An 11-year-old boy was involved in an injury with a fish-hook to his eye. The hook had impaled itself to the cornea and deeper structures. There was associated corneal edema and hyphema, making visualization difficult. In this case, we performed the unusual "cut-it-out" technique to remove the hook from the eye.
We report the case series of phacoemulsification-related Descemet membrane detachment (DMD) encountered at a tertiary hospital in Kuala Lumpur. Case 1 was an iatrogenic DMD which was detected intraoperatively and managed early with good outcome. Case 2 and case 3 described unusual presentation of DMD which was initially undiagnosed. This report highlights the use of anterior segment optical coherence tomography (ASOCT) in detecting and confirming the correct diagnosis for DMD. With the aid of an experienced corneal specialist, the higher threshold for suspicious occurrence of DMD was confirmed using ASOCT. Treatment was tailored accordingly, with successful clearance of corneal oedema and visual recovery. This case series highlighted the importance of proper operative documentation and high threshold for suspicion for DMD in focal corneal oedema following an otherwise uneventful cataract surgery. It is concluded that ASOCT is an excellent tool to confirm diagnosis of DMD and success of treatment.
A 42-year-old gentleman presented with left eye pain after accidental contact with Euphorbia lactea sap while gar- dening. At presentation, left eye best-corrected visual acuity (BCVA) was 20/30. Ocular examination revealed left eye conjunctiva congestion and cornea abrasion. Eye symptoms and BCVA deteriorated over 12 hours. Cornea showed diffuse stromal oedema with presence of anterior uveitis. A diagnosis of toxic keratouveitis was made. He was treat- ed with intensive topical steroids, cycloplegics, lubricants, prophylactic antibiotics and oral non-steroidal anti-in- flammatory analgesic. Patient achieved complete resolution two weeks later. We aim to raise awareness among the ophthalmologists to detect and manage these injuries.