Comment on Senthilkumaran et al. Bilateral Simultaneous Optic Neuritis Following Envenomations by Indian Cobra and Common Krait. Toxins 2022, 14, 805.

It is with interest that I read the case report by Senthilkumaran et al [...].

Bilateral Serous Detachments with Roth Spots after COVID-19 Vaccination: A Case Report.

With the rise of novel types of vaccines during the pandemic, new side effects are encountered. The aim of this paper is to describe an atypical case of bilateral serous detachments with Roth spots after COVID-19 vaccination using an mRNA vaccine. A healthy, 38-year-old male presented with a central scotoma and metamorphopsia in his left eye, 4 days after his second COVID-19 booster shot. Bilateral serous detachments were seen, with one area showing Roth spots. Patient's symptoms resolved spontaneously without any treatment. Although serous detachment after COVID-19 vaccination has been described in the context of other diseases, such as Vogt-Koyanagi-Harada disease, central serous chorioretinopathy, and posterior scleritis, this is the first report of serous detachments with Roth spots as an isolated entity.

A Guide to Direct (Peri)ocular Injuries Caused by Snakes: Systematic Review and Treatment Advice.

Ocular injuries caused by snakes are very rare, but damage can be severe. There is little evidence on the effective treatment of these injuries. The aim of this systematic review is to discuss all available literature and summarize existing experiences in a treatment advice. In January 2022, a search was performed in the PubMed database. Penetrative trauma by venomous snakebites constitute the most severe cases, and can require the evisceration of the eye. Nonvenomous snakes, mostly boas and pythons held in captivity, are also able to perforate the eye, though with a more favorable disease course. Chemical trauma by inoculation of venom occurs as well, and copious irrigation is advised in these cases. Detailed suggestions for ophthalmologic treatment are presented.

A Sudden Rise of Patients with Acute Macular Neuroretinopathy during the COVID-19 Pandemic.

The aim of this paper is to inform on the surge of cases of acute macular neuroretinopathy (AMN) - a rare disease characterized by the sudden onset of acute scotomas caused by ischemia of the retinal capillary plexus - during the COVID-19 pandemic. In 2021, during the COVID-19 pandemic, a sudden rise in patients with AMN was observed in our clinic. In this paper, 4 cases from a hospital in the south of the Netherlands are reported, all of which could directly be linked to a COVID-19 infection or vaccination against the corona virus. A search for similar cases in the PubMed database produced thirteen relevant reports, which revealed that a similar increase in cases of AMN, all linked to COVID-19, has been observed worldwide. Analysis of the literature revealed that AMN is seen more often during the pandemic and that AMN after COVID-19 happens at a significantly older age than typically reported. This is the largest case series of patients with AMN after COVID-19 infection or vaccination. With the ongoing pandemic and extensive vaccination programs, it is expected that cases of AMN will surge. It is important for ophthalmologists to be aware of this disease, especially since typical patient characteristics may differ.

Orbital Inflammation and Dacryoadenitis after COVID-19 Vaccination.

The aim of this paper was to report the case of a patient with orbital inflammation and dacryoadenitis after COVID-19 vaccination. During the COVID-19 pandemic, we noticed an increase of post-viral syndromes, both linked to infection and to vaccination. A 53-year-old male presented with proptosis, chemosis, hypotropia, and ophthalmoplegia of the right eye, 1 day after his COVID-19 booster shot. Anecdotally, he suffered similar symptoms after his initial two vaccinations. Idiopathic orbital inflammation and dacryoadenitis were diagnosed, and the patient was successfully treated with oral steroids. Orbital inflammation and dacryoadenitis after infection or vaccination are no new entities, but due to the scale of the current pandemic and the associated vaccination programs, these rare ocular diseases could be encountered more often.

On the Dangers of Tropical Spiders as a Pet: A Review of Ocular Symptoms Caused by Tarantula Hairs.

Tarantulas are large spiders that can defend themselves by shedding urticating hairs (setae). In this paper, we aim to discuss the ocular conditions caused by these setae through a literature review. In total, 25 cases were identified in the PubMed database. Tarantula setae have a barbed structure that enables migration through the globe. They give rise to a spectrum of complaints, causing a granulomatous inflammatory reaction in the compartment they settle. Superficial corneal hairs cause a mild keratitis, while hairs that penetrate Descemet's membrane can induce an anterior uveitis. Both can be treated with local steroids; when possible, hairs should be debrided. Setae that migrate into the posterior segment can cause a focal vitritis that can be more difficult to treat, sometimes requiring vitrectomy.

Ocular complications of oak processionary caterpillar setae in the Netherlands; case series, literature overview, national survey and treatment advice.

During early summer 2019, the Netherlands experienced an outbreak of the exotic oak processionary caterpillar. The vast number of caterpillars, which live in large nests on oak trees before they turn into moths, possess thousands of small, barbed hairs (setae) that are disseminated with the wind. The hairs cause a range of primarily dermatologic problems. However, Dutch ophthalmologists started reporting patients with ophthalmologic complaints caused by the penetrating hairs of the oak processionary caterpillar. This paper focuses on the ophthalmologic complications caused by the caterpillar hairs. We collected a series of four cases with reports ranging from a corneal erosion with hairs lodged into the cornea, to a sterile endophthalmitis in which hairs were found in the vitreous. A literature review for similar cases was performed using the PubMed and Embase database. Together with the Dutch Ophthalmic Society (Nederlands Oogheelkundig Gezelschap, NOG), a national survey was issued to determine the scale of this new problem. This showed that oak processionary caterpillar related complaints are primarily limited to the south of the Netherlands. Suggested ophthalmic treatment guidelines are presented. With the next summer at the doorstep, and limited preventative measures against the caterpillar hairs, we expect a new wave of ophthalmologic complaints coming year as well.

[Corneal melting after moving a tropical aquarium]. / Wegsmeltende hoornvliezen na de verhuizing van een zeeaquarium.

BACKGROUND Keeping exotic pets can lead to dangerous situations. We describe an ophthalmological injury caused by Palythoa, an anemone that produces palytoxin when irritated. Palytoxin is one of the most poisonous marine toxins ever described. CASE This case concerns a healthy, 44-year-old man who had rubbed his eyes after setting up a tropical aquarium, which contained sea-anemones among other species. This resulted in bilateral corneal melting, or keratolysis. The injury turned out to be caused by palytoxin. As a consequence, this patient was permanently visually impaired. CONCLUSION The anemone described in this case (Palythoasp) can easily be purchased online with no warnings whatsoever. When working with an aquarium, it is important to know about the species it contains and to wear protective clothing if necessary.

Impact of Super Monkey Ball and Underground video games on basic and advanced laparoscopic skill training.

OBJECTIVE: This abstract profiles the comparison of correlations between previously validated Super Monkey Ball (SMB) and recently introduced Underground (U) video game on the Nintendo Wii U to multiple validated tasks used for developing basic and advanced laparoscopic skills. METHODS: Sixty-eight participants, 53 residents and 15 attending surgeons, performed the Top Gun Pea Drop, FLS Peg Pass, intracorporeal suturing, and two video games (SMB and U). SMB is an over-the-counter game, and U was formulated for laparoscopic skill training. RESULTS: Spearman's rank correlations were performed looking at performance comparing the three validated laparoscopic training tasks, and SMB/U. The SMB score had a moderate correlation with intracorporeal suturing (ρ = 0.39, p < 0.01), and the final score involving all three tasks (ρ = 0.39, p < 0.01), but low correlations with Pea Drop Drill and FLS Peg Transfer (ρ = 0.11, 0.18, p < 0.01). The U score had a small correlation with intracorporeal suturing and final score (ρ = 0.09, 0.13, p < 0.01). However, there were correlations between U score and Pea Drop Drill, and FLS Peg Transfer (ρ = 0.24, 0.27, p < 0.01, respectively). CONCLUSION: In this study, SMB had a very significant correlation with intracorporeal suturing. U demonstrated more of a correlation with basic skills. At this point, our conclusion would be that both are effective for laparoscopic skill training, and they should be used in tandem rather than alone.

Face validity of a Wii U video game for training basic laparoscopic skills.

BACKGROUND: Although the positive effects of playing video games on basic laparoscopic skills have been studied for several years, no games are actually used in surgical training. This article discusses the face validity of the first video game and custom-made hardware, which takes advantage of these effects. METHODS: Participants were recruited at the Chirurgendagen 2013 and the Society of American Gastrointestinal and Endoscopic Surgeons 2014 annual meeting. In total, 72 laparoscopic surgeons completed a demo of the game and filled in a questionnaire. RESULTS: On a 1-to-10 scale, the mean score for hardware realism was 7.2 and the mean score for usefulness as a training tool was 8.4. Participants did not mind the fact that the workspace does not look like an abdominal cavity, but do have some trouble with the absence of tactile feedback. CONCLUSION: We obtained face validity for both the hardware and the usefulness of Underground, a video game made for training basic laparoscopic skills.

Nintendo related injuries and other problems: review.

OBJECTIVE: To identify all reported cases of injury and other problems caused by using a Nintendo video gaming system. DESIGN: Review. DATA SOURCES AND REVIEW METHODS: Search of PubMed and Embase in June 2014 for reports on injuries and other problems caused by using a Nintendo gaming system. RESULTS: Most of the 38 articles identified were case reports or case series. Injuries and problems ranged from neurological and psychological to surgical. Traditional controllers with buttons were associated with tendinitis of the extensor of the thumb. The joystick on the Nintendo 64 controller was linked to palmar ulceration. The motion sensitive Wii remote was associated with musculoskeletal problems and various traumas. CONCLUSIONS: Most problems are mild and prevalence is low. The described injuries were related to the way the games are controlled, which varies according to the video game console.

The effects of video games on laparoscopic simulator skills.

BACKGROUND: Recently, there has been a growth in studies supporting the hypothesis that video games have positive effects on basic laparoscopic skills. This review discusses all studies directly related to these effects. DATA SOURCES: A search in the PubMed and EMBASE databases was performed using synonymous terms for video games and laparoscopy. All available articles concerning video games and their effects on skills on any laparoscopic simulator (box trainer, virtual reality, and animal models) were selected. CONCLUSIONS: Video game experience has been related to higher baseline laparoscopic skills in different studies. There is currently, however, no standardized method to assess video game experience, making it difficult to compare these studies. Several controlled experiments have, nevertheless, shown that video games cannot only be used to improve laparoscopic basic skills in surgical novices, but are also used as a temporary warming-up before laparoscopic surgery.

Training basic laparoscopic skills using a custom-made video game.

Video games are accepted and used for a wide variety of applications. In the medical world, research on the positive effects of playing games on basic laparoscopic skills is rapidly increasing. Although these benefits have been proven several times, no institution actually uses video games for surgical training. This Short Communication describes some of the theoretical backgrounds, development and underlying educational foundations of a specifically designed video game and custom-made hardware that takes advantage of the positive effects of games on basic laparoscopic skills.