Association of Severity of Allergic Conjunctivitis with Skin Prick Test.

OBJECTIVE: To investigate the association between skin prick test and severity of allergic conjunctivitis. STUDY DESIGN: Cross sectional observational study. Study Place and Duration of Study: Akbar Niazi Teaching Hospital, Bara Kahu, Islamabad, between March and September 2019. METHODOLOGY: 150 eyes of 150 diagnosed cases of allergic conjunctivitis, who had had a skin prick test, were included in the study. Cases with other concurrent ocular surface diseases, conjunctivitides, systemic allergies, and those on systemic steroids, anti-histamines and tricyclic antidepressant agents were excluded. Signs of allergic conjunctivitis were graded via slit-lamp examination using a 5-5-5 exacerbation grading scale. Allergic conjunctivitis was classified as being severe if the total score was ≥230, moderate if the score was >20 and <230, and mild if the score was ≤20. Frequency distribution was reported for age, gender and result of skin prick test. Test of significance and correlation analysis was carried out between the result of skin prick test and the severity of allergic conjunctivitis using Statistical Package for Social Sciences version 20.0. A p-value of <0.05 was taken as significant. RESULTS: Mean age was 18.62 (±8.15) years in 91 males and 59 females. Mild (n = 28), moderate (n = 77), and severe (n = 45) cases showed no statistically significant correlation with the skin prick test (positive or negative) in any of the three categories (mild p = 0.44, r = 0.153, moderate p = 0.89, r = 0.016, and severe p = 0.73, r = 0.052). CONCLUSION: Skin prick test did not show a significant association or correlation with the severity of allergic conjunctivitis. Key Words: Allergic conjunctivitis, Hypersensitivity, Skin prick test.

Pars Plana Vitrectomy for Resistant Cystoid Macular Edema.

OBJECTIVE: To evaluate the results of pars plana vitrectomy for cystoid macular edema (CME) resistant to medical treatment. STUDY DESIGN: Quasi-experimental study Place and Duration of Study: Al-Shifa Trust Eye Hospital, Rawalpindi, from January to July 2019. METHODOLOGY: This study recruited 30 eyes of 30 patients with cystoid macular edema confirmed on optical coherence tomography that was refractory to medical treatment. Eyes with diabetic fibrous proliferation, optic atrophy, neo-vascular glaucoma, membrance and macular retinal pigment epithelial atrophy were excluded from the study. All patients underwent 23 G pars plana vitrectomy followed by epiretinal membrane / internal limiting membrane (ERM/ILM) peeling and gas injection. In 11 eyes, perfluoropropane gas was injected; while in 19 eyes, sulfurhexafluoride gas was injected. Main outcome measures included pre- and post-op Snellen's visual acuity and central macular thickness (CMT). All patients completed their follow-up of six months. RESULTS: Mean age of 16 male and 14 female patients was 54.30 ±3.70 years. Postoperative Snellen's visual acuity improved to 0.61 ±0.08 from 0.11 ±0.04 and postoperative central macular thickness improved to 223.80 ±40.20 µm from 578.00 ±26.57 µm. Both differences were statistically significant (p<0.001). CONCLUSION: Pars plana vitrectomy with ERM / ILM peel and gas injection for CME refractory to medical treatment is an effective treatment. There was significantly improved best corrected visual acuity (BCVA) postoperatively along with decreased CMT on optical coherance tomography (OCT).

Conjunctival Leiomyoma; a Rare Tumor of the Ocular Surface.

PURPOSE: To report a case of conjuctival leiomyoma. CASE REPORT: An 18-year-old female patient presented with a conjunctival growth in the left eye for a 2-year-period with no change in size. She merely presented for cosmetic reasons. Visual acuity was 20/20 in each eye. The lesion had prominent vessels and was not adherent to the sclera. The growth resembled a benign lesion of the conjunctiva. The tough and vascular tissue was excised and sent for histopathology. The defect was covered by an end to end conjunctival suturing. Histopathology showed the lesion to be conjunctival leiomyoma. Trichome was used to highlight the spindle shaped cells and immuno-histochemistry using anti-smooth muscle actin antibody and Vimentin was applied to confirm the diagnosis. CONCLUSION: This case adds to the total number of cases of conjuctival leiomyoma reported in the literature to date. An ophthalmologist needs to think beyond a common mass when encountering a conjunctival growth extending onto the cornea.