Benign Recurrent Sixth (Abducens) Nerve Palsy following Measles-Mumps-Rubella Vaccination.

Benign, isolated, recurrent sixth nerve palsy is rare in children. It may be associated with febrile viral illness and vaccination in exceptional circumstances although this is a diagnosis of exclusion. Here, we present the case of a 2-year-old Caucasian girl who developed recurrent 6th nerve palsy following vaccination with the measles-mumps-rubella (MMR) vaccine. No underlying pathology was identified following extensive investigations and followup. There is limited data available on the pathophysiology of vaccination-related nerve palsies. As with all previous reports of cranial nerve palsies following vaccination, there was complete resolution in this case. Long term followup with repeated physical examination and investigations is warranted to avoid missing severe pathology and operating unnecessarily.

Management of bullous keratopathy-related ulcer with autologous serum.

PURPOSE: The aim of this study was to report the use of autologous serum eyedrops (ASEs) for resolution of a corneal ulcer secondary to bullous keratopathy. METHODS: This is a case report. RESULTS: A 66-year-old patient presented with an infected ulcer and hypopyon while using a bandage contact lens for bullous keratopathy. Staphylococcus warneri infection was treated with systemic and topical antibiotics, and ASEs were subsequently administered to enhance reepithelialization and to avoid the need for a bandage contact lens. The ASE treatment led to closure of the epithelium layer within 3 weeks, and it was subsequently tapered over the next 3 months. The clinical picture remained stable subjectively and objectively during the 7 months of follow-up. DISCUSSION: To the best of our knowledge, this is the first report of successful use of ASEs in treating and preventing recurrence of ulcers in the context of bullous keratopathy.

Development and validation of the Greek version of the MNREAD acuity chart.

BACKGROUND: The aim of this study was to develop MNREAD acuity charts in the Greek language (MNREAD-GR) and establish their repeatability in a normal-sighted population. METHODS: One hundred and eighty Greek sentences were constructed based on the design principles of the Minnesota Low Vision Reading Test. The software used to validate them for width was adjusted to the parameters of the non-Latin characters used in the Greek language (MNTest-GR) and width-validated sentences were then checked for literacy by two language teachers. Pilot testing followed in 20 adults and two groups of 20 children. Subsequently, three versions of the MNREAD-GR chart were printed and validated for repeatability: 20 adults read MNREAD-GR charts 1, 2 and 3 in random order over two sessions. A linear mixed-model analysis was performed for near visual acuity (VA), maximum reading speed and critical print size to identify the contribution of each source (individual subject, session, chart and residual error) to the total variance. Subject variance determined the intraclass correlation coefficient. RESULTS: One hundred of the initial 180 sentences were validated with MNTest-GR and approved for literacy correctness. Of those, 57 sentences were selected after pilot testing, and used in the final printed chart in random distribution among three versions. The intraclass correlation coefficients were 0.72 for VA, 0.87 for maximum reading speed and 0.46 for critical print size. The between-charts within-session within-subject component accounted for a maximum five per cent of the variance. The between-sessions within-subject component had a maximum of one per cent. The coefficient of repeatability was 0.08 logMAR for VA, 46.96 words per minute for maximum reading speed and 0.10 logMAR for critical print size. CONCLUSION: The created MNREAD-GR acuity chart is a standardised clinical test that can be used reliably to measure near acuity, reading speed and critical print size in Greek-speaking literate patients of all ages.