Ultraviolet-A Light and Riboflavin Therapy for Acanthamoeba Keratitis: A Case Report

Purpose: To report ultraviolet-A (UV-A) light treatment in a patient with Acanthamoeba keratitis (AK). Methods: Interventional case report. A standard protocol for ultraviolet corneal therapy, with a power emission of 3 mW/cm2 and a wavelength of 370 nm, was used. The protocol included an 8-nm bandwidth at a 54-mm distance measured with a collimation system of diodes as well as a protective shield of riboflavin in a case of documented AK. Results: A 54-year-old female patient with AK, showing no therapeutic response to a wide variety of topical antimicrobial agents and with a visual acuity of 20/400, was treated with UV-A therapy. The patient displayed a favourable response in the first 24 h after treatment, with improvement of symptoms, visual acuity (to 20/200) and biomicroscopy cornea with haze degree I. By the third week post-treatment, the patient was symptom-free. Her visual acuity was 20/30, and the affected cornea was clear. Five months after treatment, there had been no recurrence, and her vision was 20/20. Conclusions: Treatment with UV-A light was an effective therapy in this case of AK

Branch retinal vein occlusion on Coats disease during COVID-19 infection: a case report

Background. The COVID-19 virus infection can develop ocular manifestations. Purpose. To report a case of a coats disease patient who was evaluated one week before as part of a routine retinal consultation and later had COVID-19 with sudden loss of vision on one eye. Material and Methods. the affected eye had a visual acuity of 20/400. At fundus examination was found abnormal tortuous vasculature, hemorrhages, branch retinal vein occlusion and macular edema. It was confirm with fluorescein angiography and optical coherence tomography. Results. With a combined therapy of intravitreal Aflibercept, periocular triamcinolone and focal laser was recovery the visual acuity to 20/20. Conclusion. There are few cases describes on literature, but a sudden loss of vision during a COVID-19 infection must be early detected and treated to achieve a better visual acuity recovery

Giant string Elschnig’s pearls

Background. Elschnig pearls are cells that migrate from the capsule of the lens and can cause posterior subcapsular opacity (PCO) Case: 29 years old male PO extracapsular cataract extraction two years ago, came for decreased visual acuity secondary to PCO. After the first capsulotomy 8 months ago, he developed giant Elschnig pearls at the edge of the capsulotomy forming a pearl necklace that cause the poor vision again. Conclusion. More studies are needed on the evolution of the disease to help assess the best time to give invasive treatment or wait for spontaneous disappearance of the pearls

Undiagnosed nevus of Оta, facial hemiparesis and esotropia: a case report

Perinatal history is often underrated in ophthalmologic consultation and may provide important information in order to establish an assertive diagnosis. Purpose: To report a case of a patient who was evaluated in two hospitals as a child and misdiagnosed with Goltz syndrome. Material and Methods: it was ruled out a syndrome and the existence of three independent diagnoses was proposed: nevus of Ota, non-accommodative esotropia and left facial hemiparesis due to involvement of the VII cranial nerve. Results: A combined left eye strabismus surgery and neodymium Yag laser treatment were performed under sedation over the entire length of the nevus. Conclusion: The presence of facial palsy, strabismus or a nevus directs the physician to interrogate prenatal and perinatal issues to establish a complete diagnosis. The patient received treatment after several years and now she is satisfied

Corneal macular dystrophy. Case Presentation.

Among the stromal corneal dystrophies corneal macular dystrophy is one of the most frequent. It is an autosomal recessive disorder linked to chromosome 16, in which a mutation occurs in the CHST6 gene, causing an alteration in keratan sulfate metabolism. This alteration produces extracellular deposits of glycosaminoglycans between the stromal lamellae of the cornea, as well as in the cytoplasm of the endothelial cells. Clinically, the presence of centrally predominant white-greyish focal stromal corneal opacities is observed in early stages. Symptoms begin between the second and third decade of life and consist of progressive decrease in visual acuity and photophobia. In this work, we present the clinical case of a 56-year-old male patient who came to the clinic due to progressive decrease in visual acuity and photophobia. On physical examination, multiple intrastromal macules, whitish in color, were found by biomicroscopy in both eyes that were accentuated in greater quantity in the central 5 mm of the cornea. According to the findings obtained in the examination, the diagnosis of corneal macular dystrophy is established

Trabeculoplasmy, a new surgical technique in the treatment of glaucoma: pilot report

The effectiveness of trabeculoplasmy in lowering intraocular pressure (IOP) in glaucoma patients was determined. A longitudinal study was carried out in 10 patients with open-angle glaucoma that underwent trabeculoplasmy. The postoperative results Of IOP, visual acuity (VA) and the occurrence of complications were evaluated at 24 hours, one week, 3, 6, 9 and 12 months. 10 surgeries were performed (10 eyes, 10 patients). Preoperative average IOP was 32.5mmHg and preoperative VA was 0.5. At one year the average IOP was 10.10 mmHg and the average VA was 0.7, both values were significant (p<0.001, p=0.019 respectively). Trabeculoplasmy may be effective technique in the treatment of glaucoma, providing a decrease and maintenance of IOP within normal limits after one year of follow-up

Primary mesodermal dysgenesis of the cornea (Peter´s anomaly)

Primary mesodermal dysgenesis of the cornea, also known as Peter´s anomaly (PA) or keratolenticular dysgenesis, is a rare congenital eye condition caused by an abnormal development of the anterior segment. PA is characterized by unilateral or bilateral corneal opacity (leucoma), that appears since the early neonatal period. The incidence of PA in the United States of America is approximately 1.5 per 100,000 live births. PA is known as Peters-plus syndrome when it presents with systemic malformations. In this article we describe the clinical presentation of an 18-year-old patient with PA that arrived to medical consultation due to bilateral corneal opacities since birth. The patient´s parents refer that he has hypoacusis and deny other systemic pathologies. Clinical exploration reveals a visual acuity of 20/30 of the right eye and 20/100 of the left eye. According to the clinical findings and the absence of systemic anomalies, the patient was diagnosed with PA type II

Strabismic amblyopia regression post refractive surgery

Background. Refractive laser surgery has absolute and relative contraindications. Among the relative ones is amblyopia and a history of strabismus. Caution should also be in cause of trauma, scar, or leukoma in the ablation site. Purpose. To present a case with regression of strabismic amblyopia after refractive surgery. Material and Methods. It was a pre-existing strabismus, which initially went unnoticed because it was a microtropia on left eye; the fixing right eye suffered a traumatic injury that produced a high ametropia and changed fixation. Results. The left eye developed excellent vision, but after the operation, somehow, momentarily the right eye became the fixator again, and the left eye saw very poorly. That situation was corrected quickly with right eye occlusion and lenses. That has happened because the eye had corrected its amblyopia for the years that the right eye was penalized. Once a good result was achieved, there was no change in fixation or visual loss. Conclusion. The change in ocular dominance and visual readjustment at the neuronal level that occurs in the postoperative period of refractive surgery stand out

Limbal Stem Cell Allografts and Corneal Transplant in a Patient with Severe Corneal Melting and Perforation due to Thermokeratoplasty andCross-Linking Treatment Burn

Purpose: To report corneal stem cell allografts in a patient with a persistent epithelial defect as well as corneal melting and perforation due to severe ultraviolet light burn and thermokeratoplasty treatment for keratoconus. Methods: A 21-year-old female patient with corneal melting, perforation and a persistent epithelial defect in her left eye secondary to iatrogenic treatment for keratoconus, thermokeratoplasty and cross-linking was treated with penetrating keratoplasty, using a 9.0-mm diameter corneal graft and limbal stem cell allograft implants. At the end of the procedure, subtenonian injections of a combination of bevacizumab and triamcinolone were given. Results: The patient had a favorable outcome 48 h after surgery, with an improvement of symptoms and a complete corneal healing. By the third week after surgery, she had a best-corrected visual acuity of 20/60 and a clear corneal graft, which remained stable for the 9 months of follow-up. Conclusions: Treatment with limbal stem cell allografts and penetrating keratoplasty in a female patient with a large corneal defect and melting in her left eye was effective. Larger studies are warranted to explore the real impact of this procedure