Outcomes of Corneal Tattooing by Rotring Painting Ink in Disfiguring Corneal Opacities

Aim. To evaluate corneal tattooing with Rotring painting ink (Rotring Ink, Hamburg, Germany) as an available and affordable surgical technique to improve cosmetic appearance in the eyes with disfiguring corneal opacities. Methods. Fifty-three blind eyes with corneal disfiguring opacities underwent corneal tattooing using Rotring painting ink (Rotring Ink, Hamburg, Germany) by multiple transepithelial intrastromal injections under topical anesthesia. Complete ophthalmic examination and ocular ultrasonography were performed, and photographs of the patients’ eyes were taken. Follow-up period was at least 12 months. Results. On the first postoperative day, all patients presented with mild conjunctival injection and foreign body sensation. After the end of the follow-up period, 51 patients (96%) were satisfied of cosmetic appearance while only 2 patients (4%) post-op cosmetic results were less than their expectations; however, they were better in appearance. No major complications like corneal erosions; corneal ulcers or corneal melting was noted in any case. Conclusions. Corneal tattooing with Rotring painting ink in blind disfigured eyes achieves favourable cosmetic results and is associated with high patient satisfaction. With better case selection, a high post-op satisfaction was achieved. Corneal tattooing acts as an alternative to more sophisticated and expensive cosmetic reconstructive surgery. This trial is registered with ISRCTN46626979

Pediatric self-inflicted eye trauma due to a major depressive disorder

Self-inflicted eye trauma is a serious form of self-harm as it may lead to irreversible visual disability. Diagnosing self-inflicted ocular injuries, in all its forms, can be quite challenging. In this report, we are presenting a 5-year- old girl presented to Sohag University Outpatient Clinic with a history of repeated attacks of bilateral eye redness with blood-tinged strands removed from her eyes. After ocular examination, inferior bulbar conjunctival injection with blood-tinged strands were found. After careful examination of the strands, it was discovered that they were actual threads of cloth due to self-inflicted eye injury. Following psychiatric consultation, the patient was diagnosed as having a major depressive disorder. The case was subject to pharmacological and psychotherapeutic treatment, and showed significant improvement within two months of starting treatment as regard to depressive symptoms and self-injury behaviors. Although self-inflicted ocular injuries due to pediatric mood disorders are rare, it should be suspected in any case of unexplained chronic conjunctivitis

Corneal Endothelial Cell Density and Morphology in Healthy Egyptian Eyes

Purpose. To evaluate the corneal endothelial cell density and morphology in normal Egyptian eyes. Methods. In total, 568 healthy eyes of 568 Egyptian volunteers aged 20 to 85 years were examined using noncontact specular microscopy for the central corneal thickness (CCT), mean endothelial cell density (MCD), coefficient of variation (CV) in cell area, mean cell area (MCA), and hexagonal cell (Hex) percentage. Variables were compared between sexes and between different age groups. Results. The mean CCT, MCD, and MCA were 514.45 ± 43.04 μm, 2647.50 ± 382.62 cells/mm2, and 390.59 ± 149.94 μm2, respectively. MCD and MCA showed no significant differences between men and women (P=0.171 and 0.099, respectively), whereas CV (%) and Hex (%) showed significant differences (P=0.024 and 0.015, respectively). CCT (P=0.007, r = −0.113) and MCD (P<0.001, r = −0.357) exhibited a significant negative correlation with age, whereas CV (%) (P<0.001, r = 0.341) and MCA (P=0.008, r = 0.111) exhibited a significant positive correlation. The mean rate of endothelial cell loss from 20 to 85 years of age was 0.3% per year. Conclusions. Our results provide normative data for the corneal endothelium in healthy Egyptian eyes, thus increasing the knowledge base for corneal endothelial cell parameters in healthy Egyptian eyes. Furthermore, our findings can be used as baseline values for comparisons between Egyptian and other populations and for studies of the endothelial cell reserve and capacity for intraocular surgery and corneal transplantation

Expert Performance in Visual Differentiation of Bacterial and Fungal Keratitis

This study quantifies the performance of an international cohort of cornea specialists in image-based differentiation of bacterial and fungal keratitis, identifying significant regional variation and establishing a reference standard for comparison against machine learning models