Conjunctival Intraepithelial Neoplasia Mimicking a Pigmentary Lesion in an HIV-Seropositive Indian Male.

We present the case of a 27-year-old male who presented to our ophthalmology outpatient clinic with a pigmented lesion on the conjunctiva of his right eye. There was no history of ocular trauma or familial ocular complaints, and a thorough evaluation revealed the patient's seropositive status for HIV for the past eight years. The presentation resembled a conjunctival pigmentary lesion, with typical features of ocular surface squamous neoplasia (OSSN) being absent and a demographic incongruent with typical OSSN cases as OSSN typically affects the elderly population. Given the patient's HIV status and the lesion's recent increase in size, a more aggressive treatment approach was warranted. Mass excisional biopsy surgery confirmed conjunctival intraepithelial neoplasia with one positive margin. Adjuvant treatment with mitomycin eye drops (0.04%) resulted in no lesion recurrence at the one-month follow-up. Conjunctival intraepithelial neoplasia can mimic pigmentary lesions in young HIV-positive patients with obvious signs of OSSN being absent. In such cases, the history of seropositivity should be sufficient to suspect it as OSSN and aggressive management measures should be adopted to get best possible outcomes.

Morning Glory Anomaly With Serous Macular Detachment.

The morning glory (MG) disc anomaly is a congenital excavation of the posterior globe involving the optic disc, with a distinct appearance reminiscent of the MG flower. Various intracranial and ocular associations with MG have been documented. Conditions such as trans-sphenoidal encephalocele and hypoplasia of the intracranial vasculature have been observed in association with this anomaly. In this report, we present a case of MG optic disc anomaly accompanied by serous macular detachment.

Radiologic Imaging in Third Nerve Palsy: A Case Series Investigating Etiology, Patterns, and Clinical Implications.

Third nerve palsy (TNP) is a neurologic condition characterized by dysfunction of the oculomotor nerve, leading to various ocular manifestations. Optic nerve evaluation is of utmost important among all cranial nerve palsies affecting the eye. Dysfunction of the third nerve can indicate an underlying neurologic emergency, such as cavernous arteriovenous fistula or giant cell arteritis. Early recognition and prompt treatment are vital in reversing the clinical and visual impairments associated with oculomotor nerve palsy. The typical presentation of isolated TNP involves deviation of the eye in a downward and outward direction, accompanied by ptosis (drooping of the eyelid) and, potentially, pupil involvement. The decision to use vascular imaging is influenced by factors such as age and clinical risk for an aneurysm. If TNP is isolated or partially present with pupil involvement, it suggests compression of the third nerve and necessitates immediate imaging. Given the serious implications of an intracranial aneurysm, physicians often prioritize vascular imaging during the initial evaluation, if available. However, if clinical findings indicate underlying microvascular ischemia, a delay in imaging may be considered. This case series aims to explore the role of radiologic imaging in understanding the etiology, patterns, and clinical implications of TNP.