Concentric Reversible Visual Field Loss, Nyctalopia, and Dyschromatopsia with Ezetimibe Therapy
This is a case of ezetimibe-induced concentric field loss, dyschromatopsia, and nyctalopia in a patient with no prior history of retinal dystrophy or drug hypersensitivity. A 55-year-old Caucasian woman presents with a 1-year history of increasing concentric visual field loss, nyctalopia, photophobia, and colour vision impairment. These symptoms correlated with the commencement of ezetimibe therapy 10 mg daily for hypercholesterolaemia. She demonstrated repeatable bilateral visual field constriction on 30-2 Humphrey visual filed testing and colour vision impairment on Ishihara plates (OD: 1/17, OS: 1/17). Biochemical and r...
Source: Case Reports in Ophthalmology - April 28, 2023 Category: Opthalmology Source Type: research

Possible Spontaneous Extrusion of a Traumatic Deeply Embedded Intracorneal Foreign Body: A Case Report
We report herein, an unusual case of possible spontaneously extruded deeply embedded intracorneal foreign body 5 weeks after sustaining a trauma to his right eye. Whether the foreign body was truly spontaneously extruded or absorbed by corneal tissue is unknown.Case Rep Ophthalmol 2023;14:180 –184 (Source: Case Reports in Ophthalmology)
Source: Case Reports in Ophthalmology - April 26, 2023 Category: Opthalmology Source Type: research

Progressive Central Artery Occlusion, Ophthalmic Artery Occlusion, and Hemispheric Intracranial Thrombosis after COVID-19 mRNA Vaccine Application: Case Report
Thromboembolic events as a result of COVID-19 mRNA vaccination are a rare, though life-threatening complication. In this case report, we describe a 40-year-old female patient who developed central retinal artery and ophthalmic artery occlusion progressing to intracranial thrombosis 3 weeks after vaccination with the Pfizer-BioNTech COVID-19 vaccine. Initially, she presented with progressive acute and painless unilateral vision loss in her left eye. Dilated fundoscopy of left eye showed macular whitening with sparing of the area of cilioretinal artery distribution. Labs revealed a normal erythrocyte sedimentation rate, C-re...
Source: Case Reports in Ophthalmology - April 18, 2023 Category: Opthalmology Source Type: research

A Case of a Low Vault after Posterior Chamber Acrylic Phakic Intraocular Lens Implantation
When implanting a posterior chamber phakic intraocular lens (pIOL), it is crucial to maintain a safe distance. The patient was a 29-year-old man with high-degree bilateral myopia. In February 2021, posterior chamber acrylic pIOLs (Eyecryl Phakic TORIC; Biotech Vision Care, Gujarat, India) were implanted in both his eyes. After the surgery, the right eye vault was 6 μm, and the left eye vault was 350 μm. Moreover, the internal anterior chamber depth values were 2,270 and 2,220 μm for the right and left eyes, respectively. In our case, we found a fairly high crystalline lens rise (CLR) in both eyes, but it was greater in ...
Source: Case Reports in Ophthalmology - April 11, 2023 Category: Opthalmology Source Type: research

Proliferative Sickle Cell Retinopathy in the Retinal Periphery Detected by Ultra-Widefield Imaging: A Case Report
Sickle cell proliferative retinopathy usually presents first in the peripheral retina and the ability to extend and enhance our visualization of the peripheral retina would allow for superior clinical decision-making. In our practice, we had a 28-year-old patient diagnosed with major sickle cell disease of the homozygous type SS (HbSS) that presented with sickle cell proliferative retinopathy detected by ultra-widefield imaging in the nasal side of the left fundus. At follow-up, neovascularization was detected in the extreme nasal periphery of the left eye by ultra-widefield imaging fluorescein angiography with right gaze....
Source: Case Reports in Ophthalmology - April 11, 2023 Category: Opthalmology Source Type: research

Successful Management of Fungal Keratitis by < i > Alternaria alternata < /i > Complicating Mooren ’s Ulcer
Mooren ’s ulcer is an idiopathic peripheral ulcerative keratitis whose pathogenesis is thought to be due to an autoimmune reaction. The first-line treatment for Mooren’s ulcer is the use of topical steroids, which can be difficult to discontinue. The 76-year-old patient in this case was receiving topic al steroids for bilateral Mooren’s ulcer and developed a feathery corneal infiltration and perforation in the left eye. On suspicion of a fungal keratitis complication, we started topical voriconazole treatment and performed lamellar keratoplasty. Topical betamethasone was continued twice a day. The identified causativ...
Source: Case Reports in Ophthalmology - April 11, 2023 Category: Opthalmology Source Type: research

Ultrawide-Field Optical Coherence Tomography in Transvitreal and Subretinal Fibrinoid Syndrome: A Case Report
We report a case of fibrinoid reaction after diabetic vitrectomy surgery. Our case report describes a male patient with severe fibrinoid reaction with both intravitreal fibrin bands and subretinal fibrin and fluid following vitrectomy for diabetic retinopathy. He was managed initially with posterior subtenon and suprachoroidal injection of triamcinolone as well as intravitreal injection of tissue plasminogen activator (TPA). Fluid-air exchange and air-fluid exchange were also performed to remove the fibrin degradation product. 1 millimeter of air tamponade was placed in the vitreous cavity to displace the remaining subreti...
Source: Case Reports in Ophthalmology - April 6, 2023 Category: Opthalmology Source Type: research

The Atypical Red Eye: A Case of Scleritis with Peripheral Ulcerative Keratitis Secondary to Granulomatosis with Polyangiitis
This report presents a rare case of scleritis with peripheral ulcerative keratitis secondary to granulomatosis with polyangiitis (GPA). A 65-year-old Caucasian male presented to a regional ophthalmology service with an atypical red eye. His immune work-up demonstrated positive anti-neutrophil cytoplasmic IgG autoantibodies (ANCA) with anti-proteinase 3 antibody (PR3) elevation. Multi-system vasculitis was discovered including lung, liver, bladder, prostate, nasal and paranasal sinuses involvement. His ocular sequelae included significant peripheral corneal thinning requiring cyanoacrylate gluing, juxtalimbal conjunctival r...
Source: Case Reports in Ophthalmology - April 5, 2023 Category: Opthalmology Source Type: research

Oral Corticosteroids for Teprotumumab-Related Hearing Loss: A Case Report
Teprotumumab is a novel insulin-like growth factor-1 receptor inhibitor approved for the treatment of thyroid eye disease, but growing reports of hearing loss require further investigation. To date, an effective protocol for managing hearing loss in this setting has not been determined. Here, we present the first report of the resolution of teprotumumab-related hearing loss with prompt oral prednisone. A 70-year-old woman on teprotumumab experienced sudden hearing loss and tinnitus after her first infusion. An audiogram demonstrated a mild down-sloping to moderately severe mixed conductive and sensorineural hearing loss th...
Source: Case Reports in Ophthalmology - April 4, 2023 Category: Opthalmology Source Type: research

A Rare Microsporidial Infection in Lamellar Corneal Tissue, following Transepithelial Photorefractive Keratectomy
The aim of this study was to report a unique case of microsporidial keratitis over deep anterior lamellar keratoplasty after transepithelial photorefractive keratectomy surgery that was successfully treated with therapeutic lamellar keratoplasty without recurrence at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia. The patient presented with recurrent attacks of eye pain, redness, photophobia, and decreased vision. The patient was initially treated as a case of presumed herpetic keratouveitis using antiviral medication and topical steroids with partial improvement. During the last episode, the condition deterio...
Source: Case Reports in Ophthalmology - April 4, 2023 Category: Opthalmology Source Type: research

Orbital Venous Malformation Excision after Transcaruncular Embolization with Onyx
This report highlights a detailed approach to defining flow characteristics pre- and intraoperatively and expands upon our understanding of the use of Onyx for such cases.Case Rep Ophthalmol 2023;14:121 –126 (Source: Case Reports in Ophthalmology)
Source: Case Reports in Ophthalmology - March 28, 2023 Category: Opthalmology Source Type: research

Unusual Presentations of Low-Tension Glaucoma
Low-tension glaucoma can sometimes be difficult to diagnose, particularly if patients do not have a classic presentation. This case series shows the value of Humphrey visual field (HVF) 10-2 tests to identify deficits in central vision. Case 1 describes a female in her mid-60s who presented complaining of a “blind spot” in her right eye. While a HVF 24-2 suggested her test was “within normal limits,” an HVF 10-2 showed an unusually shaped scotoma in her right eye that matched her visual complaint. Case 2 describes a male in his mid-60s who was referred to the glaucoma service by a retina specia list. He complained ...
Source: Case Reports in Ophthalmology - March 22, 2023 Category: Opthalmology Source Type: research

Isolated Internal Ophthalmoplegia from Posterior Cerebral Artery Neurovascular Conflict
We report a rare case of recurrent isolated internal ophthalmoplegia attributed to oculomotor nerve (CN III) compression by the posterior cerebral artery (PCA). A 30-year-old female patient presented with recurrent right-sided headaches, right periorbital pain, and slight anisocoria. Slit-lamp examination revealed normal anterior and posterior segments except for vermiform movements of the right pupil with a temporal hyporeactive flat area. Tonic pupils were ruled out with pilocarpine 0.1% testing. Suspecting an internal ophthalmoplegia, magnetic resonance imaging was ordered which demonstrated the right CN III indented by...
Source: Case Reports in Ophthalmology - March 22, 2023 Category: Opthalmology Source Type: research

Cryotherapy after Topical Interferon Alpha 2b to Treat Conjunctival Primary Acquired Melanosis
When primary acquired melanosis (PAM) with atypia affects the tarsal conjunctiva, a radical surgery can be mutilating, requiring reconstructive surgery of the eyelid. Topical chemotherapy associated to local cryotherapy may be an alternative. A 64-year-old Caucasian female presented with diffuse PAM of the right eye involving the inferior tarsal conjunctiva, fornix, and inferotemporal bulbar conjunctiva. Histological study showed a PAM with atypia (C-MIN 5). Given the extent of the lesion and its location, a wide mutilating excision was ruled out. Topical interferon alpha 2b (IFN- α2b) treatment (1,000,000 IU/mL, 4 times ...
Source: Case Reports in Ophthalmology - March 22, 2023 Category: Opthalmology Source Type: research

A Rare ND5 Mutation Causing Leber ’s Hereditary Optic Neuropathy
Mutations to the ND5 gene are uncommonly associated with Leber ’s hereditary optic neuropathy (LHON). Herein, we describe a 57-year-old man with the m. 13528Agt;G, p. (Thr398Ala) mutation at the ND5 gene who presented with progressive bilateral vision loss over the course of 3 months. He had a significant history of smoking and alcohol consumption. Visual fie ld testing demonstrated bilateral central scotomas. At 2-year follow-up, his visual acuity improved relative to baseline and temporal optic disc pallor was observed in both eyes. There are scarce reports of this mutation in the literature, and this case report furth...
Source: Case Reports in Ophthalmology - March 16, 2023 Category: Opthalmology Source Type: research