Ocular acne rosacea in tertiary eye center in Saudi Arabia.

PURPOSE: To report the most common presenting signs and symptoms of ocular rosacea for timely diagnosis and management. METHODS: A retrospective chart review of 23 patients with a diagnosis of acne rosacea or a non-specific diagnosis was performed at a tertiary eye hospital. Patients with lid changes such as recurrent blepharitis; meibomianitis; recurrent chalazia; facial skin change such as papules, telangiectatic blood vessels, and/or rhinophyma were included. Data were collected on patient demographics, presenting symptoms, visual acuity, dermatologic findings and treatment. RESULTS: There were 23 patients documented with acne rosacea with dermatologic facial findings associated with lid and/or corneal findings of peripheral thinning and vascularization. Two cases had a serious spontaneous peripheral corneal perforation. Most of the patients had no clinically significant change in visual acuity. CONCLUSION: The diagnosis of ocular acne rosacea was straightforward despite non-specific findings. Diagnostic delay can result in serious complications.

Anterior Segment Injury by a High-Power Handheld Blue Laser Device.

PURPOSE: To report a case of severe anterior segment inflammation secondary to exposure to a high-power blue laser device. METHODS: Case report. RESULTS: A 14-year-old male presented with redness, pain and decreased vision in his left eye after exposure to blue laser. Examination indicated severe conjunctival injection associated with 4+ cells in the anterior chamber with fibrinous reaction. The posterior pole was normal. CONCLUSION: Blue laser devices are easily available through the Internet. These devices can cause devastating ocular injuries. National safety guidelines are required to regulate use.

Toxic keratitis after use of wrongly labeled non-ophthalmic medication.

We present a 24-year-old female with trauma to her right eye. The patient was prescribed topical Tobramicin-dexamethasone eye drops but the pharmacy dispensed diclofenac diethyl amine ointment. The patient presented to the emergency room with lid edema, conjunctival injection and a corneal epithelial defect and toxic keratitis. The patient was successfully managed with copious irrigation, bandage contact lens and topical antibiotic therapy.

Corneal Epitheliopathy After Trauma by Fake Snow Powder in a 7-year-old Child.

Fake snow is a polymer of sodium polyacrylates used in games and celebrations. Despite the product leaflet that indicates safety, contact with the ocular surface can cause injury. We report a case of a child with corneal epitheliopathy due to a chemical burn injury after ocular surface contact with fake snow. The case was managed with epithelial debridement and a bandage contact lenses and topical antibiotics with complete resolution.

Ocular manifestation of Ichthyosis.

PURPOSE: Ichthyosis is a rare dermato-ocular disease. This study evaluates the presenting ocular signs, symptoms, complications and prognosis of ichthyosis in a case series from Saudi Arabia. METHODS: A retrospective chart review was performed for 11 patients with ichthyosis who presented to King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, over the last 20 years. RESULTS: The most common presenting ocular diagnosis was ectropion of both the lids. Two patients developed corneal perforation with poor prognosis. Most of the patients underwent skin grafting to repair eyelid ectropion. The visual prognosis was excellent because timely surgical interventions were performed. Hence the rate of corneal complications such as perforation was low. CONCLUSION: The most ocular presentation of ichthyosis is ectropion of both the upper and lower lids. Despite good visual prognosis, there were some devastating corneal complications such as perforation with unpredictable outcomes.

Resolution of childhood recurrent corneal phlyctenulosis following eradication of an intestinal parasite.

Phlyctenular keratoconjunctivitis is a nodular foreign antigen delayed hypersensitivity reaction typically due to staphylococcal protein (but potentially secondary to antigen from a variety of different organisms, eg, mycobacteria and intestinal worms).(1-4) Conjunctival phlyctens are usually mild and transient, but corneal phlyctens can be severe and recurrent.(3,4) The subject of this report is a severe recurrent unilateral corneal case in a child whose stool was positive for Hymenolepsis nana. Following treatment for the intestinal parasite, the child no longer suffered from recurrent ocular surface inflammation.