Open-Source Automatic Biomarker Measurement on Slit-Lamp Photography to Estimate Visual Acuity in Microbial Keratitis

Background: Posterior capsular clarity is important for long-term visual gain. Postoperative visual acuity could be reduced due to posterior capsular or intraocular lens opacification, which occur months or years after cataract surgery. We report early occurrence of posterior capsular calcification without opacification of intraocular lens. Case: We report the case of a 78-year-old male who had undergone phacoemulsification with implantation of hydrophilic intraocular lens (IOL) in the left eye for cataract. The patient was non-diabetic, and the surgical procedure was uneventful. On the third postoperative day, fine granular deposits were found on the mid-peripheral part of the posterior capsule. No deposits were found on IOL. The patient presented with diminished vision four months after surgery. Slit-lamp examination revealed distinct areas of calcification with an early opacification of the posterior capsule and no IOL calcification. Neodymium doped: YAG capsulotomy was done to clear posterior capsular opacification, and the patient regained visual acuity of 20/20. To the best of our knowledge, this report is the first to investigate posterior capsular calcification without opacification of IOL in a patient without any known etiological factors. Conclusion: This case is reported to stimulate future study on the use of BSS plus and the development of posterior capsular or IOL calcification. Nepal J Ophthalmol 2016; 8(15): 91-94

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Continuous administration of voriconazole enhances therapeutic effect for recalcitrant fungal keratitis

European Journal of Ophthalmology ◽

10.1177/11206721211068628 ◽

2021 ◽

pp. 112067212110686

Author(s):

Weiyan Liang ◽

Chang Liu ◽

Xiansen Zhang ◽

Ling Li ◽

Zexia Dou ◽

...

Keyword(s):

Visual Acuity ◽

Therapeutic Effect ◽

Clinical Symptoms ◽

Treatment Protocol ◽

Corneal Stroma ◽

Fungal Keratitis ◽

Slit Lamp ◽

Continuous Administration ◽

Conventional Medical Treatment

Purpose To evaluate the therapeutic effect of incorporating continuous administration of voriconazole in the treatment of recalcitrant fungal keratitis. Methods In this prospective case study, 5 consecutive patients (5 eyes) with fungal keratitis were treated with a standard protocol after the failing maximal conventional medical treatment. The protocol involved continuous lavage of the ulcer with 1% voriconazole through an irrigator for 2 h, twice a day, combined with local and systemic antifungals. Visual acuity, slit lamp findings of the ulcer, and fungal hyphae density by confocal microscope were documented, respectively. Results In 4 patients, the clinical symptoms and slit lamp examination were significantly improved after only 3 days of treatment. The hyphae were shown to decrease in number and morphologically fragmented in corneal stroma by confocal microscopy. After the infection was controlled, 2 cases required further keratoplasty. In one case, the treatment was deemed ineffective and a conjunctival flap had to be created to help control the infection. In all 5 patients, the best spectacle-corrected visual acuity had improved after treatment. With more than 3 months of follow-up, no recurrence of infection was seen in any cases. Conclusion Our treatment protocol demonstrated improvement in the treatment of clinically resistant fungal keratitis. Continuous lavage of voriconazole is easy to be implemented and well-tolerated by patients. Modification of the current protocol should be further explored to optimize the therapeutic effectiveness in future.

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Zosteric Kerato-Uveitis Revealing a Retroviral Infection (HIV)

10.26420/austinophthalmol.2021.1023 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Naya K ◽

◽

Lidya I ◽

Hasnaoui I ◽

Tazi H ◽

...

Keyword(s):

Visual Acuity ◽

Herpes Zoster ◽

Emergency Room ◽

Female Patient ◽

The Elderly ◽

Common Condition ◽

Slit Lamp ◽

Retroviral Infection ◽

The Right

Herpes zoster ophthalmic is a common condition in the elderly or in the immunocompromised people. We present the case of a 32-yearold female patient, without any particular history, who consulted the emergency room for a red right eye with major chemosis, palpebral edema, and decreased visual acuity. There was also a crusty rash in the V1 territory, suggesting herpes zoster. Visual acuity was 2/10 in the right eye and 10/10 left eye (Figure 1 and 2). Examination at the slit lamp revealed a non-hypertensive granulomatous anterior kerato-uveitis of the right eye. Given the severity of the lesion, an immunodepressive background was suspected, HIV serology came back positive.

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When the Trauma Draws a Rose: Rosette Cataract

10.26420/austinophthalmol.2021.1026 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Madbouhi K ◽

◽

Cherkaoui O ◽

Keyword(s):

Visual Acuity ◽

Emergency Room ◽

Male Patient ◽

Slit Lamp ◽

Posterior Subcapsular Cataract ◽

Slit Lamp Examination ◽

Corrected Visual Acuity ◽

The Hours ◽

Rose Rosette

A 40-year-old male patient referred to the ophthalmologic emergency room for complaints of diminution of vision in the left eye since three months after a trauma. Examination of the left eye showed a corrected visual acuity of 20/70. Slit-lamp examination revealed a rosette cataract (Figure 1). The patient underwent phacoemulsification with implantation of an IOL in the bag. The rosette cataract is a posterior subcapsular cataract due to a violent contusion with a closed globe. It can develop in the hours that follow, or on the contrary several years later.

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Ellipsoid layer restoration after Ozurdex® treatment in a patient with acute posterior multifocal placoid pigment epitheliopathy

European Journal of Ophthalmology ◽

10.1177/1120672119883598 ◽

2019 ◽

pp. 112067211988359 ◽

Cited By ~ 1

Author(s):

Arnau Mora-Cantallops ◽

M Dolores Pérez ◽

Marcelino Revenga ◽

Julio Jose González-López

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Optical Coherence ◽

Dexamethasone Implant ◽

Slit Lamp ◽

Slit Lamp Examination ◽

Intravitreal Dexamethasone Implant ◽

History Of ◽

Intravitreal Dexamethasone ◽

Consequent Improvement

An atypical case of acute posterior multifocal placoid pigment epitheliopathy with a clear reappearance of the ellipsoid layer of the retina after Ozurdex® intravitreal implantation is presented. A 51-year-old woman reported a 3-week history of left eye photopsia. On slit-lamp examination, yellowish placoid lesions were found on her left eye fundus. Ancillary tests were performed. The patient was diagnosed as a left eye acute posterior multifocal placoid pigment epitheliopathy, and observational approach was decided. Later, the condition started to progress in an ampiginous manner and a decrease of visual acuity caused by an increase in number and size of the lesions was observed. As the disease was progressing with the conservative, observational approach, and the macula was menaced, an intravitreal dexamethasone implant was injected in the left eye with a consequent improvement of the visual acuity and lesion stabilization. The ellipsoid layer, unidentifiable inside the placoid lesions in previous optical coherence tomography tests, reappeared after the treatment. Intravitreal dexamethasone implants can be used to stabilize acute posterior multifocal placoid pigment epitheliopathy lesions and help resolve the condition. Spectral domain optical coherence tomography can also be useful for monitoring these lesions, as the ellipsoid layer may reappear upon resolution.

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Achondroplasia Associated with Bilateral Keratoconus

Case Reports in Ophthalmological Medicine ◽

10.1155/2012/573045 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Ammar M. Al Mahmood ◽

Hind M. Al Katan ◽

Ghada Y. Al Bin Ali ◽

Samar A. Al-Swailem

Keyword(s):

Visual Acuity ◽

Rare Case ◽

Penetrating Keratoplasty ◽

Slit Lamp ◽

Poor Vision ◽

The Past ◽

Uncorrected Visual Acuity ◽

Hard Contact ◽

Slit Lamp Biomicroscopy ◽

Contact Lens Fitting

We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE). Right eye (RE) improved to 20/25. The patient underwent penetrating keratoplasty (PKP) in his LE. Twenty-seven months postoperatively, uncorrected visual acuity (UCVA) was 20/30. Ophthalmologists should be aware that patients with achondroplasia who complain of poor vision should be suspected of having keratoconus once other more common conditions are ruled out.

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Effect of monocular surgery for large-angle horizontal deviation in adults

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i1.4275 ◽

1970 ◽

Vol 3 (1) ◽

pp. 27-30 ◽

Cited By ~ 3

Author(s):

S Ganguly ◽

R Pradhan

Keyword(s):

Visual Acuity ◽

Large Angle ◽

Anterior Segment ◽

Case Series ◽

Strabismus Surgery ◽

Slit Lamp ◽

Surgical Success ◽

Squint Surgery ◽

Indirect Ophthalmoscope

Background: Surgical success rate of strabismus is variable. Objective: To evaluate the outcome of monocular strabismus surgery for adults with largeangle deviation. Subjects and methods: This study was that of a retrospective interventional case series. A total of 48 consecutive adult patients with large-angle socially-noticeable strabismus underwent clinical evaluation for squint surgery. They were divided into 2 groups of which 28 had exotropia while 20 had esotropia with deviation ranging from 40 to 80 prism diopters (PD). Visual acuity measurement (V/A), cycloplegic refraction and orthoptic evaluation were done in all cases along with detailed anterior segment evaluation. Fundus examination was carried out with indirect ophthalmoscope and slit-lamp bio-microscopy with + 90 D lens. For each case, a repeat evaluation was done after a six-week interval. The surgical procedure was monocular recession and resection carried out under peri-bulbar anesthesia by the same surgeon. Post-operative visual acuity, fusion, stereopsis and ocular alignment were noted in all cases during follow up visits. Results: Successful ocular alignment (< 10 PD) was achieved in 40 patients while binocularity was noted in 3. Forty patients were happy with the cosmetic outcome and psychosocial rehabilitation. No statistically significant improvement was noted in visual acuity and binocular function. Successful alignment was related to pre-operative deviation of less than 30 degrees. Conclusion: Monocular surgery under peri-bulbar anesthesia is a useful procedure for large-angle horizontal strabismus. Key words: strabismus; exotropia; esotropia; fusion; binocularity DOI: 10.3126/nepjoph.v3i1.4275Nepal J Ophthalmol 2011;3(5):27-30

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A Novel Method for the Localization and Management of Traumatic Cyclodialysis Cleft

Journal of Ophthalmology ◽

10.1155/2014/761851 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Mingling Wang ◽

Shufang Hu ◽

Zhenquan Zhao ◽

Tianlin Xiao

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Intraocular Pressure ◽

Clinical Study ◽

Ultrasound Biomicroscopy ◽

Slit Lamp ◽

Normal Range ◽

Postoperative Visual Acuity ◽

Novel Method ◽

Cyclodialysis Cleft

Purpose.To propose a novel surgical method for the localization and management of traumatic cyclodialysis clefts.Methods.Five patients with traumatic cyclodialysis clefts who underwent the innovative surgery were retrospectively reviewed. The new method was introduced to repair a cyclodialysis cleft with two running sutures from the middle to each end of the cleft under the guidance of a probe. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), slit lamp and gonioscopic results, ultrasound biomicroscopy (UBM), and optical coherence tomography (OCT) findings were recorded.Results.Cyclodialysis clefts were completely closed postoperatively in four patients (four eyes); this was confirmed by progressively improved VA, restoration into the normal range of the IOP, disappearance of suprachoroidal fluid, and reduced macular edema. Only one patient with multiple clefts had an incomplete reattachment.Conclusions.This clinical study offers a novel and efficient method to localize and repair the cyclodialysis clefts.

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INFLUENCE OF THE SCLERAL LENS AND FLUID RESERVOIR THICKNESSES ON RESIDUAL ASTIGMATISM

Journal of Contact lens Research and Science ◽

10.22374/jclrs.v5i1.40 ◽

2021 ◽

Vol 5 (1) ◽

pp. e1-e8

Author(s):

Langis Michaud ◽

Gabriella Courey

Keyword(s):

Visual Acuity ◽

Prospective Study ◽

Refractive Error ◽

Slit Lamp ◽

Logmar Acuity ◽

Clinically Significant ◽

Lens Wear ◽

High Order Aberrations ◽

Fluid Reservoir

PurposeThis study aims to determine if lens or tear fluid reservoir thicknesses (LT/FRT) may influence the presence of residual astigmatism and participant’s visual acuity. MethodsThe study was a randomized, non-dispensing, prospective study. Empirically and randomly chosen participants were fitted with 4 combinations (350 and 250 um LT fitted with 250 and 350 um FRT) of 16 mm diameter scleral lenses, designed using a corneo-scleral profiler software (sMap 3D, Visionary Optics, US). Lenses haptics were kept spherical for all lenses. They were evaluated under a slit lamp, anterior segement OCT (objective fluid reservoir and lens thicknesses), topography over lenses and aberrometry, after 30 minutes of lens wear. Spherico-cylindrical refraction and logMar acuity were also assessed. ResultsStudy population was composed of 24 participants aged 24.2 + 4.7 years old. Baseline refractive error was -2.3 + 1.6 D with -0.48 + 0.26 D of astigmatism. In vivo (OCT) lens A was 344.1 ± 15.4 um thick, fitted with a vault of 213.6 ± 42.4 um; Lens B was 346.2 ± 12.5/327.2 ± 44.8; Lens C was 260.3 ± 17.7/214.0 ± 40.6 um and Lens D was 262.2 ±13.2/330.8 ± 52.0 respectively. All lenses were found similarly decentered inferiorly by 0.10 to 0.15 um. BCVA was −0.32 + 0.08 (A), −0.21 + 0.10 (B), −0.28 + 0.08 (C), and −0.14 + 0.10 (D), compared to −0.25 + 0.08 (A), −0.11 + 0.10 (B), −0.23 + 0.06 (C), and −0.05 + 0.12 (D) when sphere only was compensated. Residual refractive astigmatism (RA = -0.50 to -0.75D) is found significantly higher based on the FRT (F=9.560; p=0.037) and not LT(F=0.429; p=0.522). There is no correlation be-tween RA and over-k readings (Lens A r=-0.078, p=0.773; Lens B r=−0.073, p=0.788; Lens C r=−0.345, p=0.171; Lend D r=0.019, p=0.944). Higher order aberrations, mostly vertical coma, were found clinically significant but not statistically different between lenses (A= 0.350 + 0.032; B=0.382 + 0.053, C=0.329 + 0.044 and D=0.385+ 0.062; p=0.776) ConclusionThis study proves that low level of RA may be found when scleral lenses are fitted on normal corneas. Its occurrence is related to the presence of high-order aberrations and less likely to lens flexure.

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