Sphenoid wing meningiomas are slow-growing tumors that originate from outer arachnoid meningeal epithelial cells. They can present with progressive symptoms of an orbital or temporal fossa mass, including temporal fullness, proptosis, globe displacement, ptosis, and impaired ocular motility. The ophthalmic manifestations of sphenoid wing meningiomas vary depending on the location of the primary tumor. In this case report, we discuss a 52-year-old female with meningioma of unusual presentation which was reported to be removed completely, and recurrence was noticed after a lapse of 3 years with subsequent extension into the orbit resulting in the structural and functional destruction of the eye.
{"title":"Recurrent sphenoid wing meningioma extending into the orbit","authors":"Cherungottil Radhadevi, Kaplinghat Bhavadasan, Kolady Jayakrishnan","doi":"10.4103/kjo.kjo_30_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_30_21","url":null,"abstract":"Sphenoid wing meningiomas are slow-growing tumors that originate from outer arachnoid meningeal epithelial cells. They can present with progressive symptoms of an orbital or temporal fossa mass, including temporal fullness, proptosis, globe displacement, ptosis, and impaired ocular motility. The ophthalmic manifestations of sphenoid wing meningiomas vary depending on the location of the primary tumor. In this case report, we discuss a 52-year-old female with meningioma of unusual presentation which was reported to be removed completely, and recurrence was noticed after a lapse of 3 years with subsequent extension into the orbit resulting in the structural and functional destruction of the eye.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"161 - 163"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49579584","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}
Aim: Cyanoacrylate synthetic glue is an instant acting adhesive material often used for household, biomedical and industrial requirements. Accidental instillation of glue into eyes seems to be the commonest mode of chemical eye injuries especially in the paediatric and geriatric population. Methods: A series of five cases of synthetic glue eye injuries following accidental instillation into eyes that presented to our hospital were reported. Results: All the cases were managed conservatively as per the current guidelines with good visual outcome. Conclusion: These case series highlight how even daily activities utilizing the superglue may result in unexpected serious eye injuries. Creating awareness and provision of immediate medical aid can prevent ocular morbidity in such eye injuries.
{"title":"Falling prey to superglue ocular injuries: A case series","authors":"Agrima Bhatia, S. Mohan, S. Reddy","doi":"10.4103/kjo.kjo_20_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_20_22","url":null,"abstract":"Aim: Cyanoacrylate synthetic glue is an instant acting adhesive material often used for household, biomedical and industrial requirements. Accidental instillation of glue into eyes seems to be the commonest mode of chemical eye injuries especially in the paediatric and geriatric population. Methods: A series of five cases of synthetic glue eye injuries following accidental instillation into eyes that presented to our hospital were reported. Results: All the cases were managed conservatively as per the current guidelines with good visual outcome. Conclusion: These case series highlight how even daily activities utilizing the superglue may result in unexpected serious eye injuries. Creating awareness and provision of immediate medical aid can prevent ocular morbidity in such eye injuries.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"149 - 153"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49249146","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":"Ophthalmic simulation: The need of the times","authors":"Smita Narayanan","doi":"10.4103/kjo.kjo_62_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_62_22","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"89 - 91"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46017884","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}
S. Anilkumar, Navaneeth Saggam, Madhuri Thotakura, R. Rammohan, K. Narendran
Purpose: This study aims to describe the visual and surgical outcomes of 810 eyes of 805 patients who underwent unilateral cataract surgery on the same day with 1 h of preoperative antibiotic regimen. Setting: Tertiary Care Ophthalmic Hospital. Design: Retrospective, descriptive study. Methods: This study comprised of consecutive adult patients who underwent preoperative cataract work up, received 1 h of preoperative antibiotic regimen, and underwent cataract surgery on the same day of consultation with a minimum 3-week follow-up period. This study describes the demographic profile, preoperative, intraoperative details, postoperative (PO) best-corrected visual acuity (BCVA), and surgical outcomes of these patients. Results: 810 eyes of 805 patients with a mean age of 61.0 ± 9.7 years, 50% had systemic and 9% had ocular comorbidities. The mean preoperative BCVA was 0.8 ± 0.7 LogMAR. Phacoemulsification was performed in 90.1%. Intraoperative complications had occurred in 8 (1%) eyes. The mean PO BCVA of the study group on PO day 1 (POD1) and PO 3 weeks was 0.13 ± 0.3 LogMAR and 0.07 ± 0.3 LogMAR, respectively. Our study showed that 95.68% had improvement in vision, while 96.8% achieved BCVA 6/18 or better. None had PO endophthalmitis. Comparison between preoperative and both POD 1 day and PO 3-week BCVA showed statistically significant improvement (P < 0.001). Conclusion: Our study results satisfied the benchmark set by the World Health Organization (WHO) for PO BCVA with good surgical outcome. Preoperative antibiotic applied 1 h before cataract surgery provided safety and comfort and with low risk for endophthalmitis. This strategy can be adopted to tackle the backlog of cataract surgeries due to COVID-19 (or any other emergency situation) in developing countries.
{"title":"Outcome of cataract surgery with 1 h of preoperative antibiotic regimen: A strategy during COVID-19 Pandemic: Study from a tertiary eye care hospital","authors":"S. Anilkumar, Navaneeth Saggam, Madhuri Thotakura, R. Rammohan, K. Narendran","doi":"10.4103/kjo.kjo_190_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_190_21","url":null,"abstract":"Purpose: This study aims to describe the visual and surgical outcomes of 810 eyes of 805 patients who underwent unilateral cataract surgery on the same day with 1 h of preoperative antibiotic regimen. Setting: Tertiary Care Ophthalmic Hospital. Design: Retrospective, descriptive study. Methods: This study comprised of consecutive adult patients who underwent preoperative cataract work up, received 1 h of preoperative antibiotic regimen, and underwent cataract surgery on the same day of consultation with a minimum 3-week follow-up period. This study describes the demographic profile, preoperative, intraoperative details, postoperative (PO) best-corrected visual acuity (BCVA), and surgical outcomes of these patients. Results: 810 eyes of 805 patients with a mean age of 61.0 ± 9.7 years, 50% had systemic and 9% had ocular comorbidities. The mean preoperative BCVA was 0.8 ± 0.7 LogMAR. Phacoemulsification was performed in 90.1%. Intraoperative complications had occurred in 8 (1%) eyes. The mean PO BCVA of the study group on PO day 1 (POD1) and PO 3 weeks was 0.13 ± 0.3 LogMAR and 0.07 ± 0.3 LogMAR, respectively. Our study showed that 95.68% had improvement in vision, while 96.8% achieved BCVA 6/18 or better. None had PO endophthalmitis. Comparison between preoperative and both POD 1 day and PO 3-week BCVA showed statistically significant improvement (P < 0.001). Conclusion: Our study results satisfied the benchmark set by the World Health Organization (WHO) for PO BCVA with good surgical outcome. Preoperative antibiotic applied 1 h before cataract surgery provided safety and comfort and with low risk for endophthalmitis. This strategy can be adopted to tackle the backlog of cataract surgeries due to COVID-19 (or any other emergency situation) in developing countries.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"412 10","pages":"115 - 122"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41286741","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}
Roopashri Lakkundi, Himani Manral, Manasi More, H. Pagad
Stroke has been reported as one of the several deadliest complications noted in COVID-19 infection. Stroke in COVID-19 is multifactorial and has propensity to involve large vessels and multiple territories. The most appealing mechanisms for strokes in COVID infection are the cytokine-induced coagulopathy and the endotheliopathy triggered by the infection. Stroke in young patients has been particularly observed. The treatment is also challenging in terms of judicious use of antithrombotic/anticoagulation agents concomitant to oral or intravenous steroids administration. We report a case of cerebellar stroke/ Wallenberg syndrome in a diagnosed COVID-19 patient with deranged coagulation profile and elevated interleukin-6. She presented with binocular diplopia, oscillopsia and had a very well documented skew deviation with torsional nystagmus. She also had impaired cerebellar functions. We also highlight the characteristic features of COVID stroke, its management, and shed light on the diagnosis of skew deviation and its management.
{"title":"A case of cerebellar stroke/Wallenberg syndrome postx-COVID-19 infection","authors":"Roopashri Lakkundi, Himani Manral, Manasi More, H. Pagad","doi":"10.4103/kjo.kjo_11_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_11_22","url":null,"abstract":"Stroke has been reported as one of the several deadliest complications noted in COVID-19 infection. Stroke in COVID-19 is multifactorial and has propensity to involve large vessels and multiple territories. The most appealing mechanisms for strokes in COVID infection are the cytokine-induced coagulopathy and the endotheliopathy triggered by the infection. Stroke in young patients has been particularly observed. The treatment is also challenging in terms of judicious use of antithrombotic/anticoagulation agents concomitant to oral or intravenous steroids administration. We report a case of cerebellar stroke/ Wallenberg syndrome in a diagnosed COVID-19 patient with deranged coagulation profile and elevated interleukin-6. She presented with binocular diplopia, oscillopsia and had a very well documented skew deviation with torsional nystagmus. She also had impaired cerebellar functions. We also highlight the characteristic features of COVID stroke, its management, and shed light on the diagnosis of skew deviation and its management.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"154 - 156"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45948673","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}
The classification of diabetic retinopathy has been based on 7-field photographs. With advances in retinal imaging, there is an unmet need to reclassify this condition as new predictive factors have been identified in the peripheral retina. In addition, we have transitioned from an era of laser treatment for vision-threatening complications to robust evidence that anti-VEGF therapy can modulate the diabetic retinopathy scores. In this review, the literature on both retinal imaging and role of anti-VEGF on diabetic retinopathy highlights both the merits and shortcomings of available evidence in this area.
{"title":"Update on imaging and anti-VEGF therapy for diabetic retinopathy","authors":"S. Sen, S. Sivaprasad","doi":"10.4103/kjo.kjo_65_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_65_22","url":null,"abstract":"The classification of diabetic retinopathy has been based on 7-field photographs. With advances in retinal imaging, there is an unmet need to reclassify this condition as new predictive factors have been identified in the peripheral retina. In addition, we have transitioned from an era of laser treatment for vision-threatening complications to robust evidence that anti-VEGF therapy can modulate the diabetic retinopathy scores. In this review, the literature on both retinal imaging and role of anti-VEGF on diabetic retinopathy highlights both the merits and shortcomings of available evidence in this area.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"98 - 103"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47529698","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}
Purpose: To present our results of dermis-fat graft as a secondary procedure after implant extrusion. Materials and Methods: A retrospective chart review was performed to examine 34 anophthalmic socket carriers undergoing dermis-fat graft. All patients had a history of ocular trauma and underwent evisceration surgery. Small defects and Grade 5 contracted sockets were not included. The patients reported the complaints of pain and discharge. Data were collected on the characteristics of the exposed implant material and surgical technique used for implant insertion; complications related with dermis-fat graft, cosmesis; and functional results such as the ability to hold an external prosthesis. For socket reconstruction, the graft was taken from the lateral upper quadrant of the gluteal region, 30% larger than the orbital defect. The mean follow-up period was 12.26 ± 1.13 months. Results: Of the 34 patients, 26 had porous polyethylene implants and 8 had acrylic implants. The average diameter of the conjunctival defect with scleral melting was 11.6 mm. The findings encountered in the follow-up of patients who underwent socket reconstruction with dermis-fat graft were as follows: graft necrosis in one patient, reduction in graft size in two patients, insufficient vascularization of the graft in one patient, ptosis in two patients, deep superior sulcus in one patient, cysts over the dermis-fat graft in one patient, and necrosis at the donor site in two patients. Except for two patients with fornices shrinkage, all of them used their ocular prosthesis well. Conclusion: Dermis-fat graft with low complication rate is a good option for anophthalmic socket reconstruction, but care of the donor site should not be neglected.
{"title":"The consequences of dermis fat graft in the reconstruction of anophthalmic socket with large orbital implant exposure","authors":"T. Yazıcıoğlu","doi":"10.4103/kjo.kjo_34_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_34_21","url":null,"abstract":"Purpose: To present our results of dermis-fat graft as a secondary procedure after implant extrusion. Materials and Methods: A retrospective chart review was performed to examine 34 anophthalmic socket carriers undergoing dermis-fat graft. All patients had a history of ocular trauma and underwent evisceration surgery. Small defects and Grade 5 contracted sockets were not included. The patients reported the complaints of pain and discharge. Data were collected on the characteristics of the exposed implant material and surgical technique used for implant insertion; complications related with dermis-fat graft, cosmesis; and functional results such as the ability to hold an external prosthesis. For socket reconstruction, the graft was taken from the lateral upper quadrant of the gluteal region, 30% larger than the orbital defect. The mean follow-up period was 12.26 ± 1.13 months. Results: Of the 34 patients, 26 had porous polyethylene implants and 8 had acrylic implants. The average diameter of the conjunctival defect with scleral melting was 11.6 mm. The findings encountered in the follow-up of patients who underwent socket reconstruction with dermis-fat graft were as follows: graft necrosis in one patient, reduction in graft size in two patients, insufficient vascularization of the graft in one patient, ptosis in two patients, deep superior sulcus in one patient, cysts over the dermis-fat graft in one patient, and necrosis at the donor site in two patients. Except for two patients with fornices shrinkage, all of them used their ocular prosthesis well. Conclusion: Dermis-fat graft with low complication rate is a good option for anophthalmic socket reconstruction, but care of the donor site should not be neglected.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"130 - 136"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42059121","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}
Lens coloboma can occur with ocular or systemic associations like Marfan's and Stickler's syndrome. Causes of poor vision include refractive error, anisometropia and amblyopia. Visual rehabilitation and surgery is technically challenging in these patients. Here we report a child with progressive defective vision with Marfans syndrome and lens coloboma who underwent successful surgery with intraocular lens (IOL) placement. The bag was stabilised with capsule tension ring and iris hooks, and the IOL was further stabilised with optic capture. Postoperatively, the child regained good vision in the operated eye with very good centration of the IOL at three month follow up visit.
{"title":"Bilateral lens coloboma in child with Marfan's syndrome treated with lens surgery","authors":"S. Ganesh, Krishnababu, S. Elizabeth, Jogitha","doi":"10.4103/kjo.kjo_120_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_120_21","url":null,"abstract":"Lens coloboma can occur with ocular or systemic associations like Marfan's and Stickler's syndrome. Causes of poor vision include refractive error, anisometropia and amblyopia. Visual rehabilitation and surgery is technically challenging in these patients. Here we report a child with progressive defective vision with Marfans syndrome and lens coloboma who underwent successful surgery with intraocular lens (IOL) placement. The bag was stabilised with capsule tension ring and iris hooks, and the IOL was further stabilised with optic capture. Postoperatively, the child regained good vision in the operated eye with very good centration of the IOL at three month follow up visit.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"34 1","pages":"176 - 177"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44238242","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}
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