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Kawali A.,Uveitis and Ocular Immunology Services | Mahendradas P.,Uveitis and Ocular Immunology Services | Srinivasan P.,Vitreo retinal Services | Yadav N.K.,Vitreo retinal Services | And 3 more authors.
Journal of Ophthalmic Inflammation and Infection | Year: 2015

Background: Though rickettsiosis is common in India, there is paucity of rickettsial retinitis (RR) reports from India. Moreover, rickettsial sub-types and their association with retinitis have not been studied. We are reporting a case series of presumed RR with their course of the disease, visual outcome, and association with rickettsial sub-type based on Weil-Felix test. Findings: This is a retrospective study of 19 eyes of 10 patients presented to a single institution. Cases diagnosed with presumed RR were identified from our database from March 2006 to October 2014 and studied retrospectively for patient’s demography, clinical presentation, and treatment. Patients with history of fever, retinitis, and a positive Weil-Felix test and a negative chikungunya and dengue serology were diagnosed as presumed rickettsial uveitis. One patient was diagnosed to have epidemic typhus, and four were diagnosed to have Indian tick typhus. Nine patients had bilateral presentation. One patient had history of dog tick bite, and four patients had skin rashes. All the patients presented between 2 and 4 weeks after a fever. Conclusions: Retinitis on posterior pole with recent history of fever with or without skin rash and a positive Weil-Felix test may suggest a rickettsial etiology. Its ocular manifestation could be an immune response to recent systemic rickettsial infection. Indian tick typhus and epidemic typhus could be the common sub-types seen in our population. Although it has aggressive presentation, it has a good visual prognosis. © 2015, Kawali et al.

Shanker V.,Venu Eye Institute and Research Center | Nigam V.,Venu Eye Institute and Research Center | Mathur U.,Cornea and Refractive Services
Oman Journal of Ophthalmology | Year: 2015

A 32-year old male hairdresser presented with redness and irritation of the left eye for past 15 days. A fragment of hair was found embedded in deep corneal stroma with minimal scarring. No evidence was found of previous or current inflammation incited by this foreign body. The position and depth of the hair fragment was documented by anterior segment optical coherence tomography (AS-OCT) and its effect on the corneal endothelium was assessed by specular microscopy. Hairdressers should take adequate precautions to prevent ocular injury although human hair appears to be well tolerated by the cornea. © 2015 Farjadnia M, et al.

Kawali A.A.,Uveitis and Ocular Immunology Services | Mahendradas P.,Uveitis and Ocular Immunology Services | Gupta K.,Vitreo retinal Services | Srinivasan P.,Vitreo retinal Services | And 3 more authors.
Journal of Ophthalmic Inflammation and Infection | Year: 2016

Diagnosis of rickettsial retinitis remains presumptive when gold standard tests are not available or not done due to financial constrains. History of tick bite followed by fever with skin rash particularly in winter and spring season may point towards Rickettsiosis. The absence of scarring post resolution of rickettsial retinitis suggests inner retinal involvement in contrast to toxoplasmosis. Bilaterality of the disease, 2–4 weeks of latent period, and multifocal nature of retinitis lesions (cotton wool spot-like lesions) especially around the disc and posterior pole may suggest an immune response to recent systemic infection. The use of only antibiotics or only steroids or both together for treatment of rickettsial retinitis is controversial and warrants randomized controlled trials. © 2016, The Author(s).

Saha S.,Priyamvada Birla Aravind Eye Hospital | Saha S.,Vidyasagar University | Sengupta J.,Cornea and Refractive Services | Chatterjee D.,Cornea and Refractive Services | Banerjee D.,Vidyasagar University
Indian Journal of Ophthalmology | Year: 2014

Rhodotorula mucilaginosa rarely cause keratitis in immunocompromised individuals. A 30 year old male with history of minor trauma presented with cotton wool like stromal infiltration and hypopyon in left eye. Microbiological examination of corneal scraping showed fungal hyphae and yeast cells in direct smear. Molecular identification of the organism was performed which showed 100% homology with Rhodotorula mucilaginosa. Management of these cases is difficult often necessitating surgical procedures. However further reports are necessary to understand the disease and establish a treatment protocol.

Shetty R.,Cornea and Refractive Services | Sethu S.,GROW Research Laboratory | Deshmukh R.,Cornea and Refractive Services | Deshpande K.,Cornea and Refractive Services | And 3 more authors.
BioMed Research International | Year: 2016

Dry eye disease (DED) has evolved into a major public health concern with ocular discomfort and pain being responsible for significant morbidity associated with DED. However, the etiopathological factors contributing to ocular pain associated with DED are not well understood. The current IVCM based study investigated the association between corneal dendritic cell density (DCD), corneal subbasal nerve plexus (SBNP) features, and serum vitamin D and symptoms of evaporative dry eye (EDE). The study included age and sex matched 52 EDE patients and 43 heathy controls. A significant increase in the OSDI scores (discomfort subscale) was observed between EDE (median, 20.8) and control (median, 4.2) cohorts (P < 0.001). Similarly, an increase in DCD was observed between EDE (median, 48.1 cells/mm2) patients and controls (median, 5.6 cells/mm2) (P < 0.001). A significant decrease in SBNP features (corneal nerve fiber length, fiber density, fiber width, total branch density, nerve branch density, and fiber area) was observed in EDE patients with OSDI score >23 (P < 0.05). A positive correlation was observed between DCD and OSDI discomfort subscale (r = 0.348; P < 0.0003) and SBNP features. An inverse correlation was observed between vitamin D and OSDI scores (r = - 0.332; P = 0.0095) and DCD with dendritic processes (r = - 0.322; P = 0.0122). The findings implicate DCD, SBNP features, and vitamin D with EDE symptoms. © 2016 Rohit Shetty et al.

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