• Users Online: 1053
  • Print this page
  • Email this page
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
   Table of Contents - Current issue
Coverpage
April-June 2022
Volume 2 | Issue 2
Page Nos. 337-641

Online since Wednesday, April 13, 2022

Accessed 33,719 times.

PDF access policy
Journal allows immediate open access to content in HTML + PDF
View as eBookView issue as eBook
Access StatisticsIssue statistics
RSS FeedRSS
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list
EDITORIAL  

External photography – Get it right Highly accessed article p. 337
Santosh G Honavar, Rolika Bansal
DOI:10.4103/ijo.IJO_879_22  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

No-touch management in tick infestation of periocular skin Highly accessed article p. 341
Vaisna Gopi, Lathika V Kamaladevi, Charles K Skariah
DOI:10.4103/ijo.IJO_1620_21  
Ixodidae ticks are vectors of Lyme borreliosis, Rocky Mountain spotted fever, tick-borne encephalitis, and relapsing fever. We present a case of eyelid tick infestation in a 49-year-old patient for 1 week. A slit-lamp examination suggested it to be a tick tethered on the patient's skin. Complete removal of the tick was done with 2% lignocaine infiltration locally around the swelling. The tick fell off from the periocular skin without any further manipulation. On entomology evaluation, it was categorized to be a hard tick Rhipicephalus sanguineus belonging to the Ixodes family. The patient was put on topical moxifloxacin and chloramphenicol eye ointment. The patient was followed up after 5 days and after 2 weeks and was found to be normal.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Eccrine acrospiroma: A rare malignant tumor of the eyelid Highly accessed article p. 343
Gaurang Sehgal, Prempal Bal, Karamjit Singh, Riya Chopra, Swati Setia
DOI:10.4103/ijo.IJO_1747_21  
Eccrine acrospiroma are benign skin tumors of sweat duct origin which are occurring in eyelids. They present as small solid or cystic lesions that are confused clinically with other lesions. This is a case of eccrine acrospiroma with malignant potential of a 90 year-old female with mass over the ventral aspect of the left upper eyelid with bleeding, ulceration, and discharge. This is a rare presentation of histopathological that confirmed eccrine acrospiroma so as to alert the clinician about the differential diagnosis of mass over eye lids. By careful examination, meticulous wide excision and rigorous follow-up potential vision can be restored.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Endocrine mucin-producing sweat gland carcinoma mimicking meibomian gland carcinoma Highly accessed article p. 345
Sumeet T Lahane, Rohan A Sawant, Pragati Agarwal, Varun K Doshi, Ragini H Parekh, Tatyarao P Lahane
DOI:10.4103/ijo.IJO_1299_21  
Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare adnexal tumor of the skin with immunoexpression and neuroendocrine differentiation. It can be easily misdiagnosed as a meibomian gland tumor due to its prevalence in the Indian subcontinent over EMPSGC. It has a predilection for the skin of the eyelid and elderly females. It is histologically and immunohistochemically analogous to solid papillary carcinoma of the breast/endocrine ductal carcinoma in situ with a nodular, solid, papillary, and/or cribriform architecture, neuroendocrine differentiation, and mucin production. We describe a case of EMPSGC clinically mimicking meibomian gland carcinoma which was confirmed on immunohistochemistry and histopathological diagnosis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Ocular changes after accidental exposure to distilled water: A case series Highly accessed article p. 348
Pooja Karki, Chandra M Gurung, Archana Sharma, Ayush Joshi, Priya Bajgai
DOI:10.4103/ijo.IJO_1617_21  
We report ocular changes following accidental injection of distilled water into the anterior chamber during cataract surgery. We have documented eight eyes that had an accidental distilled water exposure in the anterior chamber following which they developed corneal edema, raised intraocular pressure (IOP), and pigment dispersion into the anterior chamber. We treated all the patients with topical steriods and sodium chloride 5% solution and anti-glaucoma medications as required. All of them had pigment dispersion and deposition into the anterior chamber and onto the corneal endothelium and the intraocular lens surface. All the patients had resolution of edema and good vision postoperatively after a month. Thus, patients who were exposed to accidental injection of distilled water into the anterior chamber during cataract surgery had a toxic reaction in the postoperative period. However, the corneal transparency was restored completely without complications with adequate treatment. A strict protocol must be followed by the OT staff and the members at various stages of surgery to prevent such mishaps from happening.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Surgery for invasive corneal neoplasia in xeroderma pigmentosum – Optimizing outcomes p. 353
Rama Rajagopal, Geetha Iyer, Bhaskar Srinivasan, Sunita Pandey, Krishnakumar Subramanian
DOI:10.4103/ijo.IJO_1320_21  
Nodular corneal invasion in xeroderma pigmentosum is rare. The depth of clinical involvement can be deceptive. Anterior segment optical coherence tomography/ultrasound biomicroscopy can aid in surgical planning. We reviewed the clinical features, surgical details and long-term outcomes of three patients who underwent superficial keratectomy, lamellar keratoplasty, and penetrating keratoplasty for invasive corneal neoplasia. The histopathology revealed squamous cell carcinoma in all three eyes. No recurrence was noted over a minimum follow-up of 4 years. Early surgery is recommended in view of the risk of deeper penetration. Besides surgery, options include plaque therapy. Comorbid conditions are best addressed sequentially, and long-term follow-up is mandatory.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Ocular dirofilariasis - A zoonosis with rapidly changing epidemiology p. 356
Vikas Sharma, Ankuj Tinna, Ishan Aggarwal, Atul K Singh, Ritesh Waghray, Arpit Srivastava
DOI:10.4103/ijo.IJO_2526_21  
Human dirofilariasis is a rare but known zoonotic infection with a worldwide geographical distribution. Ocular dirofilariasis is rare but more and more cases are being reported from all over India. Despite the southern states being endemic for this disease, cases are being reported from different Indian states due to better transport facilities, better infrastructure, and increased awareness among healthcare workers regarding this zoonosis. We present a series of three cases that focuses on the epidemiology of the disease and compares cases reported from various states, which indicates a northward shift of the disease to non-endemic states.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A rare case of post-laser-assisted in situ keratomileusis Scedosporium prolificans keratitis p. 359
Aditi Parab, Josephine S Christy, Shivananda Narayana, Joseph Gubert
DOI:10.4103/ijo.IJO_1081_21  
A 21-year-old female presented with a stick injury in her right eye 6 months after an uneventful laser in situ keratomileusis (LASIK). Diffuse lamellar keratitis which responded well to the initial treatment with topical steroids, progressed rapidly within the next 3 weeks to develop corneal perforation. A microbiological examination revealed a rare fungus Scedosporium prolificans. The patient was successfully managed with topical voriconazole 1% and cyanoacrylate glue for corneal perforation. At the end of 7 weeks, keratitis healed with a best-corrected visual acuity of hand movements. Hence, a strong suspicion of infectious interface keratitis is warranted while treating post-LASIK keratitis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Spontaneous corneal stromal bed perforation in post-laser-assisted in situ keratomileusis ectasia: A case report p. 362
Mohammed Abusayf, Abdullah Alfawaz
DOI:10.4103/ijo.IJO_2565_21  
A 30-year-old female presented to our emergency room for the first time with reduced vision in her right eye (OD) after gentle rubbing. Her ocular history revealed laser-assisted in situ keratomileusis in both eyes (OU) 10 years back. Five years later, she developed ectasia OU where only the right eye was cross-linked. Both procedures were performed at another center. Isolated corneal stromal bed perforation with severe surrounding stromal thinning was evident. Sole glue application either at the bed or the flap edge was not successful. The patient underwent Penetrating keratoplasty (PKP) with a good outcome.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Management of refractive surprise after phacoemulsification due to a decentered laser-assisted in situ keratomileusis zone: Intraocular lens power calculation using aphakic refraction methods p. 365
Samrat Chatterjee, Deepshikha Agrawal
DOI:10.4103/ijo.IJO_2960_21  
A 39-year-old male with prior history of having undergone laser-assisted in situ keratomileusis (LASIK) in both eyes was referred for management of refractive surprise of +5.0 diopter following phacoemulsification with intraocular lens (IOL) implantation in the left eye. The IOL power was re-calculated using post-LASIK IOL power formulae, but it did not differ significantly from that of the implanted IOL. Topography in the left eye showed decentration of the laser ablation zone and mild ectasia. An IOL exchange was performed in the following steps: IOL extraction, postoperative aphakic refraction to calculate IOL power, and IOL implantation. Postoperatively, there was no refractive surprise. In the right eye, the IOL power was calculated using post-LASIK IOL power formulae, which did not result in postoperative refractive surprise. Our experience highlights the efficiency of aphakic refraction over post-LASIK IOL power formulae in predicting IOL power in eyes with decentered laser ablations.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Corneal arcus and low serum high-density lipoproteins: A report of two cases of probable Fish eye disease p. 369
Pallak Kusumgar, Cynthia Amrutha Sukumar, Shipra Rai, Yogish Subraya Kamath
DOI:10.4103/ijo.IJO_1789_21  
We report two cases with dense corneal arcus with abnormally low levels of serum high-density lipoproteins. One case with arcus senilis had a history of corneal clouding since youth but no systemic associations. The other case had an arcus juvenilis with anemia and hepatosplenomegaly but an absence of renal involvement. The genetic analysis of this case was performed and was suggestive of lecithin-cholesterol aminotransferase deficiency.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Recurrence in Reis Bücklers corneal dystrophy: Clinicopathological correlation p. 371
Murugesan Vanathi, Alisha Kishore, Yogita Gupta, Prithvi Bheemanna Setty, Seema Sen, Tapas C Nag, Ranjan Gupta, Arundati Sharma, Radhika Tandon
DOI:10.4103/ijo.IJO_2410_21  
We report a case series highlighting clinical correlation of recurrence of Reis–Bucklers corneal dystrophy (RBCD) with histopathology (HPE), genetic analysis, and electron microscopy (EM). This was an interventional case series of three cases in three generations of one family. The index case was a 23-year-old male with bilateral recurrent RBCD following OD PTK and OS ALTK done 6 years earlier. His father had undergone OU PK. His 35-year-old sister and 9-year-old niece were also affected who underwent OU ALTK. Clinical examination, histopathological examination (HPE), and electron microscopy (EM) evaluation were done. The recurrence of RBCD was noted in one of the three members of the same family. Corneal examination showed a dense reticulate pattern of epithelial-stromal involvement. On HPE, disrupted Bowman's membrane and underlying abnormal subepithelial collagen staining positive with PAS and Masson's trichrome were noted. On EM, degenerated stroma with dense collagen fibrils in aggregates, dispersed among regular collagen fibrils, were noted. All four members showed TGFß1 mutation (chromosome 5q31) with Arg124Leu mutation. A trend toward more advanced presentation with increasing age of cases was noted. The clinical and pathological correlation was performed. Clinical correlation with HPE, EM with genetic analysis of RBCD is interesting with presentation severity varying in different generations.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Severe marginal sterile keratitis in a patient with staphylococcal endophthalmitis after phacoemulsification p. 376
Yi-Ting Hou, Bing-Jun Hsieh, Jo-Hsuan Wu, Wei-Li Chen
DOI:10.4103/ijo.IJO_924_21  
Postoperative endophthalmitis is sight-threatening, severe inflammation in posterior vitreous cavity and anterior chamber. Marginal keratitis with infiltrates or ulcers following endophthalmitis can be infectious or sterile, but the etiologies related to intraocular infection have rarely been reported. Here we present an unusual case of severe marginal keratitis with sterile infiltrates concomitant with staphylococcal endophthalmitis after phacoemulsification. Creamy white ring infiltrates at the corneolimbal junction was found with severe vitritis. With antibiotics treatment, endophthalmitis improved while the corneal infiltrates progressed. After corneal specimens yielded negative results, the corneal infiltrates improved under proper topical corticosteroid without marked sequelae. In conclusion, noninfectious, immune-related marginal sterile keratitis may develop in patients with staphylococcal endophthalmitis after phacoemulsification.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Recurrent herpes simplex virus nummular keratitis in a case of irritable bowel syndrome and seronegative ankylosing spondylitis p. 379
Pratik Bhadra, Somasheila I Murthy, Savitri Sharma, Sangeeta Wagh, Esther Sheba
DOI:10.4103/ijo.IJO_2575_21  
A 35-year-old male presented with a 16-month history of left-eye recurrent redness, photophobia, and blurring in his left eye. Systemically, he suffered from irritable bowel syndrome and HLA-B27-negative spondyloarthropathy. The cornea showed multiple nummular epithelial and anterior stromal lesions. The aqueous sample was positive for herpes simplex virus-1 DNA (glycoprotein-D gene) by polymerase chain reaction. The lesions resolved with oral acyclovir and topical dexamethasone 0.01% in tapering doses; however, he continued to have recurrent periodic redness even at 1 year. We hypothesize that coexisting systemic immune-mediated conditions may have a role in altering the disease course leading to its prolongation in our case.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Fungal corneal ulcer in a 27 weeks primigravida with anemia and multi-vitamin deficiency p. 382
Siddharth Madan, Sarita Beri, Sarah Khan, Pragya Prakash, Rajesh Jain
DOI:10.4103/ijo.IJO_957_21  
Fungal keratitis is an infection of the cornea which can lead to severe visual compromise if not diagnosed on time and managed appropriately. It may present with minimal symptoms and many signs. Likely to be overlooked by the patient, it results in a late presentation when substantial damage has already occurred. It is usually seen in patients with a severe immune compromise such as acquired immunodeficiency syndrome (AIDS), uncontrolled diabetes, transplant patients on immune-suppressants or long-term steroids, and in pre-existing ocular surface disorder. This is a case report of a 27-week primigravida who presented with extreme fatigue and a fungal corneal ulcer with no preceding history of trauma or any other immune compromised state.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Management of progressive keratoconus in a patient with xeroderma pigmentosum after treatment of ocular surface tumors p. 385
Julia J Carvalho, Alléxya A A Marcos, Melina C Morales, Rubens N Belfort, Denise de Freitas, Myrna Serapião dos Santos
DOI:10.4103/ijo.IJO_2084_21  
We report a 16-year-old female patient with diagnosis of xeroderma pigmentosum (XP), previously treated for simultaneous conjunctival squamous cell carcinoma in the right eye (OD) and conjunctival melanoma in the left eye (OS), showing progressive keratoconus during follow-up. Considering the risk of cross-linking treatment due to UV exposure in XP patients, an intrastromal corneal ring segment was implanted in the right eye. The patient was fitted with mini-scleral lenses that would promote corneal lubrication and provide the patient with better visual acuity than glasses. The patient has been followed-up for 1 year with no tumor recurrence and good vision.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Hyperacute stromal and endothelial rejection in therapeutic penetrating keratoplasty with residual intra-stromal crystalline deposits p. 388
Manokamna Agarwal, Bhaskar Srinivasan, Geetha Iyer, Shweta Agarwal, Sridharan Sudharshan, Jothi B Janarthanam, Rama Rajagopal
DOI:10.4103/ijo.IJO_2443_21  
Stromal rejection is rare and uncommonly seen in its pure form. We report a case of hyperacute stromal rejection followed by endothelial rejection post-therapeutic penetrating keratoplasty (PK) done for fungal keratitis. The rejection episode responded to steroids with a clearing of the graft. Residual mid to deep intra-stromal crystalline deposits remained at the area of stromal rejection, which remained stationary for a follow-up period of 1 year. The patient underwent Anterior segment optical coherence tomography (AS-OCT) to demonstrate the condition objectively.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bilateral symmetrical spontaneous anterior capsule rupture of the cataractous lens in a child p. 391
Chinmayee J Thrishulamurthy, Deepthi Saiprasad
DOI:10.4103/ijo.IJO_1689_21  
We report the management of a rare case of bilateral, symmetrical, and spontaneous anterior lens capsule rupture with total soft cataractous lens in a 7-year-old child. The patient had no other predisposing factors or systemic associations. Bilateral lens aspiration was done through the fibrosed capsular opening, which behaved like a stable capsulorhexis and hydrophobic intraocular lens was implanted. At 6 weeks follow-up, the patient had good visual outcome without any astigmatism. Although capsule rupture is reported in trauma, Alports syndrome or in hypermature cataracts, to our best knowledge this is the first case report of bilateral symmetrical spontaneous anterior capsule rupture in an otherwise normal child.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Bilateral pediatric spontaneous anterior capsular rupture p. 393
Savleen Kaur, Jaspreet Sukhija
DOI:10.4103/ijo.IJO_2429_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORT Top

Electron microscopic analysis of explanted opacified posterior chamber intraocular lens p. 395
Kandagadla Jyoti, Maj Sumedha Vats
DOI:10.4103/ijo.IJO_2729_21  
Opacification of intraocular lens rare phenomenon occurs and causes extreme diminution of vision in patients even after uneventful cataract surgery. Several reports of wrong diagnosis and delayed diagnosis of an opacified IOL leads to delayed treatment. The opacified IOL needs to be removed and exchanged with another PCIOL. This case report describes the electron microscopic analysis of an explanted intraocular lens and also gives details of the chemical composition. This is the first case report where presence of potassium has been noted in the opacified IOL as was detected by Scanning electron microscopic analysis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Intraocular lens opacification: Study by advanced microscopy and spectroscopy p. 397
Dipankar Das, Harsha Bhattacharjee, Obaidur Rehman
DOI:10.4103/ijo.IJO_3214_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

An unusual case of hide and seek with a broken piece of a preloaded trifocal intraocular lens following an uneventful phacoemulsification Highly accessed article p. 399
Tanie Natung, Thangjam A Singh, Ishita Pandey, Oinam S Devi
DOI:10.4103/ijo.IJO_2200_21  
Breakage of an intraocular lens (IOL) haptic during implantation is a rare complication of cataract surgery. We report here a case of a broken fragment of a trifocal IOL playing hide and seek and causing corneal edema repeatedly after an uneventful phacoemulsification and preloaded trifocal IOL (AT LISA tri 839MP) implantation. It was ultimately removed successfully and the patient achieved good vision. It is postulated that the broken piece of IOL migrated to and fro, from sulcus to anterior chamber. The breakage of IOL should also be kept in mind in the case of postoperative corneal edema when other causes have been ruled out.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Uveitis-Glaucoma-Hyphema syndrome following sutureless scleral fixated intraocular lens: A case report p. 402
Manavi D Sindal, Kanika Chhabra, Ayushi Sinha
DOI:10.4103/ijo.IJO_731_21  
Uveitis-glaucoma-hyphema (UGH) syndrome is a rare complication usually seen with anterior chamber intraocular lens. We report the occurrence of sudden-onset blurred vision and pain 1 year after an uneventful sutureless scleral fixated intraocular lens (SFIOL) implantation. Despite initial conservative management, the symptoms persisted. A recurrence of VH, uncontrolled IOP, and an irritable painful eye led to the diagnosis of UGH syndrome, and the SFIOL was explanted. We postulate a floppy iris secondary to previous trauma with resultant iris chaffing as the cause for the occurrence of UGH syndrome.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Pigmented hypopyon – An approach to management p. 404
Kushal Umeshbhai Agrawal, Kashmira Limaye Joshi
DOI:10.4103/ijo.IJO_1353_21  
A 60-year-old Indian male presented with diminution of vision in the right eye for 3 months duration. Subsequent evaluation showed signs of granulomatous anterior uveitis, scleral thinning and brown colored pigmented hypopyon in the right eye. Patient was thoroughly evaluated for all possible associations of pigmented hypopyon. He was found to have positive mantoux test, QTB Gold test, positive culture for Mycobacterium tuberculosis on Middlebrook 7H9 medium and positive MPT64 antigen test confirming the diagnosis of intraocular tuberculosis. He was treated with anti-tubercular treatment and oral steroids and subsequently with dexamethasone intravitreal implant. He had complete resolution of pigmented hypopyon with improvement in visual acuity. This case highlights an approach to management in cases of pigmented hypopyon and also highlights that an aggressive management in such cases is pertinent to saving the eye and vision.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Pigmented hypopyon - An approach to management p. 407
Atul Arora
DOI:10.4103/ijo.IJO_2597_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Resolution of malignant glaucoma following laser capsulo-hyaloidotomy through the optic hole of intraocular lens p. 408
Rashmi Krishnamurthy, Siddharth Dikshit, Keerthi Burugupally, Shaveta Singla
DOI:10.4103/ijo.IJO_1324_21  
We report a case of pseudophakic malignant glaucoma who was managed with laser capsulo-hyaloidotomy through the dialing hole of the optic of the nonfoldable intraocular lens (IOL). Our case presented with sudden, painful decreased vision in the left eye since 15 days, 3 years after cataract surgery. There was a uniformly shallow anterior chamber with a high intraocular pressure (IOP) of 52 mm Hg and glaucomatous disc damage. After performing laser capsulo-hyaloidotomy through the optic hole of the IOL, we noticed deepening of the anterior chamber, improvement in vision, and good IOP control on antiglaucoma medication, thus showing complete resolution of aqueous misdirection and obviating the need for surgical management.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Is XEN-glaucoma gel microstent safe enough in phakic eyes? p. 411
Oksan Alpogan
DOI:10.4103/ijo.IJO_3817_20  
Minimally invasive glaucoma surgery (MIGS) is usually preferred as it causes less complications in glaucoma surgery. XEN Glaucoma Gel Microstent (XEN-GGM, Allergan Plc., Parsippany, New Jersey) is one of the MIGS used in glaucoma surgery. Different complications of XEN-GGM that developed during or after the operation have been reported. In our case, anterior capsule perforation occurred and a cataract consequently developed during the XEN-GGM application. For this reason, the measures that must be taken during XEN-GGM application in phakic patients are discussed.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Spontaneous resolution of hypotony after Aurolab aqueous drainage implant due to fibrous ingrowth p. 413
Muralidhar Rajamani, Craig J Chaya, Chitra Ramamurthy
DOI:10.4103/ijo.IJO_1068_21  
Peritubular leak after glaucoma drainage device implantation causing hypotony can occur with the use of needles with a bore larger than 25 G for creating an entry track for the tube. We report a patient who developed persistent hypotony probably due to peritubular leak after Aurolab Aqueous Drainage Implant implantation using a 22-G needle. The hypotony spontaneously resolved 7 months after surgery due to fibrous ingrowth. High intraocular pressures due to tube blockage were treated with Nd: YAG laser to clear the fibrous ingrowth. Surgeons should be aware of fibrous ingrowth as a complication of using a large-bore needle track for tube insertion.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Pars plana relocation of existing glaucoma implant for tube exposure and corneal endothelial decompensation p. 416
Gowri J Murthy, Praveen R Murthy, Sunitha M N Gowda, Sneha Priya Prabhakar, Meghana R Hiremath
DOI:10.4103/ijo.IJO_2183_21  
Glaucoma implant tube exposure and corneal endothelial decompensation are complications of implant surgeries in eyes with glaucoma. We describe a surgical method of managing these complications by relocation of the existing anterior chamber implant tube into the pars plana, after a three-port pars plana vitrectomy. We studied eight eyes of eight patients, four with perilimbal tube exposure and four with endothelial decompensation, who underwent the procedure. Four eyes of the four patients had resolution of tube exposure without recurrence and maintained stable intraocular pressure (IOP); visual acuity and IOP remained stable in the endothelial decompensation group.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Possible IgG4-related disease in a case of necrotizing scleritis p. 419
Divya Giridhar, Marian Pauly, Vinay S Pillai, Giridhar Anantharaman, Krishnakumar Subramanian, Padmanabha Shenoy, Anuroopa Vijayan
DOI:10.4103/ijo.IJO_1455_21  
Necrotizing scleritis can be a diagnostic and therapeutic challenge. We present a case of a 51-year-old female, who had necrotizing scleritis treated for 9 years with intermittent corticosteroid therapy. In view of its recalcitrant nature, she underwent scleral biopsy, which revealed histopathological features suggestive of IgG4- related disease. This case report highlights the importance of including IgG4-related disease as a differential diagnosis of scleritis and the role of scleral biopsy as a diagnostic tool in unresponsive cases.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Low-dose rifabutin-induced uveitis with premature occurrence: A case series of rare presentation p. 422
Sumedha Vats, Mohini Agrawal, S Srikanth, Poninder Kumar, Ranjit Goenka
DOI:10.4103/ijo.IJO_2814_21  
Rifabutin is a known-drug prescribed for prophylaxis and treatment of Mycobacterium avium complex (MAC) and causes dose-related anterior uveitis in immunocompromised individuals, particularly, those infected with HIV. Previous studies have reported rifabutin-induced uveitis with high doses. It is infrequent with 300 mg/day or less; moreover, it takes weeks to months to develop. We report three HIV cases that on treatment with low-dose 300 mg rifabutin presented with anterior uveitis with early occurrence. Furthermore, one of the cases had rifabutin-induced panuveitis, another rarity. Thus, although rare, low-dose rifabutin-induced uveitis with early presentation should be kept as a differential diagnosis of unusual presentation of uveitis in HIV, early management of which prevents visual morbidity.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A pediatric case of West Nile virus chorioretinitis associated with unilateral acute idiopathic maculopathy p. 424
Hajer Ben Amor, Marwa Daoud, Habib Besbes, Imen Ksiaa, Slaheddine Chouchane, Bechir Jelliti, Sana Khochtali, Moncef Khairallah
DOI:10.4103/ijo.IJO_2577_21  
We report a pediatric case of unilateral acute idiopathic maculopathy (UAIM) associated with West Nile virus (WNV) infection. A 10-year-old child with a 15-day history of presumed acute viral encephalitis, complained of blurred vision in the right eye. Clinical and multimodal imaging findings, including disruption of the foveal ellipsoid zone (EZ) with preservation of the external limiting membrane on Swept Source OCT (SS OCT), were consistent with UAIM. The finding of associated curvilinear chorioretinal lesions in the setting of encephalitis led a diagnosis of WNV infection to be considered and subsequently confirmed by serology. The EZ spontaneously restored over a few weeks with near complete visual recovery. This is a unique pediatric case of UAIM associated with serologically proven WNV infection.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Use of intravitreal dexamethasone implant to control paradoxical worsening in a case of syphilitic acute placoid posterior chorioretinitis p. 427
Manpreet Brar, Dilraj Singh Grewal, Satinder Pal Singh Grewal, Mansi Sharma, Rahatdeep Singh Brar, Mangat Dogra
DOI:10.4103/ijo.IJO_417_21  
Paradoxical worsening of ocular syphilis after initiation of antimicrobial therapy is rare, however it is important for the clinicians to be aware of this occurrence, as prompt recognition and timely intervention with corticosteroids can lead to restoration of vision. Alteration/discontinuation of antimicrobial therapy may not be indicated. Our case highlighted the role of dexamethasone implant to control such paradoxical worsening in a young patient with ocular syphilis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Serial swept-source optical coherence tomography angiography changes within deeper choroid in tubercular serpiginous-like choroiditis: A case report p. 430
Rushik Patel, Kushal Delhiwala, Bakulesh Khamar
DOI:10.4103/ijo.IJO_2004_21  
A 31-year-old female was diagnosed with active placoid tubercular serpiginous-like choroiditis (TB-SLC) in the right eye. Serial swept-source optical coherence tomography angiography (SS-OCTA) of deeper choroid revealed unique dilated, tortuous, and disorganized tangled network of medium-sized choroidal vessels (MCV) at presentation (mimicking bag-of-worms) with increased compactness on paradoxical worsening and significant reorganization on resolution. SS-OCTA of choriocapillaris (CC) revealed extensive flow void at presentation, which increased on paradoxical worsening and its reversal with minimal CC atrophy on resolution. Visual acuity improved from 20/200 to 20/30. Serial changes from presentation till resolution provide hypothesis about unique appearance within choroid in TB-SLC lesion.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Malignant hypertension in a child - What lies beneath? p. 434
Marushka Aguiar, S Mahesh Kumar, Shashikant Shetty, Renu P Rajan
DOI:10.4103/ijo.IJO_1746_21  
We report a case of a 7-year-old girl presenting to the Neuro-Ophthalmology OPD with only complaints of chronic headache who was found to have malignant (grade 4) hypertensive retinopathy. Visual acuity was 20/400 in the right eye and 20/80 in the left eye. Blood pressure was 220/120 mm Hg. The patient was not a known hypertensive. Fundoscopy revealed bilateral optic disc swelling, macular stars, and serous retinal detachment in both eyes. The patient was urgently referred to pediatrician for detailed evaluation and systemic control of hypertension. This emphasizes the need for checking blood pressure in children presenting with chronic headache.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Hypertensive choroidopathy with bilateral multiple ink blot fluorescein leakage similar to acute central serous chorioretinopathy in a patient using synthetic cannabinoids (Bonzai) p. 437
Utku Limon, Betül Ilkay Sezgin Akçay
DOI:10.4103/ijo.IJO_2105_21  
We report a case of using synthetic cannabinoids (Bonzai) with hypertensive choroidopathy with bilateral multiple inkblot fluorescein leakage similar to acute central serous chorioretinopathy (CSC). The systemic blood pressure of the patient was 210/140 mm Hg. In fundus fluorescein angiography (FFA), there were multiple inkblot hyperfluorescent areas and an enlarging spot of fluorescein in the early phases and increased in the late phases similar to acute CSC in both eyes. All of the multiple focal hyperfluorescence areas in the FFA had disappeared, and hypofluorescent areas remained in their places at second month with systemic blood pressure regulation.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A rare finding of lamellar macular hole with lamellar hole-associated epiretinal proliferation in retinal vein occlusion p. 440
Kshitiz Kumar, Tushar K Sinha, Debashish Bhattacharya
DOI:10.4103/ijo.IJO_2139_21  
A 69-year-old female presented with right eye vision of 20/120 Snellens. Ultrawide-field fundus imaging showed old vitreous hemorrhage with superotemporal sclerosed vessels post venous occlusion. Spectral-domain optical coherence tomography revealed degenerative lamellar macular home (LMH) with lamellar hole-associated epiretinal proliferation (LHEP). The patient underwent surgery using vitrectomy with the embedding technique. Post surgery, good recovery of the foveal contour was achieved with vision improving to 20/40. LMH with LHEP can be a sequela of chronic macular edema in RVO.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Fundus autofluorescence in detection of embolus in retinal artery occlusion p. 443
Pradeep Sagar, Suchitra Biswal, HN Ravishankar
DOI:10.4103/ijo.IJO_1769_21  
Fundus autofluorescence (FAF) is a noninvasive imaging tool helpful in various retinal and choroidal diseases. In this series, we report the utility of FAF in two cases of retinal artery occlusion (RAO). Cholesterol embolus was seen as a bright hyper autofluorescent foci on FAF in a case of branch RAO. Platelet fibrin embolus exhibited minimal hyper autofluorescence in another case of multiple RAO in contrast to bright hyper autofluorescence of cholesterol embolus. Fundus autofluorescence may be helpful in easier identification of cholesterol embolus in RAO and helps in differentiating it from platelet fibrin embolus.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Unilateral proliferative diabetic retinopathy following central retinal vein occlusion p. 445
Sashwanthi Mohan, Muna Bhende
DOI:10.4103/ijo.IJO_1223_21  
This case report describes a diabetic patient with nonischemic central retinal vein occlusion who developed findings suggestive of proliferative diabetic retinopathy in the same eye, with a normal retina in the right eye 3 years after presentation.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Unilateral proliferative diabetic retinopathy following central retinal vein occlusion p. 447
Ashish Markan, Mohit Dogra, Manasi Tripathi
DOI:10.4103/ijo.IJO_2590_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Refractory perifoveal exudative vascular anomalous complex like lesion responding to intravitreal dexamethasone implant: A therapeutic challenge p. 449
Ashok Nataraj, Jay Sheth, Manoj Soman, Unnikrishnan Nair
DOI:10.4103/ijo.IJO_1000_21  
A 66-year-old male patient presented with the right eye (OD) decreased vision for 1 month duration. His best-corrected visual acuity (BCVA) was 6/36 in OD and 6/6 in the left-eye (OS). He had bilateral non-proliferative diabetic retinopathy (NPDR) changes with the presence of a large perifoveal aneurysmal lesion, which was diagnosed as perifoveal exudative vascular anomalous complex (PEVAC)-like lesion based on clinical evaluation, spectral domain optical coherence tomography (SD-OCT), and fundus fluorescein angiography (FFA). The patient underwent three intravitreal ranibizumab injections with minimal response. However, he showed excellent improvement in BCVA to 6/6 with complete resolution of fluid on SD-OCT after switching to intravitreal Ozurdex implant. This case highlights that an intravitreal dexamethasone implant can be considered as a viable option for the optimal management of PEVAC-like lesions, with good visual acuity outcomes and morphologic response on SD-OCT. Further studies are warranted to gain better insight into the pathogenesis of PEVAC-like lesions and the potential role and mechanism of action of intravitreal dexamethasone implant in its management.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Commentary: A thesaurus for aneurysms - Anomalous exudative complexes, capillary macroaneurysms, TelCaps, macro- microaneurysms p. 453
Pradeep Sagar, Mahesh Shanmugam, Guruprasad Ayachit, Shrinivas Joshi, Apoorva Ayachit
DOI:10.4103/ijo.IJO_2900_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Wide-field swept source optical coherence tomography angiography for peripheral polyps in peripheral exudative hemorrhagic chorioretinopathy - A case report p. 454
Charu Gupta, Sandeep Kumar, Daraius Shroff, Stuti Astir, Cyrus Shroff
DOI:10.4103/ijo.IJO_1292_21  
We depict the novel use of wide-field swept-source optical coherence tomography angiography (SSOCTA) to image and longitudinally follow peripheral polyps in peripheral exudative hemorrhagic chorioretinopathy (PEHCR). A 65-year-old man with hemorrhagic mounds in the temporal mid-periphery of his left eye underwent wide-field en face and cross-sectional SSOCTA at the baseline and 3 monthly with a total follow-up of 10 months. We were able to image the peripheral polyps and branching vascular network (BVN) on wide-field SSOCTA and document its response to treatment. The SSOCTA findings correlated well to the gold standard indocyanine green angiography (ICGA).
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Torpedo maculopathy with bilateral familial fleck retina: An unusual coexistence p. 458
Mahesh Kumar, Kanchan Singh, Gottipati Ravichandra, Akash Patel, Monika Kapoor, Rahul Bhargava
DOI:10.4103/ijo.IJO_1610_21  
This report describes a patient with redness in the left eye and normal vision. Routine fundus examination revealed bilateral macular sparing multiple yellow white retinal flecks situated beneath the retinal vessels. In the right eye, a torpedo-shaped hypopigmented lesion with a hyperpigmented temporal edge was observed temporal to the macula. There was mild thickening of retinal pigment epithelium on spectral-domain optical coherence tomography and retinal thinning and atrophy. Fundus autofluorescence showed multiple hyperfluorescent lesions around the posterior pole with a normal signal and a torpedo lesion of variegated autofluorescence in the right eye. The unusual coexistence of unilateral torpedo maculopathy with bilateral retinal flecks is being reported here.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Multimodal imaging features of a case of aripiprazole-induced retinopathy p. 461
Anamika Patel, Avinash Pathengay
DOI:10.4103/ijo.IJO_2395_21  
Case of a 52-year-old schizophrenic female with uniocular retinopathy like presentation is described who was on aripiprazole medication for last fifteen years. This case report illustrates the multimodal imaging features of this rare case presentation.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Tamoxifen maculopathy – A case with early optical coherence tomography changes p. 463
P Sai Kiranmayee, Viswanath Kalluru, Vishal Govindahari
DOI:10.4103/ijo.IJO_2350_21  
Tamoxifen is an antiestrogen agent used as adjuvant therapy in breast carcinoma. Crystalline maculopathy due to tamoxifen toxicity, though rare, causes irreversible changes in the retina. High-resolution imaging like spectral-domain optical coherence tomography (SD-OCT) can detect early degenerating changes like crystalline deposits and cavitation in the retina. Early detection helps in the prevention of visual loss by prompt consideration in discontinuing or replacing the drug. Periodic screening with SD-OCT is essential as structural changes in the retina are noted even in asymptomatic patients receiving low-dose tamoxifen.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Acute eclipse retinopathy: Significance of hyper-reflective foci on optical coherence tomography scan - A case report p. 465
Iva R Kalita, Harsh V Singh
DOI:10.4103/ijo.IJO_2196_21  
Eclipse retinopathy is a rare clinical entity occurring as a result of unprotected gazing at the solar eclipse. OCT features of eclipse retinopathy vary with time of presentation and degree of damage. The presence of hyperreflective foci (HRF) in acute solar retinopathy has never been described in past. We are reporting a case of eclipse retinopathy presenting very early with asymmetrical involvement of the right eye (RE) more than the left eye (LE). We demonstrated the presence of HRF on early OCT corresponding to the degree of damage and correlating with final visual recovery (LE complete recovery while RE incomplete visual recovery).
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Hyper-reflective spots in acute solar retinopathy p. 467
Naresh Babu, Piyush Kohli
DOI:10.4103/ijo.IJO_3177_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORT Top

Hyper-reflective track as an imaging biomarker for clinical improvement in photic retinopathy p. 469
Manavi D Sindal, Bholesh Ratna, Kurian Jose
DOI:10.4103/ijo.IJO_2357_21  
Photic damage occurs due to varied etiologies. In two cases presenting with acute onset symptoms, fundus exam in Case 1 (Welder's arc) showed foveal yellow spot in the left eye. In Case 2 (Solar eclipse), foveal yellow spot was noted bilaterally. Spectral domain Optical coherence tomography revealed disruption of ellipsoid zone and a hyperreflective track extending from outer to inner retina. This hyperreflective track resolved on follow-up and correlated with symptomatic improvement. The hyperreflective track possibly indicates acute photic damage to retina and can serve as a prognostic marker for clinical improvement.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARIES Top

Commentary: Enigma of foveolar hyper-reflective track in photic retinopathy p. 472
Kushal Delhiwala, Bakulesh Khamar
DOI:10.4103/ijo.IJO_3134_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Commentary: Clinical significance of vertical hyper-reflective track in optical coherence tomography of the fovea p. 473
Srikanta K Padhy, Koushik Tripathy
DOI:10.4103/ijo.IJO_62_22  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Reduced fluence photodynamic therapy for subretinal fluid in choroidal nevus p. 475
Harpreet K Narde, Ananya Goswami, Vimal Vashistha, Atul Kumar
DOI:10.4103/ijo.IJO_1303_21  
Choroidal nevus is a benign melanocytic lesion of the posterior uvea. Visual symptoms in choroidal nevus are most commonly secondary to serous neurosensory detachment in upto 50% cases. Here, we describe a case of symptomatic perifoveal Choroidal Nevus with sub-retinal fluid, which was treated with Reduced Fluence Photodynamic Therapy.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Intraocular eyelash-associated ocular inflammation and hypotony following open globe injury p. 478
Nirupama Kasturi, Pratima Chavhan, Kaviyapriya Natarajan
DOI:10.4103/ijo.IJO_1910_21  
A 5-year-old girl presented with penetrating ocular trauma associated with severe intraocular inflammation and hypotony persisting after globe repair. On re-exploration, intraocular eyelashes were found in the posterior chamber causing fibrosis and ciliary body traction. The child underwent membranectomy with anterior vitrectomy. Postoperatively, the inflammation subsided with steroids and cycloplegic therapy and vision improved to 6/24. This report describes a unique case of intraocular eyelashes that caused severe inflammation along with hypotony that were not found by routine slit-lamp examination but identified during membranectomy.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Late onset endophthalmitis with rare fungus Exophiala dermatitidis p. 480
Shreya J Shah, Chinmay Nakhwa, Shraddha Shah, Madhu Rai
DOI:10.4103/ijo.IJO_2280_21  
The authors report a case of a 64-year-old diabetic male patient with late-onset fulminant fungal endophthalmitis occurring 6 weeks following complicated cataract surgery. A pigmented, dimorphic fungus known as Exophiala dermatitidis was isolated from aqueous and vitreous samples of the patient. The patient underwent pars plana vitrectomy, followed by daily injections of intravitreal voriconazole, and eventually had marked improvement in the best-corrected visual acuity to 6/9. So far, eight cases of Exophiala endophthalmitis have been reported in the literature, of which six have had a poor visual outcome. This case report demonstrates a successful outcome in a case of E. dermatitidis endophthalmitis, tackled with an aggressive medical and surgical approach.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A rare ocular presentation of melioidosis: A mimic within a mimic p. 483
GS Parvathy, Anujeet Paul, Swathi Nagarajan
DOI:10.4103/ijo.IJO_1401_21  
Melioidosis, a multi-system infectious disease caused by Burkholderia pseudomallei, has varied clinical presentations. The ocular manifestations though rare are often either infectious or inflammatory sequelae. We present a case of a 49-year-old fisherman, an alcoholic and diabetic, who presented with fever, breathlessness, and altered sensorium. The pus and blood culture showed Burkholderia pseudomallei. Clinically, the patient deteriorated over a few days and succumbed to septicemia. The fundus evaluation at presentation showed multiple cotton wool spots concentric to the disk bilaterally. Subsequently, the patient developed a solitary Roth spot in the right eye coinciding with his clinical deterioration. The association of melioidosis with this fundus picture is presented for its rarity.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Highly motile intravitreal worm in epiretinal plane: Is surgical removal the only option? p. 485
Divya Yadav, Nikita Sonawane, Harsh V Singh
DOI:10.4103/ijo.IJO_2532_21  
A 37-year-old-man presented with the perception of wriggling movements in the left eye. The fundus revealed a highly motile nematode epiretinally. The location and plane of the movements were confirmed with optical coherence tomography (OCT), which also showed its intraretinal attachment. Multiple attempts of laser photocoagulation failed due to its incessant rapid movements in the antero-posterior axis. Immediate vitrectomy was deferred due to the risk of breakage. With combination therapies of peribulbar lignocaine and oral anti-helminthics for 2 days, a marked reduction in the motility, thickening, and swelling was noticed and it could finally be killed with laser. To the best of our knowledge, this is the first case report of a live intravitreal worm treated non-invasively.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Management of inadvertent scleral penetration during retinal detachment surgery p. 488
Rajesh Ramanjulu, Surendra Pal, Mahesh Shanmugam, Divyansh Mishra
DOI:10.4103/ijo.IJO_1202_21  
We report the management of a case of inadvertent full-thickness scleral penetration during rhegmatogenous retinal detachment (RRD) surgery in a 14-year-old high myope while making partial-thickness scleral tunnel for the passage of the 240 silicone band. Sudden and gross hypotony with subretinal hemorrhage were noted post-penetration. Hypotony was immediately addressed by suturing the penetration site with a 7-0 vicryl suture. Subretinal blood was removed by performing 360° relaxing retinotomy and retinectomy and the retina was attached. This case report highlights the possible reasons for the full-thickness scleral penetration and one of the various methods to handle the same.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A rare case of rapid evolution of choroidal osteoma p. 490
Manoj Soman, Asmita Indurkar, Jay U Sheth, Unnikrishnan Nair
DOI:10.4103/ijo.IJO_2152_21  
We present a case of a 19-year-old male with a history of right-sided orbital pseudotumor with suspected Burkitt's lymphoma. His best-corrected visual acuity (BCVA) was 6/36 in the right eye (RE) and 6/6 in the left eye (LE). On fundus examination, the patient had a large choroidal osteoma at the posterior pole with macular scarring, along with two additional satellite osteomas inferior and superonasal to the disc in OD, while OS was unremarkable. After conservative management with oral corticosteroids, the patient demonstrated an additional choroidal osteoma lesion nasal to the disc in the OD which had evolved over a period of merely 3 months. To the best of our knowledge, this is the first reported case to document such a rapid development of choroidal osteoma. This case highlights the need for frequent follow-up of these patients for early detection and monitoring of these lesions.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Masquerade versus masquerade: An unusual presentation of systemic B-cell lymphoma misdiagnosed as giant cell arteritis - A case report p. 494
Sajjad Abbas, Karinya Lewis, Christina Rennie
DOI:10.4103/ijo.IJO_2808_21  
This is an atypical uniocular presentation of systemic diffuse large B-cell lymphoma. An 80-year-old Caucasian female presented with acute left visual loss, anorexia, headache, and jaw pain with disk swelling. Systemic steroids for giant cell arteritis were started despite negative temporal artery biopsy. Later, an inferior exudative retinal detachment developed. Lytic skull lesions were eventually seen on magnetic resonance imaging. Diffuse large B-cell lymphoma was diagnosed postmortem. This is the second documented case of unilateral serous retinal detachment with no uveitis/pseudouveitis or choroidal infiltrate due to lymphoma. It demonstrates pitfalls of pattern recognition when pieces of the jigsaw do not fit.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Clinical and histological work-up of vitreoretinal metastases from cutaneous malignant melanoma: A case report p. 497
Antonia Osl, Georgios Blatsios, Teresa Rauchegger, Van Anh Nguyen, Christof Seifarth, Gertrud Haas
DOI:10.4103/ijo.IJO_2359_21  
We report a rare case of vitreoretinal metastases from cutaneous malignant melanoma (CMM). A 76-year-old patient with CMM presented at our clinic complaining of floaters and blurred vision in his right eye. After conducting an exploratory vitrectomy, the diagnosis of vitreoretinal metastases from CMM was made. Histopathology of the enucleated eye demonstrated residual clusters of malignant cells in the vitreous and focal invasion of the inner retina. CMM metastatic to the retina and vitreous is very rare. A detailed ophthalmological examination in all patients with metastatic CMM and complaints of ocular symptoms is highly recommended.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A case of multifocal uveal metastases from T790M-mutated non-small-cell lung carcinoma with an unexpected reaction to Osimertinib p. 500
Ding-Liang Xu, Yue-Yang Zhu, Xin-Zhe Wu, Jing Huang, Wen-Song Zhang
DOI:10.4103/ijo.IJO_2061_21  
Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) used in the treatment of metastatic non-small-cell lung carcinoma (NSCLC) patients with targetable EGFR-T790M mutations. We describe the case of a 61-year-old Chinese female confirmed with multifocal uveal metastases from T790M-mutated NSCLC after developing acquired resistance to icotinib (a first-generation EGFR-TKI). Therefore, she was instituted on oral osimertinib. The uveal masses were reported to completely disappear on anterior segment examination, ultrasound biomicroscopy (UBM), and ocular color doppler flow imaging (CDFI) after 41 weeks. However, the patient got worse and eventually died from systemic metastases 4 months later.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Acquired vertical pendular nystagmus in diffuse unilateral subacute neuroretinitis: A diagnostic dilemma p. 503
Anupama Janardhanan, Vijaylakshmi Perumalswamy, Shashikant Shetty, Chitaranjan Mishra, Matt J Dunn
DOI:10.4103/ijo.IJO_2360_21  
A retinal infectious pathology, an acquired vertical nystagmus, and a suspicious neuroimaging result! Independently, these three entities are not uncommon. However, when they are consecutively observed in a young patient, it ramifies into an intriguing clinical scenario. A 17-year-old diagnosed case of diffuse unilateral subacute neuroretinitis presented to us with acute-onset vertical oscillations. On neuroimaging, she was found to have cerebellar dysgenesis. This case prompted us to revisit the pathogenesis of acquired vertical nystagmus and evaluate whether it resulted from disturbance of afferent (severe visual impairment) or efferent (cerebellar dysfunction) components of the neural integrator mechanism.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Diagnostic criteria for pediatric idiopathic intracranial hypertension – A tale of two cases p. 506
Veenu Maan, Pradeep Agarwal
DOI:10.4103/ijo.IJO_1386_21  
There is a diagnostic dilemma for pediatric Idiopathic intracranial hypertension (IIH), presenting rarely. Most clinicians use the Friedman et al. criteria. However, it is not appropriate because of the variability in the cerebrospinal fluid (CSF) opening pressure and other parameters between children less than 8 years and adults. We report two cases of IIH in children less than 8 years. Both indicate a chance of misdiagnosis using the Friedman et al. criteria in pediatric IIH. Based on our observation, a combination of Rangwala et al.'s recommendation and Friedman et al.'s criteria is suggested for diagnosing pediatric IIH in children less than 8 years of age.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A rare case of bilateral retrobulbar neuritis and retinal vasculitis following antirabies vaccination p. 511
Gopal S Pillai, CK Anusha, Rehna Rasheed, Natasha Radhakrishnan, Pooja Kandula
DOI:10.4103/ijo.IJO_1751_21  
A 33-year-old female presented with sudden painless blurring of vision in both eyes. She gave a history of dog bite and had received two doses of intradermal anti-rabies vaccination 2 weeks prior to the onset of symptoms. Ophthalmological evaluation showed bilateral retrobulbar neuritis, superior nasal field defects in the right eye and vasculitis, and temporal hemianopia in the left eye. Extensive laboratory investigations ruled out all underlying infections, connective tissue disorders, and systemic vasculitis. Good response to pulse steroid therapy was noted. To our knowledge, this is the first case report of retrobulbar neuritis with retinal vasculitis following chick embryo cell-derived anti-rabies vaccination.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bilateral hemorrhagic grade 5 disc edema in small vestibular schwannoma with communicating hydrocephalus: An unusual presentation p. 514
Manasa Penumetcha, Nidhi Sinha, Siddhartha S Sahoo, Gundra N Rao
DOI:10.4103/ijo.IJO_1453_21  
Bilateral optic disc edema is usually a late manifestation of vestibular schwannoma. Raised intracranial pressure due to obstructive hydrocephalus or a large mass lesion are the known causes. We report a case of a 55-year-old female with decreased vision and bilateral hemorrhagic grade 5 papilledema. MRI revealed a small vestibular schwannoma (<2.5 cm) with mild communicating hydrocephalus. Intraoperative CSF pressure was high most likely due to raised protein level in CSF (1 g/L). Bilateral hemorrhagic grade 5 papilledema causing diminution of vision in a case of small vestibular schwannoma with communicating hydrocephalus prompted us to report this case.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Internuclear ophthalmoplegia as a result of cerebral metastatic disease: Workup, pathophysiology, and clinical pearls p. 517
Veshesh Patel, Divy Mehra, Yanet Diaz-Martell, Lino Saavedra, Javier Alvarado, Jose Barros
DOI:10.4103/ijo.IJO_1893_21  
This case demonstrates an acute case of internuclear ophthalmoplegia (INO) caused by cerebral metastasis from a small cell lung cancer, the only such case documented in the literature. A 54-year-old male presented to the emergency department for worsening headache and diplopia, secondary to INO. On further examination, a CT scan of the chest revealed a 6.1 × 4.8 × 6.8 cm solid mass in the right lower lung consistent with small-cell lung cancer. T2-weighted MRI exhibited bilateral supratentorial and infratentorial lesions interpreted as metastatic cancer. The patient's symptoms, including INO, were caused by the mass effect from the metastatic brain lesions.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

The eye in lock-down: An unusual acquired restrictive strabismus p. 520
Manjushree Bhate, Milind N Naik, Frank J Martin, Ravi Varma
DOI:10.4103/ijo.IJO_2076_21  
We report a rare case of a 3-year-old female child with a severe degree of hypotropia and esotropia of the left eye secondary to presumed myositis from unknown etiology treated with systemic steroids. A magnetic resonance imaging (MRI) of the orbit revealed a bulky left inferior rectus muscle. With a working diagnosis of inferior rectus contracture, and presumed dense amblyopia in the left eye, a free tenotomy of the left inferior rectus muscle along with recession of the left medial rectus restored orthotropia from the locked-down position.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Squint surgery in a case of osteogenesis imperfecta p. 522
Nitya Raghu, Sowmya Raveendra Murthy
DOI:10.4103/ijo.IJO_1520_21  
Osteogenesis imperfecta (OI) is well known to be associated with blue sclera due to thinning along with skeletal deformities. Not all cases of OI have blue sclera despite having a thinner sclera than in normal individuals. We are presenting a case report of a 28-year-old girl with intermittent exotropia and OI with no evidence of blue sclera. On AS-OCT, scleral thinning was noted at the level of medial rectus muscle insertion. The patient underwent successful recession-resection surgery for the same. The thin sclera and OI need not deter the decision to operate on squint, and a successful squint surgery is possible in eyes with some amount of scleral thinning with careful suturing.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

An integrated early intervention approach for children with cerebral visual impairment - A case report p. 525
Jannet Philip, Saranya Rajagopal Sethuraman, Jameel R Hussaindeen, Meenakshi Swaminathan
DOI:10.4103/ijo.IJO_1860_21  
A 2-year-old child with cerebral visual impairment (CVI) was brought by the mother to the pediatric ophthalmology clinic. She underwent a detailed functional vision and developmental assessment that revealed impairments in visual developmental skills, sensory, motor, and social skills. She was admitted into an integrated, parent-centered, structured early intervention program specifically designed for her for 3-months after which there were improvements noticed in visual developmental skills such as visual fixation, attention, and tracking; sensory skills such as tactile, olfactory, and gustatory; motor skills, including neck control and fine motor grasping; and age-appropriate social and communication skills. Through this case report, we aim to bring out the benefits of an evidence-based systematic early intervention approach in a child with CVI.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Effects of early intervention in a child with cerebral palsy and cerebral/cortical visual impairment: A case study p. 528
Karthik Bhushan, Beula Christy, Vivian Manohar
DOI:10.4103/ijo.IJO_1976_21  
Cerebral (CVI)/cortical visual impairment is a decrease in the visual response due to damage or malfunction of the visual processing centers in the brain. While on the other hand, cerebral palsy (CP) is a permanent, nonprogressive disorder of movement and posture due to lesion of the infant's brain. This article presents a case study of a child with CP and CVI, and the strategies adopted in the Early Intervention program to that would work on the neuroplasticity. This in turn has demonstrated the improvement in the functional mobility, and the overall independence of the child.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Possible abnormal origin of inferior oblique from a congenital dermoid cyst: A case report p. 531
Uzma Sardar, Fariha Taimur, Amna Manzoor, Maheen Akbar, Saadullah Ahmad, Tayyab Afghani
DOI:10.4103/ijo.IJO_1926_21  
A 4-year-old female child presented with a cystic swelling medially along the floor of the orbit with mild ipsilateral medial canthus dystopia on the left side. This swelling was present since birth with no significant orbital dystopia or any extraocular movement defects. During surgery, a trilobed yellowish cyst was found near the inferomedial wall of the orbit. Incidentally, the inferior oblique muscle was found to be originating from the medial lobe of the cyst. The cyst was removed completely, and the inferior oblique was reinserted to the inferomedial orbital margin. Histopathology was consistent with dermoid cyst. To the best of the authors' knowledge, the case of abnormal origin of inferior oblique muscle from an orbital dermoid cyst has not been reported before.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Systemic sarcoidosis presenting as nasolacrimal duct obstruction – A rare presentation p. 534
Shebin Salim, Marian Pauly, Subramanian Krishnakumar
DOI:10.4103/ijo.IJO_1524_21  
Lacrimal sac sarcoidosis is rare and reported in 7.7% of the cases of systemic sarcoidosis. Nasolacrimal duct obstruction, as the initial presentation of sarcoidosis, is very rare. A 50-year-old woman presented to us with complaints of watering and discharge from the right eye for the past 3 months. On examination, she was found to have a right-sided nasolacrimal duct obstruction and underwent external dacryocystorhinostomy (DCR). Intraoperatively, a biopsy was done because of the abnormally thickened sac wall. The histopathology examination was suggestive of granulomatous inflammation. After ruling out tuberculosis and fungal infection with the appropriate investigation, a diagnosis of pulmonary sarcoidosis with lacrimal sac involvement was made because of the mediastinal lymphadenopathy on computed tomography. She was treated with a course of oral steroids along with immunosuppressants for 3 months. There was no evidence of recurrence at 8 months of follow-up.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Paradoxical reaction presenting with orbital signs in possible intraocular tuberculosis: A case report p. 537
Suganeswari Ganesan, Arkaprava Pradhan, Nataraj Palaniappan, Neethu Latiff, Muna Bhende, Sudha K Ganesh
DOI:10.4103/ijo.IJO_1738_21  
We report an unusual presentation of paradoxical reaction (PR) with orbital signs in a case of possible intraocular tuberculosis (POTB). A 15-year-old boy presented with vitreous hemorrhage in the right eye (OD) and multifocal choroiditis in the left eye (OS) and progressed to develop bilateral proptosis, lid edema, chemosis, subretinal lesions, and progression of choroidal lesions following the rapid tapering of oral steroids with anti-tubercular therapy for POTB. The orbital reaction and progressing posterior segment lesions were managed with pulse steroid therapy, oral steroids, intravitreal anti-vascular endothelial growth factor (anti-VEGF), and steroid implant. The orbital involvement is rarely seen in POTB with PR.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Sino-orbital gas gangrene – A guest unknown p. 540
Sumeet Lahane, Tejal Gujar, Aman Vaishya, Dhananjay Prajapati, Saurabh Dembla, Ragini Parekh, Tatyarao Lahane
DOI:10.4103/ijo.IJO_2514_21  
Orbital cellulitis is a dreaded entity that can lead to an array of complications from visual loss to cavernous sinus involvement. Paranasal sinus (PNS) infection and trauma are the most common etiology. We report a case series of three patients who were victims of landslide and developed orbital cellulitis. Facial edema, proptosis, central retinal artery occlusion and hyperdense foci in the orbit, and PNS with proven growth of Clostridium perfringes were the common features in all these patients. Natural calamity leading to this fulminant infection led to mortality of all three patients. This is the first case series of sino-orbital gas gangrene in victims of heavy rainfall causing landslide.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Fungal orbital cellulitis presenting as a discharging fistula p. 543
Ram Y S Yadav, Chiranji Rai, Aditi Jhunjhunwala
DOI:10.4103/ijo.IJO_2257_21  
We present a very rare case of fungal orbital cellulitis which presented to us as a pus-discharging fistula below the medial canthus. The patient presented with signs of orbital cellulitis along with a pus-discharging fistula below the medial canthus with positive mucopurulent discharge from the puncta and fistula on syringing. It started with swelling near the medial canthus. The patient responded well on broad-spectrum antibiotics but developed a necrotic patch on the hard palate. The Magnetic resonance imaging (MRI) showed intraconal and extraconal involvement. Diagnostic nasal endoscopy (DNE) was done and the tissue was sent for Potassium hydroxide (KOH) mounting, culture, and histopathology. After the KOH mount showed budding-like yeast cells, the patient was started on antifungals and discharged when the repeat culture report showed no growth. Therefore, a high level of suspicion should be maintained for a fungal cause even in the presence of the pus-discharging fistula.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Necrotizing fungal preseptal cellulitis secondary to Candida orthopsilosis in a diabetes mellitus patient – A rare case report and review of literature p. 546
Nirupama Kasturi, Tanmay Gokhale, Sandip Sarkar, Farnaz Yazeer, Nelzo Thomas, Rakesh Singh
DOI:10.4103/ijo.IJO_2380_21  
Non-albicans candida infection is an emerging threat in immunocompromised patients like those with diabetes mellitus, bone marrow transplant recipients, or HIV-positive patients. We report a rare case of necrotizing preseptal cellulitis extending to the cheek caused by Candida orthopsilosis in a young diabetic patient. Fungal etiology must be considered as a possible cause of preseptal and facial cellulitis in the setting of uncontrolled diabetes mellitus, which is unresponsive to broad-spectrum antibiotics even in the absence of a local nidus of infection in the paranasal sinuses or oral cavity.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Low-flow carotid-cavernous fistula causing oculomotor nerve palsy – More than meets the eye! p. 549
Kowsalya Akkayasamy, Marushka Aguiar, S Mahesh Kumar
DOI:10.4103/ijo.IJO_1776_21  
Isolated oculomotor nerve involvement in a posterior draining CCF is relatively rare. We present the case of a 70-year-old female with complaints of painful left-sided ophthalmoplegia and ptosis. She was detected to have a pupil involving third nerve palsy on the left side. We asked for neuroimaging in the form of MRI and MRA which showed a left-sided low-flow CCF compressing the cavernous and the extra-cavernous portion of the oculomotor nerve. This report stresses the importance of keeping low-flow CCF as a differential diagnosis as early detection can be life-saving.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bilateral isolated superior ophthalmic vein thrombosis: An initial presentation of antiphospholipid syndrome p. 552
Sahil Agrawal, Swechya Neupane, Sujeeth Modaboyina, Mandeep S Bajaj, Deepsekhar Das
DOI:10.4103/ijo.IJO_2666_21  
Bilateral superior ophthalmic vein thrombosis (SOVT) being extremely rare requires diligent evaluation for a definitive diagnosis. A 19-year-old male presented with pain and swelling around both eyes for 5 days. He had bilateral proptosis with gross limitation of movements (extraocular movement) and visual acuity of 6/9 in both eyes. On palpation, no mass was found. Contrast-enhanced magnetic resonance imaging orbit demonstrated bilateral superior ophthalmic vein dilation. Keeping a clinical suspicion of bilateral SOVT, systemic evaluation revealed raised anticardiolipin antibody levels at two occasions 12-weeks apart. A diagnosis of antiphospholipid syndrome was made and anticoagulant therapy was commenced. At 2-week follow-up, there was marked improvement in clinical features.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Intraoperative use of C-arm fluoroscope for removal of gun pellet in the orbit p. 554
Ramesh Murthy
DOI:10.4103/ijo.IJO_2390_21  
Gun pellet injury is rare but devastating to the eye. Airgun pellets made of lead can ricochet between the orbital bony walls and can damage the intraocular structures, even causing loss of vision. These pellets can get displaced in the orbital fat during surgical manipulation. Intraoperative CT scan is not readily available in hospitals; however, C-arm fluoroscopy is readily available in most setups. We used a C-arm fluoroscope and three instruments (i.e., two malleable retractors and a periosteal elevator) for locating and removing the pellet successfully in two cases, which to the best of our knowledge has not been reported before.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A rare case of orbital injury with a keychain in a toddler p. 557
Ujjwal P Jha, Sudesh K Arya, Hennaav K Dhillon, Sonia Bariya
DOI:10.4103/ijo.IJO_3091_21  
Orbital injuries caused by foreign bodies are common among children and young adults and may cause ocular morbidity. We report a rare case of an 18-month-old child who sustained an injury with a large metallic keychain in the right medial orbital wall and bridge of the nose following a fall. Timely radiological imaging with X-ray and CT orbit helped in localization and planned removal of the metallic keychain in the most atraumatic way. Early surgical removal with a multidisciplinary approach played a pivotal role in preventing infection, salvaging vision, and anatomical integrity, leading to holistic recovery of the child.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Rubber tree fruit in the eye: A case report of large organic foreign body in orbit p. 560
Velu Maneksha, Setty Kavya, Sabyasachi Chakrabarty
DOI:10.4103/ijo.IJO_1990_21  
Orbital foreign bodies are seen commonly, but the presence of an unusually large organic foreign body in-toto in the orbital cavity is rare. Here, we are discussing a case of the organic orbital foreign body following a fall. A 22-year-old gentleman with a history of fall presented to us with a large organic foreign body in his right orbit with the collapsed globe. Following thorough history and evaluation, the foreign body was removed and the globe was repaired. The eye became phthisical. A custom-fit prosthesis was applied a month after surgery. We are highlighting the importance of surgical intervention and follow-up to achieve good cosmetic outcomes and the importance of protective gear in the workplace.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
PHOTO ESSAY Top

Iceberg phenomenon of striate keratopathy p. 563
A Arut Priya, Bala Saraswathy, Kalpana Narendran
DOI:10.4103/ijo.IJO_1605_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Corneal keratopigmentation for aesthesis in scarred vascularised corneas p. 565
Rakhi D'cruz, Aravind Roy
DOI:10.4103/ijo.IJO_1230_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Iridoschisis - A rare form secondary angle-closure glaucoma p. 567
Anindita Pal, Aparna Rao
DOI:10.4103/ijo.IJO_1608_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Demonstration of the sinking cortex sign - Pre-existing posterior capsule rupture in mature traumatic cataract p. 569
Arut Priya, Bala Saraswathy, Kalpana Narendran
DOI:10.4103/ijo.IJO_1868_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Double trouble - Explanting an unwanted extra intraocular lens p. 571
Amber A Bhayana, Priyanka Prasad, Shorya V Azad, Sudarshan K Khokhar, Manpreet Kaur
DOI:10.4103/ijo.IJO_2094_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Unilateral open-angle glaucoma associated with ipsilateral Naevus of Ota p. 573
Priyanka Dhaytadak, Navela Philip, Sumeet Lahane, KR Meghana, Ragini Parekh, Tatyarao Lahane
DOI:10.4103/ijo.IJO_1067_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Decompression retinopathy following self sealing open globe injury p. 575
Divya Yadav, Nikita Sonawane, Santosh Ramesh
DOI:10.4103/ijo.IJO_2267_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Severe rheumatic heart disease presenting as central retinal artery occlusion: A case report p. 577
Rawdha Al Nuaimi, Aruna Srinivasulu, Sumayya Al Marzouqi
DOI:10.4103/ijo.IJO_2182_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Central retinal artery occlusion as a presenting sign of acute retinal necrosis - A rare finding p. 579
Amber A Bhayana, Priyanka Prasad, Shorya V Azad, Akshaya Balaji, Pradeep Venkatesh
DOI:10.4103/ijo.IJO_1302_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Coexisting diabetic macular edema and choroidal neovascularization: Emphasizing the role of optical coherence tomography angiography p. 581
Snehal Bavaskar, Muna Bhende
DOI:10.4103/ijo.IJO_1935_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Multiple pigment epithelium detachment and ischemic optic neuropathy p. 583
Raj S Hirawat, CK Nagesha, Pratyusha Ganne, Ghanshyam Panday
DOI:10.4103/ijo.IJO_2561_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bacillary layer detachment in carotid–cavernous fistula p. 585
Rashmi Pawar, M Usha, Pradeep Sagar, HN Ravishankar, Suchitra Biswal
DOI:10.4103/ijo.IJO_1432_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Full thickness macular hole with subretinal bleed formation following Nd: Yag laser posterior hyaloidotomy for macular subhyaloid hemorrhage p. 587
Ashish Markan, Nitin Gautam, Mohit Dogra, Ramandeep Singh, Basavaraj Tigari
DOI:10.4103/ijo.IJO_2150_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Optical coherence tomography angiography in type III retinal astrocytic hamartoma p. 589
Kshitiz Kumar, Tushar K Sinha, Debashish Bhattacharya
DOI:10.4103/ijo.IJO_2316_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bilateral morning glory disc anomaly with unilateral internal carotid artery agenesis p. 592
Koyel Chakraborty, Sucheta Parija, Bhagabat Nayak, CS Lalitha
DOI:10.4103/ijo.IJO_2247_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Focal choroidal excavation p. 594
Arthi Mohankumar, Manoj Khatri
DOI:10.4103/ijo.IJO_2520_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Penetrating ocular trauma with a long plastic toy arrow p. 595
Sanira S Vaghmare, Naveen Radhakrishnan, N Venkatesh Prajna
DOI:10.4103/ijo.IJO_2141_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Autologous retinal transplant harvest site long-term healing: Unexpected result p. 597
Abel Ramirez-Estudillo, Sergio E Hernández-Da Mota, Raul Velez-Montoya
DOI:10.4103/ijo.IJO_2353_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Complete traumatic auto-enucleation of eyeball following road traffic accident p. 599
Prerna Sinha, Bhawesh C Saha, Priyanshi Awasthi, Naila Aftab, Ranjeet Kumar
DOI:10.4103/ijo.IJO_2095_21  
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
OPHTHALMIC IMAGES Top

Pseudo double disc p. 601
Shilpi H Narnaware, Prashant K Bawankule, Rakesh Nagdeve
DOI:10.4103/ijo.IJO_2058_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bruckner's test in an oil-filled eye p. 602
Amber A Bhayana, Priyanka Prasad, K Anshida
DOI:10.4103/ijo.IJO_1902_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Netarsudil induced reticular epithelial edema p. 603
Abhipsa Sahu, Rinu George, Premanand Chandran
DOI:10.4103/ijo.IJO_1973_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Double standards in corneal epithelial compensation p. 604
Radhika Natarajan, Jothi J Balaji, Sunita Pandey
DOI:10.4103/ijo.IJO_2516_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Pseudo-Vossius ring p. 605
Shakha Gupta, Amber A Bhayana, Priyanka Prasad, Shorya V Azad, Sudarshan K Khokhar
DOI:10.4103/ijo.IJO_2879_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Subepithelial corneal hemorrhage in a patient with treated conjunctival melanoma p. 606
Jonathan S Trejo, Minh T Nguyen, Andrew W Stacey
DOI:10.4103/ijo.IJO_2275_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Annular corneal blood staining p. 607
Amber A Bhayana, Manpreet Kaur, Sudarshan K Khokhar
DOI:10.4103/ijo.IJO_2869_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Fine needle diathermy for reducing corneal vascularization prior to high-risk corneal grafts p. 608
Swetha Ravichandran, Radhika Natarajan
DOI:10.4103/ijo.IJO_1824_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

“Hesitancy wounds” like corneal scars p. 609
Priyanka Prasad, Amber A Bhayana
DOI:10.4103/ijo.IJO_2725_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Double anterior chamber or descemet membrane detachment - Why and how to distinguish? p. 610
Swetha Ravichandran, Radhika Natarajan, Jothi Balaji Janarthanam
DOI:10.4103/ijo.IJO_1936_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Filiform pupil p. 611
Surbhi Khurana, Parul Chawla Gupta, Jagat Ram
DOI:10.4103/ijo.IJO_2776_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Retained intracorneal and intracameral eyelashes following blunt trauma p. 612
Ramya Natarajan, Dilip K Mishra, Pragnya Rao, Sunita Chaurasia
DOI:10.4103/ijo.IJO_1958_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Spades prove enantiomorphism in congenital cataract p. 613
Amber Amar Bhayana, Vipasha Sharma, Priyanka Prasad, Sudarshan Kumar Khokhar, Md. Sohail Alam
DOI:10.4103/ijo.IJO_123_22  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Ophthalmic shadow puppetry - Retinal cinema in cataractous silhouette p. 614
Amber A Bhayana, Arpita Kulshrestha, Priyanka Prasad
DOI:10.4103/ijo.IJO_2908_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

“Cataract”- as it should be p. 615
Sudarshan K Khokhar, Shashi Prakash, Amber A Bhayana, Priyanka Prasad, Pradeep Venkatesh
DOI:10.4103/ijo.IJO_2765_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Leaky cataract p. 616
Amber A Bhayana, Rohan Ranjan, Shorya V Azad, Priyanka Prasad, Sudarshan K Khokhar
DOI:10.4103/ijo.IJO_2175_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Phacoemulsification in a case of ciliary staphyloma p. 617
Mukesh Kumar, Surabhi Agrawal
DOI:10.4103/ijo.IJO_1965_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Posterior dislocated intraocular lens: Intraoperative optical coherence tomography p. 618
Ankur Singh, Bruttendu Moharana, Ramandeep Singh
DOI:10.4103/ijo.IJO_1231_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Sunset intraocular lens dislocation and imprinted anterior capsule p. 619
Harsha Bhattacharjee, Mohit Garg, Isha Agarwalla
DOI:10.4103/ijo.IJO_2453_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Voyage of a desolate capsular tension ring! p. 620
Venugopal Anitha, Meenakshi Ravindran
DOI:10.4103/ijo.IJO_2334_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Iris-penetrated haptic of an in-bag intraocular lens with fibrotic proliferation p. 621
Eugene Yu-Chuan Kang, Wei-Chi Wu
DOI:10.4103/ijo.IJO_1024_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Two intraocular lenses in the anterior chamber p. 622
Debdulal Chakraborty, Tuhin Choudhury
DOI:10.4103/ijo.IJO_2912_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

All that dislocates is not lens - Unusual case of a free-floating vitreous cyst p. 623
Ram S Ravindran, Piyush Kohli, R Vigneshwar
DOI:10.4103/ijo.IJO_2349_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Hyporeflective spot in fibrinous central serous chorioretinopathy p. 624
Akshita Aggarwal, Ankur Singh, Gopal K Das
DOI:10.4103/ijo.IJO_1576_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Patient with severe macular telangiectasia type I p. 625
In Hwan Hong, In Hwan Cho
DOI:10.4103/ijo.IJO_2325_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A rare case of circumferential peripheral vascular occlusion presenting with decompression retinopathy p. 626
Nikita J Sonawane, Divya Yadav, Bholesh B Ratna, Kulharsh B Jaiswal
DOI:10.4103/ijo.IJO_2184_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bilateral central retinal artery occlusion in a child due to hyperhomocystinemia p. 627
Ninan Jacob, B Srihari, Amit K Deb, Nirupama Kasturi, Sandip Sarkar
DOI:10.4103/ijo.IJO_2811_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A well in the eye – A case of a peripappilary staphyloma p. 628
Asmita Mahajan
DOI:10.4103/ijo.IJO_2603_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bilateral isolated optic disc coloboma with posterior staphyloma in a case of high myopia p. 629
Rajshri Hirawat, Harshit Vaidya
DOI:10.4103/ijo.IJO_2742_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bowl in a bowl: A rare case of bilateral Curtin's type VI posterior staphyloma presenting with two different complications p. 630
Roshni Mohan, Divya Yadav, Sourabh P Behera
DOI:10.4103/ijo.IJO_1821_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Gape in the void: Atypical optic disc pit location with retinoschisis p. 631
Tarannum Mansoori
DOI:10.4103/ijo.IJO_2669_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Idiopathic intracranial hypertension with peripapillary choroidal neovascular membrane p. 632
Devashish Dubey, Devika Singh
DOI:10.4103/ijo.IJO_2053_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Silicone oil emulsification on optical coherence tomography p. 633
Lalit Verma, Yusra Asad, Vijay Kumar
DOI:10.4103/ijo.IJO_1876_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Intraocular air gun pellet p. 634
Amber Amar Bhayana, Shorya Vardhan Azad, Priyanka Prasad, Shashi Prakash, Antriksh Wahi
DOI:10.4103/ijo.IJO_2867_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Choroidal detachment after intravitreal Razumab p. 635
Remya M Paulose, Thomas Cherian
DOI:10.4103/ijo.IJO_1196_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Adult-onset xanthogranuloma: Looking beyond the eye p. 636
Ayushi Agarwal, Ruchi Goel, Shalin Shah, Akash Raut, Shweta Raghav, Ravindra K Saran
DOI:10.4103/ijo.IJO_2518_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Boomerang sign on orbital ultrasound in carotid-cavernous fistula p. 637
Sujeeth Modaboyina, Deepsekhar Das, Mandeep S Bajaj, Sahil Agrawal
DOI:10.4103/ijo.IJO_2695_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

The ever changing face of ocular surface reconstruction p. 638
Anahita Kate, Sayan Basu
DOI:10.4103/ijo.IJO_3103_21  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
LETTERS TO THE EDITOR Top

Comment on: Management of microspherophakia and angle-closure glaucoma in Goldenhar syndrome p. 640
Anubhav Chauhan, Deepak Kumar Sharma
DOI:10.4103/ijo.IJO_384_22  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Response to comment on: Management of microspherophakia and angle-closure glaucoma in Goldenhar syndrome p. 641
Vijayalakshmi A Senthilkumar, Chinmayee Pradhan, Sharmila Rajendrababu, Chitaranjan Mishra, Naresh B Kannan
DOI:10.4103/ijo.IJO_526_22  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta