{"title":"Active removal of anterior segment-migrated dexamethasone implant (Ozurdex®)","authors":"Jozef Adelson M. Depla, M. Veckeneer, I. Bleyen","doi":"10.3205/oc000195","DOIUrl":"https://doi.org/10.3205/oc000195","url":null,"abstract":"Background: Ozurdex® (Allergan plc., Dublin, Ireland) is an intravitreal sustained-release dexamethasone (DEX) implant. The implant has been reported to migrate into the anterior chamber, potentially causing corneal decompensation. Prompt removal or relocation in the vitreous cavity is advised but troublesome due to its fragility. Several techniques exist, but elaborate setup and specialized surgical skills that are required may cause delay in treatment. We report a novel technique that avoids these shortcomings. Case presentation: A 59-year-old woman presented to the emergency department with visual loss due to an anterior chamber-migrated DEX implant and corneal edema. Using an ophthalmic viscosurgical device (OVD) and a bent 19-gauge needle, the implant has promptly been removed in a one-minute procedure under topical anesthesia. Conclusion: Aspirating an anterior chamber-migrated DEX implant using a 19-gauge bent needle is a cost-effective, time-efficient and safe technique, not requiring specialized surgical skills.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49599786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unilateral simultaneous optic nerve and choroidal infiltration - unusual presentation of metastatic disease in breast carcinoma.","authors":"Poninder Kumar, Ashok Kumar, Srujana Dubakka, Jaya Kaushik, Mohini Agrawal","doi":"10.3205/oc000187","DOIUrl":"https://doi.org/10.3205/oc000187","url":null,"abstract":"<p><p>Breast carcinoma metastasis can involve any ocular structures, but involvement of the optic nerve is extremely rare. Choroidal metastasis is usually multifocal as well as bilateral and occurs late. We report an unusual initial presentation of metastasis from breast cancer; unilateral infiltrative optic neuropathy with concurrent choroid metastatic deposits in an adequately treated middle-aged female. Our present case, wherein for the first time in the literature, we illustrated unilateral infiltrative optic neuropathy and choroidal metastatic deposits secondary to breast carcinoma, will increase our knowledge about the various potential ocular presentations of this relatively common malignant disease.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc14"},"PeriodicalIF":0.0,"publicationDate":"2021-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39519115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GMS ophthalmology casesPub Date : 2021-08-04eCollection Date: 2021-01-01DOI: 10.3205/oc000186
Ujjwala Narang, Laura Maubon, Vishal Shah, Vijay Wagh
{"title":"Ocular trauma or Oedipism: completing the evisceration.","authors":"Ujjwala Narang, Laura Maubon, Vishal Shah, Vijay Wagh","doi":"10.3205/oc000186","DOIUrl":"https://doi.org/10.3205/oc000186","url":null,"abstract":"<p><p>Self-enucleation, also known as Oedipism, is a rare form of ocular trauma. The objective of this clinical case report is to highlight the importance of diagnosing this unusual injury and thus ensuring its appropriate management. We herein describe a case of a 58-year-old man who presented to hospital with a bleeding left eye. Initially, limited history was provided, however, on further enquiry it was revealed that he had paranoid schizophrenia. The patient eventually had to be sectioned with assistance from the Police and Psychiatry team, upon discovery of self-inflicted mechanism of injury. Subsequently, the patient had evisceration of the left eye and afterwards, demonstrated insight into the pre-operative problems. Literature review emphasizes the importance of close cooperation required between medical specialities to ensure that the underlying cause, usually schizophrenia, is managed in conjunction to the eye injury in order to provide optimum care for the patient.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc13"},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39430091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GMS ophthalmology casesPub Date : 2021-07-28eCollection Date: 2021-01-01DOI: 10.3205/oc000185
Yamini Attiku, Pukhraj Rishi
{"title":"Miliary tuberculosis presenting as bilateral pseudo-retinoblastoma.","authors":"Yamini Attiku, Pukhraj Rishi","doi":"10.3205/oc000185","DOIUrl":"https://doi.org/10.3205/oc000185","url":null,"abstract":"<p><p><b>Objective:</b> To describe an interesting case of miliary tuberculosis mimicking retinoblastoma. <b>Method:</b> A retrospective case report. <b>Result:</b> The twin brother of a known case of retinobastoma presented with headache. On fundus examination, multiple yellowish-white lesions were noted in both eyes. Magnetic resonance imaging of the brain showed multiple enhancing lesions. A diagnosis of miliary tuberculosis was made and anti-tubercular therapy was started. <b>Conclusion:</b> Ocular tuberculosis can mimic retinoblastoma and lead to diagnostic dilemma especially in cases with family history of retinoblastoma.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc12"},"PeriodicalIF":0.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39431105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GMS ophthalmology casesPub Date : 2021-07-20eCollection Date: 2021-01-01DOI: 10.3205/oc000184
Ameay V Naravane, Jacquelyn Weber, Grishma Barucha, Joshua H Hou
{"title":"Acute anterior uveitis after topical interferon for conjunctival intraepithelial neoplasia (CIN).","authors":"Ameay V Naravane, Jacquelyn Weber, Grishma Barucha, Joshua H Hou","doi":"10.3205/oc000184","DOIUrl":"https://doi.org/10.3205/oc000184","url":null,"abstract":"<p><p><b>Objective:</b> Ocular surface squamous neoplasia (OSSN) is the most common type of non-melanocytic ocular surface tumor. Conjunctival intraepithelial neoplasia (CIN) is a type of OSSN that be medically managed by either topical interferon alpha-2b (IFN α-2b), 5-fluorouracil (5-FU), or mitomycin C. While a paradoxical response to IFN α-2b in the HIV population has been reported, we report a case of a paradoxical response in an immunocompetent individual. <b>Methods:</b> A 65-year-old immunocompetent female presents to the clinic with CIN. <b>Results:</b> She is started on topical IFN α-2b, resulting in an unexpected hypopyon, increased corneal epithelial defect, and increased size of the lesion. Switching to topical 5-FU resulted in decreasing size of the CIN lesion and resolution of the epithelial defect. <b>Conclusions:</b> Topical IFN α-2b can produce a paradoxical worsening of CIN lesions in some patients. Providers should be aware of this reaction, as well as the presenting signs and symptoms, to make appropriate treatment changes when treating CIN.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc11"},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39431104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Infectious crystalline keratitis induced by Citrobacter.","authors":"Zeba Khanam, Gaganjeet Singh Gujral, Shariq Wadood Khan","doi":"10.3205/oc000182","DOIUrl":"https://doi.org/10.3205/oc000182","url":null,"abstract":"<p><p><b>Background:</b> Microbial keratitis is an important cause of ocular morbidity, with emerging organisms and drug resistance posing a real threat to vision of patients. <b>Case presentation:</b> A 30-year-old female presented with infective keratitis in the left eye. She had been using rose nectar as home remedy for her ailment. With no improvement in her symptoms, she presented to the eye emergency department, where she was started on empirical therapy with moxifloxacin, which was shifted to levofloxacin eye drops after the antimicrobial susceptibility test results came in. Microbiological examination revealed infection with rare gram-negative bacilli <i>Citrobacter koseri</i>. The patient responded well to the treatment with 1.5% levofloxacin eye drops and her vision improved from 20/120 to 20/30 over a course of 3 months. <b>Conclusion:</b> Treatment of microbial keratitis with those antibiotics that the organism is most sensitive to is of paramount importance today, where we often find patients on a cocktail of eye drops, which leads to further resistance and vision deterioration. Culturing of cornea scrapings and antimicrobial susceptibility testing of the isolated organism is now the standard guideline to be followed in the investigation of microbial keratitis.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc09"},"PeriodicalIF":0.0,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39092028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GMS ophthalmology casesPub Date : 2021-05-17eCollection Date: 2021-01-01DOI: 10.3205/oc000183
George Castle, Gregory Heath
{"title":"Endogenous ocular nocardiosis.","authors":"George Castle, Gregory Heath","doi":"10.3205/oc000183","DOIUrl":"https://doi.org/10.3205/oc000183","url":null,"abstract":"Nocardiosis is an extremely rare, opportunistic, Gram-positive bacterial infection that has a high mortality rate in those patients who are immunocompromised in the presence of disseminated disease. We describe a case of an elderly lady being treated with high-dose corticosteroids for giant cell arteritis that presented with ischaemic optic atrophy. Subsequent deterioration was accompanied by the development of subretinal lesions. Further extensive evaluation discovered she had pulmonary nocardiosis with widespread dissemination. The case has several learning points, in particular: Subretinal abscesses maybe a harbinger of serious hitherto undiagnosed infection which portend a poor prognosis. Vital signs in the immunocompromised may appear to be normal in the presence of serious infection.","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc10"},"PeriodicalIF":0.0,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39109808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GMS ophthalmology casesPub Date : 2021-05-11eCollection Date: 2021-01-01DOI: 10.3205/oc000181
Fani Akritidou, Konstantina Misiou, Elina Tsanidou, Georgios N Katsaras, Theodora Papamitsou
{"title":"Unexpected hair regrowth in a woman with longstanding Alopecia universalis.","authors":"Fani Akritidou, Konstantina Misiou, Elina Tsanidou, Georgios N Katsaras, Theodora Papamitsou","doi":"10.3205/oc000181","DOIUrl":"https://doi.org/10.3205/oc000181","url":null,"abstract":"<p><p>Alopecia areata (AA) is an autoimmune disorder leading to non-scarring hair loss. As long as hair follicles are not destroyed, the potential for hair regrowth remains. Alopecia universalis is a severe form of AA and the chance of full hair regrowth is below 10%. We present a case of a 55-year-old woman with longstanding AA, who presented to the Outpatient Clinic of our Hospital Unit with almost full eyelashes and hair regrowth after an emotional stressful event. She reported no hair regrowth for the last 35 years. There are few case reports which have exhibited that hair follicles are still alive and may be reactivated after many years.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc08"},"PeriodicalIF":0.0,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39092027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GMS ophthalmology casesPub Date : 2021-03-29eCollection Date: 2021-01-01DOI: 10.3205/oc000180
Madhivanan Nivean, Devi Pratheeba Nivean, Rithula Raja
{"title":"An innovative alternative for spherophakia.","authors":"Madhivanan Nivean, Devi Pratheeba Nivean, Rithula Raja","doi":"10.3205/oc000180","DOIUrl":"https://doi.org/10.3205/oc000180","url":null,"abstract":"<p><p><b>Objective:</b> The aim of this case report is to report a new aphakic intraocular lens (IOL) that can be used for spherophakia. <b>Methods:</b> This is a single case report wherein the authors elaborate the technique of inserting the new IOL design in patients with spherophakia. <b>Results:</b> This new IOL design is very stable and is very promising in our follow-up of 6 months. <b>Conclusion:</b> The CM T-flex IOL can be a simple and alternate option for correcting aphakia.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc07"},"PeriodicalIF":0.0,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38932254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
GMS ophthalmology casesPub Date : 2021-03-12eCollection Date: 2021-01-01DOI: 10.3205/oc000179
Stefano Erba, Andrea Govetto, Antonio Scialdone, Giuseppe Casalino
{"title":"Role of optical coherence tomography angiography in Vogt-Koyanagi-Harada disease.","authors":"Stefano Erba, Andrea Govetto, Antonio Scialdone, Giuseppe Casalino","doi":"10.3205/oc000179","DOIUrl":"https://doi.org/10.3205/oc000179","url":null,"abstract":"<p><p>Vogt-Koyanagi-Harada disease (VKH) is an autoimmune severe multisystem condition characterized by both ocular and systemic findings that should be promptly recognized and treated. Although invasive imaging modalities, namely fluorescein angiography and indocyanine green angiography, are still the gold standard for the diagnosis and follow-up of the ocular findings in VKH, the role of retinal non-invasive imaging including optical coherence tomography angiography (OCTA) is under investigation and is not mentioned in the current diagnostic criteria of VKH. The aim of this manuscript was to report the clinical course and the multimodal retinal imaging of a VKH case and to discuss the role of OCTA in this condition. Our case supports the evidence that OCTA is able to help determine disease activity and progression in VKH. We therefore contend that OCTA should be considered for future developing diagnostic criteria of this condition.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"11 ","pages":"Doc06"},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25541135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}