Anterior segment infiltration in acute lymphoblastic leukemia (ALL) presenting as hypopyon uveitis in an adult is rare. We report this case as an uncommon presentation in a patient in remission after ...chemotherapy for ALL. In addition to the hypopyon, the patient presented with congested eye caused by secondary raised intraocular pressure. There is a need to maintain a high index of clinical suspicion in uveitis cases, as early diagnosis of ocular malignancy can save vision. Atypical unilateral hypopyon, even in adults, can be an indication of relapsing ALL.
Purpose: High-altitude pulmonary edema (HAPO) is an acute medical emergency occurring typically in lowlanders, who ascend rapidly to heights of 3000 m or more. It presents with marked dyspnea on ...exertion, fatigue with minimal-to-moderate effort, prolonged recovery time, and dry cough with manifestations of cyanosis, tachycardia, tachypnea, and temperature which generally does not increase beyond 38.5°C. The condition may be fatal if not treated in time with supplemental oxygen or hyperbaric oxygen or rapid descent to lower altitude. There is paucity in literature on changes in corneal thickness in HAPO. The effect of continued oxygen therapy on corneal thickness has also not been studied in detail. Hence, this study was conducted at high altitude among physician-confirmed HAPO cases. Methods: A case-control study was conducted at an altitude of 11,400 feet. Cases were patients suffering from HAPO and controls were patients admitted in hospital for low back pain, fractures, and minor surgical procedures. Central corneal thickness (CCT) was measured with an ultrasound pachymeter on day 1 of hospitalization and every day of hospital stay. Systemic oxygen concentration was also measured daily. Results: There was no statistically significant difference in corneal thickness between two groups at the onset of illness, but a significant decrease in CCT was found in both right and left eyes in HAPO cases when oxygen levels were increased by giving supplemental oxygen. Hierarchical modeling showed a decrease in 1.3 μm in CCT with one unit increase in oxygen mmHg in cases. Conclusion: The findings of statistically insignificant difference in CCT between HAPO cases and controls and a decrease in CCT in HAPO cases on being treated with systemic oxygenation are points to ponder about.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To report a case of unilateral posterior dislocation of the cataractous lens and subluxation of the lens in the fellow eye of a patient with Parkinson-plus syndrome.
A 67-year-old-man who was a known ...case of Parkinson-plus syndrome on long-term dopamine agonists and anti-psychotic medications demonstrated apraxia of lid opening associated with moderate-to-severe blepharospasm. He had unilateral posterior dislocation of the cataractous lens and subluxation of the lens in the fellow eye with no prior history of trauma or other known ocular risk factors.
This case may represent an unusual example of spontaneous lens dislocation secondary to apraxia of lid opening and concurrent blepharospasm, which is associated with Parkinson-plus syndrome.
Introduction: To study the ocular changes in patients on long term treatment with Hydroxychloroquine (HCQ); and detect means for early detection of toxicity.Methods: We conducted a cross-sectional ...observational study at a tertiary care hospital, in which 100 patients, male and female, aged 35 years or more, taking HCQ for 5 years or more were included. Patients with any known ocular or systemic diseases were not included. Indication, dosage, duration and cumulative dose of HCQ intake were recorded. History of ocular symptoms, visual acuity, colour vision, complete ophthalmic examination, visual field using Amsler grid and 10-2 Humphrey’s automated fields (HVF), Spectral Domain Optical Coherence Tomography (SD-OCT), colour fundus photography, fundus fluorescein angiography (FFA) and fundus autofluorescence (FAF) were recorded. The data was analyzed using descriptive and inferential analysis.Result: 15% of the study population showed signs of HCQ related ocular toxicity. 17%, 21% and 10% patients had abnormal SD-OCT, HVF and FAF findings respectively.Conclusion: HCQ related ocular toxicity has been found in patients in the absence of symptoms. Objective tests like HVF, SD- OCT and FAF were more useful in early detection of toxicity than subjective tests such as Amsler grid, colour vision and FFA.
PRéCIS:Swedish Interactive Threshold Algorithm (SITA) Faster (SFR) saves considerable test time but needs further amendments for considering it to be an accurate test that can replace SITA Fast (SF) ...or SITA Standard (SS).
PURPOSE:To compare visual field results obtained using SFR, SF, and SS programs in patients with manifest and suspect glaucoma.
MATERIALS AND METHODS:In this cross-sectional observational study involving manifest patients with glaucoma and glaucoma suspects, perimetric outcomes of SFR, SF, and SS were compared. Outcomes included test time, mean deviation, pattern standard deviation (PSD), Visual Field Index (VFI), foveal threshold, number of points depressed at P<5%, P<2%, P<1%, and P<0.5% on PSD probability plot, individual threshold test points, glaucoma hemifield test, and grade of field defect.
RESULTS:Seventy eyes of 70 patients were included in this study. SFR test times averaged 36.1% shorter than SF and 60.7% shorter than SS (P<0.001). Mean deviation values were lower with SFR compared with both SF and SS (Δ=1.5, P<0.001). Mean PSD and VFI showed no significant differences between the algorithms. The mean foveal threshold was higher for SFR compared with SF (Δ=1.6, P<0.001) and SS (Δ=2.1, P<0.001). The number of points depressed at P<0.5% was lesser in SFR than in both SF and SS (P=0.002). Bland-Altman plots showed that considerable variability existed between the algorithms.
CONCLUSION:SFR provides benefits in test time and shows similar VFI compared with SF and SS. However, the detection of early cases with SFR is questionable and few modifications are needed in the future to improve its accuracy. SF and SS gave almost similar results. The algorithms cannot be used interchangeably for the same patient on different test sessions.
Strabismus and anisometropia are the most common causes of amblyopia. It can be easily prevented or treated if detected early. With the changing socio-cultural-economic milieu of the society, the ...perspectives of strabismus in society are gradually changing but still adequate knowledge, awareness, and attitude of parents toward strabismus will help in preventing amblyopia and aid in the proper psychosocial adaptation of such children. This study aimed to assess knowledge and attitude of parents toward children suffering from strabismus.
A prospective study was carried out from January 1 to February 29, 2016, through a structured questionnaire to assess the level of knowledge and attitude of parents of children suffering from strabismus.
One hundred and twenty parents of children with strabismus were interviewed through a questionnaire. Education level of 78 parents was less than graduation (60%) and of 42 parents (40%) was graduation or higher. The majority of the parents, i.e., 116 (96.67%) were bothered due to strabismus. One hundred and one (84.17%) parents felt that their child's strabismus was noticed by others during interaction. Seventy-four (61.67%) parents felt that their children will have difficulty in making friends. Ninety (75%) parents felt uncomfortable if someone asked something about their child's strabismus. One hundred and ten (91.67%) parents considered strabismus as cosmetic stigma.
Some parents, especially from the lower educated segment, had poor understanding of strabismus, thus resulting in late presentation and ineffective countermeasures. The key to prevent strabismic amblyopia and its psychosocial impacts is to provide health education regarding strabismus.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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