Diagnostics and treatment of orbital myositis.

Objective: Orbital myositis is a rare clinical condition that involves idiopathic inflammation mostly of extraocular muscles. The purpose of this study was to present a diagnostic and treatment plan of orbital myositis. Methods: A 60-year-old female presented with decreased visual acuity on her left eye, ocular hypertension, restricted and painful left abduction, diplopia, swollen eyelids, and orbital discomfort. MRI, as well as ultrasound, showed enlargement in width of medial rectus muscle. After other diagnoses were excluded, the diagnosis of left orbital myositis was established. Results: She was started on systemic corticosteroid treatment, but each time the steroid dose was tapered she experienced a relapse. Immunosuppressive therapy was introduced and the steroid dose was gradually tapered and excluded. One year after immunosuppressive therapy, the clinical findings improved. Conclusion: The diagnosis of orbital myositis requires detailed examination, laboratory testing and MRI scans of the orbits in order to exclude other diseases with similar clinical findings. The first line treatment option is systemic corticosteroid therapy with additional immunosuppressive therapy if needed. Abbreviations: MRI = magnetic resonance imaging, BCVA = best corrected visual acuity, ENT = ear, nose, throat specialist, CBC = complete blood count, WBC = white blood cell, ESR = erythrocyte sedimentation rate, CRP = C reactive protein, HM = hand motion, TED = thyroid eye disease, SLE = systemic lupus erythematosus, ECG = electrocardiogram, CT = computed tomography.

TFOS European Ambassador meeting: Unmet needs and future scientific and clinical solutions for ocular surface diseases.

The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the TFOS European Ambassador meeting in Rome, Italy, in September 2019.

Occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy at Cantonal Hospital Zenica.

AIM: To determine the occurrence and morphological characteristics of cataracts and the impact of general steroid therapy on its occurrence. METHODS: A retrospective/prospective study was conducted on 90 patients who had been treated at the Cantonal Hospital Zenica with general steroid therapy. There were 30 patients whose general steroid therapy lasted shorter than 4 years and 30 patients on steroid therapy for more than 4 years. The remaining 30 patients were the control group. An examination of lens transparency and morphological characteristics of cataract was made by slit lamp with previously achieved mydriasis. RESULTS: A significant (p less than 0.05) occurrence of cataracts in patients taking general steroid therapy > 4 years and significantly more frequent occurrence of cataract in patients aged 60 years and over was found. Iatrogenic diabetes affects the occurrence of cataracts in addition to age and duration of therapy, especially in those who were on steroid therapy for more than 4 years. Steroid cataract was of subcapsular type according to its morphological characteristics. CONCLUSION: A possibility of cataract occurrence during or after the treatment with corticosteroids therapy should not be ignored. Subcapsular location of cataracts reduces work ability, normal daily activities and requires surgery. Ophthalmic examination should be an obligatory part of the preparation of patients for corticosteroids treatment. Control examinations should be repeated every six months during the therapy, and even more frequently if required.