Although there is no mention of acute glaucoma on the list of side effects of citalopram in some patient information leaflets, here have been previous published case reports on association of citalopram and other ssr is (selective serotonin reuptake inhibitors) with acute glaucoma. It is the most severe SSR that is related to ocular complications. Risk factor: race-Asian origin, hypermetropia, family history, female gender, age, and shallow anterior chamber. The mechanism of SSRI induced acute glaucoma is not clear. An elderly lady with no previous history of glaucoma presented with acute headaches, bilateral ocular pain, photophobia, worsening vision, and fixed dilated pupils. With bilateral raised intraocular pressures she was initially treated with systemic acetazolamide, ocular hypotensives then bilateral YAG iridotomy. Subsequently stopped acetazolamide and pilocarpine.she returned with worsening vision and significantly raised iops this time. Her ultrasound b-scans remained unremarkable (though sometimes they can show typical findings).she was discussed with a glaucoma specialist (rs) who asked for a full drug history and who stopped the oral citalopram subsequently. Her IPOS normalized improving her symptoms and vision markedly. This patient had been seen a few times earlier , however, a comprehensive drug history was not obtained earlier. A low threshold for drug induced causes of bilateral acute glaucoma, including this as side effect in pils (patient information leaflet) and detailed ophthalmic examination including gonios copy should be carried out even in the presence of patent iridotomies in high risk patients. Warning advice and counselling to the patients should be given.
Nutrition has influence in vision. Important nutrients, such as vitamins A, C, D and E, lutein and zeaxanthin have essential function on visual health. The objective of this study is to demonstrate the nutrition´s influence in the beginning or prevention of visual diseases like dry eye syndrome, cataracts and age-related macular degeneration. A search was made in PubMed, Infomed, EBSCO, HINARI, Scielo; using as key words: nutrition, visual diseases, vitamin. Were used 32 articles in Spanish and English languages. The 60% corresponds to the last five years. Trials have reported a prevalence of dry eye syndrome twice higher in females than in males; it´s related with vitamin D deficiency. Trials with vitamin D and omega-3 supplements have shown relief of the illness. Cataract, the principal cause of reversible blindness on the world, it´s related with vitamin C and E deficiency. Vitamin A, lutein and zeaxanthin have influence in age-related macular degeneration. As conclusions, this study gives information about the actual stated of nutrition and its relationship with the beginning or prevention of some visual diseases.
OBJECTIVE:This study aimed to assess the presence of novel coronavirus in tears and conjunctival secretions of SARS-CoV-2-infected patients. METHODS:A prospective interventional case series study was performed, and 30 confirmed novel coronavirus pneumonia (NCP) patients were selected at the First Affiliated Hospital of Zhejiang University from 26 January 2020 to 9 February 2020. At an interval of 2 to 3 days, tear and conjunctival secretions were collected twice with disposable sampling swabs for reverse-transcription polymerase chain reaction (RT-PCR) assay. RESULTS:Twenty-one common-type and nine severe-type NCP patients were enrolled. Two samples of tear and conjunctival secretions were obtained from the only one patient with conjunctivitis yielded positive RT-PCR results. Fifty-eight samples from other patents were all negative. CONCLUSION:We speculate that SARS-CoV-2 may be detected in the tears and conjunctival secretions in NCP patients with conjunctivitis.
Purpose: To assess visual acuity, surgically induced astigmatism, endothelial cell loss, operative time and complications of sutureless wide incision cataract surgery in brown mature senile cataract using viscoexpression. Settings: Tertiary care ophthalmic unit, Egypt, over the last 8 years from 2012 to January 2020 Methods: Retrospective, interventional case series that included 472 eyes in 413 patients with brown, mature senile cataract that deemed risky for phacoemulsification. Wide and long superior sclerocorneal tunnel incision with straight posterior border was constructed. After anterior capsulotomy, the nucleus was rotated into the anterior chamber (AC). The nucleus was expressed by injection of ophthalmic viscosurgical device (OVD) into the AC followed by irrigation aspiration and intraocular lens implantation. Results: patients ages ranged from 57 to 93 years, (Mean 74.6 +5.3) Ten weeks after surgery, decimal visual acuity of 0.5 or better was achieved by 80.6% of cases as best corrected and by 67.6% of cases as uncorrected visual acuity. Flattening of the vertical meridian by 1 diopter or less was noted in 88.7% of eyes. Average loss of endothelial cells was 13 % (P < 0.0001 paired samples T-test) in 104 eyes that underwent specular microscopy. Average duration of the operation was 11.2 +3.5 minutes. Postoperative hyphema was recorded in 6 eyes (1.27%). Significant corneal edema was noted in 3 eyes (0.64%). Vitreous loss occurred in 5 eyes (1.06%). Postoperative uveitis with residual posterior synechiae developed in 4 eyes (0.85%). Early postoperative rise of tension was recorded in 10 eyes (2.1%). Decentration of IOL was recorded in 2 eyes due zonule dehiscence (0.42%) that required replacement with Ac-IOL. Conclusions: Sutureless wide incision cataract surgery (SWICS) was a safe alternative to the classic ECCE for removal of brown mature senile cataract where phacoemulsification appeared hazardous. It spared time and reduced surgically induced astigmatism related to wound suturing.
Intermittent exotropia is one of the most common types of strabismus in children especially in Asian and South Asian populations. Prevalence of exotropia in this group is estimated to range from 7–18.5× higher than esotropia. Spontaneous resolution is rare and if neglected may lead to loss of Binocular Single Vision (BSV) and negative psychosocial consequences. We aim to evaluate the outcomes of surgical management for intermittent exotropia at a unit in Birmingham (UK), an area unique for its high non-White ethnic population (43%), majority of who are Asian/South-Asian. Retrospective case notes review of patients diagnosed with intermittent exotropia who underwent strabismus surgery in 2019–2020 by two surgeons using two different surgical approaches with a 3 month follow-up. Measures included pre- and post-operative visual acuity and stereopsis, surgical indications, near and distance strabismus angle with refractive correction, type of surgery performed and parental satisfaction at follow-up. Nineteen children underwent surgery during this period with a mean age of 7 range (4–12). Eighteen patients had surgery for functional reasons and one for cosmetic. Two patients recovered BSV where previously Frisby negative, remaining patients maintained BSV. The mean preoperative near and distance exodeviation in prism dioptres (PD) was 30.16 and 34.47, respectively. The mean postoperative near and distance exodeviation was 1.53 PD & 5.16 PD, respectively at 3 months. Two patients developed suture granulomas which resolved with steroid drops post-operatively. No significant difference between the two surgical techniques was noted. In all cases, parents were satisfied with the results. Outcomes in our multi-ethnic population have been excellent in terms of improvement in exodeviation and maintenance of BSV. Long-term follow-up is required to see how many patients will show evidence of recurrence requiring reoperation and whether ethnicity impacts this.
