Ocular manifestations of COVID-19 are still being studied. Posterior segment involvement in viral entities is either direct viral involvement or a delayed immune response to the antigen. A 22-year-old woman presented with history of perceiving absolute inferior scotoma in the right eye for 4 days and history of fever and sore throat 10 days ago. Fundus examination revealed disc edema and vessel tortuosity. Humphreys Field Analyzer confirmed inferior field defect and Optical Coherence Tomography showed superior, nasal and inferior retinal nerve fiber layer thickening in the right eye. Patient was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) testing. Patient received three doses of injection methylprednisolone over 3 days. There was subjective resolution of scotoma reported 3 weeks posttreatment. We bring forward the first reported case of parainfectious optic neuritis associated with COVID-19.

Background: Myopia is considered a risk factor for open-angle glaucoma. This study aimed to assess the association of axial length and degree of myopia on RNFL thickness. Material and Method: This cross-sectional study is conducted among 50 myopic patients aged between 18 to 60yrs attending ophthalmology OPD at a tertiary care hospital. The study was conducted after getting approval from institutional ethics committee and patients recruited after obtaining informed consent. The ocular examination of all the included patients was done using an auto refractometer, retinoscopy, ONH OCT for RNFL thickness measurement, fundus with IDO and 90D. The average RNFL thickness was recorded globally and separately for the superior, inferior, nasal, and temporal quadrants. Results: A total of 100 eyes were evaluated, mean age of the study population was 35.02±9.07 years with range of 21-54years. The mean of refraction errors in all the patients was -3.41±2.04D with a range of -1 to -20D and mean axial length was 24.11±1.10 with a range of 22.18 to 26.8mm. There is a significant decrease in the RNFL thickness in patients with increase in refractive error and the axial length. (p<0.001) We found a significant strong linear association of axial length and myopia with the RNFL thickness. (p<0.001) Conclusion: The people with higher degrees of myopia and increased axial length had thinner RNFLs. A significant linear relation of the decrease in RNFL thickness with the severity of myopia and the axial length was found.

Fat embolism syndrome (FES) is a multiple organ disorder that can appear after long bone fractures. The clinical picture includes hypoxia predominantly, accompanied by diffuse petechiae, alveolar infiltrates, altered mental status, fever, tachypnea, and tachycardia. We present a case of FES in a 35year-old man with no prior medical history, following fracture of neck of right femur. Fifteen hours post-admission, patient developed respiratory failure with altered mental status and needed admission in the intensive care unit. The chest radiography and later chest tomography raised the suspicion of a COVID-19 disease, even if our first suspicion was FES. After being carefully investigated for COVID-19 with two negative RT-PCR SARS-CoV-2 tests, patient received treatment for FES. In the context of the SARS CoV-2 pandemic, differential diagnosis has become an increasingly challenging process.