PurposeTo study visual outcomes after implantation of Versario intraocular lenses (IOLs) Patients and MethodsIn 20 selected patients (40 eyes) uneventful, bilateral cataract surgeries with implantation of trifocal Versario (IOLs) were performed. Designprospective case series. Six months after surgery the following parameters were analysed: binocular uncorrected visual acuities (log MAR): for distance (UDVA) at 4 m, for intermediate (UIVA) at 60, 70, 80 cm and for near (UNVA) at 40 cm, photopic defocus curve, mesopic and photopic contrast sensitivities (CSs), spectacle independence, visual function test questionnaire (modified VFQ-25), subjective symptoms and postoperative complications. ResultsSix months after surgery, the mean of binocular visual acuities were as follows: UDVA: -0.12 ± 0.08; UIVA (60 cm): +0.07 ± 0.10, (70 cm): +0.05 ± 0.11, (80cm): +0.07 ± 0.09; UNVA (40cm): +0.12 ± 0.08. CSs in mesopic and scotopic conditions for distance and photopic for near were between normal range of age- match healthy control. All patients were spectacle independent. General satisfaction was high and equal 9.37±0.83. No severe glare and halo were detected. There were no postoperative complications. ConclusionsThe bimanual MICS with the Versario lenses implantation was a safe and effective method for patients who want to be spectacle independent at different distances.
A 56-year-old male patient on maximal topical intraocular pressure-lowering medications for primary open-angle glaucoma underwent combined trabeculotomy-trabeculectomy with mitomycin C for an uncontrolled intraocular pressure of 30 mmHg in the left eye. A localised sub-Descemet bleeding occurred during the sweep of the trabeculotome into the anterior chamber. The localised haemorrhagic Descemet detachment did not obscure the visual axis, and the intraocular pressure was controlled at 12 mmHg. Continued follow-up after 1 year revealed the localised sub-Descemet haemorrhage resolving into localised haemosiderin deposit, the visual acuity revealed slight improvement, and the intraocular pressure remained controlled.
A 54-year-old woman with a history of peripheral spondyloarthropathy for 10 years, treated with steroids and methotrexate, was hospitalized due to necrotic retinitis with arteritis of left eye. Right eye was thought to have self-healing toxoplasma retinitis one year earlier. Different opportunistic infections, including toxoplasma, cytomegalovirus and herpes zoster virus, were considered. Discontinuation of methotrexate and treatment against toxoplasmosis including intravitreal clindamycin stopped the infection. During the follow-up period massive retinal neovascularization, vitreous hemorrhage and macular edema occurred despite panretinal laser photocoagulation. After spontaneous posterior vitreous detachment, anti-VEGF injections were performed to improve visual acuity by reduction of macular edema and resolution of vitreous hemorrhage. At the last follow-up visit, 18 months after presentation, visual acuity was 0,1 (Snellen).
Eye injuries represent 10-15% of all ocular diseases, with over 55 million cases reported annually due to household, occupational, sports, and automotive accidents. The World Health Organization (WHO) identifies eye injuries as a leading cause of visual impairment. Timely intervention is critical, as complications such as infections, hemorrhages or changes in intraocular pressure can result in irreversible damage to the visual system. A 21-year-old patient presented to the Emergency Room with a left eye injury caused by a metallic foreign body during sheet metal cutting without protective equipment. The object penetrated the lower eyelid, conjunctiva, and sclera from the nasal side. Visual acuity in the injured eye was 5/5 without correction, and intraocular pressure was 16 mmHg. A scleral wound at the 10 o’clock position was identified via slit-lamp examination and a CT scan ruled out intraocular foreign bodies. The patient was treated with intravenous broad-spectrum antibiotics and underwent surgical intervention. Surgery was undertaken under local anesthesia and involved revision of the conjunctival and scleral wound, followed by suturing of the scleral, conjunctival, and lower eyelid wounds. Postoperative outcomes included preserved visual acuity and stable intraocular pressure. Early diagnosis and prompt treatment can often save vision and improve quality of life. Public education on eye injury first aid and access to specialized care are essential to reduce the burden of visual impairment.
In the group of phakomatoses, four major disease syndromes are recognized: Sturge-Weber syndrome (angiomatosis encephalotrigeminalis), neurofibromatosis type 1 (peripheral form) and type 2 (central form), tuberous sclerosis (Bourneville disease), and von Hippel-Lindau disease (characterized by capillary malformations of the retina and cerebellum). They are defined by the presence of hamartoma-type tumors in various organs, including the visual system. This paper describes the general and ocular manifestations most commonly observed in these genetically determined disorders. In addition to medical history and physical examination, genetic testing and diagnostic imaging play an important role in diagnosis. Therapeutic management is tailored to the individual needs of each patient. Children with phakomatoses require regular ophthalmologic follow-up as well as multidisciplinary medical care.
This paper presents an overview of partially accommodative esotropia focusing on its key characteristics, classification, and underlying mechanisms, primarily associated with uncorrected hyperopia and a high accommodative convergence to accommodation (AC/A) ratio. Diagnostic approaches, including refraction testing, visual acuity assessment, measurement of the angle of strabismus, prism adaptation testing, AC/A ratio evaluation, and binocular vision testing, are discussed. Emphasis is placed on the importance of accurate spectacle correction, also with the use of bifocal lenses, in conservative treatment. Additionally, invasive options used in the management of partially accommodative esotropia, such as botulinum toxin injections and strabismus surgery, are briefly explored.
