Ophthalmic Manifestations In Patients Research Articles

Ophthalmic Assessment and Management in Acute Facial Palsy.

This article aims to provide insights into emerging concepts in ophthalmic manifestations in patients with facial palsy and discusses considerations used to develop patient-specific management plans in acute management.

Ophthalmic Manifestations of COVID-19: A Retrospective Study on Prevalence, Characteristics, and Clinical Implications.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, has had far-reaching implications beyond the respiratory system. Mounting evidence suggests that COVID-19 can impact various organ systems, including the eyes. This study aimed to elucidate the prevalence, characteristics, and clinical implications of ophthalmic manifestations in patients diagnosed with COVID-19. This retrospective study analyzed data from electronic medical records of adult patients hospitalized with COVID-19 between March 1, 2020, and December 31, 2020, at a large tertiary academic medical center. Ophthalmic manifestations, including conjunctivitis, dry eye symptoms, ocular pain, epiphora, ocular redness, and visual disturbances, were identified and examined for their prevalence, onset, duration, and associations with COVID-19 severity and systemic symptoms. Among 342 patients included in the study, 106 (31.0%) experienced at least one ophthalmic manifestation during their COVID-19 illness. Conjunctivitis was the most common manifestation in 62 patients (18.1%), followed by dry eye symptoms in 38 patients (11.1%), ocular pain/discomfort in 27 patients (7.9%), epiphora in 19 patients (5.6%), ocular redness in 14 patients (4.1%), and visual disturbances in nine patients (2.6%). Ophthalmic manifestations were significantly associated with severe COVID-19 illness (42.9% vs. 26.7%, p = 0.003) and the presence of systemic symptoms such as fever, cough, and dyspnea. The median time of onset was six days, and the median duration was 10 days. Ophthalmic manifestations are prevalent in COVID-19 patients, particularly in those with severe illness and systemic symptoms. The study highlights the importance of recognizing and managing ocular symptoms in affected individuals and underscores the multifaceted nature of COVID-19, necessitating interdisciplinary collaboration for comprehensive patient care.

Ophthalmic Manifestations in Patients with Blood Malignancies.

Ocular complications can occur in up to 90% of patients with blood malignancies. Such complications range from direct infiltration to local hemostatic imbalance and treatment-related toxicity. This narrative review is based on a systematic computerized search of the literature conducted until January 2024 and examines the common ocular complications associated with blood cancers. Ocular complications from primary disease include mass effects from ocular adnexal lymphomas and intraocular lymphomas, with B-cell lymphomas accounting for 95% of primary ocular presentations. Secondary disease involvement from systemic hematological malignancies can lead to a wide range of ocular manifestations, such as leukemic retinopathy. Furthermore, toxicity from antineoplastic therapies and ocular graft versus host disease (oGVHD) after hematopoietic stem cell transplantation present additional risks to ocular health. In conclusion, ocular complications in blood cancer patients are an integral part of patient management, requiring regular ophthalmic evaluations and close collaboration between oncologists and ophthalmologists. Advances in therapy and an increased focus on early symptom recognition are essential for preserving vision and enhancing patient quality of life.

Ophthalmic manifestations in patients recovered from COVID-19 in Mexico

Introduction and objectivesAlthough the ophthalmic manifestations appear to be associated with the coronavirus disease 2019 (COVID-19), there is not enough evidence. Hence, the aim of this study was to determine the various types and frequency of ophthalmic manifestations in patients recovered from SARS-CoV-2 infection in Mexico. Material and methodsThis retrospective, observational and descriptive study included all patients recovered from SARS-CoV-2 infection attending the tertiary level hospital of Mexican Social Security Institute (IMSS) from June 2020 to June 2022. During the hospital admission of patients, the demographic data such age, name, gender was recorded. Ophthalmologic examination was performed under torchlight by an ophthalmologist in the Department of Ophthalmology from IMSS. Data was compiled and statistically analyzed using Fisher’s exact test and Spearman correlation. ResultsA total of 3081 SARS-CoV-2-positive patients were recorded, of which 318 (10.32%) met the inclusion criteria. Of them, 21 (6.60%) had ophthalmic manifestations and the female-to-male ratio was 1.6:1. The mean age (±SD) was 47.95±15.27 years and the median (interquartile range) time from the diagnosis of COVID-19, as defined by positive SARS-CoV-2 RT-PCR testing, to detection of the ophthalmic manifestation was 31 (142) days. The most common ocular manifestation was orbital mucormycosis (23.80%). Interestingly, the presence of ophthalmic manifestations was not associated with severe COVID-19 (p=0.665). ConclusionsThe ophthalmic manifestations are infrequent in patients recovered from severe COVID-19. Nevertheless, further large sample studies are needed to confirm these findings.

Manifestaciones oftálmicas en pacientes recuperados de COVID-19 en México

Introduction and objectivesAlthough the ophthalmic manifestations appear to be associated with the coronavirus disease 2019 (COVID-19), there is not enough evidence. Hence, the aim of this study was to determine the various types and frequency of ophthalmic manifestations in patients recovered from SARS-CoV-2 infection in Mexico. Material and methodsThis retrospective, observational and descriptive study included all patients recovered from SARS-CoV-2 infection attending the tertiary level hospital of Mexican Social Security Institute (IMSS) from June 2020 to June 2022. During the hospital admission of patients, the demographic data such age, name, gender was recorded. Ophthalmologic examination was performed under torchlight by an ophthalmologist in the Department of Ophthalmology from IMSS. Data was compiled and statistically analyzed using Fisher's exact test and Spearman correlation. ResultsA total of 3,081 SARS-CoV-2-positive patients were recorded, of which 318 (10.32%) met the inclusion criteria. Of them, 21 (6.60%) had ophthalmic manifestations and the female-to-male ratio was 1.6:1. The mean age (±SD) was 47.95±15.27 years and the median (interquartile range) time from the diagnosis of COVID-19, as defined by positive SARS-CoV-2 RT-PCR testing, to detection of the ophthalmic manifestation was 31 (142) days. The most common ocular manifestation was orbital mucormycosis (23.80%). Interestingly, the presence of ophthalmic manifestations was not associated with severe COVID-19 (p=0.665). ConclusionsThe ophthalmic manifestations are infrequent in patients recovered from severe COVID-19. Nevertheless, further large sample studies are needed to confirm these findings.

STUDY OF OPHTHALMIC MANIFESTATIONS IN PATIENTS WITH HAEMATOLOGICAL DYSCRASIAS

STUDY OF OPHTHALMIC MANIFESTATIONS IN PATIENTS WITH HAEMATOLOGICAL DYSCRASIAS

STUDY OF OPHTHALMIC MANIFESTATIONS IN PATIENTS WITH HAEMATOLOGICAL DYSCRASIAS

BackgroundAndObjectives:Haematologicaldyscrasiasreferstodisorders of the cellular elements of the blood, indicating a pathologicalcondition.Tostudythetypesofophthalmicmanifestationsinhaematological dyscrasias. Methods: This was a Descriptive cross-sectional study of 200cases admitted and diagnosed with various haematological dyscrasias inMedicine, Paediatrics wardsof the hospital betweenDecember 2020 toNovember2022.Allpatientsunderwentastandardisedandcomprehensiveophthalmic evaluation. Results:Outof200cases,152caseswereofnonmalignantdiseases,and 48 cases were of malignant diseases.Male cases were predominantly higherthan female cases. Conjunctival pallor was the most common anteriorsegment manifestation observed, and Retinal haemorrhage was the mostcommon posterior segmentmanifestation observedduring the studyperiod. Conclusion: It is essential to examine all patients with haematologicaldisordersforocularmanifestationsasithelpsindiagnosisandprognosis. Early recognition of the ocular manifestations is of greatimportance as an early treatment institution may prevent or alleviatebothocularandsystemic complications.

Predictors of Ophthalmic Manifestations in Patients with Ankylosing Spondylitis

The aim of this study was to conduct a clinical and statistical analysis of ophthalmological manifestations in patients with Ankylosing Spondylitis (AS) using biologic disease-modifying antirheumatic drugs (bDMARDs) as a basic therapy. The study included 58 patients (19[32.7%] women and 39[67.3%] men) with AS receiving bDMARDs. The median age of patients was 41.81(25;60) years. The average age of the disease onset was 25.23(9;47) years. The patients were divided into two groups: Group 1 included 24 patients with ophthalmic manifestations; Group 2 included 34 patients without ophthalmic manifestations. All patients in Group 1 took TNF-α inhibitors, (infliximab, adalimumab, golimumab, etarnacept, and cetrolizumab-pegol). In Group 2, TNF-α inhibitors (infliximab, adalimumab, golimumab, etarnacept) were received by 32(92.4%) patients and interleukin-17 inhibitor (secukinumab) by 2(5.8%) patients. Group 1 was characterized by a greater age and average duration of the disease, as well as the presence of metabolic instability (blood glucose and creatinine levels in the borderline range). The effectiveness of bDMARD in AS is characterized by the normalization and stabilization of clinical and biochemical parameters, including blood cholesterol and creatinine levels, which prevents the occurrence of vascular lesions, including uveitis.

Prevalence of Ophthalmic Manifestations Related to Tourette Syndrome Based on Big Data

Purpose: To investigate the prevalence of ophthalmic manifestations in patients with Tourette syndrome using big data based on samples extracted from the Health Insurance Review and Assessment Service. Methods: The study participants included Korean patients under the age of 18 years who had received a Tourette syndrome diagnostic code (F95.2) between January 1, 2012, and December 31, 2016. Ophthalmic manifestations reported to be related to Tourette syndrome such as tic disorder, blepharospasm, involuntary gaze abnormality, and strabismus were selected as ophthalmic clinical diagnostic codes; amblyopia and refractive errors that had never been investigated in conjunction with Tourette syndrome were also selected. Prevalence was investigated using big data. Results: A total of 3,643 Tourette syndrome patients (2,777 men and 866 women) were included in the study. The number of patients receiving a tic disorder diagnostic code was 3,643 (100%); blepharospasm, 48 (1.3%); involuntary gaze abnormalities, 9 (0.2%); and strabismus, 109 (3%). In addition, the number of patients receiving an amblyopia diagnostic code was 29 (0.8%), and the number of patients with a refractive errors code was 1,306 (35.8%). Conclusions: Tourette syndrome can be accompanied by several ophthalmic manifestations. Thus, cooperation between a neuropsychiatrist and an ophthalmologist, and regular ophthalmological examinations, are considered necessary.

Eye disorders in patients with celiac disease and inflammatory bowel disease: A study using clinical data warehouse.

To analyze the prevalence of ophthalmic manifestations in patients with celiac disease, Crohn's disease and ulcerative colitis in Munich/Germany. A total of 272,873 patients of Ludwig Maximilians Universitat Ophthalmological Hospital with eye disease were evaluated between 2003 and 2019. The International Classification of Diseases, 10th revision (ICD-10) of celiac disease Crohn's disease, ulcerative colitis, and all medical records which had the diagnosis of these diseases were analyzed. A total of 272,873 patients were analyzed, with a mean age of 53 years, with approximately 48% female patients, and 51% male patients. We selected 72 patients with celiac disease (68% women and 32% men), with a minimum age of 8 years, maximum of 103 years, and an average of 52 years. The most common diagnoses were dry eye (32%) and cataract (12%). The mean intraocular pressure of patients with celiac disease was 15 mmHg. During the same study period, 103 patients with Crohn's disease were analyzed, with an average intraocular pressure of 14 mmHg.The minimum age of the patients was 12 years and a maximum of 93 years with an average age of 55 years, with 57% of females and 43% of males. The most common diagnoses were cataract (22%) and dry eye (19%). During the same study period, 99 patients with ulcerative colitis were analyzed, with an average intraocular pressure of 14 mmHg.The minimum age of the patients was 6 years and a maximum of 96 years, with an average age of 61 years, with 36% of females and 64% of males. The most common diagnoses were cataract (29.2%) and dry eye (12%). The main ophthalmological manifestations of patients requiring eye follow-up were dry eye and cataract for all the diseases analyzed, which can be considered as coincident complications. None of the three diseases had increased intraocular pressure. Thus, celiac disease presented a profile of ophthalmological manifestation similar to the other intestinal inflammatory diseases studied.

Ophthalmic manifestations in patients with collagen vascular disorders: a hospital-based retrospective observational study.

To study frequency and characteristics of ocular manifestations in Indian patients with collagen vascular disorders. The medical records of 73 patients (Males: Females 16:57) aged between 22 and 78years (mean ± SD = 43.5 ± 12.9years) with collagen vascular diseases were analyzed retrospectively for demography, subtypes of collagen vascular disease, and findings of complete ophthalmic examination. Lupus erythematosus (LE) in 39(53.4%, (SLE 18, DLE 21), systemic sclerosis in 27(37%), dermatomyositis in 5(6.8%), and primary Sjögren's syndrome in 2(2.7%) patients, respectively, were observed. Only 35(47.9%) patients had ocular manifestations. In LE keratoconjunctivitis sicca (n = 6), keratitis (n = 5), severe blepharitis (n = 3), retinopathy (n = 2), and optic neuritis in one patient, respectively, were major ocular manifestations. Major abnormalities occurring in systemic sclerosis included restricted eyelid mobility of variable severity (n = 8), eyelid telangiectasia (n = 5), keratoconjunctivitis sicca (n = 6), cataract (n = 5), shallow fornices (n = 4), conjunctival surface disease (n = 4), and uveitis, keratitis, episcleritis in one patient each, respectively. One patient with dermatomyositis had heliotrope rash. Two patients with primary Sjögren's syndrome had keratoconjunctivitis sicca. The study shows that LE frequently presented with keratoconjunctivitis sicca, retinopathy, and optic neuritis. Systemic sclerosis commonly develops eyelid immobility, blepharitis and telangiectasia, ocular surface disease and keratoconjunctivitis sicca, corneal abnormalities, and uveitis. A comprehensive ocular evaluation is imperative for early detection and management particularly of ocular surface disease, uveitis, and retinopathy to prevent potential sight-threatening complications. Limitations include retrospective study design and small number of patients for stratification.

Ocular manifestations of people living with HIV in Tunisia.

BackgroundOcular involvement is a common complication of human immunodeficiency virus (HIV). Knowledge about this topic in Tunisia is limited.ObjectiveTo investigate ophthalmic manifestations in patients living with HIV in Tunisia.MethodThis was an observational study, performed between January 2007 and December 2016. We included patients with ocular disorders related to HIV. The data were recorded retrospectively from chart review.ResultsAmongst 98 people living with HIV (PLWH), 36 participants (55 eyes) had ocular manifestations. The mean age was 32.2 ± 5.6 years. Twenty-four patients were men and 12 were women. The mean value of CD4+ T-cell count was 156.5 ± 4.2 cells/µL. Bilateral lesions were found in 19 eyes. Best corrected visual acuity was better than 6/12 in 36 eyes. The most common ocular finding was dry eye syndrome (22%), cotton-wool spots (20%) and retinal haemorrhage (16%) followed by cytomegalovirus (CMV) retinitis (9%), anterior uveitis (7%), toxoplasmosis (4%) and tuberculosis retinochoroiditis (7%) Herpetic keratitis (5%), Herpes zoster ophthalmicus (2%) and syphilitic chorioretinitis (2%). Papilledema was found in three eyes (5%). Panuveitis was observed in four eyes (7%): three of them were associated with chorioretinal toxoplasmosis, syphilitic chorioretinitis and CMV retinitis. The fourth was attributable to immune recovery uveitis. A CD4+ T-cell count of ≤ 200 cells/µL was found to be an independent risk factor for developing posterior segment manifestations.ConclusionVarious ophthalmic manifestations were observed in PLWH. The most common lesion was retinopathy. Ocular involvement can be serious leading to poor visual prognosis, which requires close collaboration between the ophthalmologist and infectious disease physician.

The Clinical and Radiologic Features Affecting the Ocular Symptoms in Patients With Paranasal Sinus Mucoceles Involving the Orbit.

Paranasal sinus (PNS) mucoceles may involve orbit and have ophthalmic manifestations. The objective of this study was to investigate the clinical and radiological features affecting the ophthalmic manifestations in patients with PNS mucoceles involving the orbit. Fifty-two patients underwent endoscopic sinus surgery for PNS mucoceles with orbital involvement were investigated. Ophthalmic manifestations included exophthalmos, ocular pain, diplopia, visual disturbance. The correlation between ocular symptoms and the mucocele volume, origin site of mucocele, and the involvement of extraocular muscles or optic nerve were evaluated. Ophthalmic manifestations were significantly higher in the anterior ethmoid and frontal sinus involvement. Exophthalmos was significantly increased in the involvement of anterior ethmoid sinus, frontal sinus, and superior group ocular muscles, but decreased in the mucocele of maxillary sinus. Ocular pain was significantly lower in the involvement of anterior ethmoid sinus, frontal sinus, and superior group ocular muscle. Diplopia showed no significant differences among clinical and radiological parameters. Visual disturbance was significantly higher in the involvement of posterior ethmoid sinus and sphenoid sinus. The volume of mucocele, relation to optic nerve, adjacent bony change, and duration of ocular symptom had no significant effect on ocular symptoms in patients with PNS mucoceles involving the orbit. The volume of mucocele did not affect the ophthalmic manifestations in patients with PNS mucoceles involving the orbit. Exophthalmos, ocular pain, and visual disturbance were significantly correlated with the involved sinus of PNS mucoceles.

SARS-CoV-2 and the Eye: Implications for the Retina Specialist from Human Coronavirus Outbreaks and Animal Models.

The current SARS-CoV-2 pandemic has escalated rapidly since December 2019. Understanding the ophthalmic manifestations in patients and animal models of the novel coronavirus may have implications for disease surveillance. Recognition of the potential for viral transmission through the tear film has ramification for protection of patients, physicians, and the public. Information from relevant published journal articles was surveyed using a computerized PubMed search and public health websites. We summarize current knowledge of ophthalmic manifestations of SARS-CoV-2 infection in patients and animal models, risk mitigation measures for patients and their providers, and implications for retina specialists. SARS-CoV-2 is efficiently transmitted among humans, and while the clinical course is mild in the majority of infected patients, severe complications including pneumonia, acute respiratory distress syndrome, and death can ensue, most often in elderly patients and individuals with co-morbidities. Conjunctivitis occurs in a small minority of patients with COVID-19 and SARS-CoV-2 RNA has been identified primarily in association with conjunctivitis. Uveitis has been observed in animal models of coronavirus infection and cotton-wool spots have been reported recently. SARS-CoV-2 and other coronaviruses have been rarely associated with conjunctivitis. The identification of SARS-CoV and SARS-CoV-2 RNA in the tear film of patients and its highly efficient transmission via respiratory aerosols supports eye protection, mask and gloves as part of infection prevention and control recommendations for retina providers. Disease surveillance during the COVID-19 pandemic outbreak may also include ongoing evaluation for uveitis and retinal disease given prior findings observed in animal models and a recent report of retinal manifestations.

Neurosyphilis cerebrospinal fluid findings in patients with ocular syphilis

ABSTRACT Purpose: To evaluate neurosyphilis cerebrospinal fluid (CSF) findings and initial ophthalmic manifestations in patients with syphilitic uveitis. Methods: We retrospectively reviewed the records of CSF analysis of 14 patients with syphilitic uveitis with treponemal analysis - chemiluminescent immunoassay and TPHA- and non-treponemal analysis - Rapid Plasma Reagin test – RPR. Results: 86% were males and 43% HIV+. Ocular signs of syphilis lead to the diagnosis of syphilis in 78% of patients. Typical syphilitic uveitis presentations included: acute syphilitic posterior placoid chorioretinitis (50% of patients), retinitis (21% of patients) and punctate inner retinitis (7% of patients). 57% of patients had definite neurosyphilis by the CDC criteria, while 71% had CSF abnormalities suggestive of central nervous system involvement. Conclusion: Based on international guidelines, the frequent CSF abnormalities found in syphilitic uveitis patient supports the diagnosis of neurosyphilis in a majority of patients.

Ocular manifestations in patients with cerebrovascular accidents in India: a cross-sectional observational study.

To assess ophthalmic manifestations in patients with stroke and emphasize the importance of a formal screening for visual problems in stroke patients in hospital and rehabilitation settings. This was a cross-sectional study of 50 newly diagnosed patients with stroke with Glasgow Coma Scale (GCS) > 8 examined within 3days of onset. A detailed ophthalmic examination was performed for each patient including visual acuity, fields, ocular motility, slit lamp and fundus examination, line bisection tests and cranial nerve assessment. Radiological investigations were reviewed and anatomically correlated. A total of 50 patients (41 male and nine female) were included in the study. Mean age of the stroke cohort was 51.36years. Twenty-nine patients (58%) had a subcortical stroke, while 42% (n = 21) patients had a cortical stroke. Nineteen patients (38%) demonstrated visual field defects. Twenty-one patients (42%) had a gaze palsy. Vertical gaze palsy (n = 8) was more common in cortical stroke, while internuclear ophthalmoplegia (n = 2), horizontal gaze palsies (n = 4) and Parinaud's syndrome (n = 1) were seen more commonly in those with subcortical stroke. Twenty-four percent (n = 12) patients had nystagmus. Twelve percent (n = 6) patients had diplopia. Thirty-eight percent (n = 19) patients had convergence insufficiency. Sixteen patients (32%) complained of visual impairment. Retinal abnormalities were seen in 58% (n = 29) of patients. Ophthalmic manifestations were seen in 90% of stroke survivors. Their presence in majority of the patients in our cohort suggests that earliest routine ophthalmic examination should be mandatory in all patients with acute stroke.

Ocular Manifestations in Patients with HIV infection.

To evaluate the characteristics and incidence of ophthalmic manifestations in patients with HIV (Human Immunodeficiency Virus) infection. Aretrospective evaluation of medical records of 147 patients with HIV infection (22 female, 125 male), the average age of 41 (range 22-79 years) examined by an ophthalmologist at the Clinic of Ophthalmology at the University Hospital Ostrava in years 1987 - 2015. Ophthalmic manifestations of HIV were observed in 16 patients (11.9 %). There was not observed ocular involvement in patients in asymptomatic stage of HIV infection. Ophthalmic complications were observed in 1 patients (0.7 %) in early symptomatic stage and 15 patients (10.2 %) with stage AIDS (Acquired Immune Deficiency Syndrome). The most frequent ocular symptoms were caused by the virus (HIV retinopathy, mikroangiopathy) - total of 13 infected (76.5 %). Three patients had opportunity infections (17.6 %). As aresult of the underlying AIDS disease 5 patients died. Ocular findings were observed at 2 of those (40.0 %). Ocular manifestation are common finding in late stages of HIV infection. Ophthalmic examination is an integral part of the diagnostic algorithm of patients with HIV infection. Most frequently, ocular symptoms have been found within the group of patients with advanced part of disease, which is in relation with the body´simmune defense decrease thus death itself.

Ophthalmic Manifestations In Patients of Acute Leukaemia Presenting to A Tertiary Care Centre In Western Rajasthan

Purpose:- To determine the prevalence and pattern of ophthalmic manifestations in patients of Acute Myeloid Leukemia (AML) and Acute Lymphoid Leukemia (ALL) presenting to a tertiary care centre in Western Rajasthan.

Ophthalmic Manifestations of Congenital Zika Syndrome in Colombia and Venezuela

The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed. To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela. This prospective case series included 43 patients from 2 ophthalmic centers in Colombia and Venezuela who underwent evaluation from October 1, 2015, through June 30, 2016, and were clinically diagnosed with congenital Zika syndrome. Twenty patients were Hispanic; 13, African; 8, white; and 2, Native American. Ophthalmic and systemic evaluations and serologic testing were performed on all infants. Patients underwent external ocular examination and dilated ophthalmoscopy. Serologic testing ruled out toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus. Ophthalmic manifestations of congenital Zika syndrome. Of the 43 patients included in this series (28 female and 15 male), the mean (SD) age at examination was 2.1 (1.5) months. The mothers of all the children had no ophthalmic findings and did not report ocular symptoms during pregnancy. All patients had bilateral ophthalmic manifestations. Optic nerve findings included hypoplasia with the double-ring sign, pallor, and increased cup-disc ratio in 5 patients (11.6%). Macular abnormalities included mild to severe pigment mottling in 27 patients (63%) and lacunar maculopathy in 3 (6.9%). Chorioretinal scarring was present in 3 patients (7%). Eleven patients (26%) had a combination of lesions in the posterior pole. Five patients (12%) were diagnosed with congenital glaucoma, characterized by the clinical triad of epiphora, photophobia, and blepharospasm; increased intraocular pressure; corneal clouding at birth; and buphthalmos. These data reveal that 12% (95% CI, 5%-24%) of cases of congenital Zika with microcephaly had anterior segment abnormalities and 88% (95% CI, 76%-94%) had important macular and optic nerve abnormalities. The visual sequelae of these ophthalmic manifestations remain unknown. Congenital Zika syndrome in the current study had severe ocular abnormalities, and all patients had bilateral involvement. Ocular findings were focal macular pigment mottling, chorioretinal atrophy with a predilection for the macular area, congenital glaucoma and optical nerve hypoplasia, and optic disc abnormalities. Ophthalmic examination is recommended in patients with congenital Zika syndrome.

Ophthalmic manifestations in patients with inflammatory bowel disease: A review.

Clinical manifestations of inflammatory bowel disease (IBD) are not locally restricted to the gastrointestinal tract, and a significant portion of patients have involvement of other organs and systems. The visual system is one of the most frequently affected, mainly by inflammatory disorders such as episcleritis, uveitis and scleritis. A critical review of available literature concerning ocular involvement in IBD, as it appears in PubMed, was performed. Episcleritis, the most common ocular extraintestinal manifestation (EIM), seems to be more associated with IBD activity when compared with other ocular EIMs. In IBD patients, anterior uveitis has an insidious onset, it is longstanding and bilateral, and not related to the intestinal disease activity. Systemic steroids or immunosuppressants may be necessary in severe ocular inflammation cases, and control of the underlying bowel disease is important to prevent recurrence. Our review revealed that ocular involvement is more prevalent in Crohn’s disease than ulcerative colitis, in active IBD, mainly in the presence of other EIMs. The ophthalmic symptoms in IBD are mainly non-specific and their relevance may not be recognized by the clinician; most ophthalmic manifestations are treatable, and resolve without sequel upon prompt treatment. A collaborative clinical care team for management of IBD that includes ophthalmologists is central for improvement of quality care for these patients, and it is also cost-effective.