Epidemiology of keratoconus.

Prevalence of keratoconus is variable in different parts of the world. Environmental and ethnic factors and the cohort of patients selected for such studies may explain the wide variation in the reported rates. Family history, gender differences, asymmetry in the two eyes, association with ocular rubbing, and natural history of disease are discussed.

Oral cyclosporine therapy for refractory severe vernal keratoconjunctivitis.

We report the success of oral cyclosporine therapy in a patient with severe vision-threatening vernal keratoconjunctivitis. A child presented with severe allergy which was not controlled with topical steroids, cyclosporine and mast cell stabilizers. Oral steroids were required repeatedly to suppress inflammation.

Mitomycin C therapy for corneal intraepithelial neoplasia masquerading as limbal stem cell deficiency with recurrent epithelial defect.

Diagnosis of corneal intraepithelial neoplasia was missed in a patient who presented with recurrent large epithelial defects with pannus. The patient was eventually diagnosed and successfully treated with topical mitomycin C. Mitomycin C may be preferable to surgery in lesions with extensive corneal involvement.

Diclofenac-induced acute corneal melt after collagen crosslinking for keratoconus.

Purpose: We report a case of acute corneal melt with perforation in a patient with keratoconus after collagen crosslinking treatment and the use of topical diclofenac and proparacaine eyedrops.

Methods: The authors present a case report with clinicopathologic correlation.

Results: A patient diagnosed with keratoconus underwent corneal collagen crosslinking followed by postoperative use of ofloxacin, dexamethasone, diclofenac, and proparacaine eyedrops.

Scleral ulceration after vitreoretinal surgery.

Scleral ulceration after ocular surgery is a rare but serious complication. Determination of the underlying systemic and local causes is critical for treatment. An unusual case of ischemic scleral ulceration after vitreoretinal surgery in a diabetic patient is reported.

Late corneal edema due to retained foldable lens fragment.

Late onset of corneal edema after cataract surgery is an unusual complication. We report a case of corneal edema presenting one month after cataract surgery. During implantation of the foldable lens, one haptic of the intraocular lens fractured at the optic haptic junction.

Viscoexpression technique in manual small incision cataract surgery.

Viscoexpression method of nucleus delivery in manual small incision cataract surgery is described in this article. The practical modifications to the conventional technique in special situations are presented. Intraoperative and postoperative problems likely to be encountered and the steps to avoid them and tackle them effectively are discussed.

Medical management approach to infectious keratitis.

This section provides guidelines on medical therapy of patients with infectious keratitis. In addition to initial empirical therapy, preferred medications, once the organisms responsible are isolated, are discussed. Atypical mycobacterial keratitis following lasik is described.

Surgically induced necrotizing scleritis after pterygium surgery.

We report a case of surgically induced necrotizing scleritis following pterygium surgery with the bare sclera technique, without the use of adjunctive irradiation or mitomycin C. The patient was successfully treated with systemic immunosuppression.

Nocardia infection following phacoemulsification.

Infection of a self-sealing tunnel incision is a rare but vision-threatening complication of cataract surgery. We describe two cases of side port infection following an uneventful phacoemulsification. Nocardia was isolated in one case.

Unusual dendritic keratitis.

Bilateral pseudo-dendritic keratitis in infancy can be due to tyrosinemia, a rare metabolic disorder. Ocular involvement may be the earliest presenting manifestation of this disease. Early diagnosis is essential because dietary modifications can result in complete reversal of the manifestations of this disorder.