A case of aggressive natural killer cell leukemia.

A 23-year-old man presented with a 1-month history of a red and painful right eye, with visual acuity reduced to hand motions. Examination showed uveitis with keratic precipitates, cells and flare in the anterior chamber, and vitritis that obscured visualization of the right fundus. The following week, he was noted to have the following left-sided findings: reduced visual acuity (6/18), painless upper eyelid edema, an elevated, pink bulbar conjunctival lesion, limitation of ocular abduction, paresthesia in the V1 and reduced sensation in the V2 distributions. Blood tests showed pancytopenia. Results from the aspirate and trephine biopsy of his bone marrow were consistent with aggressive natural killer (NK) cell leukemia, a rare cause of ocular and periocular inflammation that requires a multidisciplinary team approach to care.

A Cross-sectional Study of Prevalence and Etiology of Childhood Visual Impairment in Auckland, New Zealand.

PURPOSE: Childhood visual impairment has significant individual and socioeconomic costs with global differences in etiology and prevalence. This study aimed to determine prevalence, etiology, and avoidable causes of childhood visual impairment in New Zealand. DESIGN: Retrospective data analysis from a national referral center, the Blind and Low Vision Education Network New Zealand, Auckland. METHODS: The World Health Organization Program for Prevention of Blindness eye examination records for visually impaired children, 16 years or younger, registered with the Auckland Visual Resource Centre, were included. Data analyzed included demographics, etiology, visual acuity, visual fields, educational setting, and rehabilitation plan. RESULTS: Charts of 340 children were examined, of which 267 children (144 blind, 123 low vision) were included in the analysis, whereas the remaining 73 charts of children with no visual impairment were excluded. The calculated prevalence of blindness and low vision was 0.05% and 0.04%, respectively, in the Auckland region. Principal causes of blindness affecting 91 children (63.9%) were cerebral visual impairment in 61 children (42.4%), optic nerve atrophy in 18 children (12.5%), and retinal dystrophy in 13 children (9.0%). The main potentially avoidable causes of blindness in 27 children (19%) were neonatal trauma, asphyxia in 9 children (33%), and nonaccidental injury 6 children (22%). CONCLUSIONS: This first report of prevalence for childhood blindness and low vision in New Zealand is similar to data from Established Market Economy countries. The leading causes of blindness are also comparable to other high-income countries; however, proportions of avoidable causes differ significantly.

A novel treatment of central serous chorioretinopathy with topical anti-inflammatory therapy.

A 45-year-old Caucasian female with diagnosis of central serous chorioretinopathy (CSCR) did not improve on conventional observational approach. She was not willing to proceed with photocoagulation or photodynamic therapy. An unconventional approach of topical anti-inflammatory (ketorolac, dexamethasone and hydrocortisone) preparation was prescribed. The course of her CSCR responded well on this unconventional treatment, but relapsed on cessation or tapering of treatment. After 18 weeks of treatment with a gradual taper, her condition resolved. The present case highlights an alternative but unconventional treatment of CSCR with prolonged use of anti-inflammatories.