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.