The SCHEIE Visual Field Grading System

No method of grading visual field (VF) defects has been widely accepted throughout the glaucoma community. The SCHEIE (Systematic Classification of Humphrey visual fields-Easy Interpretation and Evaluation) grading system for glaucomatous visual fields was created to convey qualitative and quantitative information regarding visual field defects in an objective, reproducible, and easily applicable manner for research purposes.

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Periorbital Cellulitis that Developed after Alternative Medication of Hirudo Medicinalis Application

We aimed to present a case of periorbital (preseptal) cellulitis that developed after Hirudo medicinalis alternative medicine application for glaucoma treatment which can be rarely seen in routine ophthalmology practice. A 36 year old woman with a glaucoma was admitted to our outpatient clinic because of redness, pain and swelling around the right eye for three days and gave a history of leech application 1 week ago, that recommended by her relatives as a remedy for glaucoma.

Orbital cellulitis was excluded and cure was achieved with oral ciprofloxacin and flurbiprofen treatment. Patients with chronic diseases such as glaucoma, they are abandoning the treatment over time, will seek solutions from alternative medicine. These inappropriate treatments without scientific evidence can cause various complications. Physicians should maintain proper communication with the patients inform them about their chronic diseases (e.g. glaucoma) to make them the part of the solution and treatments.

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 anti-inflammatory 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-year-old 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.

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Ocular Foreign Bodies: A Review

A foreign body is any abnormal substance or object that does not belong to the body (eye). The incidence of foreign body in the eye is high especially in the industrial towns. It can occur at any age and in both genders. It affects the eye by mechanical effects, by introduction of infection or by specific reaction. Introduction of a foreign body is a significant disturbance and can create health problem. The study of the foreign body presents unparalleled opportunities for reducing morbidity and for realizing significant savings in both financial and human terms.

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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Further Research needed to explore the link between Posterior keratoconus and Ocular coloboma

Posterior keratoconus is a rare corneal disorder that results in non-inflammatory thinning of the cornea, leading to cone-like protuberance in the posterior cornea. Ocular coloboma is malformation due to faulty closure of the embryonic fissure, where the entire ocular structure may affect iris, ciliary body, choroid, optic nerve or all of the above. Posterior keratoconus may lead to vision loss over a period of time. A rare case of both Posterior keratoconus along with Ocular coloboma was presented here. The study predict genetic linkage as one of the reasons and suggest further studies to explore the link between Posterior keratoconus and the Ocular coloboma.

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Advanced Case of Rhabdomyosarcoma of Orbit Mimicking Orbital Cellulitis

Rhabdomyosarcoma is a malignant neoplasm of primitive mesenchyme exhibiting skeletal muscle differentiation. Rhabdomyosarcoma, which can histo pathologically be of embryonal, alveolar, botryoid and pleomorphic types; is a rare tumor in children, with an annual incidence of 4.3 cases per million. Pleomorphic rhabdomyosarcomas is a rare variant, occurring more commonly in adults. 

We report a rare case of ocular pleomorphic rhabdomyosarcoma in an 18-month-old child with atypical presentation mimicking orbital cellulitis. A provisional diagnosis of orbital cellulitis was made based on clinical and radio logical examination and was planned for surgery. Histopathology confirmed the diagnosis of pleomorphic rhabdomyosarcoma. This case shows that pleomorphic rhabdomyosarcoma may also occur in children, it may mimic symptoms of orbital cellulitis, and any fast growing swelling should be carefully examined with a high degree of suspicion of this entity.

Keratoconus Management: Role of GP Contact Lenses

Keratoconus is a corneal disorder progressive characterized by thinning and steepening of the central and paracentral cornea, which leads to protrusion. The exact cause of the disease remains to be fully elucidated although its etiology probably is multi factorial with a genetic predisposition to keratoconus influenced by external environmental factors (eye rubbing and atopy) with different systemic involvement. In the early stages, keratoconus can be managed with spectacles or contact lenses (CL), but when keratoconus progresses, other surgical techniques are often required.

For example, anterior lamellar (dDALK) or penetrating keratoplasty (PK) permit than 3 of 4 patients achieve best-corrected visual acuity of 20/40 or better. Intra corneal ring segment(ICRS) are proposed to increase corneal stability and decrease the astigmatism a symmetry normalizing the corneal contour with slight improvement of patients’visual acuity. Corneal collagen cross-linking (CXL) is a common technique proposed to reduce disease progression with a light improvement of visual acuity (1 to 2 Snellen lines).

Myelinated Retinal Nerve Fibers in Children: OCT Imaging, Refractive Error and Vision

To characterize peripapillary retinal nerve fiber layers (RNFL’s) and macular retinal structure in children with unilateral myelinated retinal nerve fibers (MRNFs). We also investigated the correlation between MRNF abnormalities and refractive error/visual acuity. 

Twelve children (7-13 years old) with MRNFs were included. Fourier domain optical coherence tomography was used to image both the peripapillary RNFL and the macular retinal structures in 6 patients. Using the instrument’s segmentation software, global RNFL thickness and central subfield thickness(CST) of the macula were analyzed. Planimetry was used to quantify the MRNF area observed on fundus photography. Visual acuity and cycloplegic refractive errors (spherical equivalent) were also recorded. Results from the MRNF-affected eye were compared with the fellow eye.

Investigation of Electrolyte Changes in Bovine Vitreous at Different Postmortem Interval

Investigation of the changes in electrolyte level in the Bovine vitreous at different postmortem interval under two different temperature conditions. Ninety eight bovine right eyes from freshly slaughtered healthy cows were gotten from the government abattoir in Edo State, Nigeria. 

They were divided into two sets; forty nine right eyes were kept at 32°C while forty nine right eyes were kept at 4°C in a mobile refrigerator. The samples of vitreous were carefully aspirated from the bovine eyes within an hour of death of the animals. Measurements of the levels of cations (sodium and potassium) and anions (chloride and bicarbonate) were taken at various postmortem intervals of 2, 12, 24, 36, 48, 60 and 72 hours, using E110111 Flame Photometer.

Amantadine Corneal Toxicity: Case Report and Review of the Literature

To report a case of bilateral corneal edema in a patient with a history of cocaine abuse and bipolar-depression treated with amantadine for 6 months, and to review the literature on amantadine corneal toxicity.

The clinical record of a patient with amantadine corneal toxicity and the existing literature on this subject were extensively reviewed for prevalence, clinical presentation, pathogenesis and therapy.

A 27 year-old male who suffered from depression and cocaine abuse presented with sudden visual loss (20/150 OD and 20/200 OS) caused by bilateral corneal stromal edema without ocular inflammation. Corneal edema was related to amantadine therapy (200 mg per day) for 6 months. Visual acuity improved to 20/20 OU and corneal edema resolved after one month of cessation of therapy. Corneal endothelial cell density after3 months of discontinuation of amantadine therapy was 636 ± 359 cells/mm² in the right eye and 1,176 ± 238 cells/mm² in the left eye. There was also increased pleomorphism (45.3% 6A cells OD, 56.4% 6A cells OS) and polymegatism (coefficient of variation, 39.04 ± 6.38 OD and 34.76 ± 2.68 OS).