Differentiating Infective Neuroretinitis and Nonarteritic Anterior Ischemic Optic Neuropathy: Clinical and OCT Parameters

To evaluate the role of clinical and Optical Coherence Tomography (OCT) characteristics to differentiate between neuroretinitis and non arteritic anterior ischemic optic neuropathy (NAAION)

Optic Nerve Head Edema (ONHE) Among Patients Presenting to Emergency Department In The FOTO-ED Study

The FOTO-ED study[1-3] showed that non-mydriatic retinal photography in the emergency department (ED) is feasible and may improve patient care and outcomes when systematically performed in patients with a chief complaint of headache, neurologic deficit, visual loss, or elevated blood pressure (BP). Finding ONHE is particularly important in this patient population[4,5]. The purpose of this study was to describe the characteristics of the patients diagnosed with ONHE in FOTO-ED phases

Double Vision, Double Again

This case highlights a unique presentation of Neurofibromatosis type II with multiple episodes of sixth nerve palsy which was missed on initial MRI scans possibly due to poor delineation of the lesions or very tiny neurofibromas along the nerves

Spontaneous ophthalmic artery occlusion in children due to Hyperhomocysteinemia

Ophthalmic artery occlusion usually presents as a sudden onset profound decrease in vision in the middle-aged and elderly patients following periocular procedures (retrobulbar injection/glabellar fat injection), embolism from the heart or after prolonged systemic surgery. In this report, we describe three children with spontaneous ophthalmic artery occlusion who presented with unilateral loss of vision and diagnosed elsewhere as optic atrophy whose detailed history and examination were suggestive of ophthalmic artery occlusion. Detailed systemic and laboratory evaluation revealed hyperhomocysteinemia as the only potential risk factor. To the best of our knowledge, this is the first report of the association of hyperhomocysteinemia and spontaneous ophthalmic artery occlusion

Pulsatile enophthalmos, severe esotropia, kinked optic nerve and visual loss in neurofibromatosis type-1

Neurofibromatosis Type I if associated with aplasia of greater wing of sphenoid may be associated with a pulsatile exophthalmos. However, very rarely it may be associated with a pulsatile enophthalmos. This clinical image describes a rare presentation with pulsatile enophthalmos, esotropia and kinking of the optic nerve due to neurofibomatosis type I

Rapidly reversible visual loss in posterior reversible encephalopathy syndrome: An ophthalmologist's enigma

Posterior reversible encephalopathy Syndrome (PRES) may present with a sudden onset reversible visual loss under special visual conditions. Such patients' may initially be misdiagnosed as Malingering. Ophthalmologists may be the first physicians to be confronted by such patients. Hence, a knowledge of this condition is vital to diagnosis and management of such conditions

Myelin-oligodendrocyte Glycoprotein Associated Demyelinating Optic Neuritis in Adults: Clinical, Demographic Characteristics, and Outcomes

To describe the demographic, clinical characteristics, and outcomes of adult patients presenting with optic neuritis in setting of myelin oligodendrocyte glycoprotein (MOG) associated demyelination (MOGAD)

Circumscribed Interests in Autism: Can Animals Potentially Re-engage Social Attention?

A prominent subtype of restricted and repetitive behaviour or interests (RRBs) in autistic children comprises circumscribed interests (CI). CIs occur in 75-95% of children on the autism spectrum, are highly fixated and repetitive interests and generally center on non-social and idiosyncratic topics. The increased salience of CI objects for autistic children also results in a decreased attention to social stimuli and can interfere with social interactions, relations and activities. A parallel line of robust evidence points to greater social engagement and lesser social anxiety in autistic children in the presence of animals with impacts on crucial biomarker indices including skin conductance and salivary cortisol. Neuroimaging evidence also reports a greater activation of reward systems in the brain in response to animal stimuli in autistic individuals, whereas a similar activation is not present for human faces. Behavioral evidence as seen in studies using an eye tracking of visual gaze patterns also reveal a comparatively higher preference for animal stimuli in autistic individuals. The potentially greater social reward attached to animals in ASD, puts forward the interesting and yet unexplored possibility of the presence of competing animal stimuli reducing the disproportionately high visual preference to CI objects. We examined this possibility through a paired preference study using images of human and animal faces paired with CI and non-CI objects, within an eye tracking paradigm. 32 children (ASD n=16; TD n=16) participated in the study (3391 valid observations). Autistic children showed a significantly greater visual attention to CI objects across their pairings with non-CI objects and social images. Within typical controls, a significantly higher visual attention was seen for social images regardless of their pairing with CI or NCI objects. A key finding was that, while pairing with a CI object reduced the overall amount of social attention elicited in the ASD group, the reduction in attention was not similar for human and animal faces. When paired with CI objects, animal faces elicited greater social attention from autistic children, than human faces. These results thus suggest that social attention deficits in ASD may not be uniform across human and animal stimuli. Animals may comprise a potentially powerful stimulus category modulating visual attention in ASD

Long-term outcomes following primary intraocular lens implantation in infants younger than 6 months

Purpose: To study the long-term safety profile and visual outcomes of primary intraocular lens (IOL) implantation in infants <6 months of age. Methods: This was a retrospective observational study conducted at a tertiary eye care center in South India. Infants under 6 months meeting the selection criteria who underwent cataract surgery (lens aspiration, primary posterior capsulorhexis, and anterior vitrectomy) with primary IOL implantation between January 2008 and December 2011 and minimum 3-year follow-up were included. Patient demographics, serial refractions, visual acuity, complications, and associated amblyopia/strabismus were reviewed. Visual acuity, myopic shift, and complications were the outcome measures. Results: Sixty-nine eyes of 38 infants (31 bilateral; mean age: 4.6 months) were reviewed. Mean follow-up was 51 months (range: 36–84). Median logMAR best-corrected visual acuity at the final visit was 0.74 (interquartile range [IQR]: 0.50–0.98) in eyes with bilateral cataracts and 0.87 (IQR: 0.60–1.14) in eyes with unilateral cataracts with an average myopic shift of 6.7 diopters over 4.2 years. Most common postoperative complication was visual axis opacification (VAO) (13 eyes, 18%), necessitating membranectomy followed by pigmentary IOL deposits (11 eyes, 15%), and IOL decentration and glaucoma in four eyes each (5.6%). Mixed linear effect model found no significant association of age, gender, laterality, and postoperative complications with final visual acuity (P ≥ 0.05). Eyes with unilateral cataracts had a greater myopic shift than bilateral cases (P = 0.03). Conclusion: Primary IOL implantation in infants <6 months is reasonably safe in appropriately selected infants. VAO was the most common postoperative complication, and a large myopic shift was observed