The latest global health threat is the ongoing outbreak of respiratory disease, which was named COVID-19 and multiple ever-evolving neurological complications have since been reported. We present the case of a patient with a bilateral tonic pupil in the postinfectious context of COVID 19. Brain magnetic resonance imaging and laboratory tests were normal, a 0.125% pilocarpine test confirmed the diagnosis.
Objective to present a surgical technique for treating patients with recurrent ectropion and severe lower eyelid laxity. Methods Lateral tarsal strip and canthal fixation by osteotomy was performed in 6 patients with recurrent ectropion and 1 patient with extreme lower eyelid laxity secondary to an anophthalmic socket. Preoperative and postoperative photographs were evaluated in order to assess the outcomes of the procedure. Patients were followed up 4 weeks, 6 months, 12 months and 24 months of the postoperative period. The initial symptoms of the patients were eye redness, epiphora, foreign body sensation, aesthetic complaints, and facial asymmetry. Symptoms and aesthetic results were assessed by questioning, photographs, and fluorescein and lissamine green stains taken in each visit. Results No postoperative complications were observed. No recurrence episodes were reported during the follow-up period and physical appearance improvement and symptom severity reduction were maintained during the observation. Conclusion Lateral tarsal strip through osteotomies is an effective surgical procedure for treating severe recurrent ectropion cases or lower eyelid laxity and could be considered as an alternative treatment option or even a primary surgical technique in selected difficult cases.
Ocular involvement in Zika virus (ZIKV) infection can be present both in adults and infants as acquired and congenital diseases respectively. Through experimental studies, there has been clarified important mechanisms of ocular pathogenesis that allow the establishment of potential objectives for antiviral drugs development. The spread of the virus at the ocular level could be hematogenous or axonal, however the hematogenous route through the choroid is suggested as the most important initial mechanism for infection. Ocular manifestations vary according to the age of presentation, being mild and self-limited in adults and potentially devastating in children, related to congenital Zika syndrome (CZS). Ocular diagnosis is made based in clinical features and contact/travel history to countries of epidemiological importance; fundoscopy, optical coherence tomography, fluoresceinic/green indocianine angiography, cultures, serological and molecular tests are useful diagnostic tools. Ocular management is focused according to the clinical context of each patient. Prevention is carried out in a comprehensive manner and further research is directed to vaccine development and specific antiviral treatment. Proper attention requires a multidisciplinary team in order to reach complete visual evaluation and early rehabilitation.
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