Ankita Aishwarya, Prabha Gupta, Uma S Tiwari
n 19th century, sir Louis-Auguste Desmarres, a French ophthalmologist, introduced Desmarres-curved lid retractor. It is used to retract upper lid during examination of eyeball and for double eversion of upper lid to examine superior fornix. Barraquer eye speculum is used to keep lids apart during any intraocular procedure.
In 2008, a paper clip usage was demonstrated for retraction of edematous lids, but double eversion of lid is not possible with this instrument. In 2012, a case was reported by Canadian dental association wherein a dentist lost total sight in one eye after splashing calcium hydroxide in her left eye due to ineffective removal of calcium hydroxyl apatite from recess of the eye. Chemical burns are characterized by ongoing tissue destruction for as long as the inciting agent is present.,, Thus, the earliest removal of the inciting agent is crucial in management of chemical injuries. We hereby describe an easy and quick technique on how to use wire eye speculum as a wire lid retractor for double eversion of lid……
Puneet Jain, Paul T Finger
Purpose: The purpose of this study is to describe the clinical characteristics, multimodality imaging findings, and clinical course of iris varices. Methods: Retrospective, noncomparative, observational case series of 28 eyes of 26 patients with iris varices, diagnosed between 2007 and 2017, has been used. Results: The mean (±SD) age was 58.3 ± 12.5 years (median 57.5, range 37–81). Patients were 57.7% male and 27% hypertensive. Varices were bilateral in two patients. The mean and median visual acuities were both 20/20 (range 20/16–20/40). Intraocular pressures were 16 mmHg (10–23 mmHg). Secondary glaucoma did not occur. The inferotemporal iris quadrant was affected in 75%. A single varix was seen in 64% and 36% appeared multiple. Varix orientation was radial in 57% and circumferential in 21%. Combined radial and circumferential varix orientation was noted in 18%. One had independent radial and circumferential varices in separate quadrants. A single episcleral sentinel blood vessel directed to the varix was present in 36%. Ultrasound biomicroscopy (UBM) showed a slightly increased mean iris thickness of 0.8 mm and multiple echolucent iris stromal vascular channels. Iris angiography showed no leakage of dye. Managed by observation over a mean follow-up of 37.7 months (range, 3–129), 96.4% eyes were stable and one (3.6%) regressed. No corectopia, ectropion uveae, hyphema, or metachronous anterior segment benign or malignant tumors occurred. Conclusion: Iris varix is primarily located in the inferotemporal quadrant and not associated with dysmorphic pupillary findings, progression, secondary glaucoma, or malignancy. Iris varices were benign vasculopathies with no associated ocular or vision-related morbidity.
Aloysius Abraham, Kannan Thirumalairaj, Namrata Gaikwad, Veerappan Muthukkaruppan, Alla G Reddy, Kumarasamy Thangaraj, Usha Kim, Ayyasamy Vanniarajan
Retinoblastoma has an increased inheritance risk of germline RB1 mutations in offspring and siblings, especially twins. Three families, each having one retinoblastoma-affected twin, were selected for genetic analysis and DNA profiling. Germline RB1 mutations were found in all probands. DNA profiling carried on similar-looking twins of families I and II, proved them to be fraternal. This study demonstrates the importance of genetic analysis of RB1 gene for risk prediction in retinoblastoma families. It also emphasizes that DNA profiling is a mandate for genetic screening of families with twins, thus adding a new dimension in counseling of retinoblastoma.
Jenil Sheth, Suryasnata Rath, Devjyoti Tripathy
Purpose: To compare the efficacy of a single perioperative bolus dose of intravenous antibiotic versus postoperative oral antibiotic prophylaxis for prevention of surgical site infection (SSI) in external dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction (PANDO). Methods: This was a prospective randomized controlled study with a noninferiority design. Patients undergoing external DCR surgery were randomized into two groups A and B. Patients in group A received a single bolus dose of intravenous cefazolin 1 g at surgery, whereas those in group B received oral cephalexin 500 mg postoperatively twice a day for 5 days. Allocation concealment was ensured by sequentially numbered opaque sealed envelopes (SNOSEs). Both groups were advised identical postoperative local wound care regimens. Any clinical evidence of SSI at 4 weeks of follow-up in either group was the main outcome measure. Results: In all, 338 patients randomized into two groups of 169 patients each participated in this study. At follow-up of 4 weeks, only one patient in group B developed postoperative SSI. None in group A developed postoperative SSI. Other potential risk factors for postoperative SSI were also analyzed by univariate and multivariate analyses but none achieved statistical significance in either group. Conclusion: Our results demonstrate that a single bolus dose of perioperative intravenous antibiotic offers adequate prophylaxis against postoperative SSI and compares favorably with the more commonly used oral antibiotic prophylaxis in external DCR for PANDO in our population and our practice scenario.
Jonathan McLaughlin, Sara E Lally, Carol L Shields
A 60-year-old Caucasian male noted a red lesion on the right lower eyelid which was growing over 3 months. He revealed previously treated cancers of the colon, ureter, and skin, all under control without recurrence. He also noted previous eyelid surgery 2 years ago revealing a well-differentiated sebaceous carcinoma. Family history disclosed multiple members with skin and colon carcinomas. On examination of the patient, visual acuity was 20/20 OD and 20/30 OS. There was an elevated, lightly colored cutaneous lesion on the right lower eyelid margin, temporal to the site of the previous biopsy and measuring 6 × 4 × 3 mm……
Nishi Gupta, Smriti Bansal, Arpan Gandhi
Mascara, a widely used cosmetic, is associated with eye pathology. Pigmentation of conjunctiva and nasolacrimal sac occurs when macrophages ingest pigmented material that then settles within the substantia propria of the epithelium.
Rama Rajagopal, Pratik V Kataria, Sudharshan Sridharan, Krishna Kumar, Kuzhanthai Lily Therese, Poongulali Selvamuthu
Ocular manifestations of human immunodeficiency virus (HIV) are common, even in the era of highly active antiretroviral therapy (HAART)….
Sukriti Ahuja, Apjit Kaur, Madhumati Goel, Shivanjali Raghuvanshi, Ajay Arya
Eccrine poromas are benign, slow-growing tumors originating from the intraepidermal part of the eccrine sweat duct. They occur as pink, red, or flesh-colored, papules or nodules with smooth or verrucous surfaces, typically in palms and soles. They present in middle and elderly aged individuals and have no gender and race predilection. Pigmentation and multifocality are the rare features. Carbon dioxide laser-assisted removal, electrosurgical destruction, and surgical excision with clear margins are the treatment modalities available.
Tarjani V Dave, Rajeev R Pappuru, Vivek P Dave
A 27-year-old Asian-Indian lady, systemically normal, with diffuse iris hypopigmentation, telecanthus, mild synophrys with a congenital white forelock treated with hair color and 20/20 vision in both eyes presented for treatment of the heterogeneous iris color [Figure 1]a. Fundus examination revealed a sectoral superonasal hypopigmented choroid in the left eye [Figure 1]b. Fundus autofluorescence revealed hyperautofluorescence through the hypopigmented choroidal region in the left eye [Figure 1]c, indicating unmasking of scleral autofluorescence. The patient was diagnosed as a case of Waardenburg syndrome Type 1 and was offered a cosmetic contact lens. Audiometry on both sides and gastrointestinal examination was normal…..
Bhanu P S Pangtey, Piyush Kohli, Kim Ramasamy
Wyburn–Mason syndrome is associated with unilateral retinal racemose hemangioma. Rarely, it presents with bilateral and symmetrical grade of malformation. We describe a 37-year old male, who presented with Wyburn–Mason syndrome presenting with bilateral but asymmetrical retinal hemangioma. The eye with advanced grade of hemangioma was complicated with exudation, intraretinal fluid, neurosensory detachment, and reduced vision. He was treated with one intravitreal injection of bevacizumab, after which both the intraretinal fluid and neurosensory detachment resolved. His vision improved and was maintained till 1 year of follow-up.