Late-onset granular intra-amniotic infection following amniotic membrane transplantation.

BACKGROUND: The amniotic membrane (AM) is used in ocular surface reconstruction and is effective at promoting epithelialization and preventing corneal perforation in cases of acute microbial keratitis. Here, we report a case of isolated AM infection after AM transplantation for a persistent epithelial defect following tectonic penetrating keratoplasty. CASE PRESENTATION: A 47-year-old man with poorly controlled type 2 diabetes mellitus presented to the emergency department with a referral for perforated microbial keratitis. After ophthalmic examination, corneal scraping was performed, and corneal gluing was attempted and failed. Hence, the patient underwent tectonic penetrating keratoplasty. After keratoplasty, the patient developed a persistent epithelial defect that required AM transplantation as an overlay. Thirty days post-AM transplant, the patient presented with signs and symptoms resembling granular microbial infection of the cornea. After two days, the granular findings began dislodging from the corneal surface and were sent for culture, sensitivity, and histopathological identification. Histological analysis of the granular material indicated it to be a small piece of AM stroma infiltrated with mixed-type inflammatory cells. Corneal scraping cultures indicated Streptococcus mitis and Streptococcus oralis. CONCLUSION: The infiltrate was localized to the basement membrane of the AM as, despite the anti-inflammatory effects of AM, it can also act as a barrier against polymorphonuclear leukocyte infiltration from the tear film and microbial invasion into the cornea.

Poor Outcome in Camel-Related Eye Trauma with Ruptured Globe.

PURPOSE: To report the poor visual outcome of ruptured globe caused by camel bites. OBSERVATIONS: A 48-year-old camel caregiver presented to the emergency department after being bitten by a camel in the left side of his face. Ophthalmic examination revealed a superior scleral wound from 9 to 2 o'clock, about 6 mm from the limbus extending to the equator with prolapse of uveal and vitreous tissues, an opaque cornea, total hyphema, diffuse subconjunctival hemorrhage, and a lower lid laceration involving the lid margin and the nasolacrimal duct. The patient has undergone surgical repairs of ruptured globe and lid laceration, followed by retinal detachment surgery. Following these surgical interventions, the patient preserved a light perception vision with flat retina. CONCLUSION: Camel-related injuries might primarily involve the ophthalmic structures, especially in camel bites. Camel-related eye trauma might lead to poor visual and anatomical outcomes which might not improve following surgical interventions.

Brown-Mclean syndrome in an aphakic patient with homocystinuria: The first reported case in Middle East.

Brown-McLean syndrome not reported in association with homocystinuria and generally occurs in patients with long-term aphakia. Presented as peripheral corneal edema with central clear cornea tends to spare vision without the need of any surgical intervention. The purpose of reporting such a rare condition as a first case of Brown-McLean syndrome associated with systemic disease of homocystinuria. Brown-McLean Syndrome in a patient with homocystinuria generally occurs in patients with long-term aphakia after different modalities of surgical intervention. A high clinical suspicion and regular follow-up is warranted for patients with systemic diseases who are aphakic or present with a subluxated lens for early intervention and better prognosis if needed.