bluuebunny/crossref_metadata_2025 huggingface dataset:
Ghost cell glaucoma secondary to vitreous hemorrhage caused due to ruptured retinal artery macroaneurysm
Authors: Gurung Girija , Sharma Anuj , Nayak Arpita
Published: August 2023

A 59 year old diabetic and hypertensive lady with primary open angle glaucoma and past history of non ischemic central retinal vein occlusion presented with vitreous hemorrhage(VH). The VH did not resolve over a 2 month period and led to a sudden rise in intraocular pressure(IOP). Anterior chamber had 2+ khaki colored cells. Gonioscopic examination revealed open angles and no evidence of neovascularization. The IOP was controlled with medical management and vitrectomy was performed for non-resolving VH, which revealed a ruptured retinal artery macroaneurysm (RAM). Our case report contributes to the understanding of the diverse clinical spectrum of RAM.
A rare case of Exophiala dermatitidis graft infection
Authors: Beniwal Abhijeet , Manumuraleekrishna  , Das Amit Kumar , Ahmed Nishat Hussain , Rathod Prachala , Tandon Radhika
Published: August 2023

We report Exophiala dermatitidis graft infection in a 49-year-old female patient post penetrating keratoplasty. Microscopically, the slide culture showed abundant single-celled, oval, light-brown yeast-like cells that were arranged in chains. Also, a few septate hyphae with annelids bearing ellipsoidal conidia along with terminal and intercalary phialides were seen. To the best of our knowledge, this is the first such reported case in India. The infection was recalcitrant, and ultimately, visual recovery was not successful.
A rare case of progressive subretinal fibrosis in a young child – A case report
Authors: Kumar Madhu , Sriram Simakurthy , Devasia Tudymol , Kanakamedala Ashok , Gudimetla Jayamadhury , Padma K Swathi
Published: August 2023

Progressive subretinal fibrosis and uveitis is a rare entity which usually affects young myopic females and causes significant visual loss. Though there is no proven therapy, it usually requires systemic immunosuppression. We report unique pseudopodial extension of subretinal fibrosis in a 9-year-old girl and document 3-year follow-up of the case.
Absorbed cataractous lens and management – A case series
Authors: Gaur Deepa , Thulasidas Mithun , Geetha G , Reddy Drushya
Published: August 2023

Absorption of a natural crystalline lens is very rare. It can be spontaneous or secondary due to ocular trauma or associated with multiple ocular and systemic conditions. In common perception, absorbed cataracts are considered difficult to manage surgically and are associated with poor surgical outcomes. Further, such cataract is rarely encountered in day-to-day clinical practice. Here, we report a case series of absorbed cataracts due to different etiologies managed surgically based on a thorough preoperative evaluation that led to good visual outcomes.
Atypical associations of retinitis pigmentosa: A case series
Authors: Lobo Simonne , Govindraj Indu , Rajendran Anand
Published: August 2023

Central visual acuity in retinitis pigmentosa (RP) can be compromised by posterior subcapsular cataract, cystoid macular edema, epiretinal membrane, and macular hole formation. However, features like posterior pole neovascularization, central serous chorioretinopathy (CSCR), and proliferative diabetic retinopathy (PDR) are rare in RP. We report three such cases of atypical associations of common retinal diseases in RP that were detected on multimodal imaging.
Bull’s eye pattern of aberrometry in anterior lenticonus
Authors: Hariyani Rishwa , Dharani Padam , Prasad Senthil , Nagu Kamatchi , Shekhar Madhu
Published: August 2023

We report an 18-year-old male patient with a progressive diminution of vision in both eyes. On examination, he had bilateral anterior lenticonus and sensorineural hearing loss. Slit–lamp examination finding of the anterior lenticonus was confirmed by wave front aberrometry on i-Trace. A diagnosis of Alport syndrome was made. Normal corneal topography and elevation maps with high total eye aberrations pointed to internal optics as the source of aberrations with predominant negative spherical aberrations. Uneventful phacoemulsification with intraocular lens implantation was performed. A significant reduction in total aberrations was noticed, and the patient’s visual disturbances were alleviated.
Bilateral optic disc edema as the presenting sign of brain metastasis
Authors: Das Abhishek , Shah Parag K , Narendran Venkatapathy
Published: August 2023

To report a rare case of bilateral optic disc edema as a presentation of brain metastasis. Case report. A 51-year-old healthy woman presented with complaints of headache, diplopia, and distortion of peripheral vision for the past one month. Examination of both the eyes showed massive optic disc edema, multiple radial hemorrhages, hard exudates at the disc margin, and absent venous pulsation. Magnetic resonance imaging (MRI and MRA) showed leptomeningeal enhancement with raised intracranial pressure: a sign of metastasis. She had undergone mastectomy and had received eight cycles of systemic chemotherapy and radiation for breast carcinoma two years ago. She was urgently referred to an oncologist for further management. This case highlights the importance of neuroimaging in patients presenting with bilateral disc edema and prior history of breast carcinoma to rule out metastasis.
Bleb excision with donor scleral patch graft and conjunctival advancement using fibrin glue for late hypotony and overfiltering bleb
Authors: Tara Shruthi , Sasidharan Ajita , Thulasidas Mithun
Published: August 2023

Late-onset bleb-related complications like ocular hypotony can lead to serious visual disabilities if not managed appropriately. The ideal treatment of overfiltering bleb has yet to be conclusively established. Here, we describe our successful technique of bleb reconstruction using donor patch scleral graft and conjunctival advancement with fibrin glue in a 90-year-old man who presented with late hypotony maculopathy and choroidal detachment secondary to the overfiltering bleb.
A rare case report of scleral necrosis in a patient with aplastic anemia
Authors: Das Suprava , Navyasree Chinthala , Panigrahi Pradeep Kumar
Published: August 2023

A 15-year-old male presented with swelling and redness in the right eye of 1-month duration. The patient was a known case of aplastic anemia. Clinical examination revealed bilateral retinal hemorrhages and scleral necrosis in the right eye. The patient was treated with topical fortified Vancomycin and lubricating eye drops and received blood transfusion. There was an improvement in ocular condition following the initiation of therapy. Scleral necrosis is a rare but potentially blinding complication in patients with aplastic anemia. Ophthalmologists should be aware of this complication and follow-up such patients closely.
A rare case of orbital and diffuse conjunctival venous malformation
Authors: Pal Sandeep Patiram , Patidar Narendra , Gabba Harshdeep Singh , Gaikwad Himanshu , Nikhade Saurabh , Agrawal Poonam Arora
Published: August 2023

Cavernous hemangiomas (CH) are slow-flow venous malformations (VMs), not true vascular tumors. Although these are the most common benign orbital tumors in adults, conjunctival VMs are a rarity and account for less than 1% of all conjunctival tumors. We herein report a case of a 25-year-old male patient who presented with a large violaceous mass involving the inferior bulbar conjunctiva that had been present for 10 years. It was painless, progressive, and gradually increased in size over 10 years, and was associated with occasional bleeding. Any syndromic association was ruled out. Contrast-enhanced magnetic resonance imaging (CEMRI) revealed the presence of slow-flow vascular malformations involving the right superior and inferior eyelids with intraconal and extraconal involvement. An incision biopsy and histopathology (H/P) confirmed the diagnosis of formerly-called cavernous hemangioma (slow-flow VMs). The conjunctival mass was further managed by surgical debulking with ocular surface reconstruction, whereas the intraorbital part was kept under observation owing to its small size. The postoperative period was uneventful.
Glomus jugulare tumor presenting as papilledema – A rare case report
Authors: P Jayasri , Kasturi Nirupama , Khan Farnaz A , Stephen A Mary
Published: August 2023

A 54-year-old male presented with headache and blurring of vision in both eyes for 2 months. Ocular examination showed bilateral lateral rectus palsy with papilledema, suggestive of raised intra-cranial pressure. A computed tomography scan of the brain revealed an expansile infiltrating soft tissue lesion causing lysis of the right petrous and jugular fossa, suggestive of a Jugular fossa tumor. The patient’s blood pressure was high at all times despite regular medications because of the glomus tumor’s supposed release of catecholamines. Elective surgery was planned; however, the patient developed a fatal tumor rupture within 4 months of diagnosis, for which emergency neurosurgical intervention and intensive care support were given, but he succumbed to death. Tumors obstructing the jugular outflow can cause increased intra-cranial pressure and vision loss, requiring prompt neurosurgical intervention.
A case of postoperative Sphingomonas paucimobilis endophthalmitis after parsplana vitrectomy
Authors: Lodhi Sikander , Swathi C M , Kavya Teegala , Soujanya P S S
Published: August 2023

We report a case of acute onset of postoperative endophthalmitis following pars plana vitrectomy, in a healthy middle-aged male person, caused by Sphingomonas paucimobilis, a gram-negative bacillus widely distributed in the environment and reported to cause opportunistic infection in immunocompromised. The case showed complete resolution on vitrectomy and intravitreal antibiotics. The bacillus was multi-drug resistant, showing resistance to all known commonly used antibiotics except intermediate sensitivity to meropenem. There have been two reported cases of postoperative endophthalmitis caused by Sphingomonas paucimobilis following cataract surgery, but this is the first reported case following pars plana vitrectomy.
Orbital tuberculosis
Authors: Gaude Prajyoti , Potdar Nayana
Published: August 2023

Tuberculosis is a multisystem infectious disease caused by Mycobacterium tuberculosis and a leading infectious cause of morbidity and mortality worldwide. Orbital tuberculosis is an uncommon form of extrapulmonary tuberculosis, even in endemic areas. It may involve the soft tissue, lacrimal gland, periosteum, or bones of the orbital wall and can extend to adjacent paranasal sinuses or intracranial cavities. The delay in diagnosis can be due to the fact that the clinical signs simulate any inflammatory disease. The diagnosis is usually based on tissue examination in histopathological evidence, presenting as a granulomatous lesion or the presence of acid-fast bacilli (AFB). Long-term anti-tuberculosis therapy is an effective treatment. Here, we present the case of orbital tuberculosis in a 7-year-old female child who had presented with swelling over the left upper eyelid.
Vertical rotation of phakic intraocular lens to achieve optimal vaulting in a myopic eye
Authors: Khandelwal Surabhi , Shah Neeraj , Singh Devika
Published: August 2023

Optimal implantable collamer lens (ICL) sizing and normal postoperative ICL vault are important to avoid adverse events. Spherical phakic intraocular lens (PIOL) implantation was done for a case of both eye myopia. Both eyes had similar ocular biometry, hence the same size PIOL was ordered. The right eye had postoperatively, a high posterior vault of 2000 μ on POD1, which reduced to 1000 μ on POD2. Re-evaluation confirmed similar ocular and PIOL parameters in both eyes. The PIOL was rotated 90° to a vertical rotation after which a reduction in the vault from 1000 to 700 μ was achieved. Satisfactory refractive outcome and optimal vault were maintained during subsequent visits. The left eye course was uneventful.
Excision of massive orbital schwannoma through anterior orbital approach
Authors: Sharma Ramlal , Sharma Kalpana , Parmar Deepti , Tanwar Vineet , Thakur Suresh , Asotra Sarita
Published: August 2023

Orbital schwannomas are rare, benign, slowly progressing, encapsulated tumors arising from Schwann cells of the peripheral sheath of the third, fourth, and sixth cranial nerves and ciliary ganglion. The present case is of a 32-year-old male with painless protrusion of left eye for 4 years. It was radiologically diagnosed as retro-orbital hemangioma, but histopathologic examination of the orbital tumor showed orbital schwannoma. The rarity of orbital schwannomas among orbital tumors and improvement in vision along with retained eyelid functions despite excision of a massive tumor make this a unique case.
Diagnostic challenges in herpetic anterior uveitis: A case report
Authors: Khan Lubna , Kashyap Himanshu , Mantur Mahantesh A.
Published: August 2023

A 32-year-old male was clinically diagnosed as having acute anterior uveitis with secondary glaucoma. He was continued on previously prescribed steroid and antiglaucoma medications topically. Past history of trauma in same eye and vesicular eruptions near lips was positive. Aqueous sample was sent for real time PCR for herpes simplex due to strong clinical suspicion. It tested positive for HSV. Complete resolution occurred in 3 weeks with oral Valacyclovir 500 mg TDS and topical Gancyclovir 0.15% TDS for 2 weeks followed by once a day for next 2 weeks. Acyclovir 400 mg bi-daily was continued for one year orally to prevent recurrence.
Basosquamous carcinoma of conjunctiva masquerading as nevus
Authors: Gupta Pankaj , Singh Manpreet , Saini Manu , Nahar Uma , Mehta Aditi , Kumari Urmila
Published: August 2023

Primary conjunctival basosquamous carcinoma is an extremely rare tumor. To our knowledge, the present article presents the first case of primary conjunctival basosquamous carcinoma presenting in the second decade of life. The presentation was also unique by virtue of masquerading as conjunctival nevus. An 11-year-old male patient presented with a gradually progressive pigmented lesion in the bulbar conjunctiva of the right eye that was present for the past 5 years. The patient was diagnosed with conjunctival nevus clinically and was operated on for the same. Histopathological examination of excised mass confirmed basosquamous carcinoma. We conclude that primary conjunctival basosquamous carcinoma may present clinically as a nevus in a child.
Case report on epibulbar conjunctival schwannoma: A rare occurrence
Authors: Ganguly Purban , Poddar Saugata , Ghosh Shreoshee
Published: August 2023

Schwannomas involving the epibulbar conjunctiva are extremely rare and have been scantily reported in literature. In our case, a 35-year-old healthy man presented with a pinkish, highly vascular, and globular mass involving the conjunctiva in the nasal quadrant of the right eye. The mass was completely excised, and histopathology of said mass revealed an encapsulated tumor, with its cells displaying elongated nuclei and few Verocay bodies with palisaded nuclei, all of which were suggestive of schwannoma. This case thus highlights schwannoma as a differential diagnosis of conjunctival masses.
Systemic steroid-induced ocular hypertension in a 7-year-old child with nephrotic syndrome and its management with netarsudil 0.02% eye drop
Authors: Roy Swarup K , Batra Sneha
Published: August 2023

Prolonged use of corticosteroids may lead to increase in intraocular pressure (IOP), termed as steroid-induced ocular hypertension (SIOH). We report a case of a 7-year-old child with nephrotic syndrome and SIOH, uncontrolled with latanoprost 0.05%. Netarsudil 0.02%, a Rho kinase (ROCK) inhibitor, controlled IOP despite continuing steroid treatment and was tolerated well. Review of literature revealed ROCK inhibitors may be efficacious antiglaucoma medicines for SIOH owing to their direct action on corticosteroid-affected conventional aqueous outflow pathway. To the best of our knowledge, this is the first case report documenting the role of ROCK inhibitors in the management of pediatric SIOH.
Sarcoidosis of ocular adenexa
Authors: Agrawal Ashish
Published: August 2023

Sarcoidosis is a chronic inflammatory disease of unknown etiology. Any part of the body may be involved, including eye and/or its adnexal tissues. Uveitis and optic neuropathy are the main manifestations. Patients need immuno-suppression to maintain remission. Patients associated with exclusive extra-ocular involvement (lacrimal glands in our case) need a high degree of suspicion and a multi-disciplinary approach for proper management.
A rare case of lateral wall blow-in fracture of the orbit
Authors: Nayak Swatishree , Misra Somen , Raghani Manish J , Misra Neeta
Published: August 2023

Orbital blow-in fractures encompass a distinctive clinical entity that is characterized by displacement of fracture fragments into the orbital cavity with a consequent diminution in orbital volume. We report a case of a 30-year-old male who presented with outward protrusion of the left eye ball following trauma by bike handle. While fracture of the orbital roof has been documented as a common cause of blow-in fracture, in our case, a fracture of the lateral wall and floor of the orbit led to blow-in fracture. Repositioning of luxated globe was done even in the absence of visual prognosis in view of psychological benefit and prosthetic rehabilitation.
A case of globe explosion after peribulbar anesthetic injection
Authors: Wani Vivek B , Pai Sharvani G , Bubanale Shivanand , Patel Suchi M , Tenagi Arvind
Published: August 2023

The ocular explosion is a very rare but serious complication of peribulbar anesthetic injection with only a few reports in the literature. A 360 Degrees dialysis of the retina due to a globe explosion after the peribulbar injection has been reported only in one case. We are reporting the complication of 360 d dialysis of the retina with the incarceration of the detached retina in the scleral wound after periocular injection of anesthetic for cataract surgery. Management and results of the case are reported here.
Improvement in visual acuity and retinal phenotype with intravitreal aflibercept (anti-VEGF) in POEMS syndrome with Castleman disease variant
Authors: Kamath Archith , Dhalla Amit , Acharya Nachiketa
Published: August 2023

A woman in her thirties with no ophthalmic history presented two days of flashes and floaters. She had reduced right-eye visual acuity, bilateral retinal hemorrhages, and papilledema. She was diagnosed with polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin changes (POEMS) syndrome with Castleman disease variant, with elevated systemic levels of vascular endothelial growth factor (VEGF). Three doses of aflibercept (VEGF blocker) were administered to the right eye. The right eye improved from 6/60 to 6/5 after treatment. We suggest that intravitreal VEGF blockade should be considered to preserve vision in patients with POEMS syndrome and high circulating VEGF.
Bilateral orbital floor fracture in a professional cliff diver
Authors: Landini Luca , Alessio Giovanni , Micelli Ferrari Luisa , Zaccaro Filomena , Procoli Ugo
Published: August 2023

Herein, we report a case of a bilateral orbital floor fracture in a professional cliff diver, with no involvement of the inferior recti, and therefore treated conservatively.
Case report of rare sight-threatening complication of dengue hemorrhagic fever: A case report
Authors: Bhomaj Pooja , Patel Nidhi
Published: August 2023

Dengue hemorrhagic fever can present with sight-threatening complications, endemic in Asian countries. We report a case of a young patient who presented with unilateral hyphema having dengue hemorrhagic fever. The patient presented to us with hyphema & raised IOP during the thrombocytopenic state, resulting in corneal blood staining. After the platelet counts came to normal, the hyphema wash was done. The eye eventually ended in phthisis bulbi. The dengue-related ophthalmic complication is lesser known & needs for creating awareness among the treating ophthalmologists & physicians regarding the sight-threatening complications of dengue fever, for early referral & prompt management.
Vision-threatening ocular injury secondary to calcium carbide gun use in Indian children and young adults: A case series
Authors: Sabde Yogesh D , Trushna Tanwi , Bhartiya Prashant , Tiwari Rajnarayan R
Published: August 2023

Ocular injury, a significant risk factor for acquired visual impairment, is common among children and young adults during Indian festivals. However, calcium carbide gun-induced ocular injuries have rarely been reported. The current manuscript describes the clinical profile and sociodemographic information of five young male patients from central India who were injured while using cheap carbide guns with no safety features bought from local vendors/made at home using online information. All patients had monocular injuries (eyelid edema, conjunctival congestion, corneal opacification, and limbal ischemia) with vision loss ranging from 6/36 to no light perception. Improper handling, easy availability, low cost, and lack of awareness of risks contributed to the incident. Therefore, it is recommended that public awareness be generated, and restrictions are imposed on the widespread unlicensed sale of carbide guns and raw materials.
Secondary add-on IOL implantation for pseudophakic residual ametropia in high myopes – A case series
Authors: Mitra Sudipta , Pattanayak Sabyasachi
Published: August 2023

High Myopic cataract patients receiving low-powered or negative powered intraocular lenses (IOLs) after phacoemulsification, often have residual hyperopic refractive errors and remain dissatisfied. Implantation of add-on IOL is one of the easy options to address this issue. We present three such cases of refractive surprise following cataract surgery in highly myopic eyes, who, after implantation of monofocal hydrophilic acrylic sulcus fixated add-on IOL in the presence of the primary IOL in the bag, had 6/9 unaided vision without any perioperative complications. Secondary sulcus fixated add-on IOL implantation is a safe and effective procedure to correct refractive surprise following phacoemulsification cataract surgery in high myopes.
Sequential restoration of external limiting membrane and ellipsoid zone on SD-OCT after macular hole surgery
Authors: Singh Samya , Sharma Priyanka , Saxena Sandeep
Published: August 2023

Sequential restoration of the external limiting membrane (ELM) and ellipsoid zone (EZ) after macular hole (MH) surgery, over a period of 12 weeks, is reported for the first time. This case highlights the patho-anatomical process of restoration of ELM and EZ after successful macular hole surgery (MHS).
Eight-and-a-half syndrome – A rare presentation of pontine infarction
Authors: Lavanya SR , Abbigeri Manjunath , Turadagi Kishorkumar
Published: August 2023

Eight-and-a-half syndrome is clinically characterized by conjugate gaze palsy and internuclear ophthalmoplegia along with lower motor neuron type facial nerve palsy. Usually, it occurs because of infarction or demyelinating disease at paramedian tegmentum of lower pons. It emphasizes the importance of checking ocular movements. A 55-year-old male patient presented with sudden onset of double vision, headache, and vomiting and found to have horizontal gaze palsy, internuclear ophthalmoplegia, and facial palsy of the left side. High blood pressure was noted. Clinically, eight and a half syndrome was identified. MRI brain showed infarct at pons. The patient was stabilized systemically. A detailed clinical neuro-ophthalmic examination, along with a clear understanding of the neuro-anatomical pathways, gives clinicians a good diagnostic opportunity to localize precisely lesions in the brainstem. The disease should be evaluated for etiology.
Long-term outcome of limbal-sparing lamellar keratoplasty in keratoglobus: A retrospective case series
Authors: Narayanan Niveditha , Bandodkar Nivisha
Published: August 2023

We report six eyes of five patients with keratoglobus who underwent limbal-sparing lamellar keratoplasty (LSLK) with 7 years of follow-up. In two patients’ three eyes, it was congenital and the rest had acquired keratoglobus from pellucid marginal degeneration combined with keratoconus. In LSLK, the peripheral corneal epithelium is dissected to include the stem cells and reflected along with conjunctival peritomy. The host cornea is de-epithelialized, stromal irregularities dissected, and then a corneoscleral graft denuded of Descemet’s membrane is anchored to a scleral ledge fashioned. Postoperatively, all received adequate tectonic support, and except for one posttrauma eye, the rest improved visually.
It never happens, until it happens
Authors: Garcia-Teillard Damian , Tudela Antonio T , Estudillo J. Manuel Marquez , Navarrete Pedro B , Luque Tatiana
Published: August 2023

An 86-year-old female patient was treated at home after having suffered a syncopal episode preceded by intermittent dyspnea in the previous weeks. Upon admission, the electrocardiogram showed Mobitz 2 second-degree AV (atrioventricular) block. Our patient suffered from systemic hypertension and chronic open-angle glaucoma, treated, respectively, with losartan 100 mg/hydrochlorthiazise 25 mg every 24 h and timolol 0.5% two times a day (introduced three weeks before after being assessed by ophthalmology service at another hospital center). Dyspnea and electrocardiographic blockage signs stopped once ocular beta blockers (timolol) were discontinued. Ocular topical administration is usually the preferred route for drug supply in ophthalmology and especially in glaucoma treatment, but it is not devoid of interactions and adverse effects. The following clinical case describes how the use of topical beta blockers for the treatment of glaucoma may be at the origin of systemic beta-blockade in our patient, a not so common, yet described situation.
Ocular findings in Schimmelpenning–Feuerstein–Mims syndrome
Authors: Mohan Sashwanthi , Bhambhani Varsha , Srinivasan Bhaskar , Ratra Dhanashree
Published: August 2023

Schimmelpenning–Feuerstein–Mims syndrome (SFM), also known as organoid nevus syndrome or linear nevus sebaceous of Jadassohn, is a rare congenital phacomatosis. It includes cutaneous sebaceous nevus along with skeletal, neurological, cardiovascular, and ocular abnormalities. We report a case of a 14-year-old boy with this rare SFM syndrome. We highlight the various ocular features observed in this patient such as epibulbar choristoma, symblepharon, and choroidal osteoma along with the systemic features and discuss the management of each.
Atypical best disease or AOVMD? A three-generation diagnostic dilemma
Authors: Kochar Shruti , Lahane Sumeet , Israni Neeraj , Thomas Rwituja
Published: August 2023

Vitelliform macular dystrophy is an inherited condition with a gradual decrease in visual function. Differentiation between the various types may be cumbersome when the age of onset, clinical findings, and inheritance are studied. Best disease can present in childhood with progressive and characteristic changes in the macula. Adult-onset vitelliform macular dystrophy (AOVMD) occurs after the second decade with a variation in the clinical and investigational findings. We report a case of vitelliform macular dystrophy with features suggestive of Best disease as well as AOVMD.
Fishhook injury to the eyelid – A pediatric case report
Authors: Palanivel Savithiri , Selvaraj Prema
Published: August 2023

Fishing is a good recreational activity as well as an important source of daily income for people around the world. Although it is enjoyable and pleasant, if safety precautions are not undertaken, it can be one of the potential causes for ocular trauma. We report a case of fishhook injury to the eyelid in a pediatric age group. To the best of our knowledge, only handful of cases are published in the literature till date. This case report aims at increasing awareness of young ophthalmologists and all it’s readers about this uncommon presentation and its various methods of management.
One donor cornea for three corneal transplants, including a novel surgical technique of combined tight suturing to reduce and crescentic lamellar grafting to strengthen Terrien’s marginal degeneration
Authors: Narayanan Niveditha , Bandodkar Nivisha
Published: August 2023

We successfully utilized one donor cornea for three patients: firstly, a crescentic lamellar keratoplasty for Terrien’s marginal degeneration; secondly, Descemet’s membrane endothelial keratoplasty for Fuchs endothelial dystrophy; and finally, deep anterior lamellar keratoplasty for an advanced keratoconus patient. All three grafts were prepared during the first surgery, and the other two grafts were preserved and used on another day. Patients were followed up for 1 year, and all have good visual outcomes with stable grafts. Our first patient underwent a novel combined surgery of tight sutures for ectasia reduction that is usually performed at an earlier stage, with tissue augmentation using a lamellar graft meant for the later stage of the disease. With a successful outcome of up to 1-year follow-up, this technique can be considered in other suitable peripheral ectasias in the future. By sharing our experience, we hope that corneal surgeons and their patients at large will benefit.
Ocular and systemic features of Rubinstein–Taybi syndrome in a 12-year-old female
Authors: Shah Dhaivat S , Singhal Achal , Barvey Ananta , Passi Gouri R
Published: August 2023

Rubinstein–Taybi syndrome (RTS) is an extremely rare congenital neurodevelopmental disorder caused by mutation in the CREBBP and EP300 genes. It is characterized by wide and angulated thumbs and toes, facial dysmorphism, intellectual disabilities, ocular abnormalities, and postnatal growth retardation. Ocular features of the syndrome are diverse, including nasolacrimal obstructions, downslanting palpebral fissures, telecanthus, high-arched eyebrows, strabismus, glaucoma, cataract, and refractive errors. This case report discusses the ocular findings in a 12-year-old patient with the disease.
Modified island pedicle advancement cheek flap for optimal reconstruction of cutaneous defects after excisional biopsy of basal cell carcinoma right lower eyelid
Authors: Baruah Pankaj , Bhuyan Jyoti , Boro Manjit
Published: August 2023

A 64-year male came for treatment of a lesion on his eyelid. Approximately 10 years earlier, he had developed a small blackish mass on his right lower eyelid, which was gradually increasing in size along the infra-orbital crease. It is associated with blackish discharge. Laboratory tests were normal; medical history and family history were unremarkable. Incisional biopsy shows strings of stratified squamous epithelium, proliferative basal cells, and scattered melanin pigmentation. The tumor was completely excised, and the defect is reconstructed with modified island pedicle advancement cheek flap and sent for HPE examination. It is a powerful technique for reconstruction with minimal complication.
Using a commercial fibrin sealant (TISSEEL) as an adjuvant for full-thickness macular hole closure surgery: A case series
Authors: Margalit Eyal , Bahir Daniel , Jabaly-Habib Haneen
Published: August 2023

A retrospective interventional case series was performed to evaluate the anatomical and visual outcomes of macular hole surgery aided with TISEEL commercial fibrin sealant. Seven eyes of seven patients were included: three with a recurrent macular hole, one with a traumatic macular hole, and three with primary macular holes. All eyes underwent vitrectomy, internal limiting membrane peeling, fluid air exchange, instillation of 1–2 drops of the commercial fibrin sealant on the hole, and C3F8 gas injection. The macular hole was closed in all seven patients; they showed significant improvement in visual acuity and no ocular or systemic complications.
Can we always rely on Borish delayed test for latent hypermetropia?
Authors: Dalal Devanshi M , Mishra Shivani
Published: August 2023

The term hyperopia refers to a refractive condition of the eye where parallel light rays from infinity focus behind the neurosensory retina, after refraction through the ocular media when accommodation is at rest. Latent hyperopia remains hidden in non-cycloplegic conditions, but patients with latent hyperopia often complain about headache, eyestrain, and watering, especially in young children with high accommodation. The prevalence of refractive errors suggests that these symptoms generally occur more frequently with near work, leading patients to avoid such tasks and become lethargic. In case of isometropia, the Borish delayed fogging test can be used as an alternative to cycloplegic refraction, particularly when cycloplegic drops are contraindicated.
Vesicular contact dermatitis following sulfacetamide eye drop instillation raising the specter of vesiculobullous mucocutaneous syndrome – Case presentation
Authors: Pandey Nidhi , Singh Swati , Saha Debarati
Published: August 2023

Allergic reactions to ocular drops are a well-known side effect and usually present as eczematous dermatitis localized to periocular skin. However, rarely, the reactions can be severe and present with systemic involvement leading to vision or even life-threatening consequences. We report a case of vesicular allergic contact dermatitis following instillation of an over-the-counter sulfacetamide eye drop in right eye with involvement of oral mucosa, raising a threat of mucocutaneous vesiculobullous disorders. Prompt discontinuation of ocular drops followed by treatment with systemic and topical steroids, topical lubrication, and fornix glass rod sweeping prevented vision- and life-threatening sequalae.
Foveal neovascularization in proliferative diabetic retinopathy: Characterization with OCTA
Authors: Borgohain Ashapurna , Gopalakrishnan Mahesh , Giridhar Anantharaman
Published: August 2023

Foveal neovascularization (FNV) is a rare clinical finding in conditions with vascular compromise, leading to ischemia of the retina. We present a case of proliferative diabetic retinopathy (PDR) with FNV, where optical coherence tomography angiography (OCTA) confirmed the architecture, extent, activity, and origin of a hemorrhage-like clump at the fovea. Digital Florescein Angiography (DFA) showed PDR (both eyes), but intra-retina microvascular abnormalities (IrMAs) or FNV could not be differentiated at the site of leak in right eye fovea. OCTA confirmed a FNV breaching the internal limiting membrane (ILM), protruding into vitreous, and determined its origin from superficial vascular plexus (SVC). Also, segmentation revealed flow voids in choriocapillaris slab, suggesting choroidal ischemia.
Cosmetic and visual outcomes following high-voltage severe electric facial and ocular burns: A case report
Authors: Ramnani Sakshi , Rathore Sunil , Ramnani Vinita , Raichandani Divya
Published: August 2023

A 19-year-old male presented with accidental high-voltage electric burns following contact with a transformer while catching ball and developed right eye count finger vision and no perception of light in left eye. On examination, there were full thickness burns on upper half of left side of face, lids, and left leg involving 3rd, 4th, and 5th toes. Three surgeries were performed by the plastic surgeon for overall aesthetic look. The right eye regained vision following cataract surgery, but there was cosmetic and functional loss of left eye. This case report highlights that high-voltage electric burns of face and eye require proper surgical management and final visual outcome depends on amount of damage.15
Bullet in the orbital apex: Explosive situation!
Authors: Likhari Kamalpreet
Published: August 2023

A healthy thirty-seven-year-old male presented with a gunshot injury to the eye. The bullet was lodged in the orbital apex and had caused rupture of the left globe and extensive damage to the orbital soft tissues including the optic nerve, as well as the bones at the apex. This large metallic foreign body needed to be removed as it was causing continuous bleeding and cellulitis; also, its location was precarious. The surgery for tracking and removal of the bullet presented several interesting pointers which are described in this case report.
A rare association of blepharophimosis–ptosis–epicanthus inversus syndrome with unilateral posterior persistent fetal vasculature
Authors: Rizvi Syed W A , Khan Iraj A , Qaseem Syed M D , Rizvi Syed A R , Siddiqui Mohammed A , Ahuja Pragya
Published: August 2023

Blepharophimosis–ptosis–epicanthus inversus syndrome (BPES) is a rare genetic syndrome characterized by dysmorphism of ocular adnexa. We report a rare presentation of BPES and posterior persistent fetal vasculature (PFV) in a 10-year-old male child. A thorough evaluation showed all the classical features of BPES, calcified cataract in the left eye, and an echogenic mass arising from the optic disc with blood flow characteristic consistent with PFV. The coexistence of BPES and posterior PFV has never been reported in the literature before, and their co-occurrence poses a unique surgical challenge.
Reversal of hypotony maculopathy by transconjunctival flap suturing: A case report
Authors: Maheshwari Devendra , Pillai Madhavi Ramanatha , Aarthy R , Gupta Shivam , Nagdev Nimrita
Published: August 2023

Purpose:

To report a case of reversal of hypotony maculopathy after phacotrabeculectomy by transconjunctival flap suturing and anterior chamber reformation.

Methods:

A 61-year-old male with primary open angle glaucoma on maximal medical treatment underwent uneventful phacotrabeculectomy. The patient developed 360 degrees choroidal detachment and hypotony maculopathy following suturolysis at one month. Considering persistent choroidal detachment even after failure of conservative management, the patient underwent anterior chamber reformation and transconjunctival flap suturing. Postoperatively, visual acuity improved and anterior chamber was well formed with complete resolution of choroidal detachment.

Conclusion:

Adequate and timely surgical intervention can salvage vision with good outcomes in postoperative hypotony following trabeculectomy.
Late presentation of combined hamartoma of retina and retinal pigment epithelium with a boxing glove pattern: A case report
Authors: Tilak Ishan , Sharma Karen , Thanikachalam S
Published: August 2023

Combined hamartoma of retina and retinal pigment epithelium (CHRRPE) is a rare intraocular tumor of the posterior pole associated with multiple genetic syndromes. We report a late-presenting unilateral CHRRPE in a 58-year-old male with complains of gradual, painless, and progressive diminution of vision. Optical coherence tomography showed altered retinal architecture in the involved area. Furthermore, evaluation revealed vascular telangiectasia with abnormal ocular fluorescence on fundus fluorescein angiography. CHRRPE may lead to formation of epiretinal membranes, holes, and neovascular membranes in the retina. Therefore, early diagnosis and prompt management is essential. Through this case, we would like to emphasize the need of understanding the pathogenesis of CHRRPE and whether these isolated ocular lesions can be a diagnostic sign of associated genetic syndromes.
Human chorionic gonadotropin causing recurrent bilateral central serous chorioretinopathy
Authors: Sinha Ayushi , Oduru Revana Reddy , Singh Shivangi , Dodla Manaswini
Published: August 2023

The purpose is to describe an undocumented cause of recurrent bilateral central serous chorioretinopathy (CSCR). A middle-aged male presented with complaints of gradual diminution of vision in both eyes. Clinical examination and optical coherence tomography (OCT) revealed bilateral CSCR. He had similar visual disturbances in both eyes a year ago. Fundus fluorescein angiography (FFA) was done to locate the CSCR leaks. On repeated questioning patient gave the history of receiving human chorionic gonadotropin (hCG) injections for infertility.
Optical coherence tomography features of lightning-induced macular injury
Authors: Prabhakaran Parvathy , Sagar Pradeep , Biswal Suchitra , Divya Pagidimarri , Sahare Harshal
Published: August 2023

A 15-year-old boy with history of lightning exposure presented with sudden onset diminution of vision in left eye. The best-corrected visual acuity (BCVA) was 6/6 in right eye and 6/18 in left eye. Anterior segment examination was normal. A yellow dot was seen at the fovea in the left eye. Optical coherence tomography (OCT) showed a vertical hyperreflective band at fovea in right eye and low-reflective dome-shaped elevation, horizontal hyperreflective band, and disruption of ellipsoid zone (EZ) in left eye. Patient developed an episode of acute anterior uveitis in the left eye during the follow-up. At 6-month follow-up visit, BCVA in the right eye was 6/6 and in left eye was 6/36. Left eye developed grade 2 posterior subcapsular cataract during the follow-up. Extensive EZ loss and hyporeflective spaces were noted on OCT in the left eye.
Asymmetric sickle cell retinopathy in a patient with sickle cell hemoglobin D disease: A case report
Authors: Gangwe Anil B , Singh Abhishek , Parchand Swapnil M , Agrawal Deepshikha , Ekumankama Chibuzo B , Azad Raj Vardhan
Published: August 2023

Sickle cell disease (SCD), the most commonly inherited hemoglobinopathy, can result in vision loss due to sickle cell retinopathy (SCR), vascular occlusions, and retinal atrophy. SCR is more common in heterozygous (HbSc) than homozygous (HbSS) patients. HbD (Punjab) is a less commonly reported form of hemoglobin in SCD, seen in northwestern states of India. Patients with sickle cell hemoglobin D disease (HbSD) can clinically behave like HbSS. We report a case of asymmetric SCR and multiple branch retinal artery occlusions in a patient with sickle cell hemoglobin D disease in central India.
PARALEL İŞLEMCİLİ ESNEK AKIŞ ATÖLYESİ ÇİZELGELEME PROBLEMLERİ İÇİN STOKASTİK ÇÖZÜM YAKLAŞIMI
Authors: ERTEM Mehmet , SAGİR OZDEMİR Mujgan
Published: August 2023

Bu çalışmada sıra bağımlı hazırlık zamanlı k kademeli esnek akış atölyesi çizelgeleme problemi için önceden geliştirilmiş bir matematiksel model revize edilerek, sıra bağımlı hazırlık sürelerinin stokastik olma durumu incelenmiştir. Çalışmada bu anlamda üç matematiksel modele yer verilmektedir. M1 modeli söz konusu problem için daha önce geliştirilen matematiksel modeldir. M2 modeli, M1 modeline göre daha büyük problemleri, daha hızlı çözebilecek revize modeldir. M3 modeli ise M2’nin stokastik parametreleri dikkate alan halidir. Test problemlerinin çözülmesi sonucunda; M2 modelinin, çözebildiği problem boyutu ve çözüm süresi bakımından M1’e göre üstünlüğü, M3 modelinin ise stokastik parametreleri ele alarak tamamlanma zamanı bakımından daha iyi sonuçlar verdiği gösterilmiştir.
COVID-19 VE PERAKENDE SEKTÖRÜNDE DEĞİŞEN ALIŞVERİŞ ALIŞKANLIKLARI
Authors: GÜNDEŞ Eda Helin , ÜLENGİN Füsun , ÜLENGİN Burç , ZEYBEK Ömer
Published: August 2023

2020 yılının başında, COVID-19 olarak bilinen pandeminin yaygınlaşmasıyla birlikte, günlük yaşam ve iş dünyası köklü bir değişimden geçmek zorunda kalmıştır. Bu bağlamda, birçok kişi, uygulanan kısıtlamaları karşılamak için günlük satın alma araçlarını değiştirmiş ve yerel işletmeler, hastalığın hızlı yayılmasının getirdiği olumsuz etkilere uyum sağlamak için operasyonlarını ayarlamıştır. Perakende sektörü, tüketicilerin stokçuluk ve panik satın alma davranışlarına uyum sağlamak gereksinimi duymuştur. Bu çalışmada, COVID-19 pandemi döneminde çeşitli ürün grupları için satın alma tutumlarının etkisi ve çevrimiçi ve fiziksel pazarlardaki satışlar arasındaki farklar incelenmiştir. İlk adım olarak, pandemi sırasında benzer alışveriş davranışlarından hangi ürün gruplarının etkilendiğini belirleyen bir küme analizi yapılmıştır. İkinci aşamada, her bir küme için, Ardışık(Stepwise), Lasso ve En İyi Alt Küme(Best Subset) regresyon tahmin modelleri kullanılarak, COVID-19 vaka sayısının satış seviyeleri üzerindeki etkisi incelenmiş ve tüm modeller hem fiziksel hem de çevrimiçi pazar veri setlerine uygulanmıştır. Sonuçlar, pandemi sırasında fiziksel pazarlardan çevrimiçi pazarlara önemli bir geçiş olduğunu göstermiştir. Elde edilen bulguların, perakende sektörü yöneticilerine yeni dünyaya uyum sağlama yolunda önemli bir yol gösterici olması beklenmektedir.
BİSİKLET PAYLAŞIM SİSTEMLERİNDE KENETLENME İSTASYONU YER SEÇİMİ İÇİN BİR ÇKKV MODELİ
Authors: VİŞNE İzel , ÖZAYDIN Özay , TOPÇU İlker
Published: August 2023

Bisikletler, sağlık, ekonomik, çevresel olumlu etkileri nedeniyle birçok ülkede ulaşım aracı olarak da kullanılmaktadırlar. Ayrıca, paylaşım ekonomisinin başlıca örnekleri arasında bisiklet paylaşım sistemleri gelmektedir. Bu sistemler farklı istasyonlarda bulunan bisikletleri, kullanıcıların istedikleri sürelerde kullanılabilmesine izin verirken; trafik ve hava kirliliğinin azaltılmasını, bisiklet sahibi olmayanların uygun ve hesaplı bir ulaşım aracına erişmelerini sağlar.
Faydalarının yanı sıra, bisiklet paylaşım sistemleri çeşitli zorluklarla da karşılaşmaktadır. Kenetlenme istasyonlarının doğru konumlandırılmaması bazı istasyonlarda bisiklet eksikliğine, bazı istasyonlarda ise boş kenetleme ünitesi eksikliğine neden olmaktadır. Bu durum sistemin bütününün verimliliğine olumsuz etki etmektedir.
Bu çalışmada, Coğrafi Bilgi Sistemleri (CBS) ve çok kriterli karar verme yöntemlerini bütünleşik olarak kullanıp, sisteme eklenecek yeni istasyonların konumlarını belirleyen bir model önerilmektedir. Bu modelde öncelikle olurlu bölgeler CBS uygulaması desteği ile belirlenmiştir. CBS girdileri, İBB’den temin edilen verilerin yanı sıra açık kaynak veri bankalarından derlenmiştir. Olurlu bölgelerin belirlenmesinde Analitik Hiyerarşi Süreci kullanılarak kriterler ağırlıklandırılmış, belirlenen bu ağırlıklar ile ısı haritaları oluşturulmuştur. Kriter ağırlıklandırılmasında ve olurlu bölgedeki alternatifler arasından en iyiyi belirlemede paydaşların oluşturduğu bir karar verici grubuna başvurulmuştur.
Önerilen bu melez yöntem var olan bisiklet istasyonlarını da dikkate alıp, yeni istasyonların en uygun yerlere kurulmasını amaçlamakta ve sistemin her yeni istasyonla birlikte etkinliği ve verimliliğini arttırmayı hedeflemektedir.
The El Farol Bar Problem: A Comparative Analysis of Expectation Models Used in Decision Making
Authors: ÇETİNER Burak , YAŞARCAN Hakan
Published: August 2023

Arthur (1994) introduces the El Farol Bar Problem (EFBP) in his article “Bounded Rationality and Inductive Reasoning". He creates an agent-based model of the EFBP and uses it to explain the importance of the concept "bounded rationality". According to Arthur, deductive reasoning will not create decisions that will produce a desired behavior for the EFBP. Hence, boundedly rational agents using inductive reasoning in decision making is a must for this and similar type of problems. We extend Arthur's work by creating different types of agents and compare them in terms of performance measures such as mean attendance and standard deviation of attendance. We introduce adaptive learning agents that use inductive reasoning in forming their decisions expecting an improvement in the overall performance of the agents. Throughout the analysis of the EFBP, we discover the role of the heterogeneity and the detrimental effect of using the weekly attendance information. Unexpectedly, as a result of our findings, the behavior of adaptive learning agents converges to the behavior that would be expected from agents using deductive reasoning.