A 21-year-old and an 11-year-old patients presented with severe,resistant shield ulcers failed to respond to medical treatments which included topical steroids,mast cell stabilizers and antihistamines. Both of them were treated with surgical debridement of the ulcer,supratarsal injection of triamcinolone acetonide,topical cyclosporine 0.5g/L and ketotifen fumerate 0.25g/L. The ulcers healed well after three weeks. Topical cyclosporine was discontinued after two months in both patients. They were symptom free with no recurrence for six months. Combination of surgical debridement of the ulcer,supratarsal injection of triamcinolone acetonide,topical cyclosporine 0.5g/L and ketotifen fumerate 0.25g/L are effective as the treatment option in managing patients with severe vernal shield ulcer.KEYWORDS: vernal shield ulcer; surgical debridement; supratarsal injection of triamcinolone acetonide; cyclosporine; ketotifen fumerate

·Acquired uniocular blindness in pediatric group deserves an urgent attention. The blindness usually results from mechanical injury to the globe. It is one of the leading causes of acquired blindness in this group. Most of the ocular injuries were accidental and resulted from mechanical trauma. Firecracker is one of the potential causes for acquired uniocular blindness. The nature of injury varies from mild to severe, penetrating or blunt trauma, chemical or thermal. The irreversible nature of the visual loss is preventable. Public awareness will be one of the main contributors in preventing the ocular morbidity.

AIM: To describe a case of diffuse conjunctival calcinosis in hyperpararthyroidism and end stage renal failure patient.METHODS: A case report.RESULTS: A 35-year-old gentleman, known case of hyperparathyroidism with subtotal parathyroidectomy done and end stage renal failure, presented with one month history of foreign body sensation of both eyes associated with redness and tearing. On examination, vision was 6/6 OU with diffuse conjunctival deposits and congestion. Conjunctival histopathological examination showed multiple foci of calcium deposits in the subepithelial stroma. Serum calcium was markedly raised and serum phosphorus was normal. His eye symptoms was reduced with topical steroid (betamethasone) and intramuscular calcitonin. CONCLUSION: Diffuse and symptomatic conjunctival calcinosis is uncommon condition of ocular calcium deposition. Hyperparathyroidism and renal failure are the contributing factors for the development of it.

A 25-year man presented with symptom of photophobia and tearing in the right eye for 2 months duration. It was associated with painless gradual reduced vision. There was a history of hammering on a metal object prior to that. Ocular examination revealed signs of mild anterior uveitis due to a retained metallic intralenticular foreign body. Conjunctiva was white. Computed Tomography (CT) scan of the orbit confirmed presence of a single intraocular foreign body. The condition is misleading and can be easily overlooked. A detailed history and clinical examination are mandatory in this misleading situation.