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Eduardo Arenas, Gioconda Armas, Alfredo Ramirez
2019, 1:9 (26 September 2019)
Pinguecula is a common disease in tropical countries however there are not so many published articles regarding its aetiology, signs , symptoms and management . It seems that Ultraviolet rays play an important role and it is one of the reasons that explain the prevalence in zones near the equator. Pingüeculas behave different in the nasal than in the temporal side playing an important role in the development of pterygium which explains the high incidence of its nasal location. Regarding treatment and management , there are different approaches that will discussed in this mayor review.
  3,097 360 -
Pediatric ocular myasthenia gravis: Case report and literature review
Adriana Solano, Veronica Jimeno, Luisa Montoya, Natalia Espinosa
2019, 1:16 (3 December 2019)
Objective: The objective was to describe a case of ocular myasthenia gravis (MG) in a pediatric patient. Design: This is a descriptive, retrospective study and case report. Methodology: For the purpose of the case report, we searched and analyzed the literature referring to the diagnosis and treatment of ocular MG (OMG) in children. Description: A previously healthy 5-year-old girl presented to the emergency room because of sudden-onset ptosis of the right upper lid without other symptoms. Her examination demonstrated fluctuating ptosis and limitation to downgaze in the right eye. Because of the fluctuation of the ptosis, OMG was suggested, and the patient was tested with ice-pack test and neostigmine test with positive results. Treatment with pyridostigmine was initiated with a good response. Discussion: OMG has a very low incidence in pediatric patients. It is a disorder characterized by impairing neurotransmission at the neuromuscular junction that generates extraocular muscle weakness. It is important that ophthalmologists have knowledge about this disease because it is a differential diagnosis when there is a patient who has ptosis, strabismus, or limitation of movements. There are no standard diagnostic criteria for this disease; the diagnosis is based on clinical presentation and pharmacologic, serologic, and electrophysiologic tests. The treatment is based on steroids and anticholinesterase drugs. Some patients will require plasmapheresis or immunomodulators.
  2,747 282 -
Quality of life results after vitreolysis in patients with symptomatic vitreous floaters
Renzo Canote, Daniela Rodríguez, Luis Izquierdo, Roger Moncada, Carmen Maldonado, Alejandra Henriquez Maria
2020, 2:2 (23 January 2020)
Purpose: The purpose of the study was to evaluate the quality of life and visual results after yttrium aluminum garnet (YAG) vitreolysis in symptomatic vitreous floaters. Methods: This was a prospective case series study including patients with symptomatic floaters attending the Oftalmosalud Institute of eyes and underwent YAG laser vitreolysis. All patients completed the National Eye Institute Visual Functioning Questionnaire 25 for the quality of life assessment and the presence of floaters as well as the measure of the visual acuity reported preprocedure and after 3-month follow-up. Statistical analysis was done using score 0–100 for each question, and a sign test for paired samples was used. Results: Twenty eyes of 20 patients were evaluated. The comparisons for the questionnaire show an improvement in the general vision (P = 0.008), near vision (P = 0.001), and distance vision (P = 0.012). Furthermore, the dependency of glasses (P = 0.012), the score of mental health (P = 0.007), and the best visual acuity (P = 0.004) were improved. Patients who referred improvement in the quality of life were 75% pseudophakic patients and 25% phakic patients. The complications were high intraocular pressure and subcapsular cataract. Conclusions: Our study revealed a moderate improvement in floater symptoms and in quality of life and visual outcomes.
  2,432 346 -
Multimodal imaging ocular sarcoidosis
Jaime Larrea, Luz Catherine Martinez Malo, Daniel Jaramillo-Velásquez, Carlos Mario Rangel
2019, 1:14 (6 November 2019)
The study objective was to present multimodal imaging of definite ocular sarcoidosis (OS) in a young adult. A 52-year old woman consulted for 5 days of photophobia, ocular pain on movement, and redness in her left eye. Slit-lamp examination showed bilateral inferior granulomatous keratic precipitates, high cellullarity in the anterior chamber, posterior synechiae and hypopigmented subretinal lesions in the inferior vascular arcade, and nasal retina. In addition to the complete ophthalmic examination fundus photography (FP), fluorescein angiography (FA) and optical coherence tomography-angiography (OCT-A) were performed.Multimodal imaging of both eyes of the patient was performed. FP showed periphlebitis, hypopigmented subretinal lesions in the inferior temporal vascular arcade, and nasal retina. FA showed late diffuse capillary leakage from the subretinal lesions and optic nerve. OCT-A showed decreased choroidal capillary density, small hypo-intense gray areas of retinal capillary hypoperfusion, and presence of confluent and isolated areas void of flow in the deep plexus and choriochapillaris. With these findings on the multimodal imaging, chest computed tomography scan, and negative laboratory workup for other diseases, a presumptive diagnosis of OS was made which was subsequently confirmed with a positive skin nodule biopsy. The combination of OCT-A and other diagnostic methods allows a more detailed evaluation of structural and functional clinical findings in OS. There are few studies on OCTA findings in OS. Further studies with larger samples are needed in order to establish specific OCTA findings that could be used as diagnostic criteria.
  2,164 244 -
A floppy eyelid syndrome case report: Surgery and histopathologic features
Marcela Feltrin de Barros, Livia Garcia Biselli, Gustavo Kalache, Marcelo Vicente de Andrade Sobrinho, Laryssa Pereira Alves, Daniella De Paiva Almeida Stucchi
2020, 2:1 (23 January 2020)
We report a case of floppy eyelid syndrome (FES) treated with surgical approach at the PUC Campinas Hospital in 2019. This was a retrospective case report. A 42-year-old male patient diagnosed with FES. The patient elected for surgical repair due to severity of his symptoms. A lateral pentagonal upper eyelid resection was performed in the left eye, and eyelid tissue from the patient was examined using light microscopy and immunohistochemistry that revealed chronic conjunctival inflammation and papillary conjunctivitis. The pentagonal wedge resection is an effective treatment method that produces immediate relief of symptoms. In our case, no recurrence was observed up to 6-month follow-up.
  2,005 352 -
Birdshot chorioretinopathy: Importance of early diagnosis and therapeutic individualization
Elisabet Martin Garcia, Leticia Rodríguez Vicente, José Javier Chávarri García, José Luis del Rio Mayor
2020, 2:3 (23 January 2020)
Introduction: Birdshot chorioretinopathy (BCR) is a bilateral and recurrent posterior uveitis with an uncertain natural history and visual prognosis. Currently, there is no consensus on the best treatment option and its total duration. Clinical Cases: We present a series of three clinical cases of patients with BCR diagnosed in different stages of the disease, which demonstrates the clinical spectrum of this pathology and their treatment with different immunomodulatory drugs. Conclusion: As shown in our series of cases, the early use of immunomodulatory drugs is recommended with a close monitoring and individualized treatment to achieve the best anatomical and functional results.
  1,864 327 -
Don't let me down: New intraocular lens formula effectiveness in extreme-length eyes in day-to-day practice
Tiago Morais-Sarmento, Ricardo Figueiredo, João Garrido, Ana Luísa Rebelo, Olga Berens, Augusto Candeias
2019, 1:3 (8 August 2019)
Purpose: This study aimed to assess five intraocular lens (IOL) formula refractive outcomes in eyes with extreme axial length (AL) in the day-to-day practice of a secondary care center. Design: This is a retrospective consecutive case series. Methods: From all uneventful phacoemulsification cataract surgeries performed during 2018 (n = 1528), eyes with AL ≤22 mm and ≥25 mm were included and, after applying exclusion criteria, were validated (n = 114). Five IOL power formula predictions were compared to registered postsurgical refractions using IOL Master 500©. Two subgroups were created: eyes with AL ≤22 mm (n = 52) and AL ≥25 mm (n = 62). The formula performance in each subgroup was assessed by values of mean error, mean absolute error (MAE), median absolute error, standard deviation, and frequencies of eyes within lesser values of prediction error (PE). Results: The formulae presented different PE values in both subgroups. In AL ≤22 mm subgroup, the MAE was 0.622 (±0.120) for Barrett II, 0.684 (±0.153) for Haigis, 0.625 (±0.131) for Hoffer Q, 0.593 (±0.130) for Holladay I, and 0.593 (±0.119) for SRK/T, without statistical significance (P > 0.05). In AL ≥25 mm subgroup, the MAE was 0.409 (±0.110) for Barrett II, 0.739 (±0.159) for Haigis, 1.143 (±0.224) for Hoffer Q, 1.058 (±0.212) for Holladay I, and 0.928 (±0.190) for SRK/T, with statistical significance compared to Barrett II and Haigis (P < 0.001). In this subgroup, the application of Wang–Koch AL adjustment seemed an advantage in Hoffer Q and Holladay I, whereas a disadvantage in Haigis and SRK/T. Conclusions: Despite performing better than any other formulae, the 4th generation formulae performed worse than initially expected. Formula constants might explain this difference, and different IOL models can be used. However, these limitations are faced in day-to-day practice. Thus, these results hold their value as real-life refractive outcomes in eyes with extreme AL.
  1,866 217 -
Relationship between spectral domain optical coherence tomography and the perimetry automated in glaucoma suspect and glaucoma in hispanic population
Jeanneth Toquica, Fernando Gomez-Goyeneche, Maryudi Velandia-Plata, Diana Sarmiento-Forero, Gerardo Ardila-Duarte
2019, 1:2 (8 August 2019)
Purpose: The aim of the study is to evaluate the structure-function relationship measured with NIDEK RS-3000 advance spectral-domain optical coherence tomography and standard automated perimetry (SAP) in a Hispanic population. Methods: Eighty-three eyes with open-angle glaucoma (mean age: 63.4 years, 24% male and 76% female) and 163 eyes with glaucoma suspects (mean age: 51.6 years, 38% male and 62% female) were included in a cross-sectional study. The connection between retinal nerve fiber layer (RNFL), optic disc and ganglion cell complex (GCC) reduction, and visual field losses were evaluated, and Pearson's correlation coefficients (R) was calculated. Results: A significant but mild correlation (R = 0.24; P < 0.002) was seen between functional and structural parameters in glaucoma suspects. After the classification of the patients by the Hodapp–Parrish–Anderson glaucoma grading scale, at mild glaucoma, it was established a significant correlation between SAP with temporal RNFL (R = 0314; P < 0.003) and optic disc (R = 0.36; P < 0.012). In relation to moderate glaucoma, it was found a higher correlation between temporal thinning of RNFL (R = 0.734; P < 0.005) and inferior GCC (R = 0.506; P < 0.023). At advanced glaucoma, there was a stronger correlation (R = 0.711;xz P < 0.014) between superior RNFL and optic disc with corresponding topographic SAP locations. Conclusions: There were significant correlations between RNFL, optic disc and GCC loss, and deficits on SAP that increase with the glaucoma severity. This damage could be predictive of visual field loss, the defects went from generalized to localized, and the change rates were directly related to the stage of the disease.
  1,833 230 -
Giant molluscum contagiosum mimicking a lid abscess: “Appearances can be deceptive”!!
Yamini Priya, Anupama Janardhanan
2019, 1:12 (16 October 2019)
Giant molluscum contagiosum (MC) is a rare nodular presentation of molluscum lesions. A diameter measuring more than half to 1 cm qualifies to be called as a giant MC. It has a strong predilection toward immunocompromised patients. A 45-year-old retropositive male presented with a large left upper eyelid swelling. After clinical evaluation, it was presumed to be a chronic lid abscess. On excision biopsy surprisingly, no purulent matter was obtained. A nodular mass was discovered which was confirmed to be giant MC on histopathology. No recurrence was found on follow-up. In immunosuppressed patients, MC has a chronic course and can rarely become large as a giant MC. CD4 lymphocytopenia and a phenomenon known as immune reconstitution inflammatory syndrome probably contribute to its pathogenesis. Giant MC must be kept in mind while evaluating an immunosuppressed patient coming with large lid swellings.
  1,818 205 -
Multidisciplinary management of neurotrophic and exposure keratopathy secondary to clivus chordoma resection: An ocular surface challenge
Nallely Morales-Mancillas, Andres Bustamante-Arias, Juan Homar Paez-Garza, Hector Marines-Sanchez, Alejandro Rodriguez-Garcia
2020, 2:7 (24 March 2020)
The purpose is to report the ocular complications observed after compound cranial nerve palsies secondary to multiple clivus chordoma resection surgeries. A 38-year-old man was referred to our clinic with diplopia and foreign-body sensation. Examination revealed a right peripheral facial paralysis with paralytic lagophthalmos leading to exposure keratopathy and a right sixth nerve palsy with esotropia. Subsequently, the patient developed a longitudinal fusiform-shaped corneal epithelial defect in the right eye. The corneal sensation was reduced due to a fifth nerve palsy leading to neurotrophic keratopathy. The combination of neurotrophic with exposure keratopathy is one of the worst scenarios for corneal integrity.
  1,836 159 -
Granuloma annulare in a young patient: An unusual presentation
Vinicius Clementino Falcao, Elvira Barbosa Abreu, Julia Valdemarin Burnier, Miguel Noel Burnier
2019, 1:10 (7 October 2019)
Here, we report the case of a 16-year-old patient with lesions on the upper eyelids, which were diagnosed as granuloma annulare. This is an uncommon site of presentation of this lesion type, which is more commonly found on the extremities such as the hands, ankles, and trunk. Excisional biopsy of the lesion was performed, and the patient presented with recurrence. The patient was started on systemic treatment and showed improvement of the clinical picture and reduction of the lesions, with continuous follow-up.
  1,839 147 -
Retrolental vascular membrane in a case of ciliary body medulloepithelioma: Clinicopathologic correlation
Luca Bongiovanni De Miranda Gonçalves, Joao Carlos De Miranda Gonçalves, Maria Cristina Martins, Miguel N Burnier
2019, 1:15 (6 November 2019)
A unilateral nonteratoid malignant ciliary body medulloepithelioma presented in a 13-year-old girl as a leukocoria with an extense vascularized retrolental membrane in her right eye. In this description, clinical documentation, posterior segment ultrasound, and ultrasound biomicroscopy were obtained, and an anatomopathological correlation was made by showing rosettes in some histological cuts stained by haematoxylin and eosin obtained from the mass and the membrane.
  1,764 206 -
Effect of neodymium: yttrium aluminum garnet laser posterior capsulotomy on intraocular pressure
Neha Verma, Ashish K Ahuja
2020, 2:6 (24 March 2020)
Objective: To find out whether there exists a correlation between the quantum of energy used and the amount of rise of intraocular pressure (IOP) following neodymium: yttrium aluminum garnet (Nd: YAG) laser capsulotomy. Materials and Methods: A total of 110 patients who had undergone Nd: YAG laser posterior capsulotomy for the management of posterior capsule opacification with a minimum of 3 months following cataract surgery were enrolled after taking written informed consent. After detailed history and ocular examination, Nd: YAG laser capsulotomy was performed. Prelaser IOP was noted. Nd: YAG laser posterior capsulotomy was performed. Laser energy used was noted following which postlaser IOP was also recorded after 1, 2, and 4 h postprocedure. Paired t-test was used for the comparison of means of IOP and energy levels. Receiver operating characteristic analysis was used to predict the cut-off value of energy on the basis of change of IOP from baseline. Results: The mean energy used in the Nd: YAG laser posterior capsulotomy procedure for all patients was 58.57 ± 34.63 mJ. The mean IOP at 1st h follow-up was 15.32 ± 2.91 mmHg, at 2nd h follow-up was 16.24 ± 3.23 mmHg, and at 4th h follow-up was 16.18 ± 3.35 mmHg. At all three follow-ups, the mean change in IOP was found to be statistically significant (P < 0.001). Conclusion: Postlaser IOP rise is minimal and transient; it varies with the amount of energy used.
  1,704 222 -
Pars plana Ahmed glaucoma valve implantation in refractory glaucoma: Surgical technique and long-term outcomes
Harsh Kumar, Avnindra Gupta, Suman Bandil, Mithun Thulasidas
2020, 2:16 (24 June 2020)
Purpose: The aim of this study was to evaluate the long-term efficacy of intraocular pressure (IOP) control and complications of pars plana Ahmed glaucoma valve (AGV) implantation in refractory glaucoma patients. Design: This was a prospective interventional study. Materials and Methods: We conducted a single-center study, involving eyes with refractory glaucoma. Study variables were IOP, the number of glaucoma medications, and corrected distance visual acuity (CDVA) evaluated preoperatively and postoperatively at 1 day, 1 week, 1 month, 3 months, 6 months, and every 6 months till the last follow-up. Complete success was defined as absolute if IOP was between 6 and 21 mmHg in the absence of any glaucoma medication and qualified success if IOP was between 6 and 21 mmHg with medication at the last follow-up. Results: The study included 27 patients (29 eyes) with a mean age of 54.28 (standard deviation [SD]: 16.76; range: 11–73) years and a mean follow-up of 21.31 (SD: 20.38; range: 6–60) months. The mean IOP reduced from 38.14 (SD: 7.4; range: 25–50) mmHg preoperatively to 12.76 (SD: 3.92; range: 6–20) mmHg at the last follow-up (P <0.001). CDVA improved in 16 (55.2%) eyes, remained the same in 10 (34.5%) eyes, and worsened in 3 (10.3%) eyes. There was a mean reduction of antiglaucoma medications from 4.07 (SD: 0.26) preoperatively to 0.93 (SD: 1.31) postoperatively (P <0.001). The absolute success rate was 62%, reaching 100% in terms of qualified success. Postoperative complications included vitreous hemorrhage in 4 (13.8%) eyes, transient hypotony in 3 (10.3%) eyes, hyphema in 2 (6.9%) eyes, tube exposure in 2 (6.9%) eyes, and development of a small iris cyst in 1 (3.4%) eye. Conclusion: Pars plana implantation of AGV is a viable option in refractory glaucoma eyes where other surgical options are precluded, as it provides a good success rate with fewer postoperative complications. One must still keep a watch for tube exposure, vitreous incarceration in the tube, vitreous hemorrhage, and future retinal complications.
  1,795 127 -
A continuous red eye: Case report about a carotid cavernous fistula
Sonia Cristina Raposo Parreira, Sandra Barros, Diogo Lopes, Joaquim Silva, Nuno Campos
2019, 1:11 (16 October 2019)
The purpose of the study is to present a case of indirect carotid cavernous fistula (CCF) successfully treated with endovascular approach. A 46-year-old male presented with a progressive, painless visual loss and conjunctival injection of the right eye with 1 month of evolution. On ophthalmology examination, the patient had best-corrected visual acuity of 20/30 in the right eye and an intraocular pressure (IOP) of 20 mmHg. The patient still had pulsating proptosis and an orbital bruit on the auscultation. Slit-lamp examination revealed corkscrew episcleral vessels. The patient was submitted a magnetic resonance angiography that confirmed the presence of an indirect carotid-cavernous sinus fistula. The patient was submitted to endovascular embolization by the transarterial approach to close the fistula with complete clinical and imaging resolution. Two months after the procedure, the visual acuity was 20/20, and the IOP was 8 mmHg. CCF is an uncommon disease and may be misdiagnosed when there are few signs and symptoms on presentation. Different subtypes of CCF cause different clinical signs, with varying speeds of onset and severity. The diagnosis is based on clinical findings and by imaging studies. However, the definite diagnosis is only possible with cerebral angiography. It is important to consider risks and benefits in relation to endovascular treatment, mainly in indirect CCF.
  1,664 203 -
Extracellular vesicles from the aqueous humor of patients with uveitis
Carmen Luz Pessuti, Deise Fialho Costa, Kleber S Ribeiro, Heloisa Nascimento, Rubens Belfort, Alessandra G Commodaro, Ana Claudia Torrecilhas
2019, 1:1 (8 August 2019)
Context: Extracellular vesicles (EVs) are related to the dissemination of the pathogen and to the regulation of the host immune system in infectious diseases. However, the role of EVs in Ocular toxoplasmosis remains unclear. Aims: The goal of this study was to identify and characterize the concentration and size of EVs in the aqueous humor (AH) and plasma of patients with ocular toxoplasmosis (OT) compared to other types of uveitis (OTU) and cataract. Settings and Design: AH and plasma were collected from six patients with active OT, six patients with OTU, and six patients with cataract. All patients were also assessed clinically. Subjects and Methods: EVs were isolated using the membrane affinity column method. Nanoparticle Tracking Analysis (NTA) was performed to determine the size and concentration of EVs. Statistical Analysis Used: The ANOVA test was used to determine statistical difference. P < 0.05 was considered statistically significant. Results: EV was present in the AH of different types of uveitis as well as in patients with cataract. The concentration of EV in AH was significantly lower in OT and OTU compared to cataract (P = 0.03). However, in the plasma, all groups presented a similar concentration of EV. The size of EV was the same in the AH and plasma among the three groups. Conclusion: This initial study successfully identified and characterized EVs in the AH and plasma from patients with OT as well as OTU and cataract. Further studies are necessary to better understand the role of EVs in different ocular pathologies.
  1,670 192 -
Design of a new instrument for microsurgery in anterior and posterior segment
Eduardo Arenas Archilla, Gioconda Armas Herrera
2019, 1:13 (24 October 2019)
  1,660 197 -
Poppers' maculopathy
Renzo Canote Flores, Johana Rueda Rueda
2019, 1:8 (26 September 2019)
We report a case of visual alterations after the first use of poppers in a young male patient. A 32-year-old male patient with no past medical history presented with decreased central visual acuity and phosphenes in both eyes. He admitted the use of poppers a day before the symptoms began. Optical coherence tomography showed bilateral disruption of the ellipsoid zone. Poppers' use is increasing in young people and so is the possibility of visual and structural alterations that can persist over time as a result of macular toxicity.
  1,683 162 -
How lethal is a pellet gun for eyes?
Suhail Rafiq, Musaib Ahmad Dar, Jan Muhammad Suhail, Arshid Ahmad Bhat, Irshad Mohideen
2020, 2:5 (27 February 2020)
Background: Etiologically ocular injuries can be classified into domestic, occupational, sports, road traffic accidents, iatrogenic, fights and assaults, and war injuries. In the 1960s and 1970s, road traffic accidents became the most common cause of serious ocular injuries. In the 1980s, sports and leisure activities became a common cause of severe eye injury. The home is now the most common location for eye injuries. However, bomb blast and battlefield ocular injuries are becoming increasingly common in different parts of the world. Recently introduced non-lethal pellet guns used by law enforcement Indian agencies in Kashmir were the most common cause of ocular injuries in the valley. Objective: The objective of this study was to evaluate ocular pellet gun injuries in patients of a conflict zone by a so called non-lethal weapon as a mass control measure. Method: The study was conducted in post graduate department of Radiodiagnosis and imaging, Government Medical College, Srinagar Jammu and Kashmir. Our study was conducted between January 2019 to 15th May 2019. A total of 30 patients with ocular pellet injuries were taken up for study. Results: The most common type of injuries encountered were corneal laceration in 66.7 % eyes, vitreous haemorrhage in 52.8% and scleral laceration in 33.3% of eyes. Indirect signs like decreased volume of anterior chamber were suggestive of corneal laceration. Retained intraocular foreign body (IOFB) was seen in 7 patients and intraorbital foreign body excluding intraocular foreign body in 3 patients. Conclusion: In conclusion a so called non-lethal pellet gun used by law enforcement agencies has the potential to cause devastating ocular injuries.
  1,641 168 -
Pearl of the eye…ocular cysticercosis
Neha Verma, Ashish Kumar Ahuja
2020, 2:4 (23 January 2020)
We present a case of an 18-year old female with intraocular cysticercosis in the form of a freely mobile cyst in the anterior chamber of the right eye,that was successfully removed by viscoexpression.
  1,532 256 -
Literature consulted by Spanish-speaking candidates who passed the International Council of Ophtalmology examinations
Agustina Lucia Adaniya, Gabriela Palis, Eduardo Mayorga, Raphaela F Forgues, María Paula Aquino, Pablo Bazterrechea
2020, 2:13 (27 May 2020)
Context: Most ophthalmologic literature is written in English. There is a wide range of books available for the preparation of the International Council of Ophthalmology (ICO) examinations. Aims: The aim of this study is to evaluate the assessment of the literature consulted by Spanish-speaking candidates who sat for the ICO examinations. Settings and Design: Observational study based on a survey to candidates in Spanish-speaking countries. Methods: Online surveys were sent to candidates residing in Latin America and Spain who passed the ICO examinations in the past 5 years. The survey asked about fluency in English, language in which the examination was studied, literature consulted in English and Spanish. Literature was classified by the language. Statistical Analysis Used: Qualitative analysis and description of the answers. Results: One hundred and thirty-three responses were obtained from the candidates from Argentina, Chile, Colombia, Costa Rica, Ecuador, Spain, Mexico, Peru, the Dominican Republic and Venezuela, who had passed at least one ICO examination. Seventy-eight resources were identified (14 in Spanish and 64 in English). The most widely used resource was the Basic and Clinical Science Course collection of the American Academy of Ophthalmology, English version. Conclusions: The prevalence of English bibliography can be a challenge for Spanish-speaking candidates when taking international examinations. It would be useful to increase the number of publications and more updated literature in Spanish to encourage Hispanic candidates.
  1,543 157 -
Weil–Marchesani syndrome: A case report and literature review
Carlos Emiliano Rodríguez Lopez, Guadalupe Fernando Mora González, Gerardo Daniel Jáuregui García
2020, 2:10 (23 April 2020)
Weill–Marchesani syndrome is a rare connective tissue disorder, with a poorly understood etiology that has been primarily related to hereditary genetic factors, including mutations in ADAMTS10 and fibrillin-1. Clinically, it is characterized by a phenotype of short stature and brachydactyly, associated with joint stiffness and eye problems that begin to be noticed in childhood. There is little information about this disease in the Mexican population. This is a description of the case of a 17-year-old female patient with clinical feature compatible with this syndrome, as well as a brief review of the literature on this entity. The knowledge of this syndrome is important to achieve a timely diagnosis and prevent the complications associated with it.
  1,483 159 -
Unusual associations with toxoplasmosis: Report of two cases
Denis Anaya, Alberto Castro
2019, 1:4 (8 August 2019)
Toxoplasma retinochoroiditis is an entity of variable incidence according to the country and it is prevalent in Colombia and Latin America. The purpose of this report is to present two cases of toxoplasma retinochoroiditis with unusual associations with other retinal diseases. The first case corresponds to a young immunocompetent patient who developed toxoplasma retinochoroiditis in one eye and was treated. Six years later, he presented a similar picture in the contralateral eye and the same diagnostic was done. But the evolution was torpid and finally an herpetic acute retinal necrosis was confirmed. The second case corresponds to a healthy young patient, who developed toxoplasma retinochoroiditis and at the time of diagnosis he had exudative lesions in the same eye, that difficulted the diagnosis and were due to adult Coats´ disease.
  1,429 201 -
Prevalence of cataract and barriers to cataract-related care in rural Ecuador
Sila Bal, Carlos Gonzalez, Sarah Marjane
2019, 1:7 (26 September 2019)
Introduction: Cataracts remain the leading cause of blindness worldwide. Despite this, there is a lack of information surrounding cataracts in Ecuador. We sought to assess the rate and barriers to cataract-related care in two Ecuadorian communities to identify points of intervention for local and international organizations. Methods: This was a cross-sectional assessment using a convenience sample of patients seen in clinics run by Fundacion Internacional Buen Samaritano Paul Martel, a local nonprofit providing affordable eye care in Ecuador. Two populations were assessed. Week 1 patients were from the Andean region of Chimborazo (W1) and week 2 patients from Santa Cruz Island, Galapagos (W2). All patients seen were assessed for cataracts. Patients identified as having cataracts completed a six-question survey related to barriers to care. The primary outcomes were the rate of cataracts and the leading barriers to care. Results: Forty-four total patients during W1 and 1,002 during W2 were seen and screened for cataracts. Mean age (years) was W1 – 44 years and W2 – 42 years. The overall rate of cataracts was 4 (9%) in W1 and 50 (5%) in W2. When stratified by age, the rate of cataracts in individuals aged 50 and over was 21% (W1) and 6% (W2). Forty-six participants with cataracts completed the survey. The major barriers to cataract-related care were cost (n = 26), followed by access (n = 7), and fear of surgery (n = 4). Conclusions: Our results confirm the high overall rate of cataracts in patients presenting to eye clinics in two distinct communities. We found that cost and access are the main barriers to care. These communities would benefit greatly from care delivery models that bring services close to where individuals live, through partnerships between local and global organizations.
  1,381 173 -
Keratoconus in hypohidrotic ectodermal dysplasia
Carolina Peres Batalha, Marcelo Vicente Andrade Sobrinho, Gabriela Chaves Hoehr, Letícia Tavares Selegatto, Rafaela Bacco Amade
2019, 1:6 (18 September 2019)
The hypohidrotic ectodermal dysplasia (HED) is a rare genetic disease characterized by the absence or deficiency function of the ectodermal derivatives. Ocular involvement includes dry eyes, cataract, blefaritis, and alterations of meibomian glands. However, keratoconus has not been included as a manifestation in the literature. We report the case of a 17-year-old male who presented HED and keratoconus, an ocular manifestation seldomly related to this syndrome. The patient was submitted to a contact lens fitting, and the final visual acuity was 0.1 logMAR in both eyes. Therefore, to the best of our knowledge, our patient can be considered the fourth patient diagnosed with keratoconus and HED simultaneously worldwide. The uniqueness and rarity of this syndrome associated with keratoconus, as well as the satisfactory contact lens fitting, motivated this case report, which can provide useful information and alert to this possible etiological association.
  1,384 155 -