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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