Clinical Applications of Anterior Segment Optical Coherence Tomography: An Updated Review.

Since its introduction, optical coherence tomography (OCT) has revolutionized the field of ophthalmology and has now become an indispensable, noninvasive tool in daily practice. Most ophthalmologists are familiar with its use in the assessment and monitoring of retinal and optic nerve diseases. However, it also has important applications in the assessment of anterior segment structures, including the cornea, conjunctiva, sclera, anterior chamber, and iris, and has the potential to transform the clinical examination of these structures. In this review, we aim to provide a comprehensive overview of the potential clinical utility of anterior segment OCT (AS-OCT) for a wide range of anterior segment pathologies, such as conjunctival neoplasia, pterygium, scleritis, keratoconus, corneal dystrophies, and infectious/noninfectious keratitis. In addition, the clinical applications of AS-OCT (including epithelial mapping) in preoperative planning and postoperative monitoring for corneal and refractive surgeries are discussed.

Bilateral corneal endothelial failure following COVID-19 pneumonia.

We describe a patient who developed acute bilateral corneal decompensation following COVID-19 pneumonia and prolonged intensive care unit ventilation. SARS-CoV-2 uses human ACE2 as the receptor for entry with subsequent downregulation of ACE2. ACE2 receptors are found in human ocular surface cells including cornea. Mouse models of ACE2 deficiency result in corneal haze, oedema and ocular surface inflammation due to upregulation of the inflammatory cascades. We therefore hypothesise that the cause of this patient's corneal decompensation was viral endotheliitis due to direct infection by the SARS-CoV-2 virus.

Recurrent episcleritis in relation to menstruation: a case report.

PURPOSE: To describe a case of recurrent episcleritis associated with a patient's menstrual cycle. METHOD: A retrospective case review of a 39-year-old woman who presented with a 12-year history of recurrent episcleritis in relation to her menstruation. She was seen during an acute attack and started on a reducing regime of topical steroids for 5 weeks. She was then advised to use it a week before and after menstruation. RESULTS: Examination and investigations revealed episcleritis with a negative systems review. After starting the treatment, she was symptom free when reviewed at 4, 8, 14, and 33 weeks. Now, the patient uses topical steroids only 1 week before menstruation. CONCLUSIONS: Literature review revealed no recent case reports and provided insufficient evidence to understand this relationship. We recommend increased awareness and reporting because there is a need for more studies to understand this relationship and to provide evidence for management.

Ophthalmic herpes zoster in an 18-month-old child.

We present a case of herpes zoster ophthalmicus in an 18-month-old child. Early exposure to varicella zoster virus while being breast-fed appears to account for this clinical presentation. The incidence of herpes zoster in children younger than age 2 years is discussed.