Jarosław Kociecki

Publications of Jarosław Kociecki

• [Choroidal melanoma treatment by endoresection].

  Authors: Marcin Stopa, Jarosław Kociecki, Iwona Rospond-Kubiak, Piotr Rakowicz

  Klinika oczna. 01/2011; 113(10-12):367-72.

  To report choroidal melanoma treatment by endoresection. A retrospective review of a series of 2 patients with choroidal melanoma that did not meet the criteria for brachytherapy. Both patients wereTo report choroidal melanoma treatment by endoresection. A retrospective review of a series of 2 patients with choroidal melanoma that did not meet the criteria for brachytherapy. Both patients were treated by tumor endoresection supported by brachytherapy. Outcome measures included preoperative and postoperative visual acuity at 1, 3, 6 months. Preoperative evaluation included tumor measurements in ultrasound. Systemic evaluation (liver function test, chest x ray, abdominal ultrasound), was carried out to monitor possible metastases in the observation period. The two operated patients were followed-up for 6 months. Visual acuity deteriorated from 5/16 (0.51 logMAR) preoperatively to 5/25 (0.7 logMAR) postoperatively in patient 1, and improved from 3/50 (1.22 logMAR) do 5/25 (0.7 logMAR) in patient 2. This corresponded to deterioration by 0.19 logMAR and improvement by 0.52 logMAR respectively. Neither tumor recurrence nor metastases were detected in the follow-up period. Endoresection is a treatment option, alternative to enucleation, that can conserve the eye It sometimes can be performed in eyes that are not eligible for trans-scleral resection. Further larger studies are needed to establish the efficacy of this still controversial surgery.

• [The disturbances of the eye position and motility in patients after scleral buckling surgery due to retinal detachment].

  Authors: Joanna Siwiec-Prościńska, Anna Gotz-Wieckowska, Piotr Rakowicz, Jarosław Kociecki

  Klinika oczna. 01/2011; 113(4-6):141-5.

  The aim of the study was the evaluation of the frequency and intensity of the disturbances of the eye position and motility in patients after scleral buckling surgery due to retinal detachment,The aim of the study was the evaluation of the frequency and intensity of the disturbances of the eye position and motility in patients after scleral buckling surgery due to retinal detachment, treated in Ophthalmology Clinic in Poznar. Additionally the aim was to diagnose the reason for muscles damage by means of the Hess screen. Seventy patients were treated with this method between 2007-2009 and the study group was built by 40 patients, treated in average 15 months before the examination, at the age 12-79 years (mean age 55 years and 8 months). The correlation between the location of retinal holes treated with cryotherapy, the type of surgery and the changes in eye position and motility or diplopia in clinical evaluation and on the Hess screen, were evaluated. The disturbances of eye motility in clinical evaluation was diagnosed in 10 eyes (25% cases), and on the Hess screen in 16 eyes (40% cases). We noted, that the damaged muscle (overacting or weakened), was localized always on the site of cryotherapy or in the area at three o'clock from the retinal hole. (1) Patients during visual rehabilitation after scleral buckling surgery should be controlled for eye motility disturbances and diplopia. (2) The percentage of eye motility disturbances in our study group was comparable to this presented in literature, but higher in evaluation by means of Hess screen. (3) Accidental cryotherapy of the muscle, causing its weakening or overaction, seems to be a particular risk factor of extraocular muscles function disturbances.

• Anatomy and function of the macula in patients after retinectomy for retinal detachment complicated by proliferative vitreoretinopathy.

  Authors: Marcin Stopa, Jarosław Kociecki

  European journal of ophthalmology. 11/2010; 21(4):468-72.

  To investigate the anatomy and function of the macula in patients after retinectomy for retinal detachment complicated by proliferative vitreoretinopathy (PVR) grade C. A prospective study involvingTo investigate the anatomy and function of the macula in patients after retinectomy for retinal detachment complicated by proliferative vitreoretinopathy (PVR) grade C. A prospective study involving 25 patients operated with vitrectomy and retinectomy due to retinal detachment complicated by PVR grade C. Outcome measures included preoperative and postoperative best-corrected visual acuity (BCVA) at 6 months and the difference between preoperative and postoperative BCVA. Furthermore, the macular status was analyzed on postoperative optical coherence tomography (OCT) scans. Reattachment was observed in 96% (24/25) of patients. Median BCVA improved from 2.30 logMAR (range 1.00 to 2.69 logMAR) to 1.00 logMAR (range 0.38 to 2.90 logMAR). The change from preoperative visual acuity was statistically significant (p=0.0003, Wilcoxon signed rank test). Macular status with pathologies was observed in 75% of eyes on OCT (retinal pigment epithelium irregularities 37.5%, cystoid macular edema 33%, epiretinal membrane 8.3%, subretinal fluid 4%, and subretinal perfluorocarbon liquid 4%). These eyes had significantly worse final visual acuity (p=0.01, Wilcoxon rank sum test) compared to those with a clinically normal macula. The retinectomy size influenced neither visual acuity (p=0.06, Wilcoxon rank sum test) nor incidence of normal macular status (p=0.14, Fisher exact test). Even though retinectomy is an effective technique to reattach the retina in complicated cases of retinal detachment, the functional outcome was found to be influenced by abnormal macular status, observed in 75% of eyes. Moreover, 360-degree retinectomies did not show different anatomic or functional results vs subtotal ones.

• Side illumination for internal limiting membrane peeling without staining in macular surgery.

  Authors: Marcin Stopa, Jarosław Kociecki

  Retina (Philadelphia, Pa.). 09/2010; 30(8):1308-10.

• [Autologous choroidal RPE patch transplantation for submacular hemorrhage in age-related macular degeneration].

  Authors: Marcin Stopa, Iwona Rospond-Kubiak, Piotr Rakowicz, Jarosław Kociecki

  Klinika oczna. 01/2010; 112(7-9):230-5.

  To report autologous choroidal RPE patch transplantation for treatment of submacular hemorrhage in a patients with age related macular degeneration. A case report of a patient with sudden visionTo report autologous choroidal RPE patch transplantation for treatment of submacular hemorrhage in a patients with age related macular degeneration. A case report of a patient with sudden vision deterioration due to submacular hemorrhage in AMD. The visual acuity was 5/5 in the right eye and 0.5/50 in the left eye. He was treated with autologous choroidal RPE patch transplantation. Outcome measures included preoperative and postoperative visual acuity at 1, 3, 6 months, duration of hemorrhage, hemorrhage size on preoperative fluorescein angiography and thickness of the subretinal hemorrhagic complex on preoperative and postoperative OCT scans. Visual acuity improved from 0.5/50 to 5/50 in 6 months follow-up. No major intraoperative and postoperative complications were observed. The perfusion of the graft was confirmed in ICG angiography. Autologous choroidal RPE patch transplantation is an effective option for submacular hemorrhage treatment in AMD. Unlike macular translocation, the surgery can be performed even in patients with excellent visual acuity in the fellow eye.

• [Vitrectomy with intravitreal antibiotic administration in exogenous endophthalmitis treatment in eyes with vision better than light perception].

  Authors: Marcin Stopa, Jarosław Kociecki

  Klinika oczna. 01/2010; 112(1-3):15-8.

  To evaluate vitrectomy with intravitreal antibiotic administration in exogenous endophthalmitis treatment in eyes with vision better than light perception. Retrospective review of 9 patients withTo evaluate vitrectomy with intravitreal antibiotic administration in exogenous endophthalmitis treatment in eyes with vision better than light perception. Retrospective review of 9 patients with exogenous endophthalmitis and VA better than light perception. All patients were treated with vitrectomy and intravitreal antibiotic administration. Outcome measures included: preoperative visual acuity and postoperative visual acuity at 6 months, time from the initial ocular surgery and the presentation of endophthalmitis symptoms. Visual acuity at 6 months improved in 88% (8/9), of patients and decreased in 12% (1/9). The mean change in visual acuity was a gain 1.01 +/- 0.80 logMAR that corresponds to improvements of 10 lines on ETDRS chart. The differences in mean preoperative and postoperative visual acuity were statistically significant (p = 0.009, Wilcoxon signed rank test). No statistically significant differences were detected in mean visual acuity improvement between acute and chronic form of endophthalmitis (p = 0.88, Wilcoxon rank sum test). There is more evidence to consider vitrectomy with intravitreal antibiotic administration in eyes with visual acuity better than light perception i.e. in cases that Endophthalmitis Vitrectomy Study (EVS) recommends for intravitreal antibiotic administration alone.

• [The results of the treatment of the cataract in children and youth treated in Ophthalmology Clinic in Poznań].

  Authors: Joanna Siwiec-Prościńska, Anna Gotz-Wieckowska, Krzysztof Załecki, Jarosław Kociecki, Andrzej Dmitriew

  Klinika oczna. 01/2010; 112(1-3):33-6.

  Cataract is a leading course of a treatable blindness and serious visual impairment in children. Treatment, especially in one-sided cataract is a challenge and it is connected with the risk ofCataract is a leading course of a treatable blindness and serious visual impairment in children. Treatment, especially in one-sided cataract is a challenge and it is connected with the risk of complications. The decision to perform a surgery in older children with already coexisting amblyopia is not easy to make. The aim of our study was to present the effects of the cataract treatment in children between 3 and 18 years old, in the Ophthalmology Clinic in Poznań. Between 2006 and 2008, the surgery was done in 36 children (42 eyes). The data of those patients, e.g. the type and location of the cataract, accompanying disorders and visual acuity reached, were analyzed. In this group of patient 60% of children reached visual acuity equal to 0.5, and 24% of them full visual acuity. The way to prepare the patient to the surgery, the way to calculate the power of the intraocular lens to be implanted and the surgery technique will be discussed.

• [Macular translocation with 360 retinectomy for submacular hemorrhage in age related macular degeneration]

  Authors: Marcin Stopa, Jarosław Kociecki

  Klinika oczna. 02/2009; 111(1-3):50-5.

  PURPOSE: To report macular translocation with 360 retinectomy for treatment of submacular hemorrhage in patients with age related macular degeneration. MATERIAL AND METHODS: Retrospective review ofPURPOSE: To report macular translocation with 360 retinectomy for treatment of submacular hemorrhage in patients with age related macular degeneration. MATERIAL AND METHODS: Retrospective review of the two patients with age related macular degeneration and submacular hemorrhage, treated with macular translocation with 360 retinectomy. Outcome measures included preoperative and postoperative visual acuity at 1, 3, 6 months and 1 year and a difference between preoperative and postoperative visual acuity at 1 year, as well as the duration of hemorrhage, hemorrhage size on preoperative fluorescein angiography and thickness of the subretinal hemorrhagic complex on preoperative OCT scans. RESULTS: The two operated patients were followed-up for 1 year. Distance visual acuity at 12 months improved in both cases by 0.22 and 0.48 logMAR respectively. No major intraoperative and postoperative complications were observed except for a foveal atrophy on OCT in one patient. CONCLUSIONS: MT360 seems to be an effective option for submacular hemorrhage treatment in AMD in the second affected eye. However a further face to face comparison with other treatment methods and with combination of tPA, anti-VEGF and pneumatic displacement in particular, is necessary to fully determine the efficacy of this technique.

• [Evaluation of the disc shaped lens in the combined cataract and vitrectomy surgery]

  Authors: Jarosław Kociecki, Marcin Stopa, Krzysztof Załecki

  Klinika oczna. 02/2009; 111(4-6):115-8.

  PURPOSE: Evaluation of Acrimed LENTIS UNICO LU-800 RZI discoid lens in the combined cataract and vitrectomy surgery. MATERIAL AND METHODS: ten patients that underwent combined cataract and vitrectomyPURPOSE: Evaluation of Acrimed LENTIS UNICO LU-800 RZI discoid lens in the combined cataract and vitrectomy surgery. MATERIAL AND METHODS: ten patients that underwent combined cataract and vitrectomy surgery between January and April 2007 were included in the prospective study. There were 8 female and 2 male patients with the mean age of 58.4 +/- 18.7 years in the study group. Data including age, sex, indications for surgery were collected with a special form. Furthermore, difficulty of lens implantation, retinal periphery visualization during vitrectomy, and retinal periphery visualization in the follow up ophthalmoscopy were evaluated with a special scale ranging from 0 to 5 (0 = impossible, 1 = very difficult, 2 = difficult, 3 = moderate, 4 = easy, 5 = very easy). RESULTS: The difficulty of the anterior segment surgery was graded 3.1 +/- 0.74. Visualization of the retinal periphery in the vitrectomy was ranked 4.8 +/-0.42. In the postoperative follow up ophthalmoscopy visualization of the peripheral retina was scored as 4.4 +/- 0.7. The most severe complication observed intraoperatively was discoid lens dislocation into the vitreous cavity. Postoperatively there was a case of a malignant glaucoma-like syndrome that required a second surgery. CONCLUSIONS: In our opinion the discoid lens yields a very good visibility of the peripheral retina during vitreoretinal procedures and in the follow up ophthalmoscopy. We do not recommend this lens for routine cases, because of the difficult implantation and the relatively high number of complications is observed. It can be considered in some selected eyes when maneuvers in the peripheral retina or laser therapy in the future are planned.

• [Central serous choroidoretinopathy--the characteristics of the clinical picture and the evaluation of the influence of general conditions at the prognosis and the course of the disease. Metaanalysis]

  Authors: Joanna Siwiec-Prościńska, Tomasz Prościnski, Jarosław Kociecki, Krystyna Pecold

  Klinika oczna. 01/2009; 111(7-9):258-62.

  Central serous choroidoretinopathy (CSCR)--recurrent disorder characterized by the detachment of neurosensory retina and/or detachment of the RPE in the posterior pole, caused by fluid leakage fromCentral serous choroidoretinopathy (CSCR)--recurrent disorder characterized by the detachment of neurosensory retina and/or detachment of the RPE in the posterior pole, caused by fluid leakage from choroidal vessels, coming through retinal pigment epithelium layer. The aim of the following paper was to create a historic revue of examinations of CSCR and modern description of signs and symptoms of this disease. CSCR may be present in various clinical forms with different prognosis, and therefore also all kind of retina and choroidea lesions were described. The role of hypertension, steroid treatment and stress in course of CSCR was shown in many studies during past years and for that reason the correlation between those factors and the incidence and the course of CSCR, was analysed. It is important to stress, that in contrast to current opinion, steroids can evoke CSCR and intensificate its symptoms and are contraindicated in the treatment of this disease. To addition CSCR is not always a benign disease, and may cause significant impairment of the visual acuity and colour vision, therefore, it should be carefully followed-up.

• [Central serous choroidoretinopathy (CSCR)--the diagnostics, monitoring and treatment]

  Authors: Joanna Siwiec-Prościńska, Tomasz Prościnski, Jarosław Kociecki, Krystyna Pecold

  Klinika oczna. 02/2008; 110(10-12):397-400.

  There are many clinical forms of central serous choroidoretinopathy (CSCR) with different prognosis. Although fluoresceine angiography still plays the most important role in the diagnosis of CSCR, itThere are many clinical forms of central serous choroidoretinopathy (CSCR) with different prognosis. Although fluoresceine angiography still plays the most important role in the diagnosis of CSCR, it should be pointed out, that examination with retinal thickness analyser and optical coherent tomography is a modern and non-invasive method of retinal examination, which can provide with some significant and reliable observations helping in objective monitoring of CSCR. The aim of this paper was the description of diagnostic methods and analysis of optimal methods used for monitoring of CSCR. Because the research of the literature suggests, that local: nonsteroid anti-inflammatory drugs, beta-blockers and systemic or local carbonic anhydrase inhibitors may be helpful in therapeutic choice, the treatment options of CSCR were also analysed.

• [The Lowe syndrome in a 16-year-old patient--case report]

  Authors: Iwona Mazur-Michałek, Anna Gotz-Wieckowska, Jarosław Kociecki

  Klinika oczna. 02/2007; 109(7-9):327-9.

  The Lowe syndrome is a rare genetic disorder. It is inherited in an X-linked recessive manner. The clinical symptoms occur in eyes, central nervous system and kidneys. We describe the case of 16The Lowe syndrome is a rare genetic disorder. It is inherited in an X-linked recessive manner. The clinical symptoms occur in eyes, central nervous system and kidneys. We describe the case of 16 years old boy with Lowe syndrome who underwent the bilateral congenital cataract surgery at the age of 14 months. The clinical symptoms of patient's mother are also described.

• [Intravitreal triamcinolone acetonide injections in treatment of cystoid macular edema due to diabetic maculopathy]

  Authors: Anna Lubczyńska, Jarosław Kociecki

  Klinika oczna. 02/2007; 109(4-6):165-8.

  PURPOSE: To appoint the most adequate follow-up parameter of intravitreal TA injections in CME treatment due to diabetic maculopathy and to find the most reliable treatment scheme. MATERIAL ANDPURPOSE: To appoint the most adequate follow-up parameter of intravitreal TA injections in CME treatment due to diabetic maculopathy and to find the most reliable treatment scheme. MATERIAL AND METHOD: 4 mg (in 0.1 ml) of crystalline TA were injected into the vitreous of 17 eyes. RESULTS: There was a statistically significant improvement of BCVA for distance and near vision. There was statistically significant difference in retinal thickness outcomes measured at baseline and at the end of thefollow-up by both OCT and RTA No correlation of BCVA changes and retinal thickness changes measured in OCT and RTA was found. CONCLUSIONS: Intravitreal TA administration seems to be an effective method of treatment in diabetic CME. OCT is the most adequate method of follow-up of intravitreal TA injections in treatment of CME due to diabetic maculopathy. RTA and FA changes analysis are alternative monitoring methods. Dosage of 4mg TA in 0.1 ml seems to be sufficient. In cases of CME recurrence subsequent intravitreal injection in the first 6 month after initial injection seems to unnecessary.

• [Inhtravitreal triamcinolone acetonide injections in the treatment of cystoid macular edema due to the central or branch retinal vein occlusion]

  Authors: Anna Lubczyńska, Jarosław Kociecki

  Klinika oczna. 02/2007; 109(4-6):169-72.

  PURPOSE: To appoint the most adequate follow-up parameter and to find the most reliable scheme of intravitreal TA injections in CME treatment in the course of CRVO and BRVO. MATERIAL AND METHODS: 18PURPOSE: To appoint the most adequate follow-up parameter and to find the most reliable scheme of intravitreal TA injections in CME treatment in the course of CRVO and BRVO. MATERIAL AND METHODS: 18 eyes treated with intravitreal injection of 4 mg (in 0.1 ml) of crystalline TA. RESULTS: There was improvement of BCVA for distance noticed in 38.9% of eyes and for near in 44.4% of cases. There was statistically significant difference in retinal thickness outcomes measured at baseline and at the end of the follow-up by both OCT and RTA. No correlation of BCVA changes and retinal thickness changes measured in OCT and RTA was found. CONCLUSIONS: The intravitreal TA injections should be considered as an effective method. Foveal morphology and thickness analysis performed by OCT is the most adequate method in follow-up monitoring of intravitreal TA injections in CME treatment in non-ischemic CRVO or BRVO. Central retinal thickness measured by RTA and FA changes analysis are alternative monitoring methods. Dosage of 4mg TA in 0.1 ml seems to be sufficient. In cases of CME recurrence of subsequent intravitreal injection in the first 6 month after initial injection seems to be unnecessary.

• [Cytomegalovirus infection--selected aspects of clinical pathology]

  Authors: Jarosław Kociecki, Wanda Kociecka, Andrzej Dmitriew

  Klinika oczna. 02/2007; 109(1-3):74-8.

  In this review short biological characteristics of human cytomegalovirus (CMV), the sources and its modes of transmission to human organisms, are presented. The authors described clinical pathologyIn this review short biological characteristics of human cytomegalovirus (CMV), the sources and its modes of transmission to human organisms, are presented. The authors described clinical pathology mainly of ocular organ and central nervous system in children with congenital cytomegalovirus infection and in acquired form of cytomegaly in adults with immunosupression (especially with HIV infection and AIDS). In review there are included contemporary diagnostic laboratory methods used in detection of CMV infection and in evaluation of clinical pathology.

• Acute retinal pigment epithelitis in 18 years old patient.

  Authors: Anna Gotz-Wieckowska, Jadwiga Bernardczyk-Meller, Joanna Siwiec-Prościńska, Jarosław Kociecki

  Klinika oczna. 02/2007; 109(4-6):214-5.

  We report case of acute retinal pigment epithelitis (ARPE), a very rare ophthalmic disorder, which has a very good final visual prognosis. The 18 years old woman was examined by ophthalmologist forWe report case of acute retinal pigment epithelitis (ARPE), a very rare ophthalmic disorder, which has a very good final visual prognosis. The 18 years old woman was examined by ophthalmologist for sudden visual decrease of vision and dark spot in visual field of her left eye. The best corrected visual acuity (BCVA) of the left eye at the initial diagnosis was 0.1 and after 4 months improved to 0.9. The diagnosis or ARPE was made on the basis of fundoscopy, fluorescein angiography, electroretinography and optical coherence tomography (OCT) examination.

• [Disadvantageous course of ophthalmological changes in young women with long-lasting diabetes mellitus followed by the symptoms of anorexia nervosa]

  Authors: Jadwiga Bernardczyk-Meller, Anna Napierała, Joanna Siwiec-Prościńska, Anna Lubczyńska, Jarosław Kociecki

  Klinika oczna. 01/2007; 109(4-6):222-5.

  PURPOSE: To present the course and progression of very severe proliferative retinopathy in young women with long lasting diabetes mellitus and symptoms of anorexia nervosa. MATERIAL AND METHODS: ThePURPOSE: To present the course and progression of very severe proliferative retinopathy in young women with long lasting diabetes mellitus and symptoms of anorexia nervosa. MATERIAL AND METHODS: The data of 5 young women, in age 25-32 years, suffering from diabetes mellitus 15 to 29 years with intended weight lose. The progression of ophthalmological changes was observed, followed by considerable fluctuations of glucose blood. RESULTS: In the time of weight lose in all patients, the worsening of the visual acuity was observed and it was the first reason for ophthalmological check-up. The initial best corrected visual acuity was 0.1-0.9. The rubeosis of the iris, cataracts and proliferative retinopathy with intravitreal hemorrhage and tractional retinal detachment were observed. Despite the immediate ophthalmological treatment (lasertherapy, pars plana vitrectomy, criopexy and retinopexy) the useful visual acuity (>0.1) was maintained only in one eye. CONCLUSIONS: 1. In case of significant exacerbation of progression of ophthalmological changes in patients with long lasting diabetes mellitus and anorexia nervosa the monitoring of their psychological and physical conditions is essential. 2. In the case of weight lose in patients with long lasting diabetes mellitus the rigorous ophtalmological monthly consultations are obligate.

• [Bilateral Adie's syndrome in child]

  Authors: Anna Gotz-Wieckowska, Jarosław Kociecki

  Klinika oczna. 02/2006; 108(10-12):450-1.

  Bilateral Adie's syndrome is characterized by the presence of a tonic pupil connected with accommodation problems. Very often, it coexists with latent hypermetropia, corneal hyposensivity. TypicalBilateral Adie's syndrome is characterized by the presence of a tonic pupil connected with accommodation problems. Very often, it coexists with latent hypermetropia, corneal hyposensivity. Typical signs are weakened tendons reflexes. We present the 8 years old girl with bilateral Adie's syndrome, which was the cause of school problems.

• [Visual system involvement in selected zoontic diseases. III. Cysticercosis T. solium]

  Authors: Jarosław Kociecki, Wanda Kociecka

  Klinika oczna. 02/2005; 107(7-9):563-6.

  Cysticercosis of visual system is a serious clinical problem. Cysticercosis (cysticercus cellulose) may cause damage to different structures of this system, leading sometimes to dangerousCysticercosis of visual system is a serious clinical problem. Cysticercosis (cysticercus cellulose) may cause damage to different structures of this system, leading sometimes to dangerous consequences (phthisis and total blindness). Involvement of visual system may coexist with cysticercosis of central nervous system. In current paper we present parasytologic and epidemiologic aspects, as well as clinical pathology of T. solium cysticercosis with special attention directed to lesions within visual system. Current laboratory methods (immuno- and radiologic) indispensable for diagnosis of cysticercosis, as well as outline of therapy (pharmacological and surgical), are also presented.

• [Visual system involvement in selected zoonotic diseases. II. Trichinellosis]

  Authors: Jarosław Kociecki, Wanda Kociecka

  Klinika oczna. 02/2004; 106(3):371-5.

  Trichinellosis is the medical problem that is still actual in our country. The paper presents recent taxonomic data regarding Trichinella spp. as well as selected epidemiologic aspects.Trichinellosis is the medical problem that is still actual in our country. The paper presents recent taxonomic data regarding Trichinella spp. as well as selected epidemiologic aspects. Pathomechanism of trichinellosis and the outline of clinical pathology are also discussed. The image of lesions involving organ of sight, diagnostic methods and treatment are described with details as well. The paper is highlighting the role of ophthalmologist in early diagnosis of trichinellosis.