Is symptomatic atherosclerotic cerebrovascular disease a risk factor for normal-tension glaucoma?

OBJECTIVE: To compare the incidence of glaucomatous optic disk appearance between patients with symptomatic atherosclerotic stroke and healthy individuals with normal intraocular pressures (IOP). SUBJECTS AND METHODS: 46 patients with ischemic stroke with evident lacunar infarction or large vessel atherosclerosis, and 93 age- and sex-matched healthy individuals, all with normal IOP, were included. Patients and controls were examined for the presence of high cup-to-disk ratios (> 0.5). RESULTS: Seven patients (15.22%) in the ischemic cerebrovascular disease (CVD) group and 3 controls (3.23%) had glaucomatous optic disk appearance. All subjects with glaucomatous optic disk appearance in the control group and 3 patients in the study group had visual field defects in concordance with normal-tension glaucoma (NTG). The incidence of glaucomatous optic disk appearance was significantly higher in the group with symptomatic atherosclerotic CVD. CONCLUSION: Atherosclerotic CVD is a risk factor for having glaucomatous optic disk appearance. Symptomatic atherosclerosis involving the brain vasculature may also affect the eye and lead to NTG. Patients with ischemic strokes due to large artery atherosclerosis or small artery occlusion must be examined and followed for NTG.

Bilateral horizontal Vogt's striae in keratoconus.

PURPOSE: To report a keratoconus case with bilateral horizontal Vogt's striae. METHOD: The clinical findings of the patient and the development of the direction of striae are discussed. RESULTS: Vogt's striae, defined as vertical stress lines, are rarely horizontal. One patient with unilateral horizontal stress lines on his left eye has been reported in the literature. Our patient has horizontal Vogt's striae in both eyes. CONCLUSION: Horizontal Vogt's striae may be seen in keratoconus as a rare slit-lamp biomicroscopic finding.

Necrotizing scleritis due to varicella zoster infection: a case report.

PURPOSE: To report a case with necrotizing scleritis due to varicella-zoster infection. METHODS: The patient records were evaluated. The present literature was investigated using MEDLINE. A six-year-old boy with varicella infection was admitted to our clinic with redness, pain, and lid edema on the right eye. Slit lamp examination revealed lid edema, purulent secretion, conjunctival injection and chemosis, and inferotemporal scleral necrosis. Sclera was avascular and the conjunctiva was spontaneously detached from sclera in the necrotic region. RESULTS: Systemic and topical acyclovir treatment was started and a rapid improvement achieved in signs and symptoms. CONCLUSIONS: Ophthalmic manifestations of varicella infection are potentially blinding especially in the absence of appropriate diagnosis and medical intervention. Distinctive skin eruptions are specifically helpful in the early diagnosis of the disease.

Conjunctival necrosis due to subconjunctival injection of betamethasone in treatment of graft rejection after penetrating keratoplasty.

A rare side effect of betamethasone applied subconjunctivally is described. A 51-year-old man who had undergone penetrating keratoplasty in his left eye 2 months previously developed graft rejection and was treated by subconjunctival injection of betamethasone. Within 2 weeks, the patient complained of conjunctival hyperemia and irritation. Biomicroscopic examination revealed conjunctival and subconjunctival necrosis with white necrotic tissue at the subconjunctival corticosteroid injection site. Simple debridement and primary wound closure of the involved area resulted in complete healing. Ophthalmologists should be aware that subconjunctival injection of betamethasone may cause conjunctival necrosis.