Multiple myeloma (MM) is a malignant plasma cell disorder characterized by uncontrolled proliferation of plasma cells in the bone marrow and overproduction of monoclonal immunoglobulins. The resulting immune dysfunction predisposes patients to severe infections. Rarely, ocular infections may constitute the first clinical manifestation of MM. We describe the case of a 65-year-old male, initially treated for herpes zoster ophthalmicus, who subsequently developed a severe corneal abscess in the left eye. Ophthalmologic examination revealed a central stromal abscess with hypopyon, progressing to endophthalmitis despite intensive fortified topical antibiotics and intravitreal injections. Corneal cultures isolated Pseudomonas aeruginosa. Concurrent laboratory investigations showed bicytopenia, hypoalbuminemia, and a monoclonal IgA lambda peak. Bone marrow aspiration revealed 66% infiltration by dystrophic plasma cells, confirming MM. The patient was treated with a VRD protocol (bortezomib, lenalidomide, dexamethasone) with partial hematologic response. The ocular infection eventually resolved, leaving a dense corneal opacity. This case illustrates that a corneal abscess due to Pseudomonas aeruginosa may reveal an underlying multiple myeloma. Refractory or unusually severe infections should raise suspicion of systemic immunosuppression and warrant a complete diagnostic evaluation.

El crosslinkig corneal se considera un procedimiento seguro, aunque se han informado efectos secundarios que amenazan la visión. Aparte de nuestro caso, se han publicado pocos informes de queratitis herpética después del crosslinkig. Informamos de un caso de queratitis herpética de nueva aparición después del crosslinkig corneal para el queratocono.Una mujer de 40 años se sometió a un crosslinkig de colágeno corneal en el ojo derecho para el queratocono progresivo. La paciente regresó con dolor y fotofobia. Había una infiltración en el estroma corneal. La tinción con fluoresceína especificó defectos epiteliales que cubrían los infiltrados corneales.El diagnóstico de queratitis herpética se confirmó con la reacción en cadena de la polimerasa para la detección de ADN del VHS tipo 1 en el frotis corneal. El defecto epitelial se curó con tratamiento oral con valaciclovir.Se añadieron al tratamiento antiviral gotas tópicas de corticoides y gotas lubricantes para ojos sin conservantes. Se observó una disminución del infiltrado estromal.Este caso destaca el riesgo de queratitis herpética después del crosslinkig y aclara la importancia del diagnóstico y el tratamiento oportunos de esta complicación inusual pero importante. El oftalmólogo debe ser consciente de la posibilidad de queratitis herpética en los ojos después del crosslinkig, incluso en pacientes sin antecedentes de infección por VHS.

A conjunctival nevus is a benign pigmented lesion of the conjunctiva, usually resulting from the accumulation of melanocytes in this area. Its management ranges from simple surveillance to surgical excision with anatomopathological study. We report the case of a young patient being monitored for a cosmetically bothersome achromic conjunctival nevus, who underwent surgical excision under local anesthesia with dehydrated amniotic membrane grafting. After 6 months of follow-up, the conjunctiva had completely healed without any notion of recurrence or notable complication.

Corneal neovascularization is a common pathological condition that affects visual prognosis and the success of keratoplasty. It has multiple etiologies and can be managed with a variety of therapeutic approaches. We report a clinical case of corneal neovessels treated with a combination of fine-needle diathermy and dehydrated amniotic membrane, resulting in neovessel regression starting at one month and maintained until penetrating keratoplasty.

Pterygium is a common ocular condition characterized by a conjunctival growth over the cornea. Epithelial ingrowth (EI), a rare complication of ocular surgery, involves the proliferation of epithelial cells within the cornea or the anterior chamber. We report a case of EI in a male patient following pterygium surgery with conjunctival autograft. Slit lamp examination revealed a thin, grey-white, wave-like band beneath the corneal epithelium in the inferior-temporal quadrant, outside the visual axis and not crossing the corneal center. The diagnosis of epithelial ingrowth was made clinically and confirmed with anterior optical coherence tomography (OCT). This marks only the second documented occurrence of EI after pterygium surgery.

Objective: To describe a case of myopic syndrome in Marfan disease. Results: The patient was 45 years old, with high myopia and wearing corrective lenses, with no previous history of any particular problem. She was seen for the management of a progressive bilateral decrease in visual acuity in a white, painless eye, with no history of trauma and no other associated signs. On the clinical examination, the corrected visual acuity was estimated at 02/10 in both eyes. The refraction revealed strong myopia at -11D. The examination of the lens after pupillary dilatation reveals a cortical cataract and upward crystalline ectopia in both eyes. At the posterior pole, there was a myopic cone, chorioretinal atrophy and poor macular reflex, with vessels of normal caliber. The retina was flat with no peripheral retinal tears

White-centered retinal hemorrhages, also known as Roth spots, have long been considered pathognomonic of infective endocarditis but can be associated with several pathologies. They can be a presentation of a blood hyperviscosity syndrome in the context of multiple myeloma, light chain gammopathy, or cryoglobulinemia through a mechanism of retinal venous stasis, potentially progressing to vein occlusion. We present the case of a 55-year-old woman with no significant medical history who presented a gradual bilateral decline in visual acuity. Fundoscopic examination revealed multiple white-centered hemorrhages, and further investigation promptly linked them to a blood hyperviscosity syndrome.

BACKGROUND: The purpose of this study was to compare the concordance of measurements between a table-mounted automatic auto-refractor and a portable manual auto-refractor, test the variability of inter-operator measurements, and determine the effect of the head's position on the measurements. MATERIAL AND METHODS: A prospective study was carried out on 100 healthy eyes. Refraction was acquired with a Topcon RM-800 tabletop auto-refractometer and a Nidek HandyRef K portable auto-refractometer. The refractive errors were compared in terms of the sphere's power, the cylinder and its axis, the spherical equivalent, and the coordinates of the astigmatism power vectors J0 and J45. Statistical analysis was performed using SPSS software version 20. RESULTS: The average age was 31, with 3 and 71 years old extremes. Fifty-six patients were female (56%), and 52% were right eyes. No difference between the 2 devices concerning the sphere (p = 0.09), the cylinder (p = 0.18), and the spherical equivalent (p = 0.15) was observed. However, there is an average difference of 4° in the astigmatism axis (p ≤ 0.001), which is insignificant if we consider the Jackson power vector J0 (p = 0.24) and J45 (p = 0.85). The position of the head tilted back does not modify the measurements with the portable refractometer. In addition, the HandyRef can be used by any unqualified person with no risk of altering the results of the measurements. CONCLUSION: Our results show a good concordance between the measurements obtained by the two devices. They can therefore be used interchangeably.

We report the case of a 60-year-old patient referred for a sudden drop in visual acuity in the right eye sixteen hours after hypertensive peak. The visual acuity was limited to light perception on the right and 10/10 P2 on the left. The fundus examination revealed occlusion of the central retinal artery, with typical ischemic edema and a cherry-red macula. A fluorescein angiography showed a major circulatory slowdown. A cerebral CT scan also showed ischemic damage. The patient benefited from anticoagulation and oxygen therapy, without any improvement in visual acuity.

Aim: To describe a case of choroidal melanoma metastasis. Case presentation: This is a case of a 39-year-old female patient diagnosed with choroidal melanoma of the right eye. Initial extension exam was negative; treatment consisted of enucleation of the tumor. The patient was subsequently lost. The evolution was marked by the appearance of multivisceral metastasis which were diagnosed at re-evaluation. The patient died after a short treatment of chemotherapy. Conclusion: choroidal melanoma is a rare disease with a severe prognosis that requires appropriate treatment and regular follow-up.