A man in mid-50s noticed mild irritation in right eye for 10 days following ocular trauma with an unknown insect 1 month ago. His visual acuity was 20/20 in both eyes. Slit lamp examination of left eye revealed an elevated lesion with oval-shape, brown colour, well-defined margins and corrugated surface in inferior cornea. It was relatively translucent, and rigid shell-like, with a convex outer surface that had a waxy coating resembling the exoskeleton of insects ( figure 1 ). It was associated with surrounding stromal infiltration and vascularisation. On fluorescence staining, dye gathered around the edges of the lesion with no ...

A male in his 50s, who had undergone Descemet's stripping automated endothelial keratoplasty (DSAEK) for corneal oedema following irido-corneal-endothelial syndrome and glaucoma drainage device surgery for secondary glaucoma presented with gradual decreased vision. The patient was on ripasudil 0.4% for the past 4 months prior to the presentation. Honeycomb epithelial oedema was seen with vesicles and intraepithelial microcyst formation which were also noted on anterior segment optical coherence tomography (OCT) and histopathology, that co-related with the slit-lamp findings. The patient underwent repeat DSAEK and had a good outcome. While the clinical features and OCT findings have been reported ...

We describe a novel method to identify the position of the suture in the Schlemm’s canal during gonioscopy-assisted transluminal trabeculotomy (GATT). A patient with primary angle-closure glaucoma had right eye (RE) cataract and total glaucomatous optic neuropathy. RE vision was 5/60, and intraocular pressure (IOP) was 28 mm Hg on maximum glaucoma medications. RE phacoemulsification with 360° GATT using burnt tip 6–0 prolene suture was performed. Intraoperatively, the pigmented trabecular meshwork (TM) precluded correct identification as the suture was advanced ( figure 1A , red arrow). To assist in confirmation of the correct suture positioning and advancement within the ...

We herein describe two interesting cases of ocular toxoplasmosis (OT) wherein optical coherence tomography (OCT) findings mimicked the appearance of punctate inner retinal toxoplasmosis (PIRT) lesions. The first case was that of a young man who presented with a diminution of vision in his right eye (RE) for a week. His best-corrected visual acuity (BCVA) in the RE was 20/250, while in the left eye was 20/20 for distance. Intraocular pressures in both eyes were 12 mm Hg. His RE had 2+ anterior chamber reaction, vitreous haze grade 1 and two-disc diameters of retinochoroiditis supero-temporal to the fovea ...

The use of silicone oil (SO) as a surgical tamponade has become a standard technique for the treatment of several retinal pathologies. However, it can get emulsified leading to multiple postoperative complications. A patient in his 50s presented with pain and redness for the last 1 week in his left eye. He did not have any systemic illness. He had undergone 23-gauge pars plana vitrectomy with 1000 centistokes SO tamponade for rhegmatogenous retinal detachment 3 months ago. His best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/80 in the left eye. His intraocular pressures (IOP ...

A non-diabetic man in his 40s presented with a 4-day history of sudden, painless, rapidly progressive severe vision loss in his right eye. Anterior segment was unremarkable. A dense, solitary vitreous abscess with feathery margins obscured the macula. Retinal haemorrhages, exudates and retinal vasculitis were noted. There was no history of ocular surgery, trauma, intravenous drug abuse or immunocompromise. He received intravenous fluids during a spinal procedure 5 days prior. Prompt diagnostic and therapeutic pars-plana vitrectomy was done and Aspergillus flavus was cultured. Postoperatively, he was treated with oral Voriconazole and four intravitreal Voriconazole injections, till the chorioretinitis lesions had ...

An 83-year-old woman with a long history of glaucoma and optic disc drusen (ODD) was referred for neuro-ophthalmological second opinion. The patient had been treated for decades with bilateral intraocular pressure (IOP)-lowering eye drops, laser trabeculoplasty and trabeculectomy and had severe, bilateral loss of visual fields and retinal nerve fibre layer (RNFL) thinning on optical coherence tomography (OCT) despite IOP that never exceeded 24 mm Hg. On ophthalmoscopy, only a single ODD was visible in the left eye and no optic disc cupping was apparent in either eye. Enhanced depth imaging OCT (EDI-OCT) of the optic nerve head revealed ...

A 64-year-old man presented with an acute-onset central visual deficit in the left eye. He described a specific pattern of paracentral scotoma consisting of ‘grey spots arranged in a honeycomb pattern’. He was a 10 pack-year smoker and his medications included low-dose aspirin, which was prescribed, 2 years prior, following an episode of amaurosis fugax in the same eye. Investigations at that time had not revealed significant carotid stenosis. He was also known for ocular hypertension secondary to pigment dispersion syndrome and had stopped adhering to his prescribed daily timolol 0.5% 3 months prior to presentation. Spectacle-corrected visual acuity ...

We report a case of pseudophakic bullous keratopathy (PBK) in which clinical examination failed to identify a retained lens fragment (RLF) which was subsequently diagnosed using anterior segment optical coherence tomography (AS-OCT) A 79-year-old man underwent routine phacoemulsification in the right eye with Infiniti Vision System (Alcon, Fort Worth, USA) under topical anaesthesia. Surgery was uncomplicated and intraocular lens (IOL) was placed in the capsular bag. Preoperative biometry with IOL Master 500 (Zeiss, Oberkochen, Germany) found an axial length of 26.78 mm and anterior chamber depth of 3.22 mm. There was no background of corneal pathology other than ...

Morning glory disc (MGD) is known to develop secondary maculopathy and vision loss. We followed a 7-year-old girl with MGD in right eye from 2010 to 2021. Her best-corrected Snellen visual acuity (BCVA) was 20/20 in both eyes till 2017. She presented with reduced vision in right eye with BCVA of 20/80 in 2018. Optical Coherence Tomography (OCT) revealed maculopathy related to MGD in right eye and arcuate Vitelliform neurosensory detachment (V-NSD) temporal to fovea. She underwent 25G vitrectomy with internal limiting membrane peeling. Resolution of retinoschisis and V-NSD was analysed by OCT and fundus autofluorescence (FAF) postoperatively ...

A 39-year-old woman with gastro-oesophageal reflux disease, tobacco abuse and family history of premature coronary artery disease (CAD) presented to the hospital reporting of new onset substernal chest pain for 4 days prior to admission. She experienced multiple episodes of chest pain at rest and exertion without aggravating or alleviating factors. Each episode lasted for 15 min with radiation to the left arm. Associated symptoms included left arm tingling sensation, diaphoresis, dry mouth, blurry vision and dizziness. Physical examination was unremarkable. Initial vital signs were significant for tachycardia with heart rate in 130 s. ECG showed sinus tachycardia and ST-segment ...

A 64-year-old hypertensive man presented with angina on walking around 500 meters for the last 9 months. On examination, his blood pressure was 130/70 mm Hg and the rest of the general physical and cardiac examination was unremarkable. His 12-lead electrocardiogram was within normal limits and the transthoracic echocardiogram revealed a structurally normal heart with a left ventricular ejection fraction of 60%. A treadmill test (TMT) was positive for inducible ischaemia at moderate workload and a subsequent angiogram performed revealed normal left coronary circulation and proximal right coronary artery (RCA) chronic total occlusion ( figure 1A ).

We here in report an interesting optical coherence tomography (OCT) observation in two different eyes. First case represents a 26-year-old man, with a history of tobacco chewing for 8 years, presented with sudden onset of scotoma in his right eye for 1 week. The uncorrected visual acuity was 20/40 in right eye (OD) and 20/20 in left eye (OS), respectively. Anterior segment was essentially within normal limits. Right eye fundus examination revealed a dull foveal reflex with neurosensory detachment and subretinal fibrin features suggestive of central serous chorioretinopathy. OCT of OD passing through macula confirmed presence of a ...

A 44-year-old man developed sudden-onset right-sided weakness, aphasia and blurred vision after a cardiac valvuloplasty. Initial CT and CT angiography of the head showed early ischaemic changes involving the left medial temporal lobe, occipital lobe and thalamus with a left P2 occlusion. He was not a candidate for hyperacute therapy given his recent surgery and was already on dual antiplatelet therapy. He had improvement in his weakness and aphasia and was seen in ophthalmology consultation 1 month after the onset of stroke. He was found to have a visual acuity of 20/20 in both eyes, a complete right homonymous ...

Calcified lesions often result in undilatable lesions, balloon dog-boning, poor device delivery as well as underexpanded stents (UES). This leads to an increased risk of acute and chronic stent failure. A 49-year-old man was admitted with anterior wall myocardial infarction and angiogram showed a diffuse calcific left anterior descending artery/diagonal lesion, which was stented with two overlapping drug-eluting stents. Angiogram after post-dilatation showed UES. Optical coherence tomography (OCT) confirmed UES with 58% expansion, minimum stent area (MSA) of 2.91 mm 2 and 360° calcium arc around the stent. This UES was dilated with a ultra high-pressure balloon (UHPB ...

A 24-year-old young man presented to us with total limbal stem cell deficiency (LSCD) in the right eye 1 year post ocular chemical burn. The patient subsequently underwent limbal biopsy in the healthy contralateral eye and autologous simple limbal epithelial transplantation in the right eye. The patient was followed up with sequential imaging of the cornea with high-resolution anterior segment optical coherence tomography (HR-ASOCT) for 3 years. The serial HR-ASOCT imaging in the operated eye showed regeneration of the epithelium from the limbal transplant over the human amniotic membrane (hAM) with integration of the transplant within the cornea with subepithelial ...

Description A 69-year-old man was referred by his physician for a routine fundus evaluation. He was known to have type 2 diabetes mellitus, hypertension and left-sided hemiparesis due to a history of stroke. Best-corrected visual acuity was 20/25; N6 in both eyes. Fundus evaluation indicated the presence of a few microaneurysms in the posterior pole and preretinal haemorrhages, just above the arcades, in both eyes ( figure 1A,B ). He was imaged using wide-angle swept source optical coherence angiography (SS OCTA) 12×12 mm field of view (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, California, USA) which showed the presence ...

A 56-year-old woman presented with painless diminution of vision in her left eye since the last 2 months. She is a known case of type 2 diabetes mellitus on insulin. Her best-corrected visual acuity in right eye was 20/60; N8 and left eye were only counting fingers close to face. She was a known case of primary angle-closure glaucoma and had previously undergone peripheral iridotomy in both eyes elsewhere. She had early cataractous lens changes in both eyes. Her left eye, in addition, also showed faint iris neovascularisation at 2’o clock. Her intraocular pressure in the right and ...

Conjunctival stromal tumour (COST) is a recently described rare conjunctival tumour of mesenchymal origin with only four publications describing a handful of cases thus far. In this report, we describe the anterior-segment optical coherence tomography (AS-OCT) characteristics in a case of COST for the first time, in addition to the clinical and histopathological characteristics. The AS-OCT showed an elevated, dome-shaped hyporeflective homogenous lesion in the conjunctival stroma lined by hyperreflective outer layer with mild posterior shadowing, consistent with histological description of a paucicellular tumour with large myxoid collagenous material inside. Immunohistochemistry showed positive CD34 and vimentin but negative S100 and ...

A 52-year-old man, a known case of type 2 diabetes mellitus and hypertension, who presented to us with bilateral diminution of vision since 1 year. He was diagnosed as a case of bilateral proliferative diabetic retinopathy and hypertensive retinopathy. A non-invasive imaging modality, optical coherence tomography angiography (OCTA), detected foveal neovascularisation in a background of diffuse diabetic macular oedema which would have been obscured by other investigations like fluorescein angiography.

A 43-year-old woman who was diagnosed with the cryopyrine-associated periodic syndrome (CAPS) with severe renal failure and heart failure due to amyloid accumulation was examined by swept source optical cohernce tomography (OCT) (SS-OCT; DRI-OCT, Topcon, Tokyo, Japan) and optical coherence tomography angiography (OCTA) (RTVue XR Avanti, Optovue, Fremont, CA). Her best-corrected visual acuity was 20/40 OD and 20/25 OS. A hyporeflective band of about 100 µm thickness was seen just inferior to the retinal pigment epithelium in the cross-sectional SS-OCT images, but the deeper choroidal structures were clearly visible. In the OCTA images, the density of the retinal ...

A 7-year-old girl presented with watering and redness in the left eye for 2 months. Her parents reported poor vision in both eyes for 4 years. Visual acuity was finger counting at 1 m and finger counting close to face in the right and left eyes, respectively. Slit lamp examination of the right eye revealed corectopia, aphakia in the pupillary area, temporally subluxated clear crystalline lens, persistent pupillary membrane, irido-hyaloidal adhesion and poorly dilating pupil. Left eye revealed central corneal oedema with descemet scarring, anteriorly dislocated clear crystalline lens with lenticulo-corneal touch. Ultrasound examination of the left eye was normal ...

A 10-year-old girl presented with blurred vision of 2 months. Uncorrected visual acuity was 20/20 in both eyes (OU). Refraction revealed 0.75 diopters of astigmatism OU. Visual blur was related to a moderate convergence insufficiency. The superior 90% of the left iris was darkly pigmented and velvety in consistency with regularly spaced protuberances (mammillations) (figure 1).

We report a clinical case of a teenager whose eyes were exposed to highly negative suction pressures for brief seconds. The patient presented with a bilateral cystoid macular oedema associated with a thickening of outer nuclear layer evidenced by optical coherence tomography. The patient’s constellation of findings is most easily explained by the abrupt expansion and traction of a cohesive vitreous base onto the retinal layers.