Keratoconjunctivitis and Periorbital Edema due to Ecballium elaterium

Purpose: To report on a case of keratoconjunctivitis with periorbital edema after accidental exposure to undiluted juice of Ecballium elaterium fruit during the ripening season of this plant. Methods: Case report. Results: Keratoconjunctivitis with Descemet’s membrane folds and superficial upper corneal well-defined edematous areas were noted after an Ecballium elaterium fruit burst and its juice splashed into the patient’s left eye. Prompt administration of antibiotic and steroid eye drops along with per os antihistamine therapy, resulted in quick regression of symptoms. Conclusions: This report demonstrates the toxic effects of this herb to the eye and also that prompt therapy is effective

Ulnar Neuropathy as a Complication of Retinal Detachment Surgery and Face-Down Positioning

Purpose: To report a case of bilateral ulnar neuropathy as an extraocular complication following retinal detachment surgery and face-down positioning. Methods: Case report. Results: Bilateral hypoesthesia and numbness of the 4th and 5th finger started 2 weeks after vitrectomy for retinal detachment and face-down positioning. Due to progressive symptoms 6 months later, unilateral ulnar nerve decompression at the elbow was performed. Conclusions: This case report demonstrates that strict face-down positioning bears the risk of ulnar neuropathy

HCV genetics and genotypes dictate future antiviral strategies

At the end of the 1980s, the hepatitis C virus (HCV) was cloned and formally identified as the cause of the majority of non-A and non-B hepatitis cases. Today, around 170 million people worldwide are infected with HCV, making it five times more common than infection with the human immunodeficiency virus (HIV).  Several methods exist which mediate the spread of infection. One of the most common and efficient is sharing or re-using injecting equipment; studies have indicated that 80-90% of individuals in some populations of intravenous drug users test positive in serum HCV assays. Contracting HCV from infected blood transfusions was also a major cause of infection before screening tests were introduced in the early 1990s.  Other possible, but less common, methods of infection transmission include mother-to-child during pregnancy, sexual contact and nosocomial acquisition (for example between surgical or dialysis patients).  It appears that concurrent HIV-1 infection increases the risk of HCV transmission via the mother-to-child or sexual routes

Intravitreal bevacizumab for macular edema due to proton beam radiotherapy: Favorable results shown after eighteen months follow-up

Eleni Loukianou, Dimitrios Brouzas, Eleni Georgopoulou, Chrysanthi Koutsandrea, Michael ApostolopoulosEye Department, University of Athens, Athens, GreecePurpose: To evaluate the safety and efficacy of intravitreal injections of bevacizumab (Avastin®) as a treatment option for radiation maculopathy secondary to proton beam radiotherapy for choroidal melanoma.Case: A 61-year-old woman presented with a gradual decrease in left eye visual acuity (VA) 29 months after proton beam radiotherapy for choroidal melanoma. On presentation, her best-corrected VA (BCVA) was 2/10 in the left eye and the intraocular pressure was 15 mmHg. Fundoscopy revealed cystoid macular edema, intraretinal hemorrhages, epiretinal membrane in the posterior pole, and residual tumor scar with exudative retinal detachment and hard exudates in the periphery of the superotemporal quadrant. A treatment with intravitreal injections of bevacizumab (Avastin®) was recommended. The injections were performed on a six-weekly basis.Results: The central retinal thickness prior to the treatment was 458 μm. After the first intravitreal injection of bevacizumab, the retinal thickness at the centre of the fovea was reduced to 322 μm. After the third injection, the central retinal thickness was 359 μm and 18 months after presentation, it reduced to 334 μm. The BCVA increased to 3/10 after the intravitreal injections of bevacizumab and remained stable during the follow-up period. The intraocular pressure was within normal range during the follow-up period.Conclusion: Bevacizumab should be regarded as a treatment option for macular edema due to proton beam radiotherapy for choroidal melanoma. By reducing the central retinal thickness, intravitreal bevacizumab can improve VA or ameliorate further decline caused by radiation maculopathy.Keywords: bevacizumab (Avastin®), choroidal melanoma, macular edema, radiation retinopath

Nonorganic visual loss in a child due to school bullying

Purpose: To describe a case of a child with nonorganic visual loss due to school bullying. Observations: An eight-year-old boy presented with bilateral painless vision loss for a few days. His best corrected visual acuity (BCVA) was 20/200 in the right eye and 20/140 in the left eye. Color vision was normal. Fundoscopy, visual fields, electroretinography, electrooculography and visual evoked potentials were within normal limits. A nonorganic (psychogenic) cause of visual loss was suspected. A conversation with his parents and school teachers revealed that he was undergoing intense school bullying. Discussion between the boy and his parents and teachers' awareness helped in relieving the boy's stress. After two weeks BCVA was 20/20 bilaterally. Conclusions and importance: School bullying is a potential cause of nonorganic vision loss in children. Correct diagnosis, and support by the parents and teachers might rapidly alleviate the symptoms