Aberrometric Outcomes of Intrastromal Corneal Ring Segment (KeraRing 355) Implantation Using Pocket Maker Microkeratome in Patients with Keratoconus

Keratoconus, the most common primary corneal ectasia, is a bilateral asymmetric corneal degeneration which accompanies with local corneal thinning and occurs mostly in inferior and central part of the cornea. Initiating in puberty, Keratoconus (KCN) often progresses until fourth decade of life.

Affecting all ethnic groups equally, KCN usually causes high myopia and irregular astigmatism which results in poor quality of vision. Based on disease severity, many treatment modalities exist including glasses and contact lenses for mild to moderate disease while corneal graft preserved for more advanced disease. High costs, need to long follow-ups, long periods for visual rehabilitation, risks of graft rejection or infection, wound dehiscence and suture-related problems make corneal grafts preserved for the last therapeutic choice by many ophthalmologists.

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Scleral Fixation of Sinking Bag-IOL Complex: A New Surgical Technique

Treatment options for symptomatic subluxated or dislocated IOLs include observation; and repositioning, removal, or exchange of the IOL. We describe a surgical technique of trans-scleralsuture fixation for subluxated bag-IOL complex. A 29 year old male; known case of bilateral recurrent tubercular panuveitis underwent left eye phacoemulsification with three piece hydrophobic acrylic IOL implantation a decade ago.

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LIPC rs10468017, rs493258 and LPL rs12678919 Role in Patients with Age Related Macular Degeneration

Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly individuals in developed countries. The etiology and pathophysiology of AMD are not fully understood. Formation of drusen is the main pathological change in AMD. Lipids make up about 40% of drusen volume, thus possible relation between AMD and genes controlling lipid metabolism could provide novel insights into AMD. Our purpose was to determine the genotype frequencies of LIPC rs10468017, rs493258 and LPL rs126789919 in patients with AMD in Lithuanian population.

The Effects of Intense Pulsed Light on Tear Osmolarity in Dry Eye Disease

In this prospective study we show the influence of Intense Pulsed Light Therapy (IPL) on tear osmolarity, an increasingly important metric of dry eye disease. Previous studies have measured the effectiveness IPL has had on other metrics including tear break up time (TBUT), lipid layer grade (LLG), tear evaporation rate (TER), tear meniscus height (TMH), and subjective responses from patients.

Single center prospective study included 16 patients and 32 eyes. Patient ages ranged from 18 to 90 years old with 75% of participants being female. All patients had an at least one eye with a tear osmolarity of 308 mOsm/L or greater, or had an inter-eye difference in tear osmolarity of 11 mOsm/L or greater. Tear osmolarity was measured bilaterally before a single IPL treatment followed by one drop of topical NSAID. Bilateral tear osmolarity was then measured again one month later.

Strabismus Amblyopia in Young Cameroonian at their First Visit at Yaounde Hospital Centre-Essos

The management of strabismus in Cameroon is not well developed and the average age of first consultation is beyond the age amblyopia reversal. It is with the aim of improving strabismus management that we undertook this prospective and descriptive study which spanned 11 months. The objective was to describe amblyopia in patients with comitant strabismus at their first visit. Data collected included the age at the first visit, past history, refractive error, and the characteristics of strabismus, amblyopia and strabismus-associated factors. Forty patients were included amongst whom there were 21 females and 19 males.

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Central Retinal Artery Occlusion with Patent Cilioretinal Artery

A 35 year old female presented with sudden painless decrease of vision in her right eye. Visual acuity in her right eye was 6/12 on distant Snellen’s acuity chart. A relative afferent pupillary defect was noted. Fundus examination in right eye showed optic disc swelling, retinal opacification and retinal edema with a perfused area of retina at posterior pole suggestive of central retinal artery occlusion with patent cilioretinal artery.

A detailed medical history revealed that she had taken a dose of depot progesterone three months back for contraception. Complete haemogram, coagulation profile and lipid profile was normal. Carotid Doppler showed presence of a thrombus in right internal carotid artery for which she is under care of cardiologist. Central retinal artery occlusion with a patent cilioretinal artery presents with constriction of visual fields but central vision is preserved.

Epidermal Cyst of Upper Eyelid: A Case Report with Literature Review

Epidermal cysts are benign slow growing tumors resulting from proliferation of epidermal cells. Usually cysts are asymptomatic; however, they may become inflamed or secondarily infected. Epidermal cysts are solitary sub epithelial cysts, are slowly progressive and firm in consistency. They are most commonly seen on the face, scalp, neck and trunk. Epidermoid cysts are frequently seen on the upper eyelid, mainly on the conjunctiva or on the skin. This may be misdiagnosed as chalazion or sebaceous cyst. Surgical excision of the cyst in toto is the treatment of choice or else there will be recurrence, granulomatous reaction or foreign body reaction.

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Keratoconus Management: Role of GP Contact Lenses

Keratoconus is a corneal disorder progressive characterized by thinning and steepening of the central and Para central 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).