[Kearns-Sayre syndrome: a case report]. / Le syndrome de Kearns-Sayre: à propos d'un cas.

Kearns-Sayre syndrome (KSS), first described in 1958, is a multisystem disease defined by a characteristic triad of progressive external ophthalmoplegia, pigmentary retinopathy and atrioventricular block. These signs are frequently associated with increased cerebrospinal fluid protein level and cerebellar ataxia. This syndrome is caused by deletions in mitochondrial DNA, the age of onset is generally below 20, and the degree of severity differs between patients, as well as the prognosis, which may be fatal. The ocular manifestations include: bilateral ptosis, progressive external ophthalmoplegia and atypical pigmentary retinopathy. By way of this case report, the authors discuss the epidemiologic, clinical and therapeutic aspects of KSS, including the difficulty in managing ptosis in these cases.

Diagnosis and management of palpebral anthrax.

Anthrax is an infectious disease that is not well known by ophthalmologists. In its cutaneous form, it may produce lesions of the eyelids. We report eight cases of palpebral anthrax. All patients presented with a black necrotic eschar and a tegumentary edema, with a history of contact with sick animals. The curative treatment was based on intravenous penicillin G in four cases and amoxicillin-clavulanic acid in the four other cases. The palpebral lesions resolved, leaving no clinical evidence of eyelid abnormalities in six patients. Only two patients developed a cicatricial ectropion and a palpebral symphysis. Although palpebral anthrax is a rare disease in humans, ophthalmologists should be aware of its symptoms and management.

[Choroidal tuberculosis: reports of 3 cases]. / La tuberculose choroïdienne: à propos de 3 cas.

Tuberculosis is a chronic infection with a high incidence in Morocco. Ocular involvement is rare. We report three cases of choroidal tuberculosis. Case no 1: A 24-year-old female with tuberculous meningitis, multifocal choroiditis in the right eye and choroidal granuloma in the left eye. Case no 2: A 22-year-old female with multifocal tuberculosis. The ocular examination showed a choroidal granuloma. Case no 3: A 25-year-old male with HIV infection and miliary tuberculosis. Ocular involvement consisted in a choroidal granuloma. Ocular involvement in tuberculosis is uncommon. Choroidal granuloma is a characteristic manifestation.

[Orbital apex syndrome secondary to herpes zoster infection. A case report]. / Syndrome de l'apex orbitaire sur zona ophtalmique.

The orbital apex syndrome is defined by the association of visual loss, ophtalmoplegia, blepharoptosis, proptosis along with forehead and upper eyelid anesthesia. This syndrome is secondary to traumatism, malignancy or infection of orbital apex. Herpes zoster is an uncommon cause. We discuss the physiopathologic mechanism, evolution and management of this affection.

[Iris metastasis from lung cancer]. / Métastases iriennes d'un adénocarcinome bronchique.

A 47-year-old man with a history of lung adenocarcinoma presented a red and painful right eye with loss of visual acuity after the 5th course of chemotherapy. The ophthalmologic exam showed visual acuity at 3/10 and diffuse iris nodular lesions in the same eye. The fundus was not visible. The controlateral eye was normal. The ocular scan showed iris tumors without choroidal metastasis. Systemic medical evaluation demonstrated no other metastases. The patient died 1 year later.

[Ophthalmomyiasis interna: two case studies]. / Ophtalmomyiase interne: à propos de deux cas.

Myiasis is a pathology caused by the presence of fly larvae in the human organism. Ophthalmomyiasis interna is characterized by the presence of the parasite within the eye but also in the eyelids and the orbit. Herein, the authors present the clinical cases of two patients presenting ophthalmomyiasis interna revealed by retinal detachment for the first patient and by panuveitis for the second patient. These two cases should make ophthalmologists aware of this rare disease that can effect patients living in direct contact with ovine races.

Management of a severe cranio-orbito-facial trauma with a dislocation of the globe into the maxillary sinus.

We report two cases of severe cranio-orbito-facial trauma associated with a dislocation of the globe into the maxillary sinus. Simultaneous surgical repositioning the globe in the orbit and reconstruction of the orbital floor defect with an autogenous bone was performed in the first case. Postoperatively, the globe was in a normal position with a moderately reduced motility. The patient's visual acuity was reduced to light perception while indirect ophthalmoscopy was normal. In the second case, no surgery could be attempted because the patient never regained consciousness and died 7 days after the trauma. Although the visual prognosis of such conditions is usually considered to be extremely poor, avoiding primary enucleation and deploying all efforts to preserve the eye, aims at helping the patient to recover psychologically from the trauma and allows to improve her/his cosmetic aspect.

[Two cases of Wolfram syndrome]. / Syndrome de Wolfram. A propos de deux cas.

Wolfram syndrome is a rare autosomal recessive neurodegenerative disease; it is characterized by the appearance of diabetes mellitus in childhood associated with bilateral optic atrophy that often leads to blindness. Insipid diabetes, deafness, psychiatric disorders, anosmia, anomalies of the urinary tract, nystagmus, ataxia, and myoclonias are less frequent. We report two cases of Wolfram syndrome, diagnosed in a 12-year-old girl and a 13-year-old boy. In each case, there was a history of diabetes mellitus; they consulted for a progressive loss of vision. Ophthalmologic examination objectified that visual acuity was reduced to finger counting in both eyes as well as isolated bilateral optic atrophy and constriction of the peripheral visual field. Through these two cases and a review of the literature, we propose to study the genetic and clinical aspects of Wolfram syndrome.

[A recent case of palpebral anthrax]. / Charbon palpébral: à propos d'un cas.

Anthrax disease is an acute infection caused by Bacillus anthracis. It appears in three forms: pulmonary, intestinal, and cutaneous, whose palpebral location is rare but serious. The authors report the case of a 38-year-old patient who presented 3 weeks after the appearance of an upper and lower palpebral tumefaction. Questioning revealed that he was a cattle breeder. The ophthalmologic examination of the right eye brought out serosanguineous blisters, an edema, and necrotic scabs involving the upper and lower eyelids, preventing any clinical examination of the ocular bulb. The bacteriological sample was negative. The patient progressed well when treated with G penicillin, but retained a cicatricial ectropion. Anthrax is receiving increasing interest given how difficult it is to diagnose, the severe prognosis, and the possibility of its dissemination in bacteriological warfare or bioterrorism.