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Abstract Purpose To investigate the safety and efficacy of a new micro-controlled radiofrequency device for treatment of conjunctivochalasis (Cch). Methods Data of 127 patients (230 eyes) who underwent ophthalmic radiofrequency treatment for Cch from January 2020 to June 2023 were analyzed retrospectively. Cch coagulation was performed with a radiofrequency electrode tip (OcuRF®, Ilooda, Korea) and a high-frequency radio-wave electric unit (0.6 ~ 0.8 watts, 2 MHz, Acutron™, Ilooda, Korea). Pre- and postoperative Cch grading, slit-lamp photography, tear film break-up time (TBUT), and bulbar conjunctival hyperemia using Keratograph 5 M (Oculus, Wetzlar, Germany) were evaluated. Cch grade 0 or 1 after surgery was regarded as ‘success’. Complications, recurrence, and additional treatment rates were analyzed. Results In 227 (98.7%) eyes, the radiofrequency treatment led to marked improvement of Cch, with 224 (97.4%) eyes achieving grade 0 or 1 at 2 months postoperatively. Eight eyes (3.5%) received additional treatment. TBUT improved from 3.17 ± 0.82 s to 5.28 ± 1.10 s after surgery (P

Purpose: To investigate the safety and efficacy of a new micro-controlled radiofrequency device for treatment of conjunctivochalasis (Cch). Methods: Data of 127 patients (230 eyes) who underwent ophthalmic radiofrequency treatment for Cch from January 2020 to June 2023 were analyzed retrospectively. Cch coagulation was performed with a radiofrequency electrode tip (OcuRF®, Ilooda, Korea) and a high-frequency radio-wave electric unit (0.6 ~ 0.8 watts, 2 MHz, Acutron™, Ilooda, Korea). Pre- and postoperative Cch grading, slit-lamp photography, tear film break-up time (TBUT), and bulbar conjunctival hyperemia using Keratograph 5 M (Oculus, Wetzlar, Germany) were evaluated. Cch grade 0 or 1 after surgery was regarded as 'success'. Complications, recurrence, and additional treatment rates were analyzed. Results: In 227 (98.7%) eyes, the radiofrequency treatment led to marked improvement of Cch, with 224 (97.4%) eyes achieving grade 0 or 1 at 2 months postoperatively. Eight eyes (3.5%) received additional treatment. TBUT improved from 3.17 ± 0.82 s to 5.28 ± 1.10 s after surgery (P < 0.001). The total bulbar conjunctival hyperemia value showed an improvement from 1.7 ± 0.6 to 1.4 ± 0.6 postoperatively (P < 0.05). No serious complications were observed. Conclusion: The novel ophthalmic radiofrequency device led to a marked improvement of Cch with no serious adverse events during the entire follow-up period. Our results suggest that the radiofrequency device presents a safe and efficacious treatment option for Cch. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose was to study the safety and efficacy of sub-Tenon and subconjunctival anesthesia in manual small-incision cataract surgery (MSICS) in patients with hard-grade cataracts. STUDY DESIGN: The design of the study was a prospective, observational, and randomized control study. MATERIALS AND METHODS: A total of 196 eyes, including 98 eyes in the subconjunctival anesthesia group (group A) and 98 eyes in the sub-Tenon anesthesia group (Group B), undergoing MSICS were enrolled in the study. A single surgeon performed all the surgeries. Intraoperative and postoperative pain scores, patient comfort, surgeon's satisfaction, and intraoperative complications were examined. RESULTS: The mean age of patients in Group A was 66.64 ± 9.95 years and that of patients in Group B was 64.52 ± 9.46. No statistically significant difference was noted in the intraoperative (P = 0.54) and postoperative pain (P = 0.66) scores between the two groups. There was no pain (0 score) in 30% of patients in Group A and 35% of patients in Group B intraoperatively. The average surgical time (P = 0.66) and surgeon's comfort (P = 0.34) were not statistically significant. The mean corneal haze was 0.054 ± 0.12 in group A and 0.065 ± 0.22 in group B (P = 0.45). Two patients in group A required supplemental anesthesia. There were no surgical complications that could compromise visual outcomes. No patients in either group showed alterations in vital parameters or required intravenous sedation. CONCLUSION: Both techniques of anesthesia are safe and effective for performing MSICS in hard-grade cataracts. However, it is prudent to choose a technique according to the surgeon's requirements. [ABSTRACT FROM AUTHOR]

Background: Conjunctival chemosis, a complication of lower blepharoplasty, can cause persistent discomfort and functional disturbances with worsening in the postoperative period following surgery. Methods: A review of the records of the lower blepharoplasty procedures carried out at the Humanitas Research Hospital, Rozzano, Milan, Italy was performed. Patients were categorized into two groups depending on the procedure performed: (1) transconjunctival blepharoplasty with the removal of the fatty lodges with canthopexy and (2) transcutaneous blepharoplasty with the removal of the fatty lodges with lateral canthoplasty. Each group was further divided into two more groups based on the surgical method used, that is either (a) cold blade and disposable cautery or (b) radiofrequency cut and coagulation and colorado tip (respectively 1a, 1b, 2a and 2b). All patients underwent a postoperative follow-up up to 24 months, which included an evaluation of cosmetic appearance, eyelid scarring and the severity of chemosis. The aim of the study was to investigate which of the surgical procedures causes a lower incidence of persistent type 3 conjunctival chemosis. Results: A total of 1047 patients who underwent lower lid blepharoplasty were included in the study. A total of 512 patients underwent transcutaneous blepharoplasty and 535 underwent the transconjunctival procedure. Among the first group of patients, 266 belong to group 1a and 246 to group 1b. In the second group, 264 were categorized as group 2a and 271 as group 2b. The incidence of type 3 chemosis in the transcutaneous blepharoplasty procedure with lateral canthoplasty was statistically significantly higher than in the transconjunctival approach, considering both the cold blade and the radiofrequency (p = 0.012, 0.010, 0.006, 0.004, respectively). Conclusions: A higher incidence of persistent type 3 conjunctival chemosis is associated with lateral canthus surgery and with the use of radiofrequency. [ABSTRACT FROM AUTHOR]

A 56-year-old female with a history of chronic systemic steroid use for asthma control displayed orbital congestion, exophthalmos, a mild abduction deficit, and optic neuropathy. Laboratory workup was unrevealing. Neuroimaging showed increased orbital fat compartments, though the orbital fat was unremarkable on biopsy. The patient was diagnosed with iatrogenic Cushing’s syndrome of the orbit and underwent orbital decompression. Early published literature declared this orbitopathy benign. However, newer cases describe more pathologic changes, suggesting the disease is diagnosed later and/or treatment is delayed. [ABSTRACT FROM AUTHOR]

According to statistics, infectious and inflammatory eye diseases of various etiologies are widespread in the world (about 18 million cases per year). In some cases, they are severe and can lead to a decrease in acuity and even loss of vision. About 12 million in the structure of infectious and inflammatory diseases of the eye are conjunctivitis, which may be accompanied by inflammation of the edges of the eyelids (blepharoconjunctivitis) and / or the cornea (keratoconjunctivitis). A viral infection is one of the common causes of inflammation of the mucous membrane of the eyes. In the routine practice of ophthalmologists, adeno- and herpesvirus lesions of the organ of vision are most often diagnosed. Eye diseases of herpetic etiology are among the most common infections. Herpetic conjunctivitis usually develops as a result of an initial attack by Herpes simplex virus type 1 (HSV-1) in early childhood. But there is reason to believe that in adults they are no less common than herpetic keratitis, however, the diagnosis of isolated herpetic conjunctivitis is extremely rare, since, unlike herpetic keratitis or creatoconjunctivitis, the clinic is less pronounced, not always confirmed by laboratory, which leads to underdiagnosis. During the treatment of ophthalmic herpes, one should rely not only on the antiviral effect of drugs, but also on the presence of immunomodulators (interferons or inducers of endogenous interferonogenesis) in the complex therapy, which contribute to faster recovery with fewer relapses.The aim of this study was to evaluate the effectiveness of the use of the drug OCTALMOL in the treatment of 34 patients with conjunctivitis and keratitis of herpesvirus etiology. The drug contributed to the relief of clinical symptoms of inflammation and a reduction in the duration of therapy in 89 % of patients, while the average duration of treatment was 10.7 ± 0.3 days. The therapeutic effect in the group where OCTALMOL was included in the basic therapy was statistically higher than in the control group.

Sinusitis not properly treated can generate multiple complications. Among these complications, oculo-orbital manifestations can be difficult to treat and can lead to vision loss, despite modern antibiotic therapy. In this paper, we aimed to discuss the orbital complications of rhinosinusitis, especially orbital cellulitis, and the method of treatment, highlighted by the presentation of a clinical case diagnosed and treated medically and surgically in the ENT and Ophthalmology Departments, within the Braila County Emergency Clinical Hospital. [ABSTRACT FROM AUTHOR]

Serous retinal detachment is a rare complication of preeclampsia and is usually bilateral. Chemosis and presumed bacillary layer detachment are even rarer complications. The combination of unilateral chemosis, serous retinal detachment, and bacillary layer detachment has never before been described in a patient with preeclampsia. Background/Purpose: To report a case of unilateral chemosis, serous retinal detachment (SRD), and presumed bacillary layer detachment in pregnancy. Methods: Clinical examination and multimodal imaging findings were reviewed and analyzed. Results: A 17-year-old female patient with severe preeclampsia was found to have unilateral chemosis and bullous SRD. Postpartum optical coherence tomography revealed thickened choroid and presumed bacillary layer detachment. Two weeks later, chemosis and SRD resolved, leaving behind mottled hyperpigmentation, drusen, and subretinal drusenoid deposits. Conclusion: The combination of chemosis and SRD in preeclampsia is exceedingly, rare and it has never previously been reported to occur unilaterally. With delivery, visual acuity, chemosis, choroidal thickness, and SRD all normalize. [ABSTRACT FROM AUTHOR]

Chemosis is a common, though typically temporary complication of both upper and lower blepharoplasty surgery, though it is much more common after the latter. It occurs due to extravasation of fluid into the subconjunctival space precipitated by desiccation, inflammation, and manipulation of the conjunctiva and associated lymphatic drainage. Intraoperatively, minimizing surgical exposure and manipulation as well as maintaining a moist ocular surface can reduce the risks. Postoperatively, we propose a stepwise approach, starting with lubricants and escalating to increasingly potent anti-inflammatories with compression bandaging and surgery reserved for persistent cases. [ABSTRACT FROM AUTHOR]

Objectives:To prospectively evaluate the frequency of ocular findings and inflammation markers levels in patients treated in the intensive care unit due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to determine the relationship between these parameters and mortality.Materials and Methods:We prospectively evaluated 53 patients who were treated in the intensive care unit of a pandemic hospital between January 1 and June 30, 2021 and whose SARS-CoV-2 diagnosis was confirmed by reverse transcriptase polymerase chain reaction test from nasopharyngeal swab samples. Ocular findings were evaluated together with white blood cell, neutrophil, lymphocyte count, C-reactive protein, lactate dehydrogenase and ferritin levels, and mortality rate.Results:There was no statistically significant correlation between lactate dehydrogenase, white blood cell, neutrophil, and lymphocyte count elevation and the frequency of inflammatory eye signs (p=0.308, p=0.694, p=0.535, p=0.374). In multivariate analyses, no statistically significant correlation was observed between ferritin level and the frequency of inflammatory eye findings (p=0.087). In addition, for each 1 mg/dL increase in C-reactive protein level, the detection of inflammatory eye findings decreased by 1.9% (95% confidence interval: 3.3%-0.4%; p=0.015). It was determined that 7 of 13 patients with inflammatory eye findings died and this was not statistically significant (p=0.810).Conclusion:Inflammatory examination findings of the ocular surface were detected in 13 (24.5%) of 53 patients treated in the intensive care unit for SARS-CoV-2 infection. Ocular surface examination of patients treated in the intensive care unit due to the SARS-CoV-2 epidemic is important.

Fabry disease (FD) is an X-linked lysosomal disease, in which diagnosis is often established several years after onset of symptoms. Ocular manifestations can occur in childhood and be a clue to earlier diagnosis. The aim was to report ocular outcome and visual quality of life (QoL) in patients with FD. FD-patients recruited from Karolinska University Hospital underwent ophthalmological examinations including best corrected visual acuity (BCVA), refraction, biomicroscopy, optical coherence tomography, keratometry, review of medical records and QoL Inventories. A total severity score (TSS), as estimated via Fabry Stabilization Index, was calculated. Twenty-six FD-patients (16 men) mean age 36.4 years (range 5.0–63.5 years) were included. BCVA was median 1.0 (range 0.5–1.6). Conjunctival blood vessel tortuosity occurred in 15/26 patients, chemosis in 2/26 patients, cornea verticillata in 23/26 patients, lens opacities in 19/26 patients, and tortuous or dilated retinal vessels in 20/25 patients. Group-wise comparisons of adult patients showed no differences regarding age, TSS, or ocular parameters. Overall, TSS was correlated to age (r = 0.53, p = 0.02). A linear regression model showed that age and sex explained 38% of the variance in TSS. Keratometry did not reveal corneal ectasia in any of the 12 patients examined. VFQ 25 in 15 patients showed a high median composite score, 93.6 (range: 78.1–100). BCVA in FD-patients was good despite corneal and lens pathology. Ocular variables did not show an association with TSS in adult patients. Corneal or lens opacities should also lead to a suspicion of FD in children. [ABSTRACT FROM AUTHOR]

This article describes care of the eye through a period of potential vulnerability, during patient management under general anaesthesia and in the intensive care unit. Risk factors, mechanisms of injury, recognition and management of common and important eye injuries are covered, as well as good practice points and preventative measures pertinent to all anaesthetists and intensive care staff. [ABSTRACT FROM AUTHOR]

Abstract Background Indirect carotid-cavernous fistulas (CCF) are dural arteriovenous fistula of the cavernous sinus and generally present with ocular symptoms. High index of clinical suspicion and radiological work up is required for diagnosis, and treatment is primarily endovascular embolization. We present our experience in diagnosis and management of indirect CCF along with technical evolution to perform embolization and different vascular accesses for difficult anatomy. Results Among a total of 20 indirect CCF cases who were treated with embolization in our department from 2013 to 2020, five (25%) were type C and 15 (75%) were type D. Seven were treated with trans-arterial access only, 11 were treated by transvenous access only, and two were treated by taking both transvenous and trans-arterial access. No recurrence was seen in angiographically cured patients. Out of seven patients who suffered various grades of visual deficit, five recovered completely and two had fixed visual deficit. Third and sixth cranial nerve palsy persisted in two patients even after CCF embolization. Conclusion Indirect CCF is a treatable cause of troublesome ocular symptoms. Endovascular embolization is preferred treatment with excellent short- and long-term outcome. The embolization becomes difficult and challenging in cases where the conventional vascular access to the cavernous sinus is occluded.

Lower lid blepharoplasty surgery can be a challenging procedure for both the neophyte and the accomplished surgeon. It requires mastering complex periorbital anatomy and choosing the correct approach from a wide variety of patient presentations. This article spans the meticulous clinical evaluation, diagnostic approaches, and surgical techniques required to address challenging clinical scenarios of the lower eyelid, lid-cheek junction, and midface. By following these principles, surgeons can achieve excellent esthetic and functional results, even in the most challenging cases., Competing Interests: Disclosure There are no disclosures of any commercial or financial conflicts of interest for this study. There are no funding sources for the authors of this study., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: To prospectively evaluate the frequency of ocular findings and inflammation markers levels in patients treated in the intensive care unit due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to determine the relationship between these parameters and mortality. Materials and Methods: We prospectively evaluated 53 patients who were treated in the intensive care unit of a pandemic hospital between January 1 and June 30, 2021 and whose SARS-CoV-2 diagnosis was confirmed by reverse transcriptase polymerase chain reaction test from nasopharyngeal swab samples. Ocular findings were evaluated together with white blood cell, neutrophil, lymphocyte count, C-reactive protein, lactate dehydrogenase and ferritin levels, and mortality rate. Results: There was no statistically significant correlation between lactate dehydrogenase, white blood cell, neutrophil, and lymphocyte count elevation and the frequency of inflammatory eye signs (p=0.308, p=0.694, p=0.535, p=0.374). In multivariate analyses, no statistically significant correlation was observed between ferritin level and the frequency of inflammatory eye findings (p=0.087). In addition, for each 1 mg/dL increase in C-reactive protein level, the detection of inflammatory eye findings decreased by 1.9% (95% confidence interval: 3.3%-0.4%; p=0.015). It was determined that 7 of 13 patients with inflammatory eye findings died and this was not statistically significant (p=0.810). Conclusion: Inflammatory examination findings of the ocular surface were detected in 13 (24.5%) of 53 patients treated in the intensive care unit for SARS-CoV-2 infection. Ocular surface examination of patients treated in the intensive care unit due to the SARSCoV- 2 epidemic is important. [ABSTRACT FROM AUTHOR]

Background: The welcome advent and subsequent development of interventional neuroradiology led to an important paradigm shift in the management of many cerebrovascular diseases. This paradigm shift is especially true for carotid cavernous fistula and, for some time now, endovascular techniques are the mainstay approach for these lesions. The neurosurgical intervention should be adopted when the endovascular treatment is not practicable. Case Description: We present the surgical solution adopted to treat a patient with an indirect carotid cavernous fistula (CCF), with quickly progressive symptoms, in which it was not possible to treat using the currently standardized endovascular technique. A pretemporal craniotomy with peeling of the dura mater at the middle fossa and exposure of Parkinson's triangle on the lateral wall of the cavernous sinus was performed. Fibrin glue was injected by puncture of the lateral wall of the cavernous sinus for direct thrombosis of this sinus and the superior ophthalmic vein. Conclusion: In the now far 60s, Parkinson already treated patients with CCF effectively and elegantly through the lateral wall of the cavernous sinus. Revisiting techniques from the past, associating them with the supplies widely available today, can sometimes be the solution to some especially challenging cases that we face in our profession. [ABSTRACT FROM AUTHOR]

According to statistical studies in recent decades, there has been an increase of allergic diseases in most countries of the world. Predisposing factors are the deterioration of the environmental situation, the total “chemicalization” of life and the forced use of drugs. Twenty years ago, the World Health Organization called the new century “the century of allergies” and the disease itself as an “epidemic”. As time has shown, these forecasts have come true: from 2001 to 2010, the number of allergic people in the world increased by 20 % and many of these patients suffer from ophthalmic manifestations of the pathology: the eyes are involved in the process in almost every second case. This is due to the fact that the eyes are directly exposed to the environment and a variety of external allergens. The most common disease of an eye-allergic nature is allergic conjunctivitis: approximately 15 % of the total population of economically developed countries suffer from it. Allergic blepharitis, eyelid dermatitis, keratitis, iritis, uveitis, retinitis and optic neuritis are much less common. The following manifestations are typical for allergic conjunctivitis: burning, lacrimation, pruritus, hyperemia of the eyelids and conjunctiva, photophobia. In the case of a transition to a chronic form, pronounced tissue changes are observed. Therefore, timely diagnosis and effective treatment certainly have a positive effect on the quality of life of the patient and the course of the disease. The treatment of patients with allergic conjunctivitis, first of all, consists in the maximum possible restriction of contact with the allergen. During desensitizing therapy, local and general drugs are used. Numerous studies have proven the advantage of targeted and effective antiallergic local therapy compared with systemic exposure. Currently used local ophthalmic antiallergic drugs belonging to various groups. The tactics of their use is determined by the acuity, severity and etiology of the process. When choosing a drug, in some cases, you should focus on the presence of substances that provide a double mechanism of action: a pronounced antihistamine activity in combination with the stabilization properties of mast cells, which has a quick and long therapeutic effect. This study evaluated efficacy of Vizallergol (olopatadin 0.2 %) application in cases of allergic conjunctivitis in 239 patients was evaluated. The medication arrested the symptoms of allergic conjunctivitis in 89 % of patients, at that the mean period of treatment made 10.7 ± 0.3 days. In the treatment of allergic conjunctivitis, the therapeutic efficacy of Vizallergol 0.2 % was comparable to opatanol 0.1 % and was found to be more comfortable for most patients due to the convenience of a single use.

Purpose: To compare outcomes of diclofenac versus dexamethasone in patients after strabismus surgery. Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted on MEDLINE, EMBASE, EMCARE, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL). All randomized controlled trials (RCTs) comparing the outcomes of diclofenac versus dexamethasone poststrabismus surgery were included. An extraction spreadsheet for data collection and Review Manager 5.3 were used for data analysis based on the fixed and random effects models. Discomfort, inflammation, chemosis, conjunctival gap, and intraocular pressure (IOP) were primary outcome measures. Secondary outcomes included conjunctival congestion and injection, discharge, and drop intolerance. Fixed and random effects models were used for the analysis. Results: Five RCTs enrolling 248 subjects were enrolled. At week 2 postoperatively, there was a significant difference favoring diclofenac over dexamethasone in terms of discomfort (mean difference [MD] = -0.37, P = 0.02), conjunctival inflammation (MD = -0.16, P = 0.02), conjunctival chemosis (MD = -0.16, P = 0.04), and postoperative conjunctival gap (MD = -0.17, P = 0.002). In terms of IOP, there were no significant differences. However, no statistically significant differences were noted at weeks 1 and 4 postoperatively. For secondary outcomes, dexamethasone had significantly improved conjunctival congestion; however, diclofenac had significantly less injection at the site of muscle attachments at week 2. No significant difference was noted in terms of discharge and drop intolerance. Conclusion: Diclofenac is comparable to dexamethasone when used following strabismus surgery. However, a significant difference favoring diclofenac in terms of discomfort, inflammation, conjunctival chemosis, and conjunctival gap was only noted at 2 weeks postoperatively. The authors suggest conducting further studies to support the effectiveness of diclofenac as an alternative to corticosteroids following strabismus surgery. [ABSTRACT FROM AUTHOR]

[West J Emerg Med. 2014;15(4):357–358.]

Background: Indirect carotid-cavernous fistulas (CCF) are dural arteriovenous fistula of the cavernous sinus and generally present with ocular symptoms. High index of clinical suspicion and radiological work up is required for diagnosis, and treatment is primarily endovascular embolization. We present our experience in diagnosis and management of indirect CCF along with technical evolution to perform embolization and different vascular accesses for difficult anatomy. Results: Among a total of 20 indirect CCF cases who were treated with embolization in our department from 2013 to 2020, five (25%) were type C and 15 (75%) were type D. Seven were treated with trans-arterial access only, 11 were treated by transvenous access only, and two were treated by taking both transvenous and trans-arterial access. No recurrence was seen in angiographically cured patients. Out of seven patients who suffered various grades of visual deficit, five recovered completely and two had fixed visual deficit. Third and sixth cranial nerve palsy persisted in two patients even after CCF embolization. Conclusion: Indirect CCF is a treatable cause of troublesome ocular symptoms. Endovascular embolization is preferred treatment with excellent short- and long-term outcome. The embolization becomes difficult and challenging in cases where the conventional vascular access to the cavernous sinus is occluded. [ABSTRACT FROM AUTHOR]

Aim: The current world has changed in all shapes since the emergence of the novel coronavirus (nCoV-2) also known as COVID-19. Among the extra-pulmonary manifestations of nCoV-2, ophthalmic symptoms have less been systematically studied. The so far existing body of evidence indicates that nCoV-2 has the potential to affect both anterior and posterior chambers of the eye. Albeit, the exact mechanisms which underlie ophthalmic manifestations of nCoV-2 are yet to be elucidated. Methods: The present brief review is an attempt to put together and highlight the significant yet limited number of studies which have spotlighted ophthalmic issues in nCoV-2 patients using a systematic literature search strategy. Results: All case series or reports (including both published and preprint articles) which described ocular manifestations of patients with COVID-19 and/or documented testing of SARS-COV-2 in ocular secretions via various sampling or detection methods were sought to be included. Conclusion: The ophthalmic presentations in SARS-COV-2 are often found to be salient. Raising awareness in this respect may help defining evidencebased protective measures in today's practice of ophthalmology and allied disciplines. [ABSTRACT FROM AUTHOR]

A 62-year-old man presented with a 1-month history of right eye pain unresponsive to artificial tears and topical steroids. At presentation, bullous yellowish fluid collection was noted in the nasal conjunctiva. Corneal thinning and opacity were observed at the 3 o'clock position of the cornea. High-frequency radiowave ablation and biopsy were performed at the affected area. Conjunctival lymphangiectasia was confirmed by excisional biopsy. An improvement in the degree of corneal dellen and chemosis was evident 1 week after ablation. Use of a high-frequency radiowave electrosurgical device may be a simple and effective treatment option for symptomatic conjunctival lymphangiectasia.

Purpose: To evaluate ocular findings in patients with Coronavirus Disease 2019 (COVID-19) in the Northeast of Iran.Methods: In a cross-sectional, observational study all consecutive patients with confirmed COVID-19 diagnosis at the central referral center of these patients in northeast of Iran were included. Ocular examinations (external and slit) were randomly performed for the patients who were admitted to the Intensive Care Unit (ICU) and six COVID wards of the hospital. Moreover, Chart records and serum chemistry results were collected.Results: A total of 142 patients with the mean age of 62.6 ± 15 years (range: 23-96 years) and almost equal gender distribution (male: N = 77, 54.2%) were included in the study. During the initial external examination by the ophthalmologist, 44 (31%) patients were found to have conjunctival hyperemia and 22 (15.5%) patients had chemosis. Consecutive slit examination showed 41 (28.9%) conjunctival hyperemia, 22 (15.5%) chemosis, 11 (7.7%) cataract, and 9 (6.3%) diabetic retinopathy. The patients with at least one ocular manifestation had significantly higher blood urea levels at the time of admission compared to those with no obvious ocular involvement (median: 41.5, IQR: 28-66.3 vs. median: 33, IQR: 23.8-51.8, P = .023). Moreover, a significant difference was observed in the total white blood cell count, lymphocyte percent, neutrophil count, Erythrocyte Sedimentation Rate (ESR), and blood urea level between patients with positive and negative Polymerase Chain Reaction (PCR) for SARS-CoV-2 virus. None of the patients reported ocular symptoms prior to systemic involvement. The proportion of patients with at least one ocular manifestation was significantly higher in those admitted in the ICU compared to the non-ICU wards. wards. While conjunctival hyperemia was the most prevalent ocular finding in all patients, chemosis was the most common ocular manifestation in ICU admitted patients.Conclusion: Ocular manifestation was observed in more than half of our COVID-19 patients. Hence, it seems important to involve ophthalmologist in the diagnosis and management of these patients. [ABSTRACT FROM AUTHOR]

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Les fistules carotidocaverneuses sont une pathologie peu fréquente, le plus souvent dues à un violent traumatisme de l'étage antérieur de la base du crâne. Ces fistules post-traumatiques se traduisent par une symptomatologie bruyante faite d'une exophtalmie pulsatile avec un chémosis hémorragique associé à des signes neurologiques non spécifiques (céphalées, acouphène, etc.) – et ce contrairement aux fistules spontanées, dont le tableau clinique reste plus discret. Le diagnostic positif est d'abord orienté par le scanner orbitaire, éliminant les autres causes d'orbitopathies inflammatoires (Basedow), puis confirmé par l'artériographie qui permet de classer la fistule, selon la classification de Barrow, en fistules directe/indirecte (branches méningées de la carotide interne et/ou carotide externe), haut débit/bas débit. Le traitement actuel des fistules repose sur l'embolisation par ballonnet par voie artérielle ou coils par voie veineuse. L'abstention thérapeutique est parfois préférée pour les fistules à bas débit, qui peuvent se thromboser spontanément, contrairement aux fistules à haut débit qui peuvent mettre en jeu le pronostic vital et fonctionnel en l'absence de traitement. [ABSTRACT FROM AUTHOR]

Background: Orbital findings such as cellulitis, ophthalmoplegia, and proptosis are possible complications of sinusitis. Acute sinusitis can also cause a conjunctival cyst-like lesion induced by severe chemosis; however, it is an uncommon complication.Case Report: We report the case of a 53-year-old man who presented to our facility's emergency department. The patient complained of orbital discomfort resulting from an inability to close both eyes, and orbital discharge, accompanied by general weakness. On physical examination, cyst-like-appearing lesions with erythema of the eyelids were identified bilaterally and initially misdiagnosed as inflammatory lesions of the orbital area. However, orbital pathology was excluded by the ophthalmologist, and it was found that the patient had bilateral pansinusitis on the imaging studies. It was suspected that the sinusitis was responsible for the ocular symptoms. The patient was treated with emergent endoscopic sinus surgery, and the symptoms were promptly relieved. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although it is well known that orbital complications of sinusitis can occur, a conjunctival cyst-like-appearing lesion induced by severe chemosis is uncommon and is difficult to diagnose at first sight. Emergent surgical drainage is needed to prevent permanent orbital damage and other sinusitis-related complications. Therefore, recognizing the unique clinical presentation of a conjunctival cyst-like lesion resulting from severe chemosis is the key to appropriate diagnosis and management. [ABSTRACT FROM AUTHOR]

We describe here the first reported case of compartment syndrome complicating malaria. Compartment syndrome has previously been reported secondary to a number of infectious aetiologies including meningococcal septicaemia, dengue fever, and primary infection of muscles in affected compartments. Capillary leakage in sepsis and localised inflammation in myositis have previously been hypothesised as pathophysiological mechanisms. The patient's muscular physique, owing to his bodybuilding hobby, likely predisposed to compartment syndrome in this case. Whilst sequestration of parasitized red blood cells in skeletal muscle has been previously reported it is unclear whether this could have contributed to the development of this unusual complication.

This article describes care of the eye during a period of vulnerability in anaesthesia and intensive care. Risk factors, mechanisms of injury, recognition and management of common and important eye injuries will be covered as well as good practice points and preventative measures pertinent to all anaesthetists and critical care practitioners. [ABSTRACT FROM AUTHOR]

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This case reports the findings and management of a late preterm female infant born with congenital bilateral eyelid eversion with chemosis. The pathogenic process remains unknown but typically presents at birth, predominantly affecting the upper eyelid of both eyes. Black males, patients with trisomy 21, and collodion infants have a higher incidence of eyelid eversion. Treatment modalities range from conservative therapy including eye patching with antibiotic and lubricating ointment to invasive surgical eyelid suturing. In this case report, successful resolution of chemosis and eyelid inversion occurred with conservative management. [ABSTRACT FROM AUTHOR]

Objective: Evaluation of the medical data of patients with orbital and adnexal lymphoma.Design: Cohort study of all cases diagnosed with orbital or adnexal lymphoma at Meir Medical Center between 1993 and 2007.Participants: Twenty-six patients, with intraorbital or subconjunctival masses with orbital involvement, were examined and followed up between 1 and 8 years.Materials and methods: Examined data included: clinical presentation, age, gender, imaging, tumor location, surgical management, and pathological diagnosis.Results: Presenting signs and symptoms included proptosis, eyelid lesions, tearing, chemosis, decreased visual acuity, ptosis, pain, squint, and optic nerve compression. In five cases, lymphoma was misdiagnosed on neuroimaging. Bone changes were seen in four patients. All cases were B cell lymphomas; with the majority (22 cases) of small B cell type; consisting of primary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue and two cases of small cell lymphoma. One small cell lymphomas was of follicular type on a background of CLL, and the other was CLL/SLL type. Fourteen cases were primary orbital disease, and 12 cases were systemic disease. Macroscopic appearance of lymphoma at open biopsy was characteristic in most cases. Flow cytometry phenotyping gave rapid reliable diagnosis of the disease.Conclusions: Epiphora or chemosis in the presence of an orbital mass should alert the ophthalmologist to suspect lymphoma. Lymphoma may be easily misinterpreted on neuroimaging for other diseases. Bone changes seen on CT are more common than is generally perceived. Macroscopic appearance at open biopsy was characteristic. [ABSTRACT FROM AUTHOR]