Popis vývoje klinického očního nálezu 23 pacientů (35 očí) se steroidy indukovanou zadní subkapsulární kataraktou rozlišného původu se zaměřením na její charakter a mechanismus vzniku. Metodika: Retrospektivně byla vyhodnocena zdravotnická dokumentace 23 pacientů, 14 žen, 9 mužů, s průměrným věkem 44,5 let (medián 44 let, interval 29-52 let), kteří byli v době od 5/2016 do 5/2018 operováni na oční klinice Gemini Ostrava Bělský les. U všech pacientů bylo provedeno komplexní oční vyšetření a provedena operace katarakty s implantací umělé nitrooční čočky. Výsledky: U všech těchto pacientů jsme zaznamenali výskyt různých stádií zadní subkapsulární katarakty v korelaci s užíváním steroidní léčby lokálně, celkově per os, inhalačně i kombinovaně podávané u pacientů v presenilním věku. Pooperačně došlo k signifikantnímu zlepšení CDVA (corrected distance visual acuity) u všech nemocných v souboru. Závěr: Steroidy indukovaná katarakta je klinická diagnóza vyhrazena pro stavy vzniku katarakty v návaznosti na dávce a délce užívání kortikoidní medikace. Diagnostický diagram tohoto procesu zdá se býti jednoznačný, vyžadující důkladné vyšetření očního nálezu, pečlivě odebranou interní a farmakologickou anamnézu pacienta. Základním léčebným přístupem je operace katarakty, která by měla být prováděna zkušeným chirurgem pro vyšší riziko možných komplikací. Klíčová slova: zadní subkapsulární katarakta, kortikoidy, presenilní věk, nežádoucí účinky SUMMARY CORTICOSTEROID INDUCED POSTERIOR SUBCAPSULAR CATARACT Objective: A description of the development of a clinical ocular finding of 23 patients (35 eyes) with steroid-induced posterior subcapsular cataract of different source, focusing on its character and mechanism of origin. Methods: The medical records of 23 patients, 14 women, 9 men, median age 44.5 years (median 44 years, interval 29-52 years) were evaluated retrospectively and had undergone surgery from 5/2016 to 5/2018 at Gemini Eye Clinic Bělský les. All patients underwent a complex eye examination and cataract surgery with artificial intraocular lens implantation. Results: In all of these patients, the incidence of the various stages of the posterior subcapsular cataract was correlated with the use of steroid therapy locally, generally per os, inhaled or combined, mainly in pre-adolescent patients. Postoperatively, a significant improvement in CDVA (corrected distance visual acuity) was observed in all patients in the set. Conclusion: Steroid-induced cataract is a clinical diagnosis reserved for conditions of cataract formation in relation to the dose and duration of use of corticosteroid medication. The diagnostic diagram of this process seems to be unambiguous, requires a thorough examination of the ocular finding and carefuly obtain internal and pharmacological history of the patient. The basic treatment approach is cataract surgery, which should be performed by an experienced surgeon for a higher risk of possible complications.

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Chemical burns are sight-threatening injuries that require immediate management. The main goal of the initial treatment is prompt and copious irrigation to neutralize and eliminate the chemical, followed by various therapeutic options (conservative and surgical) according to the individual patient’s postinjury findings. Purpose: In this case report, we describe the course and treatment of a patient with chemical alkali burns of both eyes. This study reports the outcomes of an ocular alkali burn patient who became infected with COVID-19 and where severe keratouveitis with corneal graft melting and hypopyon occurred, ultimately resulting in evisceration of the eye. Observations: We report the case of a 35-year-old woman, after an alkali burn of both eyes. Complete re-epithelialization of both corneas occurred within three weeks. Due to this observation, we assumed a satisfactory healing prognosis. However, corneal lysis occurred in the left eye over time. The condition was managed, but subsequently severe keratouveitis with hypopyon and corneal lysis occurred in the left eye, apparently in connection with the COVID-19 infection, which ultimately led to the evisceration of the affected eye. Conclusions and Importance: In the case report, we describe the management of a mild chemical alkali burn of the right eye and a complicated moderate burn of the left eye with an alkaline chemical. Both eyes were completely healed within three weeks. However, the findings on the left eye became complicated, which ultimately led to the evisceration of the affected eye. The disease of COVID-19 could have contributed to the deterioration of the findings on the cornea, or it could have just been a coincidence of two diseases, with the keratouveitis having a serious course due to the previous difficult course of healing and many complications after the chemical burn.