Coronavirus disease 2019 , caused by SARS-CoV-2, has been linked to a number of opportunistic bacterial and fungal infections. Aspergillus and Candida have been identified as the primary fungal pathogens for COVID-19 co-infection. Recently, several cases of mucormycosis in COVID-19 patients have been reported worldwide, particularly in India. Now, remember that mucormycosis can be of different types like rhino-ocular-cerebral (ROCM), pulmonary, gastrointestinal, etc., here we are dealing with a case of rhino-ocular cerebral mucormycosis which not only occurred once but twice post covid-19 infection. As we recover from the epidemic and the pandemic, it is essential to look back and understand what led to the insane surge of mucormycosis in post-covid-19 patients, especially in our country, India. Mucor is ubiquitous and present constantly around us, so no single factor but an array of elements is responsible predominantly being the incorrect use of corticosteroids in uncontrolled diabetics, which led to severe immunosuppression, injury to the beta cells of the pancreas by the SARS-COV-2 in newly diagnosed diabetics. In such cases, it is important to evaluate the patient thoroughly and orbital exenteration is done depending upon the doctor's judgment and MRI findings. Following is a case report of one such patient with recurrent post COVID mucormycosis predisposed by uncontrolled diabetes mellitus and managed by orbital exenteration.
This study aims to compare the ganglion cell complex changes in diabetic macular edema (DME) and central retinal vein occlusion (CRVO) macular edema using optical coherence tomography (OCT). MethodsThis was a hospital-based cross-sectional study conducted for six months. All patients having DME and CRVO macular edema presenting to the Ophthalmology Department at Acharya Vinobha Bhave Rural Hospital were included in the study. A detailed and comprehensive ophthalmic examination was performed, and OCT was done for each patient. ResultsThe incidence of both DME and CRVO macular edema were both found to be maximum in the age group of 61-69 years. DME is more common in males (62.86%) than females (37.14%); the same was observed in CRVO group: 54.29% were males and 45.71% were females. Macular edema showed a mean value of 370.11 in DME and 428.71 in CRVO. Thus, the CRVO group showed more macular edema than the DME group. The ganglion cell complex thickness showed a mean value of 58.47 in DME and 66.77 in the CRVO group, implying that the thickness reduced significantly in the DME group. ConclusionOCT provides quantitative measurement of the ganglion cell complex thickness, which helps monitor the course of macular edema secondary to CRVO and diabetes Mellitus and thereby provides an assessment of the prognosis of the disease as these two diseases in particular are major causes of blindness worldwide, and timely care and management can help in altering its course.
Marcus Gunn jaw winking (MGJW) is an uncommon entity and is associated with congenital ptosis. It is a neurogenic congenital ptosis, which is also called the Marcus Gunn phenomenon, trigeminal-oculomotor synkinesis, or pterygoid-levator synkinesis. Congenital ptosis can be associated with MGJW syndrome, blepharophimosis syndrome, and monocular elevation deficiency (MED). MED is a condition where there is a unilateral congenital abnormality in the elevation of the eye in abduction and adduction. The MGJW phenomenon, congenital ptosis, and double-elevator palsy may be associated with and represent a congenital misdirection syndrome. Together, it can be challenging, and surgery is recommended in severe cases, depending on the degree of ptosis and jaw winking. We hereby want to bring to light one such case of a 14-year-old female with congenital ptosis, MGJW, and double-elevator palsy and want to highlight how both MGJW and double-elevator palsy are both parts of the same disease spectrum and how such cases can be treated.
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