Infectious conjunctivitis is a very common presentation to medical professional and ophthalmologist all over the world. Although its typically self-limiting and treatable in almost all of the cases, but we need to be aware of the rare and potentially life threatening if the cause is not promptly identified and treated accordingly. In our case report, we highlighted the rare case of Neisseria meningitidis as a primary cause of keratoconjunctivitis. Neisseria meningitidis is a rare etiology of keratoconjunctivitis and its ocular presentations are quite similar with other bacterial or viral infection. The infection may potentially fatal if systemic invasion occurred, however with immediate and proper treatment the outcome is satisfactory. Early diagnosis and proper antibiotic treatment are critical to prevent systemic spread of the infection. Public health intervention is needed to prevent outbreak of the disease.

Diabetic retinopathy (DR) may result in progressive visual impairment and blindness which affects the diabetic patients‟ morbidity and quality of life significantly. The objective of this study was to determine the proportions and prognostic factors of DR severity among Type 2 diabetes mellitus patients. A cross sectional study was conducted at the Ophthalmology Clinic in a tertiary hospital using the medical record database from 2005 to 2011. A total of 216DR patients were randomly selected. The study outcome was DR severity which was classified into four grading based on the International Clinical Diabetic Retinopathy Scale. Descriptive statistics and Ordinal Logistic Regression were applied using Stata SE/11. The mean (SD) age of DR in this study was 56.06 (9.98) years old with almost equal sex ratio. Proportion of mild non proliferative diabetic retinopathy (NPDR) was 48.6% (95% CI: 40.0, 60.0), moderate NPDR was 28.2% (95%CI: 22.0, 40.0), severe NPDR was 6.9% (95% CI: 4.0, 11.0) and proliferative diabetic retinopathy (PDR) was 16.2% (95%CI: 10.0, 22.0). Diabetic patients that suffered from diabetes mellitus for more than 10 years, having nephropathy, every increased of HbA1c by 1% and higher total cholesterol were at increased risk of worsening DR.

AIM: To report a case of cryptococcus meningitis in an immunocompetent teenager that presented early with diplopia and bilateral poor vision.METHODS:A case report RESULTS:A 17-year-old boy presented with blurring of vision in both eyes and diplopia for 3 weeks. It was associated with severe throbbing headaches, nausea and vomiting. He was also having low grade fever. On physical examination he was afebrile with no sign of meningism. His vision was 6/15 in both eyes with constricted visual field. Anterior segment was normal in both eyes. Extraocular muscles movement showed bilateral sixth nerve palsies. Fundoscopy revealed bilateral hyperaemic and slightly elevated optic disc. CT scan of the brain was normal with no evidence of intracranial mass or abnormal ventricles. Lumbar puncture revealed high opening pressure >300mmH2O. Cerebrospinal fluid(CSF) microscopically and culture showed presence of cryptococcus neoformans . This case was combinedly managed with neuro-medical team. Patient was started on intravenous Amphotericin B and fluconazole. His neurological symptoms recovered after a week. His vision was improved to 6/6 in both eyes with recovery of peripheral visual field. The diplopia improved with recovery of sixth nerve palsies in both eyes. Unfortunately, patient developed nosocomial lower respiratory tract infection and was treated for the problem.CONCLUSION: This case highlights the indolent nature of cryptococcus meningitis and the fact that the overt signs of meningism may not be present even in immunocompetent person. Diplopia may be one of the early presentations of meningitis patient.

Infectious conjunctivitis is a very common presentation to medical professional and ophthalmologist all over the world. Although its typically self-limiting and treatable in almost all of the cases, but we need to be aware of the rare and potentially life threatening if the cause is not promptly identified and treated accordingly. In our case report, we highlighted the rare case of Neisseria meningitidis as a primary cause of keratoconjunctivitis. Neisseria meningitidis is a rare etiology of keratoconjunctivitis and its ocular presentations are quite similar with other bacterial or viral infection. The infection may potentially fatal if systemic invasion occurred, however with immediate and proper treatment the outcome is satisfactory. Early diagnosis and proper antibiotic treatment are critical to prevent systemic spread of the infection. Public health intervention is needed to prevent outbreak of the disease.
Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Ceftriaxone ; administration & dosage ; therapeutic use ; Child, Preschool ; Humans ; Keratoconjunctivitis ; Male ; Meningococcal Infections ; Neisseria meningitidis