To Compare the Effectiveness of Sub-Tenon’s Anesthesia with Peribulbar Anesthesia in Patients Undergoing Manual Small-incision Cataract Surgery

Background: Blindness due to cataract presents an enormous problem in terms of human morbidity, economical loss, andsocial burden. Retrobulbar anesthesia was commonly used for cataract surgery. Rare but serious complications led manyophthalmologists to replace retrobulbar with peribulbar anesthesia. However, even peribulbar anesthesia does not eliminatethe serious complications totally. These concerns have led to increased use of blunt needle sub-Tenon’s block over the sharpneedle blocks.Materials and Methods: 200 cases were selected, of which 100 were in the sub-Tenon’s group and the remaining 100 werein the peribulbar group. The efficacy of anesthesia between the two groups was compared in terms of analgesia at variousintervals, akinesia of the globe and eyelids attained after the block. They were graded on a subjective scale and recorded.Minor complications such as chemosis, sub-conjunctival hemorrhage, and rise in increased intraocular pressure (IOP) werealso compared and analyzed.Results: Sub-Tenon’s anesthesia provided better analgesia than peribulbar anesthesia although the akinesia was poorer thanthe latter. Minor complications such as sub-conjunctival hemorrhage were more in sub-Tenon’s group while instantaneous risein IOP was more in peribulbar group. The incidence of chemosis was almost comparable in both the groups.Interpretation and Conclusion: Sub-Tenon’s anesthesia is recommended as a safe and effective alternative to peribulbaranesthesia for small-incision cataract surgery as it provides good analgesia, adequate akinesia, and rare minor complications.

Rotura ocular posterior traumática / Traumatic posterior ocular rupture

El trauma ocular es una causa importante de morbilidad oftalmológica en el mundo con implicaciones socioeconómicas importantes para el paciente y sus familiares. Ocurre generalmente en adultos jóvenes, con una buena agudeza visual al inicio del evento traumático, la cual se verá comprometida según la severidad del trauma, las estructuras oculares que afecte y las complicaciones que puedan aparecer. Presentamos dos pacientes con rotura escleral posterior secundario a trauma ocular a globo abierto contuso. Se describe el manejo personalizado el seguimiento en cada caso y sus resultados visuales(AU)

The ocular trauma is an important cause of ophthalmological morbidity in the world with significant socio-economic implications for the patient and its relatives. It generally occurs in young adults, with good visual acuity at the beginning of the traumatic event, which may be affected by the trauma severity, the ocular structures that it affects and the possible complications. This is the report on two patients with posterior scleral rupture secondary to blunt open-globe ocular trauma. The customized management, the follow-up of each case and the visual results achieved were all described(AU)

Golden half ring sign for identification of pseudophacocele.

Dislocation of intraocular lens (IOL) is a serious complication of blunt ocular trauma in pseudophakic eyes. Here, a 72‑year‑old male patient with subconjunctival dislocation of an IOL (pseudophacocele) secondary to bull horn injury was reported. In this case report, a new sign named as “golden half ring sign” was described for easy identification and localization of subconjunctival dislocation of IOL in patient with open globe injury (surgical wound dehiscence) associated dense subconjunctival hemorrhage.

Paroxysmal atrial fibrillation: an unusual association of leptospirosis.

A 60 year old nonsmoker, non-diabetic, normotensive farmer presented with 4 days history of fever, myalgia & headache. He had relative bradycardia, eye congestion, diffuse muscle tenderness and tender hepatomegaly at presentation. He developed subconjunctival hemorrhage on 3rd in-hospital day. His investigations showed thrombocytopenia, hepatic and renal dysfunctions. His leptospira serology was positive. He was treated with injection crystalline penicillin and supportive therapy. While on treatment, even though he did not have any known cardiac risk factors, except for his age & gender, he developed 3 paroxysms of atrial fibrillation on 5th - 7th in-hospital days, without hemodynamic instability. His cardiac markers and echocardiogram during the paroxysms were otherwise normal. He had uneventful recovery, remained in sinus rhythm and stable at follow-up. This paroxysmal atrial fibrillation may be a coincidence or attributed as unusual association of leptospirosis.

Caracterización de los pacientes con traumatismo ocular en el área de salud Julián Grimau / Characterization of patients with ocular trauma in Julián Grimau health area

Se efectuó un estudio observacional, descriptivo y transversal de 65 pacientes con traumas oculares, pertenecientes al área de salud del Policlínico Universitario Julián Grimau de Santiago de Cuba, desde Junio del 2010 hasta igual mes del 2011, con vistas a identificar las principales características clinicoepidemiológicas de los afectados. En la serie predominaron las contusiones (32,3 por ciento), las heridas corneales (32,9 por ciento), las erosiones corneales (27,6 por ciento), así como las hemorragias subconjuntivales y los hifemas (23,7 por ciento, cada uno). Por tales razones se recomendó realizar estudios que reflejen la prevalencia e incidencia de la mencionada afección en esta provincia

An observational descriptive and cross-sectional study was carried out in 65 patients with ocular trauma, belonging to the health area of Julián Grimau University Polyclinic in Santiago de Cuba, from June 2010 to the same month of 2011 with the purpose of identifying the main clinical and epidemiological characteristics of those affected. Contusions (32.3 percent), corneal wounds (32.9 percent) and corneal erosions (27.6 percent) prevailed in the series, as well as subconjunctival hemorrhage and hyphema (23.7 percent each). For these reasons it was recommended to carry out studies reflecting the prevalence and incidence of the condition in this province

A case of Traumatic Asphyxia Associated with Ophthalmic Manifestation

PURPOSE: Traumatic asphyxia is a rare clinical syndrome characterized by cervicofacial cyanosis, edema, and multiple petechiae after a severe chest crush injury, and ophthalmic involvement includes violaceous discoloration of lid, lid edema, bulbar subconjunctival hemorrhage, exophthalmos and retinal hemorrhage. The authors experienced a case of traumatic asphyxia with typical ophthalmic manifestations after a crush chest injury, and we report this case with literature review. METHODS: A-54-year old man was consulted for bilateral proptosis after a crush chest injury. Ophthal-mologice valuation and intervention were performed. RESULT: Right eye was not checked due to previous corneal opacity, but visual acuity was 0.8 and IOP was 45 mmHg in left eye. There were bilateral proptosis and severe bulbar subconjunctival hemorrhage, and orbital computed tomography showed orbit fat interposed between globe and medial orbital wall. IOP was controlled with medications and other clinical signs including proptosis showed progressive improvement.

Treatment of Conjunctivochalasis Using Bipolar Cautery

Conjunctivochalasis cause epiphora because abnormal redundant conjunctival tissue obstruct the punctum and block the tear outflow. The surgical resection of the redundant conjunctial tussue with scissors has been performed but it has caused such problems as difficult control of bleeding, long surgical time, high incidence of subconjunctival hemorrhage and cosmetic dissatisfaction. Therefore, the authors performed the operation of conjunctivochalasis with bipolar cautery instead of scissors and evalunted the efficacy of this new method. The authors prospectively studied 9 patients(16 eyes) of conjunctivochalasis who complained of epiphora and were found to have redundancy of conjunctival tissue around the punctal area on slit-lamp examination. They have neither lacrimal pathway insufficiency and obstruction, nor facial falsy or lid laxity that impair the lacrimal pump action, and also no anatomical anomaly of the punta was noted. After marking of redundant conjunctival tissue with gentian Violet under the operationg microscope and topiacal anethesia wint 4% lidocaine, redundant conjunctival tissue was removed by bipolar cautery. We also cauterized exposed Tenon`s capsule to contract the wound. Suture was not performed or three interrupted suture were placed. Epiphora was improved after simple cauterization of redundant conjunctiva in 15 eyes out of 16 eyes during at least 2 months of follow-up period. Removal of redundant lower incidence of subconjunctival hemorrhage than resection technique using scissore. We expect that this surgical technique will substitute for established technique with scissors beause bipolar cautery method was simple and showed lower incidence of complications.