[Unilateral optic neuritis and Miller Fisher syndrome]. / Neuropathie optique unilatérale et syndrome de Miller Fisher.

INTRODUCTION: Miller Fisher syndrome is an autoimmune neuropathy characterized by the clinical triad of ataxia, areflexia and external ophthalmoplegia. Ophthalmologic involvement in this syndrome is most often represented by motility disorders. The diagnosis is confirmed by the presence of anti-GQ1b antibodies. OBSERVATION: We report the case of a 65-year-old patient referred by his treating physician to the emergency department for ataxia, dizziness and decreased visual acuity in the left eye. In addition, the patient presented with clinical signs of subacute appendicitis for 2 weeks. After treatment with intravenous immunoglobulin, the patient complained of further decreased visual acuity and oculomotor disorders. On ophthalmological follow-up, he quickly recovered his initial visual acuity and more gradually his ocular motility. DISCUSSION: Unilateral optical neuropathy does not preclude the diagnosis of Miller Fisher syndrome. On the contrary, in the case of any rapidly progressive ophthalmologic involvement associated with peripheral neurological signs of ataxia, the diagnosis of Miller Fisher syndrome must be considered. CONCLUSION: Miller Fisher is a rare syndrome for which the diagnosis must be made quickly, so that the patient may benefit from urgent intravenous immunoglobulin therapy. In most cases, ophthalmologic recovery precedes peripheral neurologic recovery by 6 months to 1 year.

[Contextual study of Airsoft gun related ocular injuries]. / Étude contextuelle des accidents ophtalmologiques par pistolets Airsoft.

INTRODUCTION: Airsoft guns have become more common in France since the Decree of March 24, 1999, allowing people over 18 years of age to use weapons with an energy level below 2J. The present study aimed to assess the relationship between the context of Airsoft gun pellet related ocular injuries and their clinical consequences, in order to determine an effective prevention strategy. METHODS: A retrospective analysis of ocular injuries due to Airsoft gun pellets was conducted in two hospitals in northern France between September 2009 and August 2010. RESULTS: Six patients with a mean age of 12.6 ± 3.2 years were included. The most frequent injuries were corneal abrasion, hyphema and iris trauma. Functional sequelae were observed in 50% of cases and surgical intervention was necessary in one third of cases. A direct shot had occurred in all cases. In 83% of cases, the accident took place while playing in or around the house. In one out of every two cases, the gun had been won at a booth in a fair or had been purchased in a big-box store and in no cases did the patients own safety glasses. CONCLUSION: The strong appeal of Airsoft guns to minors leads us to propose several practical measures to help protect them, with the main one being to forbid selling these guns outside of specialized stores.

[Aicardi syndrome with unilateral ocular involvement]. / Atteintes ophtalmologiques unilatérales dans le syndrome d'Aicardi.

INTRODUCTION: Aicardi syndrome is a severe congenital disorder affecting females and characterized by a triad of symptoms, including infantile spasms, agenesis of the corpus callosum and chorioretinal lacunae. OBSERVATIONS: This retrospective study demonstrates that three out of eight children followed at CHRU of Lille for Aicardi syndrome exhibited unilateral chorioretinal lacunae. For these patients, the condition was diagnosed prior to 6months based on abnormal fundus exam as well as neurological and radiological (MRI) abnormalities. DISCUSSION: These patients with Aicardi syndrome have unilateral ocular abnormalities. Moreover, the differential diagnosis must be considered in the presence of microcephaly, chorioretinal dysplasia and mental retardation. CONCLUSION: Unilateral chorioretinal lacunae do not rule out the diagnosis of Aicardi syndrome in the presence of psychomotor retardation and agenesis of the corpus callosum on magnetic resonance imaging.