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Vitreous hemorrhage is associated with a myriad of conditions such as proliferative diabetic retinopathy, proliferative retinopathy following vascular occlusion and vasculitis, trauma, retinal breaks, and posterior vitreous detachment without retinal break. Multiple pathological mechanisms are associated with development of vitreous hemorrhage such as disruption of abnormal vessels, normal vessels, and extension of blood from an adjacent source. The diagnosis of vitreous hemorrhage requires a thorough history taking and clinical examination including investigations such as ultra-sonography, which help decide the appropriate time for intervention. The prognosis of vitreous hemorrhage depends on the underlying cause. Treatment options include observation, laser photo-coagulation, cryotherapy, intravitreal injections of anti-vascular endothelial growth factor, and surgery. Pars plana vitrectomy remains the cornerstone of management. Complications of vitreous hemorrhage include glaucoma (ghost cell glaucoma, hemosiderotic glaucoma), proliferative vitreoretinopathy, and hemosiderosis bulbi.

A 42-year-old male post-renal transplantation presented with sudden diminution of vision in the left eye. The right eye was lost following a failed vitreoretinal surgery 5 years ago. The patient had been hospitalized 4 months prior for coronavirus disease 2019 infection with a good recovery. The presenting visual acuity was 20/600 in the right eye and 20/250 in the left eye. Fundus examination revealed a sub-macular sub-retinal abscess in the left eye. Sub-retinal aspiration of the abscess revealed Candida albicans. The patient was managed with repeated intravitreal amphotericin B injections, following which the abscess resolved with scarring and vision improving to 20/60.

Purpose Persistent optic disc bleeding during pars plana vitrectomy (PPV) is difficult to manage. This study aims to explore the use of fibrin glue as a novel agent to achieve hemostasis in such eyes. Methods Interventional case series of patients with vitreous hemorrhage (VH) or tractional retinal detachment (TRD) due to proliferative diabetic retinopathy, retinal vein occlusion or retinal vasculitis, in whom fibrin glue was used intraoperatively for hemostasis. All the patients were followed up for 1 month. Results 14 eyes of 14 patients were included, of which 12 (85.7%) were male with mean age of 52 years. Surgery was performed in 10 eyes (71.4%) for VH and 4 eyes (28.6%) for TRD. The mean best corrected visual acuity (BCVA) improved from 1.33±0.53 Logarithm of the Minimum Angle of Resolution (logMAR) (20/428), to 0.42± 0.35 logMAR (20/53) 1 month after surgery ( P  = 0.002), 0.43± 0.32 logMAR (20/54) 3 months after surgery ( p  = 0.003) and 0.36±0.34 logMAR (20/46) at a mean of 7 months ( p  = 0.002) after the surgery. Post operative vitreous cavity hemorrhage occurred in 1 eye (7.1%), which did not require a repeat surgery. Conclusions This report demonstrates the efficacy of fibrin glue used during vitrectomy in controlling persistent optic disc hemorrhage in a cohort of diverse etiologies. Summary Persistent intraoperative optic disc bleeding is difficult to manage with adverse outcomes. Fibrin glue is a short acting bioadhesive, which has shown favorable outcomes when used in rhegmatogenous retinal detachment and macular hole surgeries. Our prospective interventional study shows that the use of fibrin glue is a valuable technique to manage optic disc bleeders, allowing for better and faster visual recovery, while reducing the incidences of rebleeding and reoperations. Of the 14 eyes included in our study, post-operative vitreous cavity hemorrhage occurred in just one case, which resolved spontaneously, and did not need any reoperation.

Albinism describes a heterogeneous group of genetically determined disorders characterized by disrupted synthesis of melanin and a range of developmental ocular abnormalities. The main ocular features common to both oculocutaneous albinism (OCA), and ocular albinism (OA) include reduced visual acuity, refractive errors, foveal hypoplasia, congenital nystagmus, iris and fundus hypopigmentation and visual pathway misrouting, but clinical signs vary and there is phenotypic overlap with other pathologies. This study reviews the prevalence, genetics and ocular manifestations of OCA and OA, including abnormal development of the optic chiasm. The role of visual electrophysiology in the detection of chiasmal dysfunction and visual pathway misrouting is emphasized, highlighting how age-associated changes in visual evoked potential (VEP) test results must be considered to enable accurate diagnosis, and illustrated further by the inclusion of novel VEP data in genetically confirmed cases. Differential diagnosis is considered in the context of suspected retinal and other disorders, including rare syndromes that may masquerade as albinism.

Aim To report the clinical settings and factors predicting outcomes in scleral tears with concurrent retained intraocular foreign bodies Methods All cases with scleral and corneoscleral wounds with retained intraocular foreign bodies (RIOFB) from January 2014 to January 2021 were retrospectively analysed. Favourable anatomic outcome was defined as presence of globe integrity, attached retina, absence of hypotony and active inflammation at last visit. Favourable functional outcome was defined as final visual acuity (VA) > 20/200. Results Total 139 eyes were included. Mean age was 30.66 ± 13.32 years (median 29 years, IQR 17). Penetrating trauma accounted for 87.1%, rupture for 5.8%, perforation for 7.2%. In 5.8% of the eyes the injury involved zone I extending till Zone II while in 66.9% it involved Zone II and in 27.3% in Zone III. Snellen visual acuity at presentation was logMAR 2.97 ± 1.01 and at last visit was logMAR 2.38 ± 1.45 ( p  < 0.0001). Time between presentation and repair was 13.93 ± 19.56 h (median 7.6 h, IQR 17.17). Favourable functional outcome was seen in 34.5% eyes and 2/3rd achieved favourable anatomic outcome. Absence of endophthalmitis (OR = 6.25, p  = 0.003) and ability to remove the foreign body (OR = 7.05, p  = 0.003) were associated with a favourable anatomic outcome. Better presenting Snellen visual acuity (OR = 2.77, p  = 0.003), manifest scleral tear (OR = 3.36, p  = 0.04), and absence of endophthalmitis (OR = 50, p  = 0.0009) were associated with a favourable functional outcome. Conclusion A third of the cases achieved favourable visual outcome while 2/3rd achieved favourable anatomic outcome. Absence of endophthalmitis is an important factor predicting both.