Dysfunctional lens syndrome.

PURPOSE: To report the pre- and post-operative findings of a case with dysfunctional lens syndrome. METHODS: An adult patient was evaluated using iTrace aberrometer, Tomey topographer and slitlamp biomicroscopy to confirm dysfunctional lens syndrome. RESULTS: A 45-year-old male patient presented with the chief complaint of poor visual quality; uncorrected visual acuity 20/40 in the right eye, best spectacle corrected visual acuity 20/25 in the right eye with refraction Plano/-1.50 × 80 (SE = -0.75D). Pre- and post-operative root-mean-square (RMS) of total higherorder aberrations in the entire eye, the internal optics and the cornea were 0.350 & 0.257, 0.311 & 0.236 and 0.214 & 0.191 micron (µ), respectively. Also, the magnitude of preoperative total, internal and corneal coma was 0.254 µ × 222°, 0.274µ×242° and 0.097µ × 131° and postoperative values were 0.170 µ × 162°, 0.131 µ × 177°, 0.054 µ × 125°, respectively. CONCLUSION: These results show that sometime the HOAs of the internal optics, mainly crystalline lens, are not compensated by the cornea and this may cause visual discomfort in the absence of any significant cataract, this situation is known as dysfunctional lens syndrome (DLS).

Bilateral cytomegalovirus retinitis in a healthy infant.

PURPOSE: To report a case of bilateral cytomegalovirus (CMV) retinitis in an otherwise healthy infant. METHODS: A four-month-old, healthy, male infant was evaluated for visual inattention. RESULTS: This full-term infant with a normal birth weight and an uneventful gestational period was referred with symptoms of visual inattention, fever, and agitation one week prior to admission. Ocular involvements were detected in the form of bilateral pan uveitis with diffuse bilateral retinitis and vasculitis with hemorrhage in the peripheral retina and posterior pole. CMV DNA was detected in the patient's ocular sample and cerebrospinal fluid by polymerase chain reaction (PCR). He was treated with intravitreal and systemic ganciclovir. Unfortunately, the infant died because of CMV encephalitis. Therefore, bilateral CMV retinitis (CMVR), which was probably transmitted from the mother, was diagnosed in this immunocompetent infant. CONCLUSIONS: The present case highlights the possibility of CMVR in immunocompetent infant associated with systemic CMV infection, even during the postnatal period. Therefore, a high index of clinical suspicion and prompt treatment may be life-saving in similar cases.