyes)/60 (21.6%) unvaccinated cases. Along with COVID?19, positive serology for other ER etiologies was seen in 5/13 cases (38.4%). All patients received oral doxycycline with/without steroids. Groups 1 and 2 included 22 and 21 eyes of 13 cases each. Macular edema resolved in 43.6 and 32 days in groups 1 and 2, respectively. Retinitis resolved at 1 month in both groups. Corrected distant visual acuity was 20/50 and 20/70 at the presentation, which improved to 20/20 and 20/25 in groups 1 and 2, respectively. Mean and median follow?up was 6 months and 4.5 months, respectively, in both groups. No complications or recurrences were seen. Conclusion: No significant impact of the COVID?19 pandemic on ER was observed

Ophthalmia due to spitting cobra venom in an urban setting - a report of three cases

To describe three presentations of spitting cobra venom induced ophthalmia in urban Singapore. Case notes and photographs of three patients with venom ophthalmia who presented to our clinic between 2007 and 2012 were reviewed. Two patients encountered the spitting cobra while working at a job site while the third patient had caught the snake and caged it. The venom entered the eyes in all 3 cases. Immediate irrigation with tap water was carried out before presenting to the Accident and Emergency department. All patients were treated medically with topical antibiotic prophylaxis and copious lubricants. The use of anti-venom was not required in any case. All eyes recovered with no long-term sequelae. If irrigation is initiated early, eyes can recover with no significant complications or sequelae

Sphenoidal mucocele presenting as acute cranial nerve palsies

Sphenoidal sinus mucoceles are indolent lesions that, when sufficiently large, can compress on the optic canal or superior orbital fissure, rapidly causing loss of vision, optic neuropathy, ptosis, pain, ophthalmoplegia, and diplopia. We herein report a 72-year-old gentleman who presented acutely with Cranial Nerve II, III, and IV palsies secondary to a sphenoidal sinus mucocele that was confirmed on magnetic resonance imaging and successfully treated with endoscopic drainage. This cause of orbital apex syndrome is important for clinicians to know as early diagnosis and treatment is critical in recovering visual potential

Visual disturbance as the first symptom of chronic myeloid leukemia

Chronic myeloid leukemia [CML] is a well-studied entity and advances made in diagnosis and treatment have improved the disease outcome. Patients with ophthalmic manifestation of CML have been reported to have lower 5-year survival rates. Hence, recognizing the early fundus changes may improve outcome by allowing earlier diagnosis and treatment. We report a case of a previously healthy 30-year-old Myanmarese male, who presented with a minor visual disturbance, complaining of seeing a 'black dot' in his left visual field for the past 1 week. Fundoscopic examination revealed bilateral retinal blot hemorrhages, white-centered hemorrhage, and preretinal hemorrhage over the left fovea. The full blood count and peripheral blood film were abnormal, and bone marrow biopsy confirmed the diagnosis of CML. Cytoreduction therapy was promptly commenced and his symptoms resolved, with improvement in visual acuity. No complications were recorded at 1-year follow-up

Anterior capsule tear after laser iridotomy complicating phacoemulsification

A 70-year-old Indian lady had a history of bilateral laser peripheral iridotomy [LPI] for primary angle closure. Subsequently she developed cataract in both the eyes. Right eye cataract surgery was complicated by an anterior capsule rupture, which was discovered intra-operatively at the site of the LPI. Trypan blue was used to stain the anterior capsule to delineate the anterior capsule defect. An attempt at continuous curvilinear capsulorhexis was unsuccessful, and the anterior capsulotomy was completed with scissors. To the best of our knowledge the surgical management of cataract in the presence of anterior capsule rupture as a result of LPI has not been reported. Awareness of this potential complication of LPI will aid in planning for successful phacoemulsification cataract surgery