Cavernous sinus thrombosis (CST) is an ocular emergency because of its devastating effect and it is prone to cause serious complications. Diagnosis of cavernous sinus thrombosis is a challenging task despite medical advancement. Efforts to promptly diagnose and initiate treatment require a high index of suspicion and a deep understanding of the disease. Unfortunately, patients suffering from CST may not always present with typical symptoms, thus making diagnosis all the more challenging. We would like to describe a 22-year-old man who presented with atypical symptoms and radiological presentations of CST. The patient was admitted and treated in our institution with full recovery demonstrated after the treatment.

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Objective Epilepsy is a debilitating disease. Visual function changes have been reported and may be attributed to the epileptic changes or as a result of medication side effect. Sodium valproate and carbamazepine are both first line anti-epileptic medications used in Malaysian health care. Sodium valproate inhibits glutamate and γ-aminobutyric acid (GABA) transaminase while carbamazepine acts on the sodium channel - both are an important part of the retina. This study aimed to compare the visual functions of epilepsy patients on carbamazepine or sodium valproate monotherapy. Design A cross-sectional study was conducted at a tertiary hospital between June 2016 and November 2018. Methods Patients with idiopathic epilepsy that fulfill the inclusion and exclusion criteria were recruited from the neurology clinic. They were divided into two groups and underwent complete eye examinations. Visual functions such as color vision testing, contrast sensitivity, visual field and retinal nerve fiber layer measurement were subsequently performed. Statistical analysis was done using Statistical Package for the Social Science, version 24 (SPSS Inc, Chicago, IL, USA). Results A total of 100 patients (sodium valproate: 50 patients; carbamazepine: 50 patients) were recruited for the study. There were no statistically significant changes in anatomical or visual function between the sodium valproate and carbamazepine group. However, patients from both groups displayed color vision defect in the blue and green axes. Changes in color vision could indicate early retina toxicity secondary to the medication. Although there were no visual field changes, patients recorded a slight reduction of mean deviation. Changes of mean deviation could be attributed to the side effect of medication or the disease process. Conclusions Epileptic patients taking sodium valproate or carbamazepine did not demonstrate statistically significant change in visual function.

Background. toxoplasmosis is caused by infection from a ubiquitous obligate intracellular parasite known as Toxoplasma gondii, which can infect both human and warm-blooded animals. this infection is commonly prevalent in developing country. Objectives. the purpose of this study is to report on a 7-year review of ocular toxoplasmosis patients that presented to the Universiti Sains malaysia hospital. Material and methods. this is a retrospective review of cases. the demographic data, ocular manifestations, clinical and laboratory profiles, treatment and disease outcome were collected from the patients' medical records from January 2010 to December 2016. Results. a total of 16 patients with a diagnosis of ocular toxoplasmosis were identified. the mean age was 43.2, with standard deviation ± 15.4 years old. the percentage was 62.5% (10 patients) females and 37.5% (6 patients) male. the majority of patients were malay (93.4%, 15 patients). the most common classification of uveitis was panuveitis (56.3%, 9 patients), followed by posterior uveitis (25%, 4 patients), anterior uveitis (12.5%, 2 patients) and intermediate uveitis (6.2%, 1 patient). Keratic precipitate (75%, 12 patients) and vitritis (75%, 12 patients) were the most common ocular manifestation of ocular toxoplasmosis. a serological test for toxoplasmosis found only 1 patient with positive serum immunoglobulin m, while all patients displayed non-reactive serum immunoglobulin G (except 1 missing data). all ocular toxoplasmosis patients were treated with oral azithromycin 500 mg daily for 6 weeks, 81.3% (13 patients) were given an instillation of a steroid eye drop, while 25% (4 patients) required administration of an oral steroid. all of the patients responded well to treatment, but 25% (4 patients) suffered from recurrence, which required a second course of treatment. Conclusions. Ocular toxoplasmosis is a serious and depilating disease that can cause serious ocular morbidities. this review shows a diverse presentation of ocular toxoplasmosis as a result of toxoplasmosis infection.