IMPORTANCE Infectious conjunctivitis is highly transmissible and a public health concern. While mitigation strategies have been successful on a local level, population-wide decreases in spread are rare.OBJECTIVE To evaluate whether internet search interest and emergency department visits for infectious conjunctivitis were associated with public health interventions adopted during the COVID-19 pandemic.DESIGN, SETTING, AND PARTICIPANTS Internet search data from the US and emergency department data from a single academic center in the US were used in this study. Publicly available smartphone mobility data were temporally aligned to quantify social distancing. Internet search term trends for nonallergic conjunctivitis, corneal abrasions, and posterior vitreous detachments were obtained. Additionally, all patients who presented to a single emergency department from February 2015 to February 2021 were included in a review. Physician notes for emergency department visits at a single academic center with the same diagnoses were extracted. Causal inference was performed using a bayesian structural time-series model. Data were compared from before and after April 2020, when the US Centers for Disease Control and Prevention recommended members of the public wear masks, stay at least 6 feet from others who did not reside in the same home, avoid crowds, and quarantine if experiencing flulike symptoms or exposure to persons with COVID-19 symptoms.EXPOSURES Symptoms of or interest in conjunctivitis in the context of the COVID-19 pandemic.
MAIN OUTCOME AND MEASURESThe hypothesis was that there would be a decrease in internet search interest and emergency department visits for infectious conjunctivitis after the adaptation of public health measures targeted to curb COVID-19.RESULTS A total of 1156 emergency department encounters with a diagnosis of conjunctivitis were noted from January 2015 to February 2021. Emergency department encounters for nonallergic conjunctivitis decreased by 37.3% (95% CI, −12.9% to −60.6%; P < .001). In contrast, encounters for corneal abrasion (1.1% [95% CI, −29.3% to 29.1%]; P = .47) and posterior vitreous detachments (7.9% [95% CI, −46.9% to 66.6%]; P = .39) remained stable after adjusting for total emergency department encounters. Search interest in conjunctivitis decreased by 34.2% (95% CI, −30.6% to −37.6%; P < .001) after widespread implementation of public health interventions to mitigate COVID-19.CONCLUSIONS AND RELEVANCE Public health interventions, such as social distancing, increased emphasis on hygiene, and travel restrictions during the COVID-19 pandemic, were associated with decreased search interest in nonallergic conjunctivitis and conjunctivitisassociated emergency department encounters. Mobility data may provide novel metrics of social distancing. These data provide evidence of a sustained population-wide decrease in infectious conjunctivitis.
Rosai-Dorfman disease (RDD), a rare form of histiocytosis, has been reported to cause choroidal masses and subsequent serous retinal detachments. We present a case of RDD associated with a choroidal mass and retinal detachment that did not respond to corticosteroid treatment and regressed after treatment with photodynamic therapy (PDT). Following treatment, the patient had a successful anatomic and clinical outcome, with no recurrence of serous detachment and 20/25 visual acuity. This is the first report of choroidal RDD successfully treated with PDT.
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Ophthalmic Surg Lasers Imaging Retina
. 2021;52:568–571.]
ment and a methylprednisolone tapered dose pack. At 1-month follow-up, she had no pain, evidence of infection, or motility disturbance.Many household and store devices pose unintended ocular and periorbital damage risks. One report describes ocular trauma from merchandise display hooks, bringing awareness of this danger to shoppers and advocating modifying display hook design. 2 Cakes with wooden dowels pose a similar potentially underrecognized danger to the uninformed public. The hidden dowels, intended to provide stability to a multilayer cake, represent possible hazards especially in the setting of pranks or cultural traditions, such as in this patient. One similar anecdotal report was shared on social media, in which a woman sustained a periorbital injury when her face was pushed into a cake with a wooden dowel as a prank. 3 Additionally, a Mexican birthday tradition is la mordida, in which the guest of honor's face is shoved into their cake for the first bite for good luck. 4 While this tradition is intended to occur humorously and festively, there is inherent risk for ocular or orbital injury from hidden dowels, including retained intraorbital wooden foreign body that may be a nidus for infection. 5,6 Orbital computed tomography should be performed in periocular trauma to assess for these intraorbital foreign bodies and the extent of the injury. 1,5 Fortunately, this patient did not sustain severe ocular or orbital injury, as vital structures were missed due to the direction of the dowel penetration.To our knowledge, this case is the first in the medical literature to document and raise awareness of this hazard. We propose that the bakery industry consider warning labels for cakes with wooden dowels, as there are no regulations or requirements to provide this information to consumers. Additionally, we recommend celebrants of la mordida eliminate wooden dowels from cake assemblies or avoid forcefully planting the face on the cake. We hope knowledge of this hazard will modify consumer behavior to prevent ocular and orbital injury.
A 46-year-old woman with Marfan syndrome presented with left crystalline lens dislocation due to zonular insufficiency. Her natural lenses had been noted to be partially subluxated when she was an infant, with spontaneous complete dislocation of her left lens over time. Her presenting visual acuity was 20/30 OU with aphakic spectacles. Her intraocular pressure levels were 26 mm Hg OD and 30 mm Hg OS. She underwent pars plana vitrectomy, lensectomy, and insertion of a scleral-fixated intraocular lens in the left eye. And intraoperative photograph (Figure ) shows the patient's dislocated native intraocular lens resting on the retina.Subluxation of the crystalline lens (ectopia lentis) is a common occurrence in patients with Marfan syndrome, with 60% of patients affected in 1 case series. 1 Complete, spontaneous posterior dislocation is a less common complication. [2][3][4]
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