Abstract Aim of the study: Presentation of ophthalmic symptoms of Cerebral Autosomal Dominant Arteriopathy with Subcortical Infracts and Leucoencephalopathy (CADASIL). Material and methods: Clinical presentation of female patient with diagnosed CADASIL, manifested by transient loss of vision, migraine, convergence insufficiency, diplopia, increased deep tendon reflexes of upper left limb, subcortical infarcts, mood disturbances and dementia. Results: Confirmed NOTCH3 gene mutation (p.Cys212Gly), and presence of granular osmiophilic material (GOM) in cutaneous small vessel wall in immunohistochemistry laboratory test (IHC). Magnetic resonance imaging (MRI) revealed bilateral focal vasogenic lesions in white matter of cerebral hemisphere with single micro-focal infarct in the left external capsule. Furthermore, a left eye exophoria, a bilateral peripheral visual field loss of 20 degrees and a loss of nasolabial fold was confirmed during ophthalmic tests. An eye fundus examination as well as a fluorescein angiography (FA) revealed vessel constriction of retinal arteries and a peripheral retinal pigment epithelium (RPE) atrophy with focal drusen in the left eye. The doppler ultrasonography (USG) confirmed a decreased blood flow and an increased vascular resistance of the extraocular vessels. The pattern electroretinogram (PERG) revealed a reduced P50 wave amplitude in the patient’s left eye. Conclusions: intermittent blindness, migraine, convergence failure, diplopia with specific MRI signs, NOTCH3 mutation, and the presence of GOM in the skin of small blood vessels in a young or middle-aged patient suggests CADASIL. New observations include: atrophic changes in the RPE, hemodynamic disturbances in blood flow in the short posterior ciliary arteries and in the central retinal artery, single drusen in the retina, and a reduced amplitude of the P50 wave in PERG.

Background: Prismatic cover test (PCT) is a gold standard assessment of strabismus angle, however it has a significant number of disadvantages which are eliminated in Strabiscan device. Methods: Patients with strabismus (n = 30) and a group of healthy subjects (n = 30) were given a detailed history and underwent ophthalmologic examinations (best corrected visual acuity assessment, cycloplegic autorefractometry, biomicroscopic examination of anterior and posterior part of the eye). Each patient and healthy subjects were then subjected to the PCT, and then the presence of strabismus was detected, and its angle assessed using a Strabiscan demonstrator. Statistical analysis was done with Statistica software. Results: No statistically significant differences were noted in the measurements of strabismus angles made by the differing methods. Among the control group, using the Strabiscan demonstration device, low-angle latent strabismus ≤3PD was diagnosed in 83% of patients, and >3PD in 13% of patients. Those using the PCT, on the other hand, diagnosed latent strabismus ≤3PD in only 13% of patients, and latent strabismus with an angle >3PD in 13% of patients. Conclusion: The Strabiscan demonstration device provides quick and accurate assessment of the strabismus angle.

Coronavirus disease 2019 (COVID-19), can manifest with ocular symptoms. These symptoms can be divided into isolated events attributed to COVID-19 and those occurring in multisystem inflammatory syndrome in children (MIS-C), a newly diagnosed disease entity associated with COVID-19 infection. Currently, the literature lacks specific guidelines and treatment regimens for COVID-19 ocular symptoms, especially in children.

Background: The variability of the obtained results of manual tests assessing the angle of strabismus depends on the experience, skills, and training of the examiner. The authors hope that the new measuring device will provide a more sensitive and repeatable method for detecting small strabismus angles compared to the gold standard – PCT. The purpose of this article is to present an innovative strabismus angle demonstration device, called Strabiscan, to present automated measurements of eye deviation, and to compare the obtained results of these measurements to the traditional manual method. Methods: In patients with the manifest strabismic disease (n = 30) and a group of healthy subjects (n = 30), a detailed history was taken and routine ophthalmologic examinations were performed, including best-corrected distance visual acuity, assessment of refractive error using an autorefractometer after cycloplegia, biomicroscopic evaluation of the anterior segment of the eye, and evaluation of the eye fundus by indirect ophthalmoscopy. Subsequently, each patient and healthy subjects were subjected to a prismatic cover-uncover test using a manual method, and then the presence of strabismus was detected and its angle assessed using demonstration Strabiscan device. Results: In the control group, using the Strabiscan demonstration device, small-angle latent strabismus ≤3DP was diagnosed in 83% of patients, and >3DP in 13%. In contrast, using the prismatic cover-uncover test, latent strabismus ≤3DP was diagnosed in only 13% of patients, and latent strabismus with an angle >3DP in 13% of patients. No statistically significant differences were noted in the measurements of strabismus angles made by the different methods. Conclusions: The Strabiscan demonstration device allows quick and accurate assessment of the strabismus angle. Compared to the prismatic cover-uncover test, it has a higher sensitivity for detecting low-angle latent strabismus. Measurements with the Strabiscan do not require the presence of additional co-assistants for the test.