·A 20-year-old healthy lady was admitted for septic arthritis in the right knee. Two weeks after the onset of joint pain, she complained progressive blurring of vision in both eyes. Slit-lamp examination revealed evidence of inflammation in both anterior and posterior segments. There were multiple chorioretinal lesions on both fundi. Synovial fluid aspiration of the right knee and blood culture grew Staphylococcus aureus . She responded well to topical and systemic antibiotics. Her final visual acuity was 6/6 in both eyes. This case illustrates a rare presentation of bilateral endogenous endophthalmitis in an immunocompetent young patient presenting with a concurrent septic arthritis. Early diagnosis and a prompt management carry a favorable visual prognosis.

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