The Wyburn-Mason or Bonnet-Dechaume-Blanc syndrome is a sporadic illness which is a type of phakomatosis, usually present as unilateral arteriovenous malformations(AVM), for the first defined by Magnus in 1874 as retinal AVM later in 1932 another description gave by Yates and Payne; as an AVMs of the retina and cerebral vasculature, while in 1937 Bonnet, Dechaume and Blanc defined as AVM involving facial, retinal and brain blood vessels, then in 1943 all literature revised by Wyburn-Mason to put together to his case reports, therefore, the name of Bonnet-Dechaume-Blanc syndrome given in France, but in English articles entitled as Wyburn-Mason syndrome. At that time, due to a deficiency in diagnostic imaging techniques, all the diagnosis were performed by clinical findings, operation, or autopsy. Usually, it is a unilateral disorder comprising of three distinct components: orbit, brain (ipsilateral to the retina) and face, in the face; the sensory region of the trigeminal nerve distribution involved, that takes the shape of naevi which might be wholly formed and illness, is complete, or the naevi might be faint or absent, the latter regarded as an incomplete disease but rarely a bilateral involvement encountered with an asymmetrical grade of malformation. The pathology starts in the early embryonic period, and if vascular dysgenesis encountered can lead to a wide range of neurocutaneous vascular defects in the cerebrum or ocular or both. When the disorder reaches the last stage, the AVM can compress the optic nerve causing impaired perfusion, ischemia eventually optic atrophy. Another explanation for visual loss is glaucoma as a result of elevated vascular pressure, neovascularization resulting from ischemia, which might lead to vitreous hemorrhage(5). Archer et al. staged the disease into three groups: Group 1 (AVM cannot be detected clinically). Group 2 (Clinically seen as edema and hemorrhage due to direct AVM, i.e., no capillary network between them). Group 3 (Clinically, it is impossible to distinguish arteries from veins due to severely dilated blood vessels all over retina). We present a 41-year-old male presented with a gradual decrease in his visual acuity in both eyes.
A 58-year-old Caucasian female presented to the clinic with progressive cloudy vision in her left eye. She had an ocular prosthesis in her right eye, and her visual acuity was 20/100 and intra-ocular pressure was 32 mm-Hg in her left eye. Exam revealed a polymethyl methacrylate (PMMA) lens with the optic and inferior haptic anterior to the iris. She had trace pigmented cells and a ring-shaped scar posterior to the iris consistent with a Soemmering's ring.. This was confirmed on ultrasound biomicroscopy and determined to be the causative etiology of her intraocular lens (IOL) dislocation.
The treatment of normal tension glaucoma can be difficult. Some normal tension glaucoma patients show progression of glaucomatous optic neuropathy despite an intraocular pressure in the normal range, and sometimes even with an intraocular pressure in the low teens. The question therefore arises as to whether there are other therapeutic options besides lowering the intraocular pressure. One treatment modality discussed in the literature is calcium channel blockers. We suspect that calcium channel blockers are particularly useful in glaucoma patients having a primary vascular dysregulation.
Objective: To outline the clinical presentation, management and outcome of lens induced glaucoma in Chittagong Eye Infirmary and Training Complex. Methods: A case series review was done among the patients who visited Chittagong Eye Infirmary and Training Complex from January 2015 to December 2018. Demographic data, clinical presentations, management and outcome were recorded and analysed. Results: 30 phacomorphic cases and 20 phacolytic glaucoma patients were included in our study. The mean age at presentation was 60 years. Female to male ratio was 2:1. The reason for late presentation was distance which was 60% in phacomorphic glaucoma and 50% in phacolytic glaucoma. The main symptoms were reduced vision followed by ocular pain and redness of eye. Visual acuity was either HM or just PL in all eyes before surgery. All patients underwent SICS with posterior chamber lens implantation. IOP reduced tremendously upon discharge and vision kept improving up to a month after surgery. Conclusion: Reduced vision, ocular pain and redness are the main clinical presentations of lens induced glaucoma. Cataract surgery proves to be effective in lowering IOP and visual recovery in patients with lens induced glaucoma.
As possession of a mobile phone becomes ubiquitous in the general population, its hazards, especially for vision, should be better known and understood. Although blast injuries are common in war, gas cooking and with firecrackers, mobile phone blasts, popularly known as BOMBILE (Blast of Mobile Battery in the Living Eye), are becoming more and more frequent. We present three cases phone battery explosion diagnosed with ocular surface burn. Although none had severe injuries and vision was salvageable and no visual or cosmetic impairment resulted, this may not always be so. Public education, producer liability, and better technological solutions are urgently required to lessen the risks.
