RESUMEN
Corneal deposits associated with topical medications, particularly fluoroquinolones, are a recognized complication in ophthalmic practice. We present a case of a 66-year-old female with pseudophakic bullous keratopathy who developed corneal crystalline deposits following prolonged use of gatifloxacin and prednisolone eye drops post-penetrating keratoplasty. The patient presented with diminished vision and significant corneal opacity in the affected eye. Anterior segment examination and OCT imaging confirmed deposits extending from the epithelium to the anterior stroma. Management included corneal scrapping and transition to topical tobramycin and propylene glycol eye drops, resulting in the resolution of deposits and improvement in vision. This case underscores the importance of vigilant monitoring and judicious use of topical medications to mitigate adverse effects in high-risk ophthalmic patients undergoing corneal procedures.
RESUMEN
Calotropis is a small perennial plant that is native to regions with tropical climates in countries like India, where it is found throughout the country. The leaves of the Calotropis plant have been used as an offering to gods since ancient times. Accidental contact with the sap of the plant, called latex, can lead to eye injury and affect vision significantly if left untreated. However, if treated in time and appropriately, vision can be restored. A 30-year-old gentleman reported to emergency medicine with accidental contact in his right eye with Calotropis plant sap. He had complaints of blurring of vision, foreign body sensation, and intolerance to light. On ocular examination, there was conjunctival congestion with corneal edema with Descemet's membrane folds. The best-corrected visual acuity (BCVA) in the right eye was 6/18 parts not improving on the pinhole. The patient was started on systemic and topical antibiotics, topical steroids, and lubricating drops immediately. After two months of treatment, the vision improved gradually, the BCVA in the right eye was 6/6, and the patient was asymptomatic. This is a case report of an uncommon injury due to plant sap, with grave consequences if left untreated. Early intervention and prompt medical management led to recovery in a short time period.
RESUMEN
Optic nerve schwannoma is a very rarely occurring tumor described in the literature. It is due to the fact that the optic nerve is myelinated by oligodendrocytes. Schwannomas are tumors of the peripheral nervous system, hence optic nerve schwannoma is a rare phenomenon. A 34-year-old patient presented in the outpatient department with complaints of gradual painless protrusion of the left eye (LE) for the past one year. There was no history of diminution of vision. On examination, vision in both eyes was 6/6, anterior segment examination in both eyes was normal, and pupils were central, circular, and reacting to light. Intraocular pressure was measured on a noncontact tonometer and was within normal range. Both eyes' optic disc, fundus, and visual fields were normal. On inspection, axial proptosis was noted in the LE. Proptosis measurement (on Hertel exophthalmometer) in the right eye was 17 mm and in the left eye was 21 mm. MRI of the orbit without contrast was done and showed a well-defined, soft tissue lesion of the optic nerve in the intraconal compartment of the left orbit. Surgical excision of the tumor was done by lateral orbitotomy approach and the tumor was removed in total. Histopathological examination of the mass revealed a benign spindle cell neoplasm suggestive of schwannoma. Postoperatively, proptosis was resolved, 17 mm both in the right and left eye (on Hertel exophthalmometer), and vision in LE remained unchanged (6/6). Postoperatively, intraocular pressure (on noncontact tonometer) was within normal range, and the optic disc, fundus, and visual fields were normal.
RESUMEN
Background In India, donor eye collection and promotion of eye banking are insufficient to meet the needs. By adequately evaluating donor corneas, eye banks can maximize the number of viable corneas for transplantation. This study evaluated donor corneal tissue based on age, lens status, and cause of death by their morphology and endothelial cell count via slit lamp and specular microscopy. Methods We conducted a prospective observational study of all eye bank donor corneas indicated for eye donation at a tertiary hospital and research center in Western Maharashtra between September 2019 to December 2021. We evaluated the corneoscleral discs by slit-lamp microscopy specular microscopy. We analyzed donor corneas quantitatively and qualitatively and graded them accordingly. We also collected blood samples for serological testing and the donor's behavioral and family medical histories. Results We collected 94 eyes from 47 donors; the mean age of the donor population was 48.2 years, and most donors were aged 41 to 80 years. Thirty-one donors (65.96%) were male, and 16 were female (34.04%. For preservation, we used Cornisol (Aurolab, Madurai, India) in 36 cases (77%) and McCarey-Kaufman medium in 11 cases (23%). We found a mean endothelial cell density (ECD) of 2214.40/mm2, with hexagonality of 53.05%, and a coefficient of variation of 38.01. Further, we observed that ECD and hexagonality of cells in phakic donors were significantly greater than that of pseudophakic (PP) donors. Moreover, ECD and hexagonality significantly decreased in donors with the chronic disease compared to those who had a sudden, unexpected death. Conclusion Corneal grafts from younger donors, phakic donors, and donors who experienced an acute cause of death were qualitatively and quantitatively significantly better than those of older donors, PP donors, and donors who experienced sudden, unexpected death. Therefore, eye bank specular examination can improve tissue utilization and transplantation success. Therefore, we strongly recommend that eye bank personnel evaluate their donor tissue with a specular microscope to enhance the quality of eye care.