We describe a case of dengue fever-associated foveolitis that presented initially to the ophthalmologists with complaints of unilateral diminution of vision. A 30-year-old Indian woman had presented with sudden onset diminution of vision in the left eye (LE) for the past 2 days. It was also associated with low-grade fever and myalgia, which started few days before visual deterioration. Fundus showed few retinal hemorrhages and tiny subretinal yellowish lesions at the fovea in the LE. Optical coherence tomography and fluorescein angiography were indicative of foveolitis. Amsler charting showed a central scotoma in the LE. She was treated with oral steroids along with supportive treatments. A nearcomplete anatomical and functional recovery was noted. Our case depicts the significance of awareness of the ophthalmic complications of dengue fever among both ophthalmologists and physicians, and also highlights the key clinical and multimodal imaging findings in a case of dengue foveolitis.
Purpose:
The aim of this study was to carry out blue light photography of fluorescein-stained corneas using a novel smartphone attachment.
Methods:
A smartphone attachment known as the cobalt blue light unit (C-BLU) was developed. It can filter out all wavelengths of light except the blue light emerging from the flashlight of a smartphone. A pilot study was carried out wherein the images captured with the C-BLU system were compared with slit-lamp photographs of the same patients. This setup was then used to photo document fluorescein-stained corneas in various clinical settings assembled at point-of-care.
Results:
Many pathologies of the fluorescein-stained cornea were captured using the C-BLU filter. It was used effectively in various settings (remote eye camps, intensive care units (ICU), pediatric group, corneal trauma triaging, etc.). C-BLU was assembled and used by optometrists and ophthalmology residents. The images captured were used for documenting, assisting in the treatment, and also for telecommunication of the patients’ findings.
Conclusion:
C-BLU is a low-cost pocket-size filter which is easy to use with a modern smartphone without any technical expertise needed to obtain a clear image of fluorescein-stained pathological corneas.
Alport syndrome (AS) is a hereditary disease with various modes of inheritance, X-linked being the the most common. Anterior lenticonus is the characteristic abnormality along with perimacular and peripheral fleck retinopathy. Our two cases of AS had simultaneous anterior and posterior lenticonus with severe temporal macular thinning on optical coherence tomography with no specific renal symptomatology and were diagnosed as AS without any invasive renal biopsy. First patient was a 19-year-old man who presented with compound myopia due to bilateral anterior and posterior lenticonus with perimacular fleck retinopathy and lozenge sign and bilateral moderate sensorineural hearing loss (SNHL). Second patient was a 24-year-old man who presented with difficulty in vision due to bilateral anterior and posterior lenticonus with bilateral severe SNHL. Our cases emphasise the crucial role of an ophthalmologist in diagnosing AS before the onset of renal symptoms and prompting further nephrological work-up in the patient or the carrier.
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