Sebaceous lesions encompass a spectrum from benign lesions to disfiguring malignant lesions. Eyelid sebaceomas are extremely rare and only two definite cases are described in the English literature, whereas sebaceous adenomas occur in the eyelids more commonly and can be distinguished easily from sebaceous gland carcinoma by its clinical and histological appearance. We describe two cases of eyelid lesions that clinically resembled a possible malignant eyelid tumor. In both the cases, frozen section report was suggestive of a well-differentiated sebaceous gland carcinoma. However, histopathology examination of the permanent section was consistent with the diagnosis of sebaceoma and sebaceous adenoma respectively.

Congenital oculodermal melanocytosis is also known as Nevus of Ota, condition where blue nevus of skin and orbit are seen with ipsilateral nevus in conjunctiva and iris. They are often associated with glaucoma which can occur at any age. They can have melanocytosis and develop choroidal melanoma. We report a case of a middle-aged female with facial pigmentation and bilateral scleral, conjunctival, and iris nevus with an advanced glaucomatous change in both eyes and pigmentation of the palatal mucosa. Trabeculectomy with mitomycin-C application was done in the left eye. Gastrointestinal endoscopy by gastroenterologist showed gastritis and Helicobacter pylori infection.

A 10-month-old male child presented with a mass lesion in the left eye which was present since birth as noted by the parents. It was non-progressive. He also had left eye upper eyelid coloboma and a single nodular lesion on the left zygomaticotemporal region along with multiple nodular lesions on the scalp with non-scarring alopecia. A pediatric consultation was sought for systemic associations and a diagnosis of Haberland syndrome was made. Surgical debulking of the ocular lesion was done along with optical correction and amblyopia therapy for visual rehabilitation.

MyoRing was implanted using a femtosecond laser to correct a high irregular corneal astigmatism after penetrating keratoplasty and high myopia. Femtosecond laser-assisted intrastromal MyoRing implantation allows to increase its sphericity, regularity and at the same time to correct high myopia. The creation of an additional “framework” in the corneal transplant by the MyoRing increased its biomechanical properties and prevented regression of the obtained refractive result. Femtosecond laser-assisted intrastromal MyoRing implantation allows to correct irregular astigmatism after penetrating keratoplasty and high myopia.

We report a case of a large bullous descemet membrane detachment (DMD) following inadvertent injection of ophthalmic viscoelastic device in the supradescemetic space. A 27 years old male with juvenile open-angle glaucoma underwent trabeculectomy in the right eye followed by anterior chamber reformation. He developed DMD for which intracameral gas injection failed twice. He presented with complaints of blurring of images in that eye. Examination revealed a bullous DMD without any corneal edema, confirmed by anterior segment optical coherence tomography (ASOCT). Microscope-integrated intraoperative OCT (mi-OCT) guided drainage with intracameral gas injection was done following which the detachment settled completely.

We report a unique case of Citrobacter freundii keratitis in a 35-year-old male presented with a paracentral corneal ulcer secondary to injury with a tile particle. Clinically, it seemed like a fungal ulcer. However, the bacterial culture was positive for Citrobacter freundii, which responded to topical amikacin and ceftazidime. Citrobacter freundii is a facultative anaerobic gram-negative bacterium belonging to the family of Enterobacteriaceae being associated with external eye infections; while this is another report of it being associated with microbial keratitis.

Porphyria cutanea tarda (PCT) is the most common form of Porphyria, which is a group of metabolic disorders of haem biosynthesis characterized by the involvement of the skin, eyes, and neuro-visceral tissue. Although scleral thinning in the interpalpebral area is a well-documented feature, severe corneal involvement is rarely described. We, herein report a young male who presented with bilateral scleral thinning in the interpalpebral area and an anterior staphyloma in the right eye. Systemic examination was suggestive of PCT. We report the first case of PCT in literature successfully treated with autologous scleral patch graft.

A 61-year-old human immunodeficiency virus (HIV)-positive female patient, planned for a repeat penetrating keratoplasty in the left eye after two failed grafts, also had an absolute right eye and a clear cornea with healthy endothelium (CD₄-2445 cells/mm²) with no perception of light. Due to an unexpected damage to the only optical grade tissue that occurred during surgery, consent was taken from the patient to perform an autokeratoplasty from the contralateral blind eye and was successfully performed on the left eye with visual potential. The blind eye received a therapeutic grade donor tissue.

A 19-year-old boy was presented 4 days after left eye acute chuna injury grade 4 (Dua). BCVA was finger counting 1 m, limbal ischemia, ground glass cornea, and corneal epithelial defect involving adjacent conjunctiva. Autologous contralateral simple limbal epithelial transplantation (SLET) was performed. Complete ocular surface epithelization was noted at day 21. At 8-months follow-up, there was a stable ocular surface with 20/20p BCVA. AutoSLET achieves rapid epithelialization in severe chemical injuries thereby preventing adverse effects of delayed epithelial healing avoiding the need for visual rehabilitative procedures later. Larger case series with longer follow-up is required.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare blistering diseases of the skin and mucous membranes with ocular involvement. This is a retrospective analysis of patients with SJS and TEN admitted in a medical college hospital from June 2016 to May 2019. Six among 21 patients had ocular involvement. Five patients with mild grade of ocular involvement were managed with conservative treatment. One patient with TEN and bilateral severe grade involvement underwent bedside application of amniotic membrane. Performing this technique can become challenging. Hence, we look forward towards the inventions of easier variations of the technique.

The objective of this study was to report a complicated case of chemical injury with symblepharon, LSCD, and pseudo pterygium managed successfully with ePTFE (Goretex) a novel method of treatment to prevent recurrence of symblepharon. A 10-year-old girl presented to us with progressive symblepharon and pseudopterygium encroaching the visual axis leading to defective vision, strabismus amblyopia, and motility restriction. The challenge, in this case, was the recurrence of symblepharon and fleshy growth. Goretex is a biocompatible and inert material. Along with Amniotic membrane transplantation (AMT), it creates a strong mechanical barrier between tenons, sclera, and tarsus. Thereby it prevents the recurrence of symblepharon, Goretex is a novel treatment approach that is simple and effective in preventing symblepharon.

We present a case of anterior megalophthalmos associated with secondary pigmentary glaucoma in the right eye, with other factors contributing to his raised intraocular pressure (IOP). The mechanism of glaucoma was multifactorial – pigment dispersion syndrome, abnormal angle architecture, IOP rises post pars plana vitrectomy with gas, postcataract extraction, element of steroid response. He underwent successful viscocanalostomy to control his IOP. To the best of our knowledge, there is no previous literature publication on viscocanalostomy as a surgical management of glaucoma in an eye with anterior megalophthalmos.

We present a rare case of phacomatosis pigmentovascularis in a 6-year-old child. The child had one functioning eye with severe glaucoma at presentation. We managed the case with primary Ahmed glaucoma valve implantation followed by two needling attempts. After 3 years of follow-up, the intraocular pressure was well maintained with the addition of two antiglaucoma medications.

We report an atypical presentation of bilateral Chandler's syndrome with secondary angle-closure glaucoma. Right eye (RE) AS-OCT showed higher lens vault. Left eye (LE) had decompensated cornea. Intraocular pressure (IOP) in RE was 18–20 mm Hg on four topical glaucoma medications. RE cup-disk-ratio was 0.8–0.9:1. Specular and confocal microscopy aided in diagnosis. As trabeculectomy had poor prognosis (due to increased lens vault), RE phacoemulsification was done in the first stage. Postoperatively IOP in the RE was 14 mm Hg on topical glaucoma medications at 3 months follow-up. Parameters like corneal status, lens vault and IOP control must be taken into account before planning for filtering surgery.

The usual biodegradation of the sustained release steroid implant does not involve fractures. The case presented in this report was noted to have vitreous haemorrhage staining a steroid implant injected for management of diabetic retinopathy. The implant gradually thinned in the areas adjacent to the haemorrhage, to eventually fracture into 2 pieces. Fracture of the implant is an uncommon event and may be a cause of concern as it can potentially alter the pharmacokinetics/dynamics of the drug.

We report the case of a 43-year-old lady with intentional dapsone overdose 26 years ago. Multimodal imaging revealed macular ischemia as the cause for visual loss, while choriocapillaries remained intact.

Stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) is a rare eye disease, hitherto unreported in Indians. We report a case of SNIFR in an Indian female wrongly treated as cystoid macular edema (CME). Differentiation between chronic CME and foveoschisis is paramount while dealing with rare diseases like SNIFR.

Pachychoroid disease spectrum includes central serous chorioretinopathy (CSR) and pachychoroid neovasculopathy (PNV). Pachychoroid phenotype is characterized by choroidal hyperpermeability, dilated choroidal vessels (pachyvessels), and focal or diffuse increase in choroidal thickness. Newer imaging modalities have aided in the diagnosis of choroidal diseases. Herein, we present a case of active concurrent CSR with PNV in a middle-aged patient with successful treatment by photodynamic therapy and intravitreal anti-vascular endothelial growth factor (VEGF) (ranibizumab) injection.

Kartagener's syndrome (KS) is Primary Ciliary Dyskinesia, autosomal recessive disorder characterised by triad of situs inversus of viscera, sinusitis, bronchiectasis due to ciliary dysfunction. Primary ciliary dyskinesia - retinitis pigmentosa syndrome is an X-linked ciliary dysfunction of respiratory epithelium and photoreceptors of retina leading to ocular disorders associated with chronic bronchiectasis, sinusitis and. sensorineural hearing loss. Here we present one such case of Kartagener's syndrome with Retinitis Pigmentosa (RP) which was also associated with Retinal Detachment (RD) in short stature individual reported for the first time, to the best of our knowledge which could be a new phenotypic presentation in Primary Ciliary Dyskinesia.

Epiretinal neovascularization (ERN) is a novel optical coherence tomography angiography (OCTA) finding, which has been recently described in association with macular telangiectasia type 2 (MacTel 2). To our knowledge, this is the first documentation of ERN and coexistent proliferative diabetic retinopathy (PDR), which could be clinically confused with diabetic foveal neovascularization. OCTA is a useful tool to evaluate ERN and differentiate it from diabetic foveal neovascularization.

A 41-year-old female presented to us with blurred vision in both eyes for the past 3 months. She was a known hypertensive and was treated for malignant hypertension in the past. She was diagnosed as hypertensive retinopathy with choroidopathy. Multiple hypopigmented linear streaks (Siegrist streaks) within the arcade and in the form of islands outside the arcades were noted. Fundus autofluorescence was performed to understand and classify the appearance and resolution of these streaks. Herein, we report the role of autofluorescence in describing Siegrist streaks secondary to hypertensive choroidopathy.

A 50-year-old male patient with proliferative diabetic retinopathy with vitreous hemorrhage underwent vitrectomy with oil tamponade. At 1 week post-operative visit, we noticed a retained cotton fiber with adjacent exudation. Patient was started on oral steroids with a subsequent clearing of exudation within 2 weeks. Inadvertent foreign body implantation after an intraocular surgery occurs more frequently than expected. To date, there is no published report of retained cotton fiber in the vitreous cavity. We present a rare case of pre-retinal retained cotton fiber post-vitrectomy with resultant inflammation and its clinical course.

We report a unique case of bilateral non-arteritic anterior ischemic optic neuropathy with co-existing idiopathic intracranial hypertension (IIH) in a young female following severe blood loss from abortion. At presentation, she had bilateral gross diminution of vision (hand movements and light perception in right & left eyes respectively) and bilateral pallid disc edema. Lumbar puncture and brain imaging were suggestive of IIH. Temporal association of vision loss with acute blood loss as well as fluorescein angiography were suggestive of bilateral NAION. Patient was treated with intravenous (IV) mannitol, IV methylprednisolone followed by oral steroids, oral acetazolamide, repeat lumbar punctures, and blood transfusion. Vision in right eye improved to 20/40 & left eye 20/500 at sixth month. Multidisciplinary approach is, thus, needed in management of such a case.

We report a case of progressive childhood myopia who developed rebound myopia and convergence excess esotropia after switching from 1% atropine eye drops to 0.01% atropine eye drops. The esotropia recovered and myopia progression was arrested after stopping 0.01% atropine drops and resuming 1% atropine eye drops.

In this study, we describe a case of restrictive exotropia in a 10-year-old female with amblyopia. The diagnosis of the accessory muscle was established through the magnetic resonance imaging (MRI) of the brain and orbit. A patient with restriction of all ocular movements in conjunction with enophthalmos of one eye or both eyes or the retraction of the eyeball should be suspected for an accessory ocular muscle and should be investigated accordingly.

Treating vertical squints especially large-angle hypertropia caused by inferior rectus palsy is a challenge. Superior rectus recession in presence of positive forced duction tests is the first step in surgical management. Following this, full tendon transposition of horizontal recti inferiorly (Inverse Knapp's procedure) is the standard procedure of choice. Modified Nishida's procedure has been described to treat vertical deviations like MED and inferior rectus aplasia. We describe a case of large-angle hypertropia treated by Modified Nishida's procedure.

A number of ocular motility disturbances such as skew deviation, saccadic/smooth pursuit abnormalities, Horner's syndrome, and nystagmus have been reported in lateral medullary infarction. We report 3 patients who had torsipulsion as the main ocular movement abnormality directly attributable to lateral medullary infarction. Patients 1 and 2 had a clockwise torsional movement that was diagnosed on slit lamp. The movement was elicited on asking the patients to make a horizontal saccade. Both patients were noted to have dorsolateral medullary infarction on MRI of the brain. Neither patient had symptoms directly attributable to torsipulsion. Patient No. 3 was referred for non-resolving left 6^th nerve palsy. He had infarcts in the left pons, cerebellum and dorsolateral medulla. Torsipulsion was the only ocular motility disorder caused by medullary infarction. Different pathways in the dorsolateral medulla have been implicated in the various ocular motility and neurological abnormalities seen in lateral medullary syndrome. It is possible that sparing of some and involvement of others could result in varied clinical presentations reported in literature. It is important for the ophthalmologist to be aware of torsipulsion as a diagnostic sign of lateral medullary infarction.

We report an interesting rare case of a child with a constellation of craniosynostosis (CS), osteopetrosis (OP), and Arnold-Chiari malformation type 1 (ACM1), presenting with developmental delay and progressive vision loss since infancy with normal intellect. The ophthalmic examination revealed bilateral advanced visual loss, bilateral proptosis, optic atrophy, and large angle esotropia in primary gaze. A systemic examination revealed facial dysmorphism, abnormal shape of the head, malunion fracture of the right arm, and scoliosis. Neuroimaging revealed features suggestive of CS, OP, and ACM-1. Neurosurgical consultation was sought, and the ventriculoperitoneal shunt was advised.

We report a case of ophthalmomyiasis profunda with a complete destruction of ocular tissues in an old diabetic lady who presented with sudden onset of bleeding from a progressively increasing, painless swelling in her left eye since two weeks. She was primarily treated with Ivermectin, paraffin dressing, manual removal of maggots, and then total exenteration. Deoxyribonucleic acid (DNA) barcoding analysis supported by DNA sequencing accurately identified the species as Chrysomya bezziana based on the mitochondrial cytochrome c oxidase 1 gene. This case report demonstrates the usefulness of DNA barcoding, complementing the conventional identification methods, in accurate identification of maggots of ophthalmic significance.

Allergic fungal sinusitis (AFS) and eosinophilic mucin chronic rhinosinusitis (EMCRS) are subtypes of a chronic rhinosinusitis with eosinophilia that have different diagnostic criteria but are phenotypically similar. Ophthalmic complications may be the presenting symptoms. Treatment of ophthalmic complications is typically directed at reducing the inflammatory burden in the sinuses and rarely requires direct surgical intervention. However, atypical cases with associated subperiosteal abscess may necessitate orbital surgery. The authors present 2 cases of EMCRS with orbital involvement – one that responded to the traditional treatment of oral corticosteroids and functional endoscopic sinus surgery (FESS), and the other requiring surgical drainage of a subperiosteal abscess in order to describe the management strategies based on clinical presentation.