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Purpose: To study the clinical spectrum and recovery patterns in patients of acquired isolated ocular motor nerve palsies (OMNPs). Methods: Patients above 5 years of age with various etiologies of OMNPs were included. Demographic and ocular details were recorded, and a squint assessment was performed. Recovery patterns at 3 and 6 months were noted. Results: OMNP was more common in adults, in the order VI > III > IV nerve. Ischemic cause (35%) was followed by idiopathic (26.3%). III nerve palsies were all unilateral, of which all ischemic palsies were pupil-sparing. By 6 months, >50 patients showing complete recovery had ischemic and idiopathic palsies. Smaller baseline deviation correlated with better recovery. Conclusion: Acquired isolated OMNPs are mostly ischemia-related, with >80% of cases fully recovering by 6 months. VI nerve palsy of ischemic or idiopathic etiology and small baseline deviation were associated with self-recovery. [ABSTRACT FROM AUTHOR]

Byline: Arumugom. Archana, Tamil. Selvan, Venkatraman. Kumar, K. Abinaya, Nirupama. Kasturi To the editor, An 18-month-old male child presented with complaints of not being able to fixate on objects and [...]

Background. Fundus examination is an integral part of the clinical evaluation of patients with medical emergencies. It is done at the bedside using a portable direct ophthalmoscope. Smartphone fundus photography (SFP) is a novel technique of retinal imaging. We evaluated the use of SFP by a physician in medical emergencies and compared it with direct ophthalmoscopy (DO) findings of the ophthalmologist. Methods. We did a prospective study on patients admitted with medical emergencies with an indication for fundus examination. The SFP was done by the physician, and its findings were noted. These were compared with the DO findings of the ophthalmologist. Results. Of the 182 patients studied, 111 (61%) had fundus findings by SFP and 95 (52.5%) by DO. Papilloedema (21.4%), haemorrhages (20%) and Roth spots (12.5%) were most common. DO missed early papilloedema and findings in the peripheral retina. Conclusions. SFP is as effective as DO, in detecting retinal findings in patients with medical emergencies and can be performed at the bedside by the physician. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) affects the eye as part of the disease or due to the drugs used in therapy. Ocular involvement is seen in one third of the patients with SLE. SLE is rare in India and found less frequently in males and children. SLE retinopathy is usually bilateral. We report an unusual case of unilateral macular infarction in a boy caused by systemic lupus erythematosus. A fourteen year old boy was presented with skin rashes and loss of vision in left eye. Posterior segment examination showed hyperemic edematous disc, arteriolar attenuation, venous dilatation, multiple cotton wool spots around the disc and macula in the left eye. There was no improvement in vision with pulse steroids and cyclophosphamide. The clinical implication of SLE retinopathy is that the disease is severe and warrants systemic immunosuppressive therapy. SLE-induced macular infarction is rare and has poor visual prognosis. As serious ocular complications of SLE can be silent, routine ophthalmological evaluation is warranted in all patients.

PURPOSE: To assess the refractive outcomes in eyes with severe Retinopathy of prematurity (ROP) after treatment with the frequency-doubled neodymium-doped yttrium aluminum garnet (Nd-YAG) laser 532 nm (green laser) at 1-2 years of age and compare with eyes that underwent spontaneous regression of ROP and to identify the risk factors associated with the refractive outcomes in laser-treated eyes with severe ROP. METHODOLOGY: Infants who underwent laser treatment with green laser were enrolled in Group 1 and those who had spontaneous regression of ROP were enrolled in Group 2. All these children underwent a visual assessment, refraction using 1% cyclopentolate eye drops and indirect ophthalmoscopy at 1-2 years of age. Data regarding the gestational age, sex, birth weight, inborn (born in our institution) or outborn (born outside and referred to us), stage and zone of ROP and laser spots given were obtained from the treatment records. Data were analyzed using SSPS 19.0 software for Windows (SSPS Inc., Chicago, Illinois, USA). RESULTS: A total of 102 infants were enrolled, 51 in each group. Visual acuity ranged from 0.25-1 cycles per cm in both groups. Spherical equivalent (SE) ranged from - 8.25 D to + 5.50 D in Group 1 and -1.00D to +4.00D in Group 2. Group 1 had an incidence of 23.5% Myopia and 33.4% Astigmatism which was significantly more than Group 2. The linear regression model predicted a decrease in the SE by 0.658D if the number of laser spots increased by 1000 (P < 0.001). No other risk factors (gestational age/birth weight) were found to have a significant association with refractive errors in the lasered ROP group. CONCLUSIONS: Eyes with laser-treated severe ROP are frequently associated with myopia and astigmatism when compared to spontaneously regressed ROP. The number of laser spots delivered has a direct association with the amount of refractive error. [ABSTRACT FROM AUTHOR]

Keywords: Adrenoleukodystrophy; optic nerve demyelination; very-long-chain fatty acids EN Adrenoleukodystrophy optic nerve demyelination very-long-chain fatty acids 2757 2760 4 07/15/22 20220701 NES 220701 Adrenoleukodystrophy (ALD) is an x-linked recessive lipid storage genetic disorder due to modifications in the ABCD1 (ATP-binding cassette) gene, resulting in defective peroxisomal -oxidation and the excessive collection of very-long-chain fatty acids (VLCFAs) in tissues and plasma.[[1]] It causes progressive demyelination of the nervous system and manifests as dementia, behavioral changes, gait disturbances, sensory disturbances, and visual loss.[[2]] It can also present as a primary adrenal insufficiency resulting in hyperpigmentation in the skin and testicle. Adrenoleukodystrophy, optic nerve demyelination, very-long-chain fatty acids. [Extracted from the article]