Treatment response and recurrence of conjunctival melanoma with orbital invasion treated with immune checkpoint inhibitors: case report and literature review.

INTRODUCTION: Conjunctival melanoma (CM) has genetic characteristics that are similar to primary cutaneous melanoma (PCM). The management of advanced CM with orbital metastasis was limited until the adoption of novel immunotherapy agents that significantly improved the survival of metastatic PCM. PURPOSE: To review and compare the immune checkpoint inhibitor (ICI) treatment response in cases reported in the English literature with orbital involvement secondary to CM versus PCM. In addition, we report a case of local recurrence of CM in a young female after successful treatment with ICI. METHODS: In addition to reviewing the chart of one patient who presented to our clinic, we conducted a comprehensive literature review to identify CM cases and cases with orbital metastasis secondary to advanced CM and PCM. Outcomes included patient demographics, response to ICI, and associated adverse effects. RESULTS: There were ten cases with orbital involvement, four were secondary to CM, and six were metastasis from PCM. Orbital metastasis from PCM regressed following treatment with ICI agents, whereas those secondary to CM resolved completely. There were 19 cases of CM without orbital invasion. Of the 29 cases identified, complete resolution of ocular melanoma was achieved in 15 patients, representing 52% of the cases collectively, and none of them reported recurrence except in our case. CONCLUSION: CM with orbital invasion responds well to ICIs, with manageable toxic effects. Despite the complete resolution, close observation is needed as the recurrence risk remains.

Bilateral Congenital Stromal Corneal Cysts: Report of a Unique Case.

The purpose of this report is to provide a comprehensive account of an exceptional case involving the presentation of congenital rubella syndrome (CRS) in a newborn. Furthermore, it aims to document the successful regression of CRS through medical treatment alone. We present the case of a five-day-old infant who was referred to our facility as a CRS case. The patient presented with bilateral white corneal opacity, which was observed shortly after birth. The mother was diagnosed as rubella-positive during pregnancy. Upon the initial examination under anesthesia, both eyes exhibited central white corneal opacity accompanied by large intrastromal cysts. Although a few breaks in Descemet's membrane were observed in both eyes, there were no signs of vascularization or the presence of iridocorneal or lenticular-corneal adhesions. After undergoing medical treatment consisting of topical sodium chloride and steroids, the cysts in both eyes completely regressed. Subsequently, the patient underwent penetrating keratoplasty to further address the dense scar. This case enhances our comprehension of ophthalmological complications associated with CRS and provides valuable insights into alternative therapeutic approaches for corneal stromal cysts.

Ophthalmology Self-medication Practices: A Questionnaire-based Study.

Purpose: The aim of the study was to identify patterns of self-medication practices in ophthalmology.Methods: We conducted an electronic cross-sectional descriptive survey of the Riyadh regional population in Saudi Arabia.Results: The study included 1354 subjects; 662 were males (49%), and 692 were females (51%). The rate of self-medication with prescription drugs (topical antibiotics and steroid-containing eye drops) in our sample was 37.2%. The number of respondents who reported using eye drops, whether it was an over-the-counter drug or a prescription drug, was 733 (54.1%). The most frequently used ophthalmic medications after lubrication drops were steroid-containing eye drops (32.6%), followed by topical decongestants (11%) and antibiotics (4.6%). The majority of steroid users (86.6%) were not aware of any steroid-related ocular complications.Conclusion: Our study showed a high rate of self-medication practices along with a low level of awareness of topical medication-related side effects. If left unaddressed, this combination may result in high rates of preventable and avoidable adverse events.