Purpose. To determine the clinical profile of lens-induced glaucoma (LIG), reasons for late presentation, and outcome of current management. Methods. Retrospective analysis of 50 eyes with LIG over a 6-year period between 2005 and 2011 at a tertiary care centre in rural India. Visual acuity and intraocular pressure (IOP) were assessed preoperatively and postoperatively along with postoperative complications. Results. Fifty (2.4%) of 12,004 senile cataracts operated at Pravara Rural Hospital, Loni, presented with LIG. There were 39 (78%) phacomorphic cases and 11 (22%) phacolytic glaucoma. Following cataract surgery, 21 of 50 operated eyes (42%) had visual acuity 6/60 or worse. Conclusion. The results highlight the importance of early diagnosis and treatment of visually disabling cataract. There is a need to educate both the patient and the cataract surgeon about the dangers of lens-induced glaucoma and of about poor outcome if treatment is delayed.
Introduction. HIV/AIDS is one of twenty first century's biggest global challenges to mankind with protean manifestations affecting all organs of our body, not even sparing the eyes. The purpose of this study was to determine the pattern of ocular manifestations of HIV/AIDS and their correlation with CD4-count in a rural area of India. Methods. A hospital based observational cross-sectional study was done on 40 HIV-positive patients presenting to ART center with ocular complaints. Data were collected using face-to-face interview, clinical examination, slit lamp examination, fundus examination, and laboratory investigations. Results. Out of 40 patients, 21 were males and 19 were females with mean age of 38.75 ± 13.9 years. HIV retinopathy was the most common HIV-associated ophthalmic lesion while anterior uveitis was the most common anterior segment finding. Posterior segment lesions showed significant association (P < 0.05) with low CD4-count of the patient. CMV retinitis, retinal detachment, tubercular chorioretinitis, and acute retinal necrosis were all seen in patients with CD4-count less than 100 cells/mm3. Conclusions. HIV retinopathy, CMV retinitis, herpes zoster ophthalmicus, and anterior uveitis are common ocular manifestations associated with HIV infection. Low CD4-count is a risk as well as predictor for ocular manifestations. There needs to be awareness of ocular involvement among HIV infected individuals and an increased emphasis on regular ophthalmic examination.
We report a case of periocular subcutaneous macrofilariasis as an initial sign of a systemic Loa loa infection. Thorough history, eye examination, surgical intervention and parasitological analysis. A periocular adult Loa loa worm was extracted from the left upper eyelid of an Indian lady living in Mumbai after presenting to our department with sensation of worm crawling under the left upper eyelid skin. Patient was admitted and was treated with diethylcarbamazine, oral steroids and albendazole with steroid cover under observation. In an era of increasing global travel, this case highlights the importance of direct questioning of previous travel as signs may be nonspecific and transitory. With clinical suspicion of Loa loa infestation, initiation of systemic investigation should not be prolonged and early treatment should be started under observation.
Orbital abscess generally occurs in older children but it can rarely affect infants and neonates too. We report a case of community acquired methicillin resistant staphylococcus aureus (CA-MRSA) neonatal orbital abscess in a 12-day-old term female neonate with no significant past medical history or risk factor for developing the infection. The case highlights the importance of consideration of CA-MRSA as a causative agent of neonatal orbital cellulitis even in a neonate without any obvious predisposing condition. Prompt initiation of appropriate medical therapy against MRSA and surgical drainage of the abscess prevents life threatening complications of orbital cellulitis which more often tend to be fatal in neonates.
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