Ocular Toxoplasmosis is a non-curable infectious disease caused by Toxoplasma Gondii and is one of the leading causes of severe visual impairment due to the involvement of posterior segment of the eye. Involvement of posterior pole causes severe visual impairment in many patients.We report a case of ocular Toxoplasmosis in a 12-year-old female child. The child was clinically diagnosed as having ocular Toxoplasmosis involving the whole posterior pole of the left eye and few parafoveal lesions in the right eye. Follow-up visit revealed new chorioretinitis lesions in the left eye. The patient was treated with oral Spiramycin 1500 mg/day in two divided doses with prednisolone tablet (1mg/kg body weight) for a period of 6 weeks. The chorioretinitis lesions regressed in 3 weeks and follow-up one year after cessation of treatment revealed no recurrence. Spiramycin proved to be effective, safe, economic and easy to administer as twice daily oral dose.
The most common complication with intraoperative viscoelastic use is an immediate elevation of intraocular pressure, particularly if the viscoelastic agent remains in the eye, which can cause serious effects. Complications may include severe ocular pain, corneal epithelial edema, and increased risk of anterior ischemic optic neuropathy and retinal artery occlusion. This study aims to find an efficient and safe adjunctive method to decrease the incidence of postoperative intraocular pressure rise. When cohesive viscoelastic agents were unavailable due to the pandemic, we diluted Microvisc 2.5% sodium hyaluronate ophthalmic viscosurgical device by 50% prior to intraocular lens implantation. Twelve eyes are included in this study, which are divided into two groups. The study followed a double-blinded methodology in which the physician and the patient were unaware of what group they were in. The first group (seven patients, seven eyes) was treated using the diluted Microvisc 2.5%, and the second group (five patients, five eyes) was controlled with the undiluted Microvisc 2.5%. The primary variable was intraocular pressure, measured at four different timeline points (baseline, day 1, week 1, and month 1). We found that the technique used had easier irrigation and aspiration with minimal viscoelastic agent left in the bag, leading to a lower postoperative intraocular pressure spike. Analysis was conducted using the Wilcoxon signed rank test, and significance was noted between the two groups on postoperative day 1 (p=0.042). The analysis also included the populations’ comorbidities (hypertension and diabetes) and postoperative outcomes (pain, corneal edema, and visual acuity).
Aqueous misdirection glaucoma is a rare post ophthalmic surgery complication. It is mostly encountered after a glaucoma filtration surgery, and less commonly comes after cataract extraction surgery. The clinical scenario usually appears immediately after the procedure, in which the intraocular pressure increases, the anterior chamber becomes flat or shallow, and the peripheral iridotomy is appropriate and patent. Several theories have been proposed to determine the pathologic background of this condition. This case report is a supplementary evidence to the mechanism involved in which an aqueous misdirection to the posterior segment of the eye is the etiology of the disease. Keywords: Anterior Chamber, Cataract, Glaucoma, Intraocular Pressure, Pseudophakia, Vitrectomy
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