Unusual increase in the incidence of unilateral Optic Neuritis: Case presentation

Optic neuritis presents as an acute or subacute inflammatory episode. Objective: Describe the clinical-epidemiological characteristics in 7 cases with unilateral optic neuritis and evaluate the therapeutic results obtained. Material and method: A series of cases with a diagnosis of unilateral optic neuritis who attended the Neurophthalmology consultation at the Hermanos Ameijeiras Hospital in Havana, Cuba, from August 6 to November 16, 2018, from Havana and Matanzas, were studied. An unusual increase in the incidence of NO was recorded in the period analyzed. Results: An unusual increase in the incidence of unilateral optic neuritis was recorded. The average age was 33.5 years. All reported unilateral painless visual loss. Four patients reported general signs and symptoms suggestive of having suffered a respiratory disease of viral origin, between 7 and 15 days before optic neuritis. In the examination carried out, great impairment of visual acuity (≤0.05) and colors (0/21) was found. The centro-caecal scotoma was the most frequent campimetric defect. Optical Coherence Tomography (OCT) in the affected eye showed increased neuroretinal thickness, decreased nerve fiber layer, and ganglion cell damage. Treatment was with intravenous methylprednisolone and B vitamins. Conclusions: An unusual increase in patients with unilateral optic neuritis was observed. The OCT revealed damage to the structures at the level of the retina and the optic nerve. The therapeutic effectiveness was conditioned by the time of evolution of the neuritis.

Unusual increase in the incidence of unilateral Optic Neuritis: Case presentation

Optic neuritis presents as an acute or subacute inflammatory episode. Objective: Describe the clinical-epidemiological characteristics in 7 cases with unilateral optic neuritis and evaluate the therapeutic results obtained. Material and method: A series of cases with a diagnosis of unilateral optic neuritis who attended the Neurophthalmology consultation at the Hermanos Ameijeiras Hospital in Havana, Cuba, from August 6 to November 16, 2018, from Havana and Matanzas, were studied. An unusual increase in the incidence of NO was recorded in the period analyzed. Results: An unusual increase in the incidence of unilateral optic neuritis was recorded. The average age was 33.5 years. All reported unilateral painless visual loss. Four patients reported general signs and symptoms suggestive of having suffered a respiratory disease of viral origin, between 7 and 15 days before optic neuritis. In the examination carried out, great impairment of visual acuity (≤0.05) and colors (0/21) was found. The centro-caecal scotoma was the most frequent campimetric defect. Optical Coherence Tomography (OCT) in the affected eye showed increased neuroretinal thickness, decreased nerve fiber layer, and ganglion cell damage. Treatment was with intravenous methylprednisolone and B vitamins. Conclusions: An unusual increase in patients with unilateral optic neuritis was observed. The OCT revealed damage to the structures at the level of the retina and the optic nerve. The therapeutic effectiveness was conditioned by the time of evolution of the neuritis.

Fresh frozen plasma as a source of plasminogen for ligneous conjunctivitis: Case report and a review of the literature

Purpose: To describe management of a patient with ligneous conjunctivitis secondary to plasminogen deficiency and review the literature on treatment with plasminogen. Design: Interventional case report. Methods: A 6-year-old Caucasian girl developed ligneous conjunctivitis recalcitrant to debridement and treatment with topical cyclosporin A and steroids. The literature was reviewed regarding treatment of ligneous conjunctivitis with plasminogen. Results: The patient was treated with plasminogen containing drops derived from her father’s fresh frozen plasma. The ligneous conjunctivitis resolved, and the patient was managed on these drops for the following 8 years, initiating treatment for flares and tapering according to clinical response. Conclusions: Plasminogen drops concentrated from fresh frozen plasma are a safe and effective option for long-term treatment of ligneous conjunctivitis.

Six steps for a successful phacoemulsification in hard cataracts

Phacoemulsification in rock-hard cataracts is always challenging for the phaco surgeon. Patient presenting with hard cataract is common in rural and suburban areas. In such situations phaco surgeons face higher incidence of significant complication like endothelial cell loss, posterior capsular rupture, zonular dialysis. By judicious use of the appropriate technology like perfect power modulations, enhanced fluidics, adequate OVDs usage better results can be achieved in these cases. In this short communication we have put together six salient steps that would help the surgeon in achieving successful phacoemulsification in hard cataracts.

Normal tension glaucoma: Prevalence, etiology and treatment

Normal tension glaucoma is the most common type of glaucoma among people of east Asian countries. While a significant minority of cases of normal tension glaucoma respond to drugs or surgical procedures that lower intra-ocular pressure, most cases continue to progress, resulting in a continuing loss of visual field and blindness. We here review the current state of knowledge of this debilitating disease, and evaluate a promising pilot study showing a potential route to evaluate normal tension glaucoma and to effectively treat it with a vitamin and mineral supplement.

Not dominance but the loss of binocularity determines the success of monovision

Purpose: To determine whether ocular dominance strength influences success of monovision Design: Single-center, prospective, double blind crossover. Subjects received contact lenses with reading addition added to the left eye in the first trial period and to the right eye in the second period so that the type of monovision was randomized and blinded for the test subject and the investigator. Methods: 17 presbyopic subjects, aged 50-65, received conventional and crossed monovision, each for 2 weeks. Satisfaction, stereopsis (TNO, Titmus) and Snellen visual acuity were measured. Ocular dominance was examined according to Haidinger and +1D test. Results: Pearson correlation coefficient between strength of ocular dominance and subject satisfaction was ρ=0.088 for the conventional and ρ=0.000 for the crossed group. 93% of subjects were most satisfied with the type of monovision that yielded the highest Titmus score. For the TNO test this was only 64%. A statistical significant interaction effect was shown for this relationship (ρ=0.019). Conclusion: A significant correlation between dominance strength, refraction error and satisfaction could not be found. However, we observed that the highest stereopsis score according to the Titmus test was more likely to yield a higher satisfaction when comparing conventional and crossed monovision. When a physician opts for monovision correction, the Titmus test can be performed with test spectacles or contact lenses to decide which eye should be corrected for distance vision. The choice should be in favor of the correction that yields the best Titmus score.