We report an observation of an uncommon form of extra-papillary myelin fibers of fortuitous discovery in a patient, 55 years old, who consulted for a change of correction. The clinical aspect of the fundus led to the diagnosis of retinal myelin fibers in front of a whitish placard with a finely striated scalloped edge, partially masking the vessels and located at the level of the inferior temporal arch. These fibers, contiguous to the papilla or distant from it, have an incidence varying from 0.57% to 0.98% according to studies and their pathogenesis is still uncertain. This congenital anomaly of the retinal fibers of clinical diagnosis is often asymptomatic, but can however be associated with other ocular disorders.

Background: The purpose of the study was to quantitively assess the optic nerve head (ONH) parameters from fundus photographs in normal and open-angle glaucoma patients and to compare them with those provided by spectral-domain optical coherence tomography (SD-OCT). Material and methods: This study compares 30 glaucomatous eyes to 30 healthy control eyes. One eye from each subject was randomly enrolled. From color photographs, different parameters were measured using image processing software (Adobe Photoshop CS6) after delimiting the boundaries of the optic disc and the excavation. The correlation between these measurements and those obtained by SD-OCT was evaluated. Results: Glaucomatous and normal patients groups were comparable in terms of age (p = 0.94), sex (p = 0.57), presence of diabetes (p = 0.52), hypertension (p = 0.40), and smoking (p = 0.67). The areas of the optic disc and the cup were significantly larger in glaucomatous patients (p = 0.004 and p < 0.001, respectively). The area of the neuroretinal rim was smaller in glaucomatous patients (p < 0.001). The vertical and horizontal cup-to-disc ratios were larger in glaucomatous patients (p < 0.001). The thicknesses of the rim in the four meridians were significantly reduced in the glaucoma group. The "ISNT" rule was fully respected in 87% of normal eyes and in only 2 cases (7%) of the glaucoma group (p < 0.001). There was an excellent correlation between different measurements obtained on photography and those provided by the SD-OCT. Pearson's correlation coefficient was R = 0.95 (p <0.0001) for the optic disc area, R = 0.94 (p < 0.0001) for the rim area, and R = 0.98 (p < 0.0001) for the vertical cup-to-disc ratio. Conclusion: Color photography is very useful in the diagnosis and monitoring of glaucoma. The determination of normative values can further corroborate its interest in this indication. Despite the relatively high interobserver variability, ONH parameters obtained on photography showed excellent correlation with those measured by OCT

Ocular syphilis is a disease known as a great simulator.It can affect the structures of the eye. It often manifests by an anterior uveitis. Posterior segment involvement is very rare and it is exceptionally complicated by exudative retinal detachment. We report the case of a patient with bilateral bullous retinal detachment in the context of ocular syphilis with a good evolution after treatment by penicillin G and corticotherapy.

Paraneoplastic optic neuropathy is a relatively rare ocular manifestation. We report the case of a patient with bilateral papilledema revealing a pulmonary squamous cell carcinoma. Paraneoplastic neuropathy is linked to an immune reaction by the presence of autoantibodies against collapsin responsive mediator protein 5 . Diagnosis is based on the determination of these autoantibodies and the search for occult cancer by PET scan.Treatment is often based on corticosteroid therapy and sometimes immunosuppressive treatment is necessary in the case of corticosteroid unresponsiveness.

Pupillary membranes are mostly encountered in infant. They present the remnants of anterior tonica vasculosa lentis which nourishes the lens during fetal life, their regression generally begins from the sixth month of gestation. However in some cases they may persist and cause a visual impairment .the management of PPM depends on the size of pupillary aperture, the extent of the membrane, and its visual impact.

Purpose To evaluate through a prospective study the efficiency and safety of triamcinolone in subconjunctival injection on macular edema (ME), in the short and medium term.Patients and methods All the patients included in the study underwent ophthalmologic examination and optic coherence tomography of the macula. The injection of 0.2–0.3 ml (8–12 mg) of triamcinolone was done in the subconjunctival space. We evaluated its efficiency by measuring the best-corrected visual acuity and the central macular thickness at 1, 3, and 6 months. Safety was evaluated by following up the intraocular pressure; the presence or absence of cataract and conjunctival complications at 1, 3, and 6 months; and the glycemic control.Results A total of 44 eyes (36 patients) were included. The overall best-corrected visual acuity and central macular thickness improved after injection. Overall, 67% of diabetic patients required reinjection at the third month. In the cases of inflammatory ME (uveitis and Irvine–Gass), the evolution has remained stable for 6 months after a single injection. No significant variation in intraocular pressure was noted after 1 month (P=0.38), after 3 months (P=0.20), or after 6 months (P=0.13). However, four patients developed ocular hypertension (10 mmHg or more above baseline), which has been well controlled with local monotherapy. Overall, 9.5% of phakic patients developed a cataract at the control of the sixth month. The change in glycated hemoglobin before and after the injection was not significant (P=0.84).Conclusion Subconjunctival triamcinolone acetonide seems to be an interesting and well-tolerated alternative therapy of ME in the short and medium term.

Dermoid cysts are common orbital developmental tumors in childhood. They account for 3 to 9% of primary orbital tumors. They are considered to be congenital, but not all of them are diagnosed at birth. Dermoid cysts are benign choristomas that arise from sequestration of ectoderm along the lines of embryonic fusion of mesodermal processes destined to be bone. In most cases, the lesion is close to the zygomatic-frontal suture leading to a superotemporal subcutaneous mass in the eyebrow or eyelid. The intraorbital location is relatively rare and more prone to complications, particularly compressive. We report the case of a 41-year-old man with a large intraorbital tumor. The imaging aspects were evocative of an extraconal dermoid cyst. The tumor was resected through a transconjunctival route. Histopathologic examination confirmed the diagnosis of dermoid cyst.

Clinical Image Uveal effusion syndrome (UES) is defined by an abnormal collection of fluid that expands the suprachoroidal space, producing internal elevation of the choroid. Some of the common causes of choroidal detachment are trauma, surgery complication, choroidal inflammation, hypotonia and melanoma. The idiopathic form seems to be the less common, and considered as a diagnosis of exclusion. The physiopathology of UES is not so clear, Histological finding shows amorphous glycosaminoglycan-like material filling the interfibrillary spaces of excised scleral tissue, with disruption of collagen fibers. In some patients there may be reduced macromolecular diffusion that interferes with the normal trans-scleral egress of albumin out of the eye. Another complementary hypothesis suggests that swollen sclera compresses the vortex veins leading to suprachoroidal fluid retention. Patients with UES are divided into 3 groups, on the basis of axial length, refractif error and sclera abnormality. Type I is characterized with nanophtalmic eye, axial length of eye ball<19 mm, high grade hyperopia in refraction and rigid sclera. Type II of UES with non nanophtalmic eye, no remarkable refractive error and rigid sclera are identified. Then in the type III, the less common type, it is associated to normal size eyeball and sclera and no refractive error. We report a case of a 59 year old man, with decreased visual acuity, pain and red eye for 3 weeks in the left eye. Best-corrected visual acuity was 20/20 (+1.75 sphere) in the right eye and light perception in the left eye. Slit-lamp examination showed conjunctival hyperemia, tortuosity of scleral vessels, traces of a Tyndall effect, in his left eye. On MRI (Figure 1), the detachment, exhibited low T1 and high T2 signal, it is not limited anteriorly by the ora serrate and it diverges posteriorly as it approaches the optic disc. The intraocular pressure was 16 mmHg in the right eye and 14 mmHg in the left. Bilateral cataract, small in the right and denser in left eye. Dilated fundus examination was inaccessible in the left eye and normal in the right eye. Ocular ultrasound examination (Figure 2) showed a chorioretinal detachment and an axial length of 24 mm of the left eye. After analyzing the complementary tests performed. Inflammatory cause and choroidal melanoma and metastatic tumor where excluded. The case corresponded with type III UES. Although, UES is a serious condition that can lead to severe and permanent visual loss in both eyes. It is considered as an exclusion diagnosis, complementary tests are mandatory to exclude other causes of uveal effusion. The role of imaging is therefore important for the differential diagnosis, in particular to rule out choroid melanoma. Keywords: Lhermitte-Duclos; MRI; CT

The Vogt-Koyanagi-Harada syndrome (VKH) is a bilateral, severe granulomatous uveitis associated with serous retinal detachment, papillary edema and extra-ocular manifestations. Uveitis in children accounts for 5 to 10% of all uveitis cases; the VKH is rarely described in the children population. The diagnosis of this condition can be very challenging; especially if clinical diagnosis criteria are not being met at the onset of this affection. The visual prognosis is mostly good if the treatment is early started.

Cataract surgery is ranked among the most frequent operations, affecting a population over 65 years of age.Its prognosis is often favorable, however, there are rare complications including inflammation of the anterior segment known as Anterior Segment Toxicity Syndrome . the majority of our patients were men and diabetes appear in almost half and all our patients present various symptoms the first 24 hours dominated by the attack of the anterior segment our therapeutic attitude consists in the use of corticosteroids and hypotonizers with a good evolution in the majority of patients.

La sclerite posterieur est une affection rare, qui represente un vrai challenge diagnostic, en raison de son polymorphisme clinique. Elle se manifeste generalement par une baisse acuite visuelle associee a des douleurs oculaires. C’est une atteinte grave qui peut engager le pronostic visuel si le diagnostic est retarde. Nous rapportons le cas d’une patiente qui a presente une sclerite posterieur traitee initialement comme cellulite orbitaire. L’interet de notre observation est de souligner l’importance de l’examen ophtalmologique initial minutieux ainsi qu’un suivi rigoureux afin de detecter une pathologie aussi inhabituelle que la sclerite posterieur qui peut mimer un tableau de cellulite orbitaire.

Mucormycosis is a serious fungal infection that is associated with high mortality, but is rarely reported in ophthalmology. It is a disease with various presentations, this is why it is important to think about it in unbalanced diabetic patients. We report the case of a 27-year-old patient admitted for febrileke to acidosis decompensation of anorbito-facial cellulitis.

Photokeratitis is a painful keratitis caused by exposure of insufficiently protected eyes to the ultraviolet (UV) rays. We talk about "arc eye" when photokeratitis is caused by UV rays emitted by electric arc during electric arc welding process. We here report the case of a 35-year old rider, with no previous medical-surgical history, who had looked at an electric arc for a few minutes while the doors of his building were welded. He had bilateral burning in his eyes associated with lacrimation, photophobia and blepharospasm. Clinical examination showed corrected visual acuity of 8/10 and 9/10, conjunctival hyperemia with punctate erosive keratitis limited to palpebral fissure after the use of fluorescein. Given patient's clinical picture, keratoconjunctivitis photoelectrica (arc eye) was diagnosed. Treatment was based on topical antibiotics, wetting agents as well as agents with healing properties. Outcome was marked by total disappearance of the signs with restoration of bilateral visual acuity (10/10). This study highlights the role of prevention using appropriate protection equipment.

Purpose. To describe a case of choroidal melanocytoma mimicking a melanoma. Methods. Retrospective case report. Patient. A 48-year-old Moroccan woman presented with progressive, painless decreased vision in her left eye for 2 months. Results. Her visual acuity was light perception in the left eye and 20/20 in the right one. Fundus examination and fluorescein angiography of the left eye showed a total retinal detachment with a large superior brownish mass. The clinical examination, B-scan ultrasonography, and magnetic resonance imaging all suggested a malignant melanoma. Consequently, the eye was enucleated. The histopathology later revealed a benign melanocytoma of the choroid. Discussion. Melanocytoma is a rare benign pigmented tumor. It is classically described as a tumor of the optic nerve head, but there are some exceptional case reports of uveal tract locations (iris, ciliary body, and choroid). In such cases, it can be difficult to clinically differentiate a melanocytoma from a malignant melanoma.