Manali Hazarika - Academia.edu (original) (raw)
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Papers by Manali Hazarika
BMJ case reports, 2015
An eyelid or orbital lipogranuloma can occur following nasal packing with liquid paraffin, petrol... more An eyelid or orbital lipogranuloma can occur following nasal packing with liquid paraffin, petroleum jelly or an antibiotic-based cream. It usually presents a few weeks or months after the initial procedure. We present a report of three such cases of sclerosing lipogranuloma involving the eyelid, which occurred following a sinonasal surgery where nasal packing using petroleum jelly was performed. The typical clinical course and the classical histopathological features are highlighted. All cases were diagnosed by histopathological examination as sclerosing lipogranuloma. Complete surgical removal resulted in complete resolution on 1 month follow-up. The diagnosis is based on a high degree of suspicion following a detailed history of prior use of lipid-based products for nasal packing following endonasal surgery. Histopathology is diagnostic. Surgical excision is the treatment of choice, however, due to its infiltrative nature, it may be difficult to obtain a complete cure.
Case Reports, 2013
Propionibacterium acnes has rarely been reported as the causative organism in acute endophthalmit... more Propionibacterium acnes has rarely been reported as the causative organism in acute endophthalmitis following penetrating ocular trauma. We report a 53-year-old man, who presented with best corrected vision of counting fingers at 2 m, <N36, in the right eye and clinical features suggestive of endophthalmitis following penetrating trauma with a tree branch 2 days earlier. Conjunctival swab, aqueous and vitreous tap were sent for aerobic, anaerobic and fungal culture. The patient was treated with intravitreal ceftazidime, vancomycin along with topical antibiotics and steroids. An aqueous anaerobic culture was positive for P acnes. At the fifth month follow-up, the best corrected vision had improved to 20/20, N6. Thus, a good visual outcome was achieved, following appropriate treatment of a rather unusual causative organism.
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2005
Zenker's diverticulum, though counnon in western countries is uncommon in India. This diverti... more Zenker's diverticulum, though counnon in western countries is uncommon in India. This diverticuham is an extension of umcosa through Killian's dehiscence. Various surgical methods have been described for the treatment of this condition including the use of lasers but none in Indian Journals. In this paper we describe a case of Zenker's diverticulum where diverticulotomy using KTP532 laser was successfully performed. Its advantages over other techniques are mentioned.
BMJ case reports, 2013
The term fibro-osseous lesion has currently grown in popularity as an overall designation for a n... more The term fibro-osseous lesion has currently grown in popularity as an overall designation for a number of rare, histologically benign head and neck lesions that are made up of bone, fibrous tissue and cementum. Cemento-ossifying fibroma is a variant of cementifying fibroma and is a fibro-osseous disease. They are usually small innocuous lesions which follow a slow benign course and are commonly seen in the skull bone rather than the sphenoid. It is rare for these tumours to attain large size, behave aggressively, destroy bone and require a radical surgery. One such rapidly growing juvenile cemento-ossifying lesion of sphenoid in our 10-year-old young patient causing proptosis and impaired vision is reported here because of its uncommon nature and its surgical dilemma. Selection of surgical approach to resect this tumour becomes difficult because it is deeply seated and needs a multidisciplinary approach.
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2013
Nasal polyposis is often encountered in rhinology practice. Those who fail conservative managemen... more Nasal polyposis is often encountered in rhinology practice. Those who fail conservative management, a definitive surgery is essential to achieve sufficient ventilation and drainage of the affected sinuses by using either microdebrider or conventional instruments for functional endoscopic sinus surgery (FESS). A prospective study was conducted on 40 cases of nasal polypi in a tertiary care hospital. 20 cases were operated by conventional endoscopic instruments and 20 using the microdebrider. The study aimed at comparing the intra operative (blood loss, duration of surgery) and post operative results (crusting, scarring, discharge, symptoms, recurrence) between the two groups using Lund-Mackay scoring system and the data was statistically analysed. There was no statistically significant difference in surgical outcome for patients when either conventional endoscopic instruments or microdebrider was used. However, there was a significant symptomatic improvement in cases undergoing micro...
Ejc Supplements - EJC SUPPL, 2010
Poster Sessions ejc supplements 8, no. 5 (2010) 5-81 81 response was evaluated by means of freque... more Poster Sessions ejc supplements 8, no. 5 (2010) 5-81 81 response was evaluated by means of frequency analysis (p < 0.05). A reactivity index (RI) was calculated as intensity (I) x percentage of positive area (A); RI values varied from 0−12; low (0−6) and high (7−12). Intensity, percentage of positive area, immunohistochemical pattern and RI were analyzed employing Chi-Square test and ANOVA (p < 0.05), after data standardization. Results: Primary malignant samples expressed MUC2 in 52% of cases; MUC1, 94%; MUC5AC, 14%; CEA, 93%; beta-catenin, 98 %; Lex, 74%; sLe x, 66%, Ley; 91%; sLea, 90% and Tn, 41%. N+ expressed MUC2, 30%; MUC1, 89%; MUC5AC, 19%; CEA, 80%; beta-catenin, 83%; Lex, 69%; sLex, 72%; Ley, 75%; sLea, 86% while Tn, 44%. In general, CCR showed a higher RI than control samples. In patients with N+ with a low sLex RI presented a longer SFD than patients with a high sLex RI (40 vs 14 months) (p 0.07). Although a significant difference was not found, patients which showed a primary tumour low Lex RI presented a longer SFD than patients with a high RI, (44 vs 26 months). A long OS was found in patients which primary tumours showed a low Le x RI (18 months). In N+ patients, Lex was also studied in lymphatic nodes, a low Lex RI correlated with a longer SFD than patients with a high Lex RI (24 vs.18 months). Conclusions: This study showed that, in CCR patients, carbohydrate antigenic expression may indicate a difference in SFD and OS.
Otolaryngology - Head and Neck Surgery, 2000
Indian Journal of Ophthalmology, 2013
Recent advances in neonatology have influenced the incidence and severity of ROP in a dichotomous... more Recent advances in neonatology have influenced the incidence and severity of ROP in a dichotomous fashion. To determine the incidence of ROP and to analyse its risk factors. Prospective clinical case series. 282 preterm infants with birthweight &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1500 g and/or gestational age ≤ 32 weeks and also those with gestational age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 32 weeks, with birthweight between 1500-2000 g, who were at risk for ROP were selected. Weight gain proportion was measured as weight at 6 weeks minus birthweight divided by birthweight. Univariate and multivariate logistic regression. Incidence of any ROP was 21.6% while severe ROP was 6.7%. Prenatal factors like multiple gestation (P = 0.510) and antenatal steroids (P = 0.104) were not significantly associated with ROP. On multivariate analysis, postnatal factors like weight at birth &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1250 g (P = 0.01) and gestational age between 31-32 weeks (P = 0.02) were independent risk factors for any ROP, while intraventricular hemorrhage (P = 0.03) was the only independent risk factor for severe ROP. Mean birthweight of infants with severe ROP was 1056 μ 207 g (P = 0.004), which was significantly low. After logistic regression, the mean weight gain proportion at 6 weeks, of those neonates with severe ROP was 30%. Low birthweight and prematurity were the most important risk factors for developing any ROP, while intraventricular hemorrhage was the independent risk factor for developing severe ROP. The mean postnatal weight gain at 6 weeks was not statistically significant in neonates with severe ROP.
Cornea, 2016
To report a rare case of polymicrobial keratitis due to Balantidium coli and gram-negative bacter... more To report a rare case of polymicrobial keratitis due to Balantidium coli and gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae, in a soft contact lens (CL) wearer. We report a case of CL-related keratitis due to B. coli, P. aeruginosa, and K. pneumoniae. The culture of the corneal scrapings, the CL cleaning solution, and the CL revealed the growth of a rare ciliated parasite, B. coli, along with gram-negative bacteria, namely, P. aeruginosa and K. pneumoniae. The patient was successfully treated with topical broad-spectrum antibiotics and intravenous metronidazole. Polymicrobial keratitis has seldom been reported with B. coli as the causative agent. CL wear can be a risk factor for this infection. Treatment with topical antibiotics may not suffice, and the intravenous route of antiprotozoal drugs may be a useful adjunct. Increasing awareness, early diagnosis, and treatment may improve the final visual outcome.
BMJ case reports, 2015
An eyelid or orbital lipogranuloma can occur following nasal packing with liquid paraffin, petrol... more An eyelid or orbital lipogranuloma can occur following nasal packing with liquid paraffin, petroleum jelly or an antibiotic-based cream. It usually presents a few weeks or months after the initial procedure. We present a report of three such cases of sclerosing lipogranuloma involving the eyelid, which occurred following a sinonasal surgery where nasal packing using petroleum jelly was performed. The typical clinical course and the classical histopathological features are highlighted. All cases were diagnosed by histopathological examination as sclerosing lipogranuloma. Complete surgical removal resulted in complete resolution on 1 month follow-up. The diagnosis is based on a high degree of suspicion following a detailed history of prior use of lipid-based products for nasal packing following endonasal surgery. Histopathology is diagnostic. Surgical excision is the treatment of choice, however, due to its infiltrative nature, it may be difficult to obtain a complete cure.
Case Reports, 2013
Propionibacterium acnes has rarely been reported as the causative organism in acute endophthalmit... more Propionibacterium acnes has rarely been reported as the causative organism in acute endophthalmitis following penetrating ocular trauma. We report a 53-year-old man, who presented with best corrected vision of counting fingers at 2 m, &amp;amp;amp;amp;amp;amp;amp;lt;N36, in the right eye and clinical features suggestive of endophthalmitis following penetrating trauma with a tree branch 2 days earlier. Conjunctival swab, aqueous and vitreous tap were sent for aerobic, anaerobic and fungal culture. The patient was treated with intravitreal ceftazidime, vancomycin along with topical antibiotics and steroids. An aqueous anaerobic culture was positive for P acnes. At the fifth month follow-up, the best corrected vision had improved to 20/20, N6. Thus, a good visual outcome was achieved, following appropriate treatment of a rather unusual causative organism.
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2005
Zenker's diverticulum, though counnon in western countries is uncommon in India. This diverti... more Zenker's diverticulum, though counnon in western countries is uncommon in India. This diverticuham is an extension of umcosa through Killian's dehiscence. Various surgical methods have been described for the treatment of this condition including the use of lasers but none in Indian Journals. In this paper we describe a case of Zenker's diverticulum where diverticulotomy using KTP532 laser was successfully performed. Its advantages over other techniques are mentioned.
BMJ case reports, 2013
The term fibro-osseous lesion has currently grown in popularity as an overall designation for a n... more The term fibro-osseous lesion has currently grown in popularity as an overall designation for a number of rare, histologically benign head and neck lesions that are made up of bone, fibrous tissue and cementum. Cemento-ossifying fibroma is a variant of cementifying fibroma and is a fibro-osseous disease. They are usually small innocuous lesions which follow a slow benign course and are commonly seen in the skull bone rather than the sphenoid. It is rare for these tumours to attain large size, behave aggressively, destroy bone and require a radical surgery. One such rapidly growing juvenile cemento-ossifying lesion of sphenoid in our 10-year-old young patient causing proptosis and impaired vision is reported here because of its uncommon nature and its surgical dilemma. Selection of surgical approach to resect this tumour becomes difficult because it is deeply seated and needs a multidisciplinary approach.
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2013
Nasal polyposis is often encountered in rhinology practice. Those who fail conservative managemen... more Nasal polyposis is often encountered in rhinology practice. Those who fail conservative management, a definitive surgery is essential to achieve sufficient ventilation and drainage of the affected sinuses by using either microdebrider or conventional instruments for functional endoscopic sinus surgery (FESS). A prospective study was conducted on 40 cases of nasal polypi in a tertiary care hospital. 20 cases were operated by conventional endoscopic instruments and 20 using the microdebrider. The study aimed at comparing the intra operative (blood loss, duration of surgery) and post operative results (crusting, scarring, discharge, symptoms, recurrence) between the two groups using Lund-Mackay scoring system and the data was statistically analysed. There was no statistically significant difference in surgical outcome for patients when either conventional endoscopic instruments or microdebrider was used. However, there was a significant symptomatic improvement in cases undergoing micro...
Ejc Supplements - EJC SUPPL, 2010
Poster Sessions ejc supplements 8, no. 5 (2010) 5-81 81 response was evaluated by means of freque... more Poster Sessions ejc supplements 8, no. 5 (2010) 5-81 81 response was evaluated by means of frequency analysis (p < 0.05). A reactivity index (RI) was calculated as intensity (I) x percentage of positive area (A); RI values varied from 0−12; low (0−6) and high (7−12). Intensity, percentage of positive area, immunohistochemical pattern and RI were analyzed employing Chi-Square test and ANOVA (p < 0.05), after data standardization. Results: Primary malignant samples expressed MUC2 in 52% of cases; MUC1, 94%; MUC5AC, 14%; CEA, 93%; beta-catenin, 98 %; Lex, 74%; sLe x, 66%, Ley; 91%; sLea, 90% and Tn, 41%. N+ expressed MUC2, 30%; MUC1, 89%; MUC5AC, 19%; CEA, 80%; beta-catenin, 83%; Lex, 69%; sLex, 72%; Ley, 75%; sLea, 86% while Tn, 44%. In general, CCR showed a higher RI than control samples. In patients with N+ with a low sLex RI presented a longer SFD than patients with a high sLex RI (40 vs 14 months) (p 0.07). Although a significant difference was not found, patients which showed a primary tumour low Lex RI presented a longer SFD than patients with a high RI, (44 vs 26 months). A long OS was found in patients which primary tumours showed a low Le x RI (18 months). In N+ patients, Lex was also studied in lymphatic nodes, a low Lex RI correlated with a longer SFD than patients with a high Lex RI (24 vs.18 months). Conclusions: This study showed that, in CCR patients, carbohydrate antigenic expression may indicate a difference in SFD and OS.
Otolaryngology - Head and Neck Surgery, 2000
Indian Journal of Ophthalmology, 2013
Recent advances in neonatology have influenced the incidence and severity of ROP in a dichotomous... more Recent advances in neonatology have influenced the incidence and severity of ROP in a dichotomous fashion. To determine the incidence of ROP and to analyse its risk factors. Prospective clinical case series. 282 preterm infants with birthweight &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1500 g and/or gestational age ≤ 32 weeks and also those with gestational age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 32 weeks, with birthweight between 1500-2000 g, who were at risk for ROP were selected. Weight gain proportion was measured as weight at 6 weeks minus birthweight divided by birthweight. Univariate and multivariate logistic regression. Incidence of any ROP was 21.6% while severe ROP was 6.7%. Prenatal factors like multiple gestation (P = 0.510) and antenatal steroids (P = 0.104) were not significantly associated with ROP. On multivariate analysis, postnatal factors like weight at birth &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 1250 g (P = 0.01) and gestational age between 31-32 weeks (P = 0.02) were independent risk factors for any ROP, while intraventricular hemorrhage (P = 0.03) was the only independent risk factor for severe ROP. Mean birthweight of infants with severe ROP was 1056 μ 207 g (P = 0.004), which was significantly low. After logistic regression, the mean weight gain proportion at 6 weeks, of those neonates with severe ROP was 30%. Low birthweight and prematurity were the most important risk factors for developing any ROP, while intraventricular hemorrhage was the independent risk factor for developing severe ROP. The mean postnatal weight gain at 6 weeks was not statistically significant in neonates with severe ROP.
Cornea, 2016
To report a rare case of polymicrobial keratitis due to Balantidium coli and gram-negative bacter... more To report a rare case of polymicrobial keratitis due to Balantidium coli and gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae, in a soft contact lens (CL) wearer. We report a case of CL-related keratitis due to B. coli, P. aeruginosa, and K. pneumoniae. The culture of the corneal scrapings, the CL cleaning solution, and the CL revealed the growth of a rare ciliated parasite, B. coli, along with gram-negative bacteria, namely, P. aeruginosa and K. pneumoniae. The patient was successfully treated with topical broad-spectrum antibiotics and intravenous metronidazole. Polymicrobial keratitis has seldom been reported with B. coli as the causative agent. CL wear can be a risk factor for this infection. Treatment with topical antibiotics may not suffice, and the intravenous route of antiprotozoal drugs may be a useful adjunct. Increasing awareness, early diagnosis, and treatment may improve the final visual outcome.