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Case Report: Hyperopic shift after refractive lens surgery in a patient with prior history of radial keratotomy |
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Julio C Hernandez-Camarena, Raul E Ruiz-Lozano, Brandon Rodriguez-Pinzon, Jorge E Valdez-Garcia Pan Am J Ophthalmol 2022, 4:39 (30 July 2022) DOI:10.4103/pajo.pajo_23_22
Radial keratotomy (RK) was a popular refractive procedure in the 90s. However, more reproducible laser-assisted surgeries are currently preferred. Furthermore, RK patients who undergo cataract surgery experience variable refractive and keratometric changes during the early postoperatory period. Unfortunately, those post-RK patients currently require cataract surgery. A 58-year-old male with a history of RK in both eyes (OU) presented with a 2-year history of night glare and progressive vision loss due to a subcapsular cataract in OU. Using the double-K Holladay formula, bilateral phacoemulsification was performed. At 1 week, refraction was + 2.25/-1.00/27° (power [Pwr]: 39.25D) in oculus dextrus (OD) and + 3.00/−0.75/171° in oculus sinister (OS) (Pwr: 37.41D), achieving a best-corrected visual acuity (BCVA) of 20/30 OU. At 6 weeks, refraction was + 0.75/−0.75/18° (Pwr: 39.71D) in OD and + 1.00/−0.25/180° (Pwr: 38.33) in OS. BCVA remained 20/30 OU. The resulting transitory hyperopic shift after surgery demands a careful and comprehensive intraocular lens calculation preferably aiming toward myopic overcorrection.
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Case Report: Neuroretinitis as the only manifestation of Lyme disease: A case report |
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Mateus Pimenta Arruda, Marcio Augusto Nogueira Costa, Jacqueline Coblentz, Miguel N Burnier Pan Am J Ophthalmol 2022, 4:38 (30 July 2022) DOI:10.4103/pajo.pajo_31_22
Lyme disease is a multisystemic infection caused by the spirochete bacterium Borrelia burgdorferi, transmitted by the tick of the genus Ixodes sp. and has three stages: primary, secondary, and tertiary. Ocular involvement is possible in any of these stages. Neuroretinitis is a rare manifestation. It is recommended that the diagnosis be performed by serology using an immunoenzymatic test, and confirmed by the Western Blot test. The recommended therapy is doxycycline 100 mg 12/12 h or 200 mg once a day for 14 days to 21 days or amoxicillin 500 mg three times a day for 14–21 days. We herein present a patient who had neuroretinitis related to a previous diagnosis of Lyme disease. The presence of neuroretinitis in a setting of Lyme disease represents a very uncommon manifestation of this particular infection.
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Case Report: Metastatic breast carcinoma to orbit causing enophthalmos |
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Catherine Pancini Rezende, Beatriz Crotti Peixoto, Felipe Belucio de Souza, Amilcar Castro de Mattos, Marcelo Vicente de Andrade Sobrinho Pan Am J Ophthalmol 2022, 4:37 (30 July 2022) DOI:10.4103/pajo.pajo_28_22
This is a case report of a 61-year-old woman who was referred to the PUC Campinas Hospital due to a femoral fracture. Ophthalmological evaluation was requested due to complaints of enophthalmos and low visual acuity, which showed signs suggestive of an orbital tumor. Physical and complementary examinations were important for the confirmation of metastatic orbital carcinoma. Knowing that breast cancer is the most common primary tumor site involved in orbital metastasis in women, this study aimed to highlight the importance of prompt recognition and appropriate diagnostic and therapeutic management in these cases.
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Case Report: Granulomatosis with polyangiitis patient with retinitis as an initial manifestation |
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Valdez Melo Dos Anjos Filho, Mateus Pimenta Arruda, Marcio Augusto Nogueira Costa, Ever Ernesto Caso Rodriguez Pan Am J Ophthalmol 2022, 4:36 (30 July 2022) DOI:10.4103/pajo.pajo_33_22
The German pathologist Friedrich Wegener described granulomatosis with polyangiitis (GPA), formerly known as Wegener's Granulomatosis, in 1936. Lesions are inflammatory, and typically include vasculitis, necrosis, and granulomatous changes. Ocular symptoms may be the first manifestation of this disease in 16%–58% of cases. The ocular manifestations of GPA occur in the most diverse ways. Delayed diagnosis can have serious consequences for patients' vision, as can the preservation of the globe, in addition to other systemic involvement, which can be rapidly progressive in some cases, leading to long-term disability or mortality.
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Original Article: Dry eye disease related to digital screen exposure in medical students |
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Alka Tripathi, Richa Agarwal, Pradip Kharya Pan Am J Ophthalmol 2022, 4:35 (30 July 2022) DOI:10.4103/pajo.pajo_16_22
Aim: The aim of this study is to determine the magnitude and severity of dry eye disease (DED) in medical students as per assessed by the questionnaire Ocular Surface Disease Index (OSDI) and Schirmer's test.
Materials and Methods: A cross-sectional study of a 2-month duration involving medical students was conducted to determine the magnitude and severity of DED. Dry eye was assessed through self-administered questionnaire, Schirmer's test, and OSDI scoring.
Results: The most common symptom among the participants was eyestrain in 39% (N = 31) followed by headache in 33% (N = 26). Based on Schirmer's test, 75% (n = 60) of the participants were normal, 8% (n = 6) students had mild DED, 5% (N = 4) students with moderate DED, and 11% (N = 9) students had severe DED. Based on OSDI scoring, 59% (n = 47) participants were normal, 28% (n = 21) had mild DED, 11% (N = 9) had moderate, while 2% (N = 2) had severe DED.
Conclusion: In this era of digitalization, DED has engulfed the younger population who are spending greater hours on different digital devices. The prevalence of symptomatic dry eyes in our study was 41% while it was 25% based on signs. This should raise concern among the caregivers to increase awareness regarding dry eyes and give strict guidelines restricting screen time. The use of ergonomic practices such as appropriate lighting in a room, adjusting digital screen parameters (resolution, text size, contrast, and luminance), and taking frequent breaks while using the screen should be encouraged.
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Review Article: Sickle cell disease: The importance of awareness and early detection of ocular manifestations |
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Dominique Geoffrion, Emma Youhnovska, Melissa Lu, Jacqueline Coblentz, Miguel N Burnier Pan Am J Ophthalmol 2022, 4:34 (30 July 2022) DOI:10.4103/pajo.pajo_7_22
World Sickle Cell Awareness Day is celebrated every June 19 to raise awareness for sickle cell disease (SCD). Access to health services remains unequitable in countries affected by the disease and stigma surrounding patients hinders access to therapies. SCD is the most common severe monogenic disease in the world and is characterized by abnormal hemoglobin production. Major complications include vaso-occlusive events, hemolytic anemia, and inflammation. Microvascular events in the eye are namely responsible for sickle cell retinopathy with or without vasoproliferative changes. Methods included the electronic search of peer-reviewed English literature published until 2021, which was screened, appraised in full version, and incorporated into the review as deemed necessary. This review provides a summary of disease mechanisms and ocular manifestations, and highlights the importance of early diagnosis, close management with imaging technology, and therapeutic avenues for patients with SCD. In addition to significant healthcare barriers encountered by patients and their families, early diagnosis for SCD must be posed by physicians. It is crucial for the healthcare community to become better familiarized with the disease manifestations for early recognition and prevention of chronic complications and morbidity.
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