Kumar Saurabh

An unusual case of penetrating ocular trauma with a pressure cooker.

Ocular trauma is a major cause of vision loss. The circumstances and agents implicated in such injuries are diverse. We present an unusual case of penetrating ocular trauma with the nozzle of a pressure cooker lid in a 32-year-old housewife causing deep laceration of the upper eye lid and sclera. The impacted metallic nozzle was removed on an emergency basis. Autoevisceration of ocular contents due the high velocity impact resulted in the final decision to surgically complete the evisceration and implant a glass ball implant. This case highlights the propensity of grievous ocular trauma in a domestic environment.

Endogenous Endophthalmitis: A 10-Year Retrospective Study at a Tertiary Hospital in South India.

Purpose The aim of this study was to review the clinical profile including predisposing systemic conditions, microorganisms responsible, clinical presentation, and outcomes of endogenous endophthalmitis (EE) in South India. Design This study is a retrospective, noncomparative case series. Methods This study presents a retrospective analysis of records of patients with EE in a 10-year period. Results A total of 61 eyes of 58 patients were included in the study. Preceding systemic illness or surgery was noted in 31 patients (53.4%). No predisposing condition was found in 27 patients (46.5%). All eyes had severe diffuse EE. Culture positivity was seen in 34 of 58 patients (58.6%). Gram-positive organisms were isolated in 9 cases (15.5%), and Gram-negative organisms were isolated in 20 cases (34.5%). Pseudomonas aeruginosa (13.8%) was the most common isolate. Eleven eyes (18%) were managed medically with intravenous and intravitreal antibiotics, and 38 eyes (62.3%) also underwent vitrectomy. Eight eyes (13.1%) required repeat vitrectomy, and 12 eyes (19.7%) were eviscerated. The mean follow-up was 16.2 ± 13.9 months. Final visual acuity of 20/200 or better was seen in 29.5% eyes. A favorable outcome was noted in culture-positive patients (P = 0.03) and in patients with no predisposing causes. Conclusions This study provides information about the clinical and microbiologic profile of EE. Aggressive medical and surgical treatment can result in favorable outcomes.

An unusual case of penetrating ocular trauma with metallic spoon.

Ocular trauma is an important cause of vision loss. The agents incriminated in such injuries are diverse. We present a case of ocular trauma with a metallic spoon causing deep laceration of lid and temple region with sclerocorneal laceration. After assessment of the general condition and stabilization of the systemic parameters the operative procedure was undertaken on elective basis. Though the final visual outcome was not rewarding due to the severity of the injury, any potential hemostatic catastrophe was averted.

Quantitative Reduction in Central Foveal Thickness After First Anti-VEGF Injection as a Predictor of Final Outcome in BRVO Patients

Purpose: To analyze the predictive ability of quantitative reduction in central foveal thickness (CFT) after the first anti‐vascular endothelial growth factor (anti‐VEGF) injection to assess final outcome in branch retinal vein occlusion (BRVO) patients. Design: A retrospective interventional consecutive case series. Methods: We retrospectively reviewed 60 treatment‐naive BRVO patients. All the patients were treated with bevacizumab injection pro re nata. We measured the reduction in CFT 1 month after injection and at each visit along with other optical coherence tomography (OCT) features like external limiting membrane (ELM) integrity, ellipsoid zone (EZ) integrity, and foveal bulge (FB). Results: At final follow‐up more patients in the >25% CFT reduction group had a better mean best‐corrected visual acuity (BCVA) and dry macula as compared with the ≤25% group (0.25 logMAR vs 0.46 log‐MAR, P = 0.03; 28 eyes vs 9 eyes, P = 0.005). Based on the final visual outcome we divided patients into 2 groups: group 1, BCVA ≥ 20/40; group 2, BCVA < 20/40. Analysis at 1 month after injection revealed the ELM was intact in 27 (73%) and 5 (21.7%), EZ was intact in 28 (75.7%) and 11 (47.8%), and FB was intact in 12 (32.4%) and 2 (8.7%) patients, respectively, in groups 1 and 2 (P = 0.001, 0.02, 0.03). Conclusions: Patients who have more than a 25% reduction 1 month after the first anti‐VEGF injection and a restored ELM, EZ, and FB have a significantly higher likelihood of achieving BCVA ≥ 20/40.

Systemic lupus erythematosus retinopathy in a 32-year-old female: Report of a case

Systemic lupus erythematosus (SLE) is rare in India with a prevalence of 3 in 100,000.[1] SLE retinopathy is second most common ocular manifestation after keratoconjunctivitis sicca and a major vision-threatening complication of SLE with an incidence of upto 29% in patients with systemic active disease.[2] We present this photo essay to illustrate the classic features of SLE retinopathy and the co-ordinated role of Ophthalmologist (including sub-specialties) with Physicians (Rheumatologist and/or Dermatologist) in managing these multi-system and multi-organ autoimmune disorders.