Purpose
In this report, we describe a case of episcleritis that appeared to be the first sign of the novel coronavirus disease (COVID-19).
Observations
A 29-year-old man with no prior medical condition presented with a complaint of redness and foreign body sensation in his left eye, which started two days before his consultation. He had no history of decreased vision, pain, photophobia, discharge, ocular surgery, or trauma. He had no symptoms in his fellow eye nor did he have any systemic symptoms. External examination of his left eye revealed a sectoral nasal conjunctival and episcleral injection and a clear cornea. There was no scleral edema. A diagnosis of episcleritis was made based on clinical grounds and topical fluorometholone 0.1%. was started. Three days later, the patient presented with headache, shortness of breath, cough, and fever (39.2 °C). Real-time fluorescence polymerase chain reaction test of his nasopharyngeal swab returned a positive result for COVID-19. The patient was then admitted for observation and supportive therapy. After five days, fever, respiratory and ocular symptoms were markedly improved and the patient was discharged and advised to isolate at home for 14 days.
Conclusions and importance
This is the first report that describes episcleritis as a possible presenting sign of COVID-19. Understanding the association between ocular signs/symptoms and COVID-19 can aid in the diagnosis of the viral infection and can help in limiting its transmission.
PURPOSE:The purpose of the study was to review the safety and stability of scleral-fixated intraocular lens (IOL) 2 years after implantation in children with idiopathic ectopia lentis (EL).METHODS:This retrospective case series enrolled children with EL managed between 2011 and 2015 at a tertiary eye hospital in the eastern of Saudi Arabia. Data were collected on age, gender, vision, isolated or syndromic pathology, intraoperative and postoperative complications, spherical equivalent refraction, and final best-corrected visual acuity (BCVA).RESULTS:The series included 18 eyes of 11 children with EL (6 males and 5 females). There were 7 bilateral and 4 unilateral cases. The median age was 3.5 years (25% quartile 1 year; range: 1–8 years). Preoperatively, fixation was absent in 3 eyes, 8 eyes were fixating but vision could not be recorded. In the remaining seven eyes, median distant visual acuity was 0.1 (25% quartile: 0.08). The median postoperative follow-up was 24 months (25% quartile, 7 months). Complications included two eyes with iris capture and one eye with lens subluxation requiring re-implantation. Postoperative BCVA was better than 20/60 in 15 (83%) eyes. At last follow-up, 6 eyes required myopic correction, 1 eye was emmetropic, and 11 eyes were hypermetropic. One eye with glaucoma was managed medically.CONCLUSION:Scleral fixated IOL in eyes of young children with EL had good visual outcomes and high stability. However, there is a high incidence of residual refractive error.
Purpose. To evaluate the efficacy and safety of MyoRing implantation in eyes with keratoconus managed at a tertiary eye hospital in the Eastern Province of Saudi Arabia. Methods. This one-armed historical cohort study included keratoconus patients operated for MyoRing implant. The cases were assessed before and 6 months after surgery. Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), spherical equivalent (SE), central corneal thickness (CCT), and corneal curvature (Kmean) were noted and measured before and 6 months after the intervention. Intra- and postoperative complications were noted. Result. We studied 12 eyes of 12 patients with moderate keratoconus. The median of Kmean was 50.6 mm (IQR 47.54; 52.5) and 44.5 mm (IQR 42.5; 46.8) before and 6 months after surgery. The change in Kmean was significant (P=0.002). The median spherical equivalent (SE) was −5.1D (interquartile range (IQR) 7.1; −3.6) and −0.6 (IQR −2.1; 0.8) before and 6 months after surgery. The difference in SE was significant (Wilcoxon signed-rank test P=0.004). The CCT was 447 ± 34 μm and 444 ± 30 μm before and 6 months after surgery, respectively. The CCT change was not significant (P=0.26). The UCVA and BCVA improved by 2 or more lines in 9 (75%) eyes, remained stable in 2 (16.7%) eyes, and decreased in 2 (16.7%) eyes. Conclusion. MyoRing implant seems to be a safe and effective procedure to manage low and moderate keratoconus. The outcomes could be further enhanced by additional procedures such as collagen cross-linkage and photorefractive keratectomy if warranted.
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