No abstract

PURPOSE:To report the outcomes of Bowman-Stromal Inlay (BSI) and corneal cross-linking (CXL) performed in the right and left eyes, respectively, of a pediatric patient with bilateral progressive ectasia. METHODS:A 10-year-old boy underwent CXL in his left eye for stage 2 keratoconus and BSI in his right eye for stage 4 keratoconus. Serial refractive and tomographic outcomes were recorded and analyzed. RESULTS:There was no progression of ectasia in either eye through the final follow-up visit at 28 months postoperatively. Compared to the left eye that underwent CXL, the right eye that underwent BSI showed a reduction in tomographic keratometry, astigmatism, superior-inferior asymmetry, and increased pachymetry. There was no perioperative complication in either eye.CONCLUSIONS: CXL and BSI achieved similar outcomes over the course of 2 years in arresting the progression of ectasia. BSI may have the additional benefit of increased postoperative pachymetry.

Rhodotorula mucilaginosa rarely cause keratitis in immunocompromised individuals. A 30 year old male with history of minor trauma presented with cotton wool like stromal infiltration and hypopyon in left eye. Microbiological examination of corneal scraping showed fungal hyphae and yeast cells in direct smear. Molecular identification of the organism was performed which showed 100% homology with Rhodotorula mucilaginosa. Management of these cases is difficult often necessitating surgical procedures. However further reports are necessary to understand the disease and establish a treatment protocol.

Situs inversus of the optic disc is a rare, usually bilateral, congenital embryological abnormality associated with high myopia, optic disc coloboma or tilted optic disc. It is characterized by emergence of the retinal vessels in an anomalous direction with dysversion of the optic disc. In this report we present a 13-year-old boy diagnosed with isolated, unilateral situs inversus of the optic disc associated with reduced binocularity and stereoacuity resembling a monofixation syndrome. The clinicians should be aware of this association and assess the binocularity in patients with unilateral optic disc or macular anomalies. Conversely, patients with reduced binocularity and stereoacuity should be carefully evaluated for macular or optic nerve anomalies, if not associated with strabismus, anisometropia and eccentric fixation. Typical fundus picture, optical coherence tomography and multifocal electro retinogram of the patient would be instructive to a clinician.