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.