Conjunctival melanoma (CM) is a rare but potentially aggressive ocular surface malignancy. CM may carry mutations in genes like BRAF or NRAS as cutaneous melanomas but are unique because, although UV exposure is not thought to be the primary cause, UV exposure may contribute in some cases where the conjunctiva is exposed to sunlight. This manuscript reviews the current management of conjunctival melanoma from surgery to sentinel lymph node biopsy, checkpoint inhibitors, and impact of certain genetic in the future management of CM.
This case report describes a 15-year-old male who presented to the clinic for the first time with long standing unexplained reduced vision of the right eye. Through a comprehensive ophthalmic evaluation, direct ophthalmoscopy revealed a well-demarcated chorioretinal lesion in the macular region of the right eye and in the peripheral retina of the left eye. The case illustrates the diagnostic challenges of identifying ocular toxoplasmosis when external signs are minimal or absent and emphasizes the critical role of a thorough ophthalmic evaluation in detecting underlying chorioretinal pathology. Early recognition of such lesions is essential to appropriate management, prevention of further vision loss, and timely referral for specialized care.
Purpose: To report an atypical case of primary meningococcal keratitis in a myopic contact lens wearer, with typical clinical features resembling acanthamoeba keratitis. This case report emphasizes the significance of early diagnosis, investigations, and management of primary meningococcal keratitis. Case-report: This is a single-patient case report describing an 18-year-old male, contact lens wearer, who presented with 1 month history of left eye redness, and discomfort. His initial exam showed a semi-ring-shaped infiltrate, and cultures confirmed the presence of Neisseria meningitidis. Results: Based on the initial clinical suspicion of acanthamoeba keratitis, the patient was managed by total superficial keratectomy, which was sent for corneal gram stain, culture and histopathology. Topical hourly moxifloxacin hydrochloride ophthalmic solution 0.5% and propamidine isotheonate 0.1% ophthalmic solution and chlorhexidine gluconate 0.02% ophthalmic solution. Following the culture confirmed pathogen, infectious disease team was consulted and a systemic treatment with 7 days of intravenous ceftriaxone 2 grams per day was given. He had persistent epithelial defect that resolved after 3 weeks from the initial visit on intense regimen of ocular lubrication. Conclusion: This case report highlights an atypical presentation of culture confirmed primary neisseria meningitidis keratitis presenting with a ring-shaped infiltrate. Misdiagnosis or inappropriate treatment, such as the use of steroids, can exacerbate the condition. When evaluating contact lens wearers presenting with a ring-shaped infiltrate, n. meningitidis may be considered as a potential causative pathogen. However, in view of both the potential ocular and systemic sequelae of n. meningitidis infection, it is important to investigate and treat these patients promptly and aggressively.
Purpose: To report a culture-proven, delayed-onset Cutibacterium acnes endophthalmitis following intravitreal dexamethasone implant (Ozurdex®) and to highlight diagnostic and therapeutic nuances that distinguish infectious C. acnes inflammation from sterile post-implant reactions. Case report: A 75-year-old pseudophakic man with proliferative diabetic retinopathy and neovascular glaucoma in the right eye presented with pain, redness, hypopyon, and vitritis seven weeks after Ozurdex. Initial management consisted of anterior chamber (AC) paracentesis and intravitreal vancomycin/ceftazidime, plus intensive topical therapy and systemic steroid taper. Because of an indolent but persistent course, a pars plana vitrectomy (PPV) was performed without IOL/capsular manipulation, combined with intravitreal vancomycin, triamcinolone, and aflibercept (for neovascular control). Prolonged incubation of the AC specimen grew C. acnes on day 11; other aerobic/fungal cultures were negative, and PCR was not performed. Inflammation resolved without relapse, and visual acuity improved to 20/30 at 18 months. A fluocinolone acetonide implant placed at 12 months for macular disease did not trigger recurrence. Conclusion: Delayed-onset C. acnes endophthalmitis can occur after intravitreal steroid implantation and mimic sterile inflammation. Microbiologic confirmation often requires extended anaerobic incubation (≥10–14 days), with PCR as a useful adjunct where available. In carefully selected eyes without demonstrable capsular involvement, PPV-based management with intravitreal antibiotics—without immediate capsulectomy/IOL exchange—can achieve durable cure and good visual outcomes, provided close follow-up confirms long-term quiescence.
Introduction: Orbital cellulitis is a rare but potentially life-threatening infection of the orbit, usually secondary to sinus, cutaneous, or dental infections. Methodology: This retrospective descriptive study analyzed 18 cases of orbital cellulitis managed at the Ophthalmology Department of the National Hospital of Niamey over an eight-month period. The objective was to describe the clinical presentation and management approaches in our setting. Results: The mean age of patients was 25.7 ± 12.4 years, with a predominance of children and adolescents (<20 years: 66.7%). Males were more frequently affected, with a male-to-female ratio of 2.03:1. Predisposing factors included diabetes mellitus, malnutrition, and prior use of non-steroidal anti-inflammatory drugs. Eyelid edema was present in all patients, while 50% had retroseptal involvement. Orbital computed tomography was performed in 55% of cases and confirmed the extent and severity of infection. All patients received systemic antibiotic therapy, occasionally combined with corticosteroids. Surgical drainage was required in 72% of cases. Clinical outcomes were generally favorable, with one case of panophthalmitis requiring enucleation. Conclusion: Although limited by the small sample size, this study emphasizes the need for early diagnosis and appropriate management of orbital cellulitis to prevent severe ocular complications. Further multicenter studies with microbiological confirmation are recommended to refine management strategies in resource-limited settings.
