Calotropis procera produces Inflammatory Effects omn Cornea, Poses threat to the eyes

Calotropis procera is a flowering plant native to North Africa, South Asia and Indonesia. The flowers produce bitter and sticky toxic milk. It possesses both inflammatory and anti-inflammatory pharmacological properties. Topic application of latex from C. procera I affects eye with diffuse corneal edema. It resulted in reduced endothelial cell count and severe ocular injuries and a loss of endothelial cells over a period of time. Public education, early recognition of such injuries, and timely intervention may prevent permanent ocular damage.

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Ocular Biometry in Patients with Primary Open Angle Glaucoma (POAG)

Glaucoma is the leading cause of blindness all over the world after cataract blindness. In 2010, worldwide 60.5 million people were expected to have OAG (Open angle glaucoma) and ACG (Angle closure glaucoma), increasing to 79.6 million by 2020, and of these, 74% will have OAG1. Asians represent 47% of those with all glaucoma and 87% of those with ACG1. 4.5 million People with OAG and 3.9 million people with ACG were expected to have bilateral blindness in 2010, rising to 5.9 and 5.3 million people in 2020, respectively.

There are approximately 11.2 million persons aged 40 years and older with glaucoma in India. Primary open angle glaucoma is estimated to affect 6.48 million persons. The estimated number with primary angle-closure glaucoma is 2.54 million. Those with any form of primary angle-closure disease could comprise 27.6 million persons.

Mascara: A Cause of Thermal Burn after Cautery for Eye Lid Lesion Excision; A Case Report

Surgical fires are rare in ophthalmic surgery. Occurrence poses disastrous risks on the eye and the patient. Mascara can play a role in the occurrence of flash fires in the vicinity of surgical fields by acting as a fuel source. We report a case of thermal burn of eye lashes, eyelid skin and eye brow hair in a patient who was wearing mascara while cautery was applied to her eyelid lesion after excision. Mascara had caused a spark fire when applying cautery after eyelid lesion excision in a young patient. Conclusion: Surgeons as well as the entire ophthalmic care team should be aware of this incident to try to minimize the risk of thermal injury by working in a make-up free ophthalmic field.

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Sports-Related Concussion: The Eyes Have It

Concussion is a form of mild traumatic brain injury (TBI) owing to structural, metabolic and functional changes involving white mater tracts of the central nervous system in the absence of macroscopic findings. Sports-related concussion is a rapidly evolving condition stimulating interest among lay and scientific communities. 

Recent studies have shown a high rate of under reporting of concussion signs and symptoms by athletes and side line personnel. Accordingly, reliable and validated testing strategies are necessary to insure timely detection and removal from play for individuals suspected of concussion. Vision and visual motor problems are commonly reported among athletes following concussion. This is to be expected as it is estimated that approximately 50% of the brain is devoted to vision and visual motor processing. As such, testing of vision and ocular motility function are critical to the evaluation of a concussed individual.

Novasorb Cationic Nanoemulsion and Latanoprost: the Ideal Combination for Glaucoma Management?

Novasorb is a patented eye drop formulation platform developed to optimise the interaction of the eye drop-the cationic nanoemulsion-with the different layers of the tear film, mainly with the tear film lipid layer (TFLL), and the ocular surface. 

The composition of the cationic nanoemulsion was designed to mimic the attributes and functions of the tear film and TFLL, and take advantage of the negatively-charged mucin layer covering the corneal and conjunctival epithelium, to increase its spreading and residence time on the ocular surface. Consequently, Novasorb®-based artificial tears (AT, e.g. Cationorm®) are functionally and mechanically very close to a healthy tear film; with an iso-osmolar to slightly hypo-osmolar aqueous phase, polar (cetalkonium chloride, CKC) and nonpolar (mineral oils or medium chain triglycerides, MCT) lipids, and surfactants (e.g. Tyloxapol and Poloxamer) that mimic the surface active proteins present at the interface with the TFLL.

Corneal Toxicity after Self-Application of Calotropis procera (Ushaar) Latex: Case Report and Analysis of the Active Components

Calotropis procera (ushaar) produces a copious amount of latex, which has both inflammatory and antiinflammatory pharmacological properties. Local application produces an intense inflammatory response and causes significant ocular morbidity. 

We report corneal toxicity following self-application of latex from C. procera in a 74-yearold man. He reported painless decreased vision in the affected eye with diffuse corneal edema, and specular microscopy revealed a reduced endothelial cell count. After he was treated with topical corticosteroids, his visual acuity improved from HM to 20/80. The composition of the active compounds in the latex was analyzed. When topically administered, the latex may cause severe ocular injuries and a loss of endothelial cells over a period of time. Public education, early recognition of such injuries, and timely intervention may prevent permanent ocular damage

Cornelia de Lange Syndrome with Congenital Glaucoma

Cornelia De Lange syndrome (CDLS), also known as Brachmann de Lange syndrome is a rare syndrome. It ischaracterised by distinctive facial dysmorphism, growth retardation,developmental delay, upper limb reduction defects, gastroesophageal dysfunction, ophthalmologic and genitourinary anomalies, hirsutism, pyloric stenosis, congenital diaphragmatic hernias, cardiac septal defects, and hearing loss. The syndrome was first described by a Dutch paediatrician named Cornelia de Lange, in 1933.

Though the genetic basis of this syndrome is not clear, a majority of cases are due to spontaneous mutations. The defective gene can be inherited from either parent, making it autosomal dominant type of inheritance.

Synophrys, long curled lashes, myopia, and hypertrichosis of the brows. These patients have also been found to have ptosis, epiphora, nasolacrimal duct obstruction, and micro cornea, congenital glaucoma, corneal opacities, iris heterochromia and optic nerve head pallor/atrophy.

Maculopathy associated with Prior Tamoxifen Use Diagnosed with Commercially Available Fourier-Domain Optical Coherence Tomography: A Case Series

Tamoxifen is a drug used to treat estrogen receptor positive breast cancer that can induce retinopathy. The diagnosis of tamoxifen retinopathy is traditionally established by macularedema seen on fluorescein angiography and retinal crystalline deposits seen on funduscopy. Macular edema associated with tamoxifen retinopathy has been reported to be reversible after cessation of the drug but the retinal crystalline opacities usually persist. 

Recently, a case of bilateral microcystoid maculopathy with patches of photoreceptor loss associated with concurrent tamoxifen use was detected using a research-grade high resolution Fourier-domain optical coherence tomography (Fd-OCT) in a patient with vision loss unexplained by funduscopy, fluorescein angiogram (FA), multifocal electro retinography and Stratus OCT. This report describes two new cases of maculopathy associated with prior tamoxifen use in which similar morphologic changes were seen using commercially available Fd-OCTs, Cirrus (Carl Zeiss Meditec, Dublin, CA) and RTVue (Optovue, Fremont, CA), in eyes that appeared unremarkable on funduscopy.

Anterior Vitreous Incarceration after Phacoemulsification Cataract Extraction Imaged with Spectral-Domain Optical Coherence Tomography

Anterior vitreous incarceration is a condition in which vitreous prolapses into the anterior chamber and passes through a microscopic wound at an incisional site. The condition can be identified as a vitreous strand leading to the wound site during slit lamp examination. If the vitreous strand penetrates through all the corneal layers on to the extra ocular surface it becomes vitreous wick syndrome. Anterior segment imaging with spectral-domain optical coherence tomography of the iridocorneal angle can provide high definition scans to confirm vitreous incarceration and rule out vitreous wicking. It is important to appropriately diagnose this condition to prevent vision threatening complications.

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General on Glaucoma and Oxidative Stress. Comments on Study Design: “Biomarkers of Lipid Peroxidation in the Aqueous Humor of Primary Open angle Glaucoma Patients”

Glaucoma is an optic neuropathy that causes progressive changes in the visual field and whose main known risk factor is the increased IOP. Primary open-angle glaucoma (POAG) is associated with asymptomatic and irreversible vision loss, although its cause is unknown, it is known that in the presence of elevated intraocular pressure (IOP) occurs sequentially death of retinal ganglion cells by apoptosis and optic nerve fibres in its evolution cause glaucomatous optic atrophy and permanent loss of vision. There has never been unanimously to establish which of the two injuries, structural or functional, it can first be detected. However, experts generally agree that early diagnosis is critical to improving the prognosis of glaucomatous patient.

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Management of Corneal Graft Rejection - A Case Series Report and Review of the Literature

To report long-term results in a case series of patients treated with systemic immune suppression for prevention of penetrating keratoplasty (PKP) graft rejection. Retrospective non comparative chart review. Three patients presented with PKP graft failure. 

Patients received oral prednisone, azathioprine and cyclosporine to prevent rejection of repeat corneal transplant. Patients received repeat PKPand graft outcome was reported. Main outcome measures: Visual acuity and graft survival were recorded. Mean age was 55 years, two male and one female. Mean follow-up period was 37 months (range 24- 46). All three patients completed the treatment protocol with minimal adverse effects. All grafts remained clear over observational period. Conclusion: Our study suggests that systemic immune suppression with 2 or more agents may be helpful to prevent corneal graft rejection in high-risk patients.

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Vision-related Quality of Life in Children with Amblyopia

Vision plays an important role in most everyday activities. Consistent with this, people with visual impairment are usually faced with significant challenges in their daily activities. In children, such activities include playing, reading, socialisation and taking care of their daily needs. In the paediatric ophthalmological field, visual problems include high refractive errors, binocular disorders, depth perception deficiency, amblyopia and ocular pathology. These visual impairments in children potentially cause psychological and functional changes and could affect educational and social prospects and may thus impact on vision-related quality of life (VRQoL).

Amblyopia is usually defined as a unilateral or bilateral reduction in visual function caused by abnormal visual input resulting from degradation of the retinal image during a sensitive period of visual development, which historically has been thought to be the first seven years of life.

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Ologen versus Mitomycin-C for Trabeculectomy in a Predominantly African American PopulationOlogen versus Mitomycin-C for Trabeculectomy in a Predominantly African American Population

Glaucoma is the most common cause of irreversible blindness worldwide. Treatment of glaucoma begins with medical management but often requires surgical intervention. Since the late 1960s, the most common surgical treatment for glaucoma has been trabeculectomy. AGIS investigators and others have established that race plays a significant role in an individual’s response to trabeculectomy. Specifically, African American patients have been shown to have advanced glaucoma at time of diagnosis and respond less favorably than Caucasian patients to trabeculectomy. Our group wishes to investigate the role of ethnicity in specific surgical treatments for glaucoma.

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Different Modalities of Antifungal Agents in the Treatment of Fungal Keratitis: A Retrospective Study

The study reviewed 251 eyes of 246 patients treated for moderate and severe fungal keratitis in the period from 2010 to 2015. The diagnosis of fungal keratitis based on the clinical characteristics features of fungal keratitis beside laboratory diagnosis. The anti fungal drugs were determined according to the commercial availability at the time depending on the clinical features, also to some extent to the laboratory diagnosis. Ten different modalities of anti fungal agents beside antibacterial agents and cycloplegic drugs were used.

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Primary Open Angle Glaucoma Poses Threats in the Form of Increased Axial Length

Primary Open Angle Glaucoma (POAG) is one of the most common forms of eye disease that occurs due to high Intraocular Pressure (IOP). If untreated, it would leads to periphery loss of vision that gradually leads to complete blindness.. When a comparative study was initiated to determine the axial length (AL) and K value between two groups of patients consisting patients with POAG and the age matched controls group, Patients with POAG are having longer AL and flatter corneas than the age-matched controls. This would clearly highlights the risks involved for the patients of POAG.

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Un-doing All that Good Work! Glaucoma after Vitrectomy and Silicone Oil Injection for the Treatment of Complicated Retinal Detachment

A fifty-two year old bilaterally pseudophakic Caucasian gentleman having a retinal detachment secondary to two retinal breaks superotemporally in his right eye underwent twenty-three gauge pars plana vitrectomy (PPV), endophotocoagulation and perfluoroethane (C2F6) gas insertion. He presented five weeks later with a total retinal detachment in the same eye presumed consequent to a retinal break infero temporally thought to represent temporal extension of the initial retinal tear beyond the margin of the aforementioned retinopexy. Twenty gauge PPV was performed, cryotherapy was applied to the retinal break, indirect retinal photocoagulation carried out and 16% perfluoropropane (C3F8) inserted into the vitreous cavity.

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