Acute visual loss as a presenting manifestation of syphilis.

A heterosexual man with acquired syphilis had an uncommon presentation in the form of acute visual loss. The unusual clinical presentation and a high cerebrospinal fluid lymphocyte count led to delayed diagnosis and treatment. Recognition of uncommon presentation of syphilis in the current epidemic is essential for the interruption of transmission.

Ocular Lyme borreliosis as a rare presentation of unilateral vision loss.

Ocular Lyme borreliosis is a rare manifestation of Lyme disease. We describe a case of an 80-year-old woman who presented with a 1-month history of unilateral painless central vision loss. Based on a temporal artery biopsy, she was initially diagnosed with giant cell arteritis and treated with a 3-day course of high-dose intravenous steroids. A more detailed history uncovered multiple previous treatments for Lyme disease and residence in an endemic Lyme area. The patient was subsequently diagnosed with ocular Lyme borreliosis and treated with intravenous antibiotics. After 5 weeks of treatment, unilateral vision loss did not progress and optic disc oedema resolved.

Bilateral severe visual loss in brucellosis.

PURPOSE: To report a case of brucellosis with bilateral permanent loss of vision. METHODS: Case report. RESULTS: Bilateral loss of vision developed within two weeks in a young adult with positive Brucella antibodies. There was optic disc swelling with optic neuropathy and serous retinal detachment in both eyes. The patient had chronic active brucellosis confirmed by serum antibody titers (1/640). CONCLUSION: This case shows that optic neuropathy may result in severe visual loss in patients with brucellosis.

Changes in the prevalence of visual impairment due to blinding trachoma in Sichuan province, China: a comparative study between 1987 and 2006.

PURPOSE: The aim of this study was to assess the changes in the prevalence of visual impairment due to blinding trachoma in Sichuan, China between 1987 and 2006. METHODS: Over 125,000 residents of Sichuan province participated in the National Sample Survey on Disabilities, conducted in both 1987 and 2006. Changes in the prevalence of visual impairment due to blinding trachoma were analyzed while accounting for other factors including gender, age and residence (urban vs. rural). RESULTS: In 1987, blinding trachoma ranked second among the eight major visual impairment causes assessed with a prevalence of 172.9 (95% CI: 152.2-196.6) per 100,000, while in 2006 it ranked eighth with a prevalence of 58.1 (95% CI: 45.5-73.0) per 100,000. The prevalence in 2006 decreased significantly compared to 1987 in both rural and urban areas, as well as in both genders. Furthermore, in both 1987 and 2006, visual impairment due to blinding trachoma tended to be concentrated among individuals over 40, although it was also seen in young people. CONCLUSION: In the past 20 years, the prevalence and percentage of visual impairment due to blinding trachoma was significantly reduced in Sichuan province, and we anticipate a further decrease in the future.

[Clinical evidence of trachoma in Colombian Amerindians of the Vaupés Province]. / Evidencia clínica de tracoma en indígenas colombianos del departamento de Vaupés.

INTRODUCTION: Trachoma is the leading cause of infectious blindness in the world. In 2008 there were 1,300,000 persons with blindness caused by trachoma and 8 million with trichiasis, which might eventually lead to blindness. In Latin America it has been documented in Brazil, Guatemala and México. OBJECTIVE: To inform the presence of trachoma for the first time in Colombia, amongst Amerindians of the Department of Vaupés. MATERIALS AND METHODS: In 2003 and 2006 the Amerindian Makú communities of San Joaquín and Santa Catalina, located 5 km from the border with Brazil, were visited. From 2007 to 2009, San Gerardo, San Gabriel and Nuevo Pueblo, at a 35 km distance from San Joaquín were visited. RESULTS: In 2006 114 people were examined in Santa Catalina and San Joaquin; 21 patients were clinically diagnosed with trachoma (18.4%), 15 (13.2%) of them children under 15 years old. All trachoma phases were observed. Three women had corneal opacity with poor vision. In the remaining three communities, three women with advanced trachoma with corneal opacity and blindness were detected. The poor quality of living conditions without fresh water and adequate sanitary disposal systems, and the abundance of flies identified as Hippelates sp., are risk factors for the transmission of the disease. DISCUSSION: Trachoma exists in Colombia, and it is frequent among the studied communities. Its focalized distribution makes it amenable to elimination. It is advisable to search for trachoma in other indigenous communities in Vaupés with similar living conditions.

Bipolaris hawaiiensis keratomycosis and endophthalmitis.

Following trauma with rice stalk to the left eye, corneal ulcer with abscess and hypopyon developed in an immunocompetent male. Direct examination of the corneal scrapings revealed septate, branched fungal hyphae. Bipolaris hawaiiensis was isolated after culture on blood agar and Sabouraud dextrose agar. Because of delay in diagnosis and appropriate treatment, the patient developed endophthalmitis needing evisceration.