Introduction: Blepharitis is defined as a chronic inflammation of the eyelid margin and is a common cause of eye irritation. Its chronic nature, multiple etiologies and coexistence with ocular surface diseases makes its management a challenge. Although blepharitis is considered a common condition in our population, there is not enough information reported in the literature about its epidemiology or the frequency of the risk factors associated. Aims and Objectives: This cross-sectional descriptive study was performed in Bogotá, Colombia, and it was designed to identify blepharitis prevalence, and frequency of subtypes. Results: Blepharitis diagnosis was made in 68% (n = 215) of the patients, of whom 12.6% (n = 27) presented anterior blepharitis, 31.6% (n = 68) marginal blepharitis and 55.8% (n = 120) posterior blepharitis. Conclusions: We believe that blepharitis is an underdiagnosed condition in our country and may be different than that in other regions. We consider important to establish the real prevalence in our population to raise awareness, encourage early diagnosis, establish a foundation for new studies that allow us to identify and stablish risk factors and, of course, to evaluate therapeutic alternatives. The strategy to improve the rate of diagnosis of blepharitis would be through the education of the visual health professional in identifying the characteristic symptoms and signs of any type of blepharitis in order to be able to make an accurate classification and treatment.

Renal tumors correspond to a small part of the total number of neoplasms. However, they can cause metastasis, mainly in the lungs, bones, and liver. In the eye, the uvea is the structure with the highest affinity due to its high vascularity, and its presence is considered a poor prognostic factor for patient survival. A case report of a patient diagnosed with a renal cell tumor with metastasis in multiple body parts, including the choroid, is presented. A review of the literature in this regard is also carried out.

A case of bilateral ocular decompression retinopathy (ODR) is presented on a patient with steroid-induced glaucoma, after immediate postoperative period trabeculectomy with mitomycin C; we observed a sudden decrease of vision due to the presence of multiple superficial retinal hemorrhages that resolved completely 2 weeks after the postoperative period. ODR is a rare complication after glaucoma surgery. Although it has been described in the literature, this case shows an unusual presentation, bilateral and consecutive in a patient with steroid-induced glaucoma.

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare inflammatory disorder affecting renal and ocular systems. Certain associations have been made with systemic conditions such as autoimmune diseases, infections, and even medications. We present the case of a 16-year-old male patient who presented to our service with bilateral uveitis and urinary symptoms, associated with proteinuria, glycosuria, increase in serum creatinine and beta-2 microglobulin in urine considering TINU as the main differential diagnosis. Antibiotics were considered a possible trigger in this patient. He presented an adequate response to systemic and topical steroids and systemic immunomodulators. Renal biopsy results reported interstitial tubulonephritis. TINU syndrome is a rare autoimmune condition, mainly seen in younger patients. Multiple triggers have been associated. Renal compromise usually resolves spontaneously with a relatively rare risk of incomplete recovery as well as uveal compromise. However, early diagnosis and multidisciplinary management is fundamental in these patients.

Design: Observational, descriptive, and retrospective. Participants: A total of 84 patients diagnosed with tumor and simulating lesions in the ophthalmology unit ot the Hospital Universitario San Ignacio between 2010 – 2020. Methods: All patients with a ICD10 code according to tumoral or inflammatory disease of the orbit at Hospital Universitario San Ignacio between January 2010 and December 2020 were included, and the diagnosis was confirmed with the clinical history. Pathology was classified according to the histopathological report or definitive diagnosis made with diagnostic tests/imaging. Additionally, the following data were obtained: age, sex, history, evolution time, lesion origin (primary, invasion, or metastasis), laterality, location in relation to the muscular cone, lesion size, symptoms, signs, presence of adenomegaly, extension, diagnostic approaches, histopathological diagnosis, intra/extrahospital treatment, and outcome. A virtual data collection format was developed for data collection, with subsequent descriptive analysis reporting percentages. Results: In adult patients (over 18 years old), 60 lesions were diagnosed. The most frequent tumor pathologies in this group correspond to squamous cell carcinoma of the eyelid with invasion into the orbit, 6 cases (18.75%), cavernous hemangioma, 4 (12.5%), lymphoid tumors, 4 (12.5%), schwannoma, 2 (6.25%), and pleomorphic adenocarcinoma, 2 (6.25%). The main simulating lesion in the adult population corresponds to thyroid orbitopathy, which is attributed to 33.3% of all tumor or non-tumor lesions. In patients under 18 years of age, 24 lesions were diagnosed. The most frequent pathologies in this group corresponded to retinoblastoma, 11 cases (45.8%), rhabdomyosarcoma, 5 (20.8%), and cavernous hemangioma, 2 (8.3%). In patients under 18 years of age, 54.1% of cases resulted in loss of the eyeball. Conclusion: During the period from January 2010 to December 2020, 84 orbital tumors and simulating lesions were diagnosed. The most frequent tumor lesion in adults corresponds to squamous cell carcinoma of the eyelid with invasion into the orbit, and in patients under 18 years of age, it corresponds to retinoblastoma. Greater secondary loss of the eyeball is documented in this latter population group, requiring enucleation or evisceration in 54.1% of cases.

Purpose: The purpose of the study is to explore the clinical spectrum of rhino-orbital cerebral mucormycosis (ROCM) and to correlate its severity with the levels of inflammatory markers of COVID-19 patients. Materials and Methods: It is an observational analytical study. Clinical and laboratory data of the patients with mucormycosis admitted in COVID-19 wards in a notified nodal tertiary care center were collected and stratified clinically according to the severity of ROCM. Serum ferritin, serum lactate dehydrogenase (LDH), D-dimer, total count, neutrophils, and lymphocyte count were considered primary outcome variables. The severity of the ROCM (Stage II, Stage III, and Stage IV mucormycosis) was considered the primary explanatory variable. Results: Forty-five participants were included, of which 38 (84%) were male and 7 (16%) were female. The mean age was 48.71 ± 10.71 years, which ranged from 29 to 75 years. In people with the severity of the ROCM, 26 (58%) were in Stage II, 15 (33%) were in Stage III, and 4 (9%) were in Stage IV. The mean serum ferritin, mean serum LDH, and D-dimer across the severity of ROCM were statistically significant. The median total count, mean neutrophils, and mean lymphocytes across the severity of ROCM were not statistically significant. Conclusion: The study shows that raised serum ferritin, LDH, and D-dimer levels at admission significantly predict disease severity in COVID-19 patients with mucormycosis. Mucormycosis and its severity are associated with higher inflammatory markers levels than the mild disease in COVID-19 patients. Tracking these markers may allow early identification or even prediction of disease progression.

This article aims to report the case of a female child with Coats disease stage 5 who underwent posterior vitrectomy plus perfluorocarbon liquid injection, internal drainage, endolaser, and cryotherapy. Follow-up of the patient showed that although visual recovery was not able to achieve due to its severity, and anatomical preservation of the eye with an appropriate surgical approach was guaranteed.

The lacrimal sac compression by an anterior ethmoidal mucocele is unusual. The ethmoidal mucocele may masquerade as lacrimal sac mucocele and may lead to disastrous consequences if treated along the lines of lacrimal mucocele. We present a case of an 18-year-old female presenting with a mass lesion over the medial canthal area causing a dilemma in diagnosis.

Purpose: To compare the long-term postoperative outcomes of unilateral horizontal muscle strabismus surgery in patients with sensory esotropia and sensory exotropia. Methods: This retrospective study included 30 patients of sensory deviation who underwent strabismus surgery between January 2017 and December 2020 and had 24 months of follow-up. The patients were classified into Group A (sensory esotropia) and Group B (sensory exotropia) of 15 each. The successful outcome was assigned to a patient with postoperative deviation ≤10 prism dioptres (PD) in primary position. Results: The mean age of the sample was 20.87 ± 6.88 years, 18 were male (60%) and 12 were female (40%). The mean preoperative deviation in Group A was 38.8 ± 10.46 PD and in Group B, it was 48.0 ± 5.92 PD. Successful surgical outcome (≤10 PD) at postoperative day 1 was achieved in 29 patients (96.77%). One patient (3.33%) having sensory exotropia was found to have residual deviation >10 PD. These results were maintained at the 6^th month and 12^th month of follow-up and there was no significant difference between surgical outcomes of both groups (Chi-square test, P = 0.309). At the 24^th month follow-up, 23 patients maintained good surgical outcome; all seven patients who had surgically failed outcome (>10 PD) belonged to the exotropia group, which was statistically significant (Chi-square test, P = 0.002). The mean postoperative deviation at the final visit at 24 months of follow-up in Group A was 3.6 ± 2.16 PD and in Group B, it was 10.87 ± 2.82 PD. The long-term outcomes are significantly worse in patients of sensory deviations with organic vision loss and sensory exotropia. Other factors which determined the long-term successful postoperative outcome were best-corrected visual acuity (BCVA), childhood-onset strabismus, and younger age at surgery. Conclusions: Good primary position alignment can be achieved in patients with sensory deviations with single strabismus surgery. Type of deviation, BCVA, age of onset, and age at the time of surgery were the factors associated with successful long-term alignment.

Kjer's optic neuropathy, also known as optic atrophy type 1 (OPA-1), is a genetic condition that usually presents with the bilateral pallor of the optic disc (OD) associated with decreased visual acuity (VA), in addition to defects in the visual field (VF) and color vision. This article aims to report a case of OPA-1 diagnosed through genetic testing. A 22-year-old male patient searched for neuro-ophthalmological care, complaining of low VA, difficulty adapting to both light and dark, and photophobia in both eyes (BE) since 6 years old. He denies VF loss, nyctalopia, or hearing deficit and has maternal relatives with similar conditions. The patient presented VA of 20/63 in the right eye (RE) and 20/50 in the left eye (LE) with dyschromatopsia and bilateral OD pallor, in addition to reduced foveal brightness. Humphrey's visual perimetry showed centrocecal scotoma in the LE only and a nonspecific loss in the RE. He brought a pattern electroretinography (PERG) examination showing the reduced function of ganglion cells in the macular area and optic nerve in BE and multifocal electroretinogram with cone system function slightly reduced in BE. A genetic panel was performed to search for mutations in the OPA-1 gene, which showed a variant associated with this disease in the patient described and in his mother. Thus, this report exemplifies a case of OPA-1 hereditary OPA, emphasizing the importance of combining clinical evaluation, electrophysiological, and genetic tests for a precise and accurate diagnosis.

Descement's membrane detachment (DMD) is separation of Descemet's membrane (DM) from the overlying stroma. It is manifested as corneal oedema at the site of detachment. With the rising number of phacoemulsification in the world, the DMD becomes an important complication that may require additional surgical intervention leading to an increase in economic as well as a social burden on the patient and hospital. Descemet's membrane detachment(DMD) is an uncommon complication of cataract surgery that may lead to corneal scarring and poor post-op vision gain. Till now, there is no standardized protocol for the management of DMD. Various authors have tried to classify DMD. Newer techniques such as AS-OCT, Schiemflug imaging, etc have helped in the early detection of DMD chance improving the prognosis.

Studies have shown that age-related macular degeneration (AMD) patients present a poor prognosis in coronavirus disease 2019 (COVID-19). These diseases have completely different etiologies and clinical courses. COVID-19 is a systemic, fast-evolving, and lethal infectious disease. AMD, in turn, is a chronic disease triggered by oxidative stress and is considered the main cause of irreversible blindness in old age. Both COVID-19 and AMD have in common the participation of immunological and inflammatory components arising from the imbalance of the redox state, responsible for the most severe phases of these diseases. Therefore, this study aims to present the triggering pathways of these diseases, as well as analyze the possible molecular mechanisms that increase the severity of COVID-19 in patients with AMD.

Importance: Large language models being approved in medical boarding examinations highlights problems and challenges for healthcare education, improving tests, and deployment of chatbots. Objective: The objective of this study was to evaluate the performance of ChatGPT-3.5 in answering the Brazilian Council of Ophthalmology Board Examination. Material and Methods: Two independent ophthalmologists inputted all questions to ChatGPT-3.5 and evaluated the responses for correctness, adjudicating in disagreements. We compared the performance of the ChatGPT across tests, ophthalmological themes, and mathematical questions. The included test was the 2022 Brazilian Council of Ophthalmology Board Examination which consists of theoretical test I, II, and theoretical–practical. Results: ChatGPT-3.5 answered 68 (41.46%) questions correctly, 88 (53.66%) wrongly, and 8 (4.88%) undetermined. In questions involving mathematical concepts, artificial intelligence correctly answered 23.8% of questions. In theoretical examinations I and II, correctly answered 43.18% and 40.83%, respectively. There was no statistical difference (odds ratio 1.101, 95% confidence interval 0.548–2.215, P = 0.787) comparing correct answers between tests and comparing within the test themes (P = 0.646) for correct answers. Conclusion and Relevance: Our study shows that ChatGPT would not succeed in the Brazilian ophthalmological board examination, a specialist-level test, and struggle with mathematical questions. Poor performance of ChatGPT can be explained by a lack of adequate clinical data in training and problems in question formulation, with caution recommended in deploying chatbots for ophthalmology.

Purpose: Ocular coloboma is defined as a congenital malformation caused by defective closure of the fetal fissure, resulting in a notch in any structure. However, the entity known as “isolated lens coloboma” does not seem to have a similar etiological basis with other ocular colobomas. This congenital malformation can induce an important decrease of the visual acuity, and facectomy has an increased risk for intraoperative and postoperative complications. Better surgical planning could be achieved with an accurate definition of the diagnosis and pathophysiology of this lens abnormality, as the extent and mechanism of zonular disease will have a significant impact on the selection of the modality of intervention. Methods: Nine eyes of seven patients, who were diagnosed with “isolated lens coloboma” and underwent phacoemulsification and implant of intraocular lens (IOL), were studied (retrospective case series). The surgeries were performed by four different surgeons, according to their preferred technique, in the last 5 years. Results: There were no intraoperative complications. Two (22.22%) eyes presented postoperative complications, one of which was the IOL decentralization. Conclusion: Considering the ocular morphogenesis and the definition of coloboma, the ideal denomination for the congenital malformation traditionally known as isolated lens coloboma would be “focal zonular dysgenesis.” The best surgical approach, contemplating the pathophysiology, in addition to the cases described and review of literature, is discussed.

White dot syndromes are a group of inflammatory chorioretinopathies that share pathologic features involving lesions in the external retinal layers and choroid. This report describes a case of acute visual loss due to a white dot syndrome superimposed on severe diabetic retinopathy (DR), leading to a challenging diagnosis. A 53-year-old man with severe DR was referred with acute unilateral vision loss, with the presumptive diagnosis of diabetic macular edema. The clinical examination and complementary diagnostic tests revealed the absence of diabetic macular edema but showed disruption of the outer retinal layers and choroidal thickening. Laboratory and imaging testing excluded other etiological factors, so an inflammatory chorioretinopathy superimposed on severe DR was considered. Following the initial presentation, without any therapeutic intervention, rapid anatomical and functional improvement was objectified. This case demonstrated that in rare cases, an inflammatory chorioretinopathy may go unnoticed in the presence of preexisting retinopathy, and the true cause of vision loss may initially be misdiagnosed.

Giant cell arteritis (GCA) is the most common primary vasculitis in adults. In general, the diagnosis is straightforward when characteristic symptoms such as headaches, scalp tenderness, jaw claudication, vision problems, or other ischemic complications are present. Atypical presentations of GCA have become increasingly recognized but we report for the first time a case of GCA presenting as partial tongue necrosis and paracentral acute middle maculopathy. This case adds to the literature and emphasizes the importance of rapid recognition of these atypical changes and optical coherence tomography in the evaluation of GCA patients.

The main purpose of this study is to describe the visual outcomes in children with bilateral cataracts undergoing small incision cataract surgery and is mainly focused on children with bilateral cataracts from poorer backgrounds who tend not to receive adequate and timely medical attention. This could lead to issues such as amblyopia. However, it is important to provide surgical care even at a later date to afford some visual redemption. When affordability is the weakest link in the treatment, a manual small incision cataract surgery (MSICS) can be an ideal manner to treat bilateral cataracts. In this study, we highlight the good visual outcome post-MSICS with polymethylmethacrylate lens implantation, primary posterior capsulotomy, and anterior vitrectomy in children with bilateral cataracts who have presented at ages beyond 5 years.

A scleral buckle is a surgical procedure used for rhegmatogenous retinal detachment repair. Different materials have been used for this technique over the years. During the 1980s, MIRAgel (MIRA Inc., Waltham, Mass) introduced hydrogel bands. This material allowed easy handling for the surgeon and self-expansion over time. A decade after their introduction, late complication reports began to appear, associated with uncontrolled expansion and the need for surgical removal. We present two complete cases and a literature review of patients presenting with ophthalmoplegia, pain, and proptosis, 25 years after hydrogel scleral buckle surgeries.

Objective: The objective of this study was to determine the frequency and main causes of visual impairment and blindness in the elderly aged 80 years or more, predominantly living in the urban area of the municipality of Maués – Amazon/Brazil. Methods: This was a cross-sectional study of a population of 360 elderly people aged 80 years or more, predominantly living in the urban area of the City of Maués-AM, who were invited to a complete eye examination along with a questionnaire to describe nutritional habits and frequency consumption of guarana. Uncorrected visual acuity, presented visual acuity, and best-corrected visual acuity of each eye were obtained. If necessary, prescription for glasses, surgery, or other types of treatment was provided free of charge. Results: A total of 360 individuals aged between 80 and 108 years (mean: 86.02 ± 5.57 years) were submitted to an ophthalmological evaluation. Of these, 182 (50.5%) were male and 178 (49.5%) female. Of the total number of eyes examined, the causes of visual impairment and blindness were cataract (51.8%), refractive errors (12.2%), age-related macular degeneration (9.1%), other nerve atrophies (3.9%), posterior capsule opacity (3.6%), glaucoma (3.5%), corneal changes (3.3%), absent globe/phthisis (3.1%), other retinal changes (1.1%), diabetic retinopathy (1.0%), pterygium (0.6%), amblyopia (0.4%), and other causes (1.8%). According to the Nutritional Screening Initiative Nutritional Dysfunction Questionnaire, 45.0% of the participants had low risk of nutritional dysfunction, 51.7% moderate risk, and 3.3% high risk. Conclusions: A high frequency of blindness (43.6%) was detected in this sample of very elderly people living in urban areas in the city of Maués. The main causes of blind eyes would be preventable with provision for cataract surgery followed by postoperative actions and prescription of glasses. Half of the elderly (50.0%) reported frequent consumption of guarana, at least once a week, but this did not prove to protect against visual impairment and blindness. These results reflect this population's limited access to eye care services, reinforcing the need for sustainable actions to improve eye health in remote areas of Brazil.

Background and Objective: Optical coherence tomography (OCT) plays a crucial role in guiding the treatment and establishing the prognosis of diabetic macular edema (DME). We aimed to determine which OCT biomarkers respond better to intravitreal triamcinolone acetonide (IVTA) switch after antivascular endothelial growth factor (anti-VEGF) treatment poor response. Materials and Methods: Fifty-eight eyes with DME, submitted to IVTA switch, were included in this retrospective study. OCT biomarkers and best-corrected visual acuity (VA) were assessed, before and after treatment with a mean follow-up of 2.9 months. Results: IVTA switch resulted in improved VA, central foveal thickness (CFT), and macular volume. Intraretinal cysts decreased or disappeared completely (P = 0.007) in 84.2% of the eyes, as well as the hyperreflective foci (P = 0.004) and the subretinal fluid (P = 0.02). Conclusion: We show that IVTA switch is an effective rescue therapy in anti-VEGF therapy refractory DME. OCT plays an important role in selecting the most appropriate treatment, namely between anti-VEGF and steroids.

Roth spots can occur as ophthalmological manifestations of systemic pathologies that compromise the retinal capillary endothelium. A case report of retinopathy due to hemolytic anemia secondary to Epstein–Barr virus is presented. Given the clinical picture, several differential diagnoses were initially considered causing Roth spots that is why a brief review of the literature is carried out to raise awareness of the diverse pathologies that can be associated with the presence of Roth spots to provide timely referrals.

Objective: The objective of the study was to assess the glycemic control and cardiovascular risk (CV risk) change in diabetes mellitus type II (DM-II) patients undergoing uncomplicated bilateral cataract phacoemulsification surgery. Design: Retrospective study. Participants: We selected 28 patients who underwent uncomplicated bilateral cataract surgery at Centro Hospitalar de Entre o Douro e Vouga between January 2018 and December 2019. Inclusion Criteria: We included patients submitted to bilateral cataract surgery without other known ophthalmological pathology. Furthermore, there were available records of their comorbidities, lipid profile, blood pressure, glycated hemoglobin (HbA1c), and body max index (BMI) prior to and in the 6 months following surgery. Materials and Methods: We assessed our patient cohort for changes in HbA1c, lipid profile, BMI, and blood pressure before and after surgery. We further subdivided our patient cohort into two different groups: group 1 – no to mild visual impairment, ≤0.48 logarithm of the Minimum Angle of Resolution (LogMAR); Group 2 – moderate to severe visual impairment, >0.48 LogMAR, and assessed for the same variables at the mentioned time points. Comparisons were done using paired samples Student's t-test or Wilcoxon rank and repeated measures ANOVA with Tukey's post hoc tests, respectively. Results: Following cataract surgery and subsequent improved visual acuity (VA), our patient cohort showed decreased HbA1c, lower arterial blood pressure, and decreased BMI, with an improved CV risk score within 6 months of cataract surgery. These improvements were more evident in the patients with worse baseline VA. Conclusions: Phacoemulsification cataract surgery resulted in improved CV risk and glycemic control in DM-II patients.

A young adult Asian Indian male presented to us with a 1-month history of trauma to the right eye (RE) with a tennis ball. He had intraocular pressure (IOP) of 32 mmHg while on three topical antiglaucoma drugs and oral acetazolamide, with uncontrolled inflammation in the anterior chamber (AC) and arteriolar occlusions in the periphery. His best corrected visual acuity was 20/20 in RE. Fluorescein angiography of the RE showed the presence of neovascularization of disc (NVD). Magnetic resonance angiography of the head and neck, and blood investigations ruled out the embolic origin of arteriolar occlusion and systemic causes for inflammation. Intra ocular pressure (IOP) and inflammation were controlled with appropriate treatment. NVD resolved with photocoagulation treatment (PRP) for capillary non-perfusion areas in 4 weeks. This case documents the occurrence of arteriolar occlusion, with neovascularization after arteriolar occlusion post blunt trauma, and successful adjunct use of topical cyclosporine in the management of AC inflammation and high IOP.

To report a rare case of orbital teratoma diagnosed in utero by ultrasound examination at 24 + 4 weeks of gestation. The fetus was delivered by cesarean section, by terminative medical indication, at 39 weeks of pregnancy, due to the possibility of dystocia caused by the size of the tumoral mass, or the risk of tumor rupture during vaginal delivery, with risk to fetal survival. The neonate, a 3 day-old female patient was examined in our Department with a large tumoral mass in the right orbit, severe proptosis, producing severe disfigurement. The diagnosis of orbital teratoma was confirmed by clinical, image, and histopathological exams. To the authors best knowledge this is the first case of orbital teratoma in Brazilian literature reporting a case where the diagnosis was made in utero, at 24 + 4 weeks of gestation.

Introduction: The increasing use of electronic gadgets (e-gadgets) has dramatically changed the adolescent lifestyle. There are rising concerns about the ill effects of the high usage of illuminated screens on vision, especially in adolescents. Objectives: The objective was to explore the pattern of e-gadget use and its association with refractive errors (REs) among adolescents. Methods: A case–control study was carried out among adolescents attending a tertiary care hospital. Adolescents with REs (cases) were compared with those without REs (controls) based on the inclusion and exclusion criteria. Two hundred matched adolescents (case-to-control ratio 1:1) were interviewed for exposure history to e-gadget use and pattern. The Chi-square test and odds ratio (OR) were calculated to find the association between e-gadget use and REs. Results: Age (17.3 ± 3.4 vs. 16.8 ± 3.3 years) and gender distribution between cases and controls were comparable. The e-gadget exposure among cases was higher than in controls (OR 1.4 P > 0.05); however, it is the duration of e-gadget exposure for >5 years was significantly higher among the cases (OR 4.6 P < 0.05). During e-gadget usage, sitting posture (OR 7.5 P < 0.05), poor lighting, indoor activity, and irregular sleep patterns were higher among cases. The purpose of using e-gadgets was predominantly for social media and browsing in cases and the educational or reading purpose among controls. Conclusion: Lesser duration, correct posture, and proper purpose of exposure to e-gadget are associated with lesser risk for REs. Results highlight the collective role of adolescents, parents, teachers, and doctors in education and lifestyle modification on e-gadget use.

Introduction: Giant cell arteritis (GCA) is a systemic disease that may cause severe visual loss. Our purpose was to determine which factors contribute to ocular manifestations (OMs) in patients with temporal artery biopsy-proven GCA. Methods: This was a retrospective review of all cases diagnosed in our center from 2010 to 2021 (>6 months follow-up). We analyzed demographic data, comorbidities, type and duration of symptoms before diagnosis, ocular features, and systemic and laboratory findings. Results: Out of 51 patients (60.8% females, mean age 74.8 ± 13.5), 32 (63%) had OM, of whom 28% had transient visual loss, 69% had permanent visual loss, and 9% had diplopia. Apart from scalp tenderness (P = 0.039), OM did not correlate with other ischemic symptoms such as jaw claudication or headache and were even significantly associated with the absence of fever (P = 0.026). Patients with OM also showed lower values of C-reactive protein (CRP) (P = 0.045). Conclusion: In our sample, visual involvement was not significantly associated with any systemic symptom apart from scalp tenderness, which highlights the importance of having a high index of suspicion for GCA in an ophthalmology setting, especially in older patients with visual loss. Furthermore, OMs were significantly associated with the absence of fever and lower values of CRP which may suggest a lower inflammatory state may in these patients.

The aim of this article was to report a well-documented case of anterior uveitis as the first manifestation of COVID-19. A 27-year-old male patient sought assistance at our emergency room complaining of bilateral painful conjuntival redness associated with photophobia for 3 weeks. These symptoms were followed by fever and chills, with a positive polymerase chain reaction for COVID-19. While his systemic symptoms improved, the ocular complaints remained. A complete panel for uveitis were performed, with negative results, except for COVID-19. The outbreak of COVID-19 in 2020 has several implications in our society. Previous reports described ocular manifestations of this condition. The ophthalmologists should be aware of the possibility of COVID-19 when facing a patient with red eye.

Introduction: Susac syndrome (SS) is characterized by microvascular occlusions in the brain, retina, and inner ear. Despite significant advances in understanding this disorder, it remains an under- and misdiagnosed entity in the clinical setting. Methods: This study was retrospective review of clinical records. Results: We present the cases of three young adults complaining of visual loss, hearing impairment, and headache. In all patients, the fundoscopy and fluorescein angiography revealed nonperfused arteriolar segments and multifocal arterial vasculitis. The brain magnetic resonance imaging demonstrated characteristic white matter brain lesions and the audiometry revealed low-frequency hearing loss. The diagnosis of SS was therefore established. We present and discuss the different treatment regimens applied and the course and outcomes of each case. Conclusion: SS is a rare and complex disease with possibly severe consequences that must be promptly diagnosed and treated. However, as no prospective or randomized controlled trials exist, empirical treatment strategies are still the norm, mainly based on the case reports and series.