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Retinal intravascular lipid aggregates were detected in the left eye in a patient with uncontrolled diabetes and very high blood triglycerides. The patient suffered visual loss in the left eye due to retinal ischemia. Optical coherence tomography, fluorescein angiography, infrared fundus photography, and autofluorescence studies of the retina demonstrated unique findings. Slowed choroidal and retinal flow was detected on fluorescein angiography, and a prominent middle layer membrane sign was present on OCT. Intravascular lipid reflectivity was manifest on retinal infrared and autofluorescence imaging. Eventually, insulin and statin therapy proved effective in reversing the vascular lesions, although retinal atrophy finally ensued. This report of a very rare clinical condition provides unique findings on multimodal retinal imaging and confirms the need for prompt insulin and statin therapy in severe/extreme hypertriglyceridemia and dysregulated diabetes. One similar case was reported in the past when multimodal imaging studies of the retina were not available. The lesions described herein should be differentiated from the more frequently encountered lipemia retinalis as they may confer worse prognosis. [ABSTRACT FROM AUTHOR]

Purpose: To compare, in a larger study population, the outcomes of strabismus surgery in patients who either had the scleral explant (EX) retained or removed after surgery for retinal detachment. Methods: A comparative retrospective study includes data from 2 centres. Surgical outcome, motor success, sensory success, the number of secondary operations for strabismus and complications were compared between the two groups. Motor success was defined as horizontal deviation of ≤6 prism diopters (PD) and vertical deviation of ≤6PD. Sensory success was defined as no diplopia without use of prism. Results: Forty‐seven patients were included in the study; 70% had retained the EX and 74% had vertical strabismus. Horizontally, the final alignment was equal between the 2 groups, 4 PD vs.5 PD in the EX removed group. The patients with retained EX were referred with a significant lower mean vertical deviation and had a significant lower post‐operative mean vertical deviation of 2 PD vs. 3 PD in the EX‐removed group. The rates of motor success (76% vs. 71%) and sensory success (79% vs. 93%) did not differ significantly between the EX‐retained and EX‐removed groups. No patients underwent more than 2 operations. Two complications occurred in the EX‐retained group: a subconjunctival cyst and an exposed EX. In the EX‐removed group, 2 patients with retinal re‐detachment were found in the follow‐up period. Conclusion: Good surgical outcomes including high motor and sensory success were obtained regardless of the presence of the EX. Retinal re‐detachment was observed in two patients with previously removed EX. [ABSTRACT FROM AUTHOR]

Purpose: Direct ophthalmoscopy can reveal systemic, neurologic and ophthalmic conditions, but is poorly mastered among young physicians. A theoretical test is needed to measure effect of educational interventions. We developed and gathered validity evidence for a multiple‐choice questionnaire (MCQ)‐based theoretical test in direct ophthalmoscopy. Methods: The MCQ was developed by interviewing experts. Then, validity evidence was evaluated using Messick's validity framework. Content was ensured by inviting the experts to contribute in a Delphi‐like process. Response process was ensured by piloting and by streamlining all instructions. Then, the test was taken by ophthalmologists and by medical students without experience in direct ophthalmoscopy. Results were used to evaluate internal structure (item quality analysis and internal consistency), relations to other variables (correlation of test scores to experience level) and consequences (establishment of pass–fail score and the consequences of its use). Results: The first phase of the study yielded 100 MCQs. In second phase, we identified that 60 items fulfilled predefined relevance and item quality requirements. These items demonstrated very high internal consistency (Cronbach's alpha = 0.95), significantly discriminated medical students from specialists (p < 0.001, independent samples t‐test) and the established pass–fail score of 50 (83%) correct answers resulted in no false positives (students passing) and no false negatives (specialists failing). A Decision study identified that sampling 15 items suffice for certification. Conclusion: We developed and validated an MCQ‐based theoretical test in direct ophthalmoscopy that enables an evidence‐based approach to measuring, evaluating and certifying the theoretical knowledge necessary for direct ophthalmoscopy. [ABSTRACT FROM AUTHOR]

Anterior scleritis and episcleritis are a well-known presentation in tuberculosis. The case of a female patient with presumed tuberculous anterior scleritis and episcleritis is discussed in this article. Anterior segment OCT was efficient in diagnosis and evaluation of the therapeutic outcome. Antituberculosis chemotherapy was sufficient to achieve clinical remission. [ABSTRACT FROM AUTHOR]

The article present a case study of a 56-year-old male patient with blurred vision in the right eye (RE) through 1 week. It mentions Ocular biomicrosopy showed cells (1+) in the anterior chamber and mild vitritis in both eyes; and also mentions spectral domain optical coherence tomography (SD-OCT) manifested disruption of the ellipsoid zone and of the external limiting membrane in both eyes.

A letter to the editor is presented in response to the article on necrotizing scleritis and its occurrence in Wegener's granulomatosis (WG) after surgery.

A letter to the editor is presented which discusses a case study of 74-year-old white women presented with vitreous haemorrhage in her left eye of unknown aetiology and diagnose with polypoidal choroidal vasculopathy (PCV).