Ocular manifestations of Wegener's granulomatosis in north India.

Evidence of ocular involvement was found in seven of eleven patients with histologically confirmed Wegener's granulomatosis. Pain (7/7), redness (6/7), scleritis (5/7), reduced visual acuity (5/7), episcleritis (5/7), uveitis (3/7), proptosis, sclerokeratitis and conjunctivitis (2/7) each were the major ophthalmological features. One patient each had bilateral corneoscleral ulcers, eyelid infiltration, scleromalacia perforans and epiphora. Corneal, scleral and uveal tract involvement was observed more frequently than has been described in the literature. These complications responded favourably to treatment with cyclophosphamide and corticosteroids. Treatment was delayed as most of these patients were diagnosed, initially, to be suffering from tuberculosis.

Cilioretinal artery occlusion: a case report.

A young man had an occlusion of the cilioretinal artery. Recirculation in the vessel was established within 48 hours. The retinal damage has been permanent with no improvement in visual acuity. Fluorescein angiography during the stages of occlusion and established recirculation have been described. Vascular spasm of a short posterior ciliary artery due to smoking is the likely causal factor. The site of obstruction and the hemodynamic factors have been discussed.

Enterovirus 70 acute hemorrhagic conjunctivitis--sporadic cases.

Acute hemorrhagic conjunctivitis (AHC) has been reported in epidemics. This is a report of 29 sporadic cases of AHC recorded over a period of two years after the 1981 epidemic in and around Chandigarh. A rapid and simple immunofluorescence test was developed and standardized in our Institute for the diagnosis of AHC. It was used for epidemiological monitoring of cases and to establish the diagnosis in suspected cases of AHC reporting after the epidemic. The clinical picture of epidemic and sporadic cases is compared.

Congenital cataract: etiology and morphology.

In a study of congenital cataract in northern India, 76 patients (146 eyes) were evaluated for morphological patterns and etiology. Partial cataracts were found to be three times more common than total cataracts, the lamellar types being the most common among the partial cataracts. Hereditary cataracts had a 19.7% incidence. The majority (46.05%) of cases of congenital cataract were of idiopathic origin. A few cases were associated with metabolic disorders (Marfan's and Marchand's). Strabismus and nystagmus were the most common associated ocular abnormalities (28.94% and 15.79%), and mental retardation was the most commonly associated systemic abnormality. Rubella cataract was seen far less frequently than expected.

Congenital cataract: management and results.

The visual outcome in cases of congenital cataract, managed both surgically and conservatively, is outlined. Final vision was better in cases with partial cataract, about 40% of whom attained 6/24 or better vision. With total cataracts, none could achieve this level of vision, with the majority (84%) attaining only 6/60 or less acuity. Visual results were also better in patients without nystagmus, 34% of whom attained 6/24 or better vision, while in cases with nystagmus, only 15% could come up to this level. Cataracts necessitating early surgery had a worse prognosis than cataracts necessitating late surgery. Visual results were best in cases with bilateral cataracts, partial cataracts, absence of associated ocular anomalies, the absence of nystagmus and in patients requiring later surgery. The important causes of nonimprovement of vision were amblyopia and after-cataract. Retinal detachment, retinopathy, and degenerative myopia were some of the less frequent causes of poor vision, while mental retardation was another important factor. Full cooperation from the parents is absolutely essential in the proper visual rehabilitation of the handicapped child.

Fuchs' heterochromic cyclitis: some observations on clinical picture and on cataract surgery.

In a study of 33 patients of heterochromic cyclitis, some unusual clinical features were observed. In many cases the iris was feltlike, month eaten, and associated with gelatinous nodules at the pupillary border or over the surface of iris stroma. An association of pseudoexfoliation of the lens capsule with bilateral heterochromic cyclitis was noted. Twenty-one eyes were subjected to cataract surgery. Hyphema (23.6%) and phacoanaphylactic uveitis (9.5%) were the main postoperative complications.

Immunofluorescence test for the epidemiological monitoring of acute haemorrhagic conjunctivitis cases.

An epidemic of acute haemorrhagic conjunctivitis (AHC) occurred in and around Chandigarh, north India, during June, July and August 1981. Considering the difficulty of virus isolation, the indirect immunofluorescence test was used for the demonstration of virus-specific antigen in the cytoplasm of exfoliated conjunctival cells, using reference antisera. The epidemic appeared to be primarily due to enterovirus type 70. The method was found suitable for the rapid diagnosis of AHC cases and for detecting subclinical infection among healthy subjects and convalescent carriers. During follow-up, it was observed that some of the AHC cases were shedding virus-infected conjunctival cells for a prolonged period, even after clinical recovery and during convalescence, before they became free from virus. In the absence of virus isolation, this method can be considered as suitable for the epidemiological monitoring of AHC.

Bilateral spontaneous regression of retinoblastoma with dominant transmission.

A young man with three patches of regressed retinoblastoma with good visual acuity is described. The other eye was phthisical. Circumstantial evidence suggests that this eye also has a regressed retinoblastoma. The patient's daughter showed histopathologically confirmed well-differentiated retinoblastoma.