Indonesian Journal of Case Reports

Managing Bilateral Congenital Cataracts in Early Childhood: A Clinical and Surgical Perspective

2025-12-31T12:05:08+07:00

Congenital cataract is a leading cause of childhood blindness that demands prompt surgical intervention to prevent irreversible visual impairment. This case report presents an infant with bilateral congenital cataracts whose diagnosis and treatment were delayed beyond the optimal intervention window. The patient underwent cataract extraction using irrigation aspiration, primary posterior capsulotomy, and anterior vitrectomy. Intraocular lens (IOL) implantation was deferred due to considerations of the patient’s age and corneal diameter, and aphakia was managed with high-powered spectacles. Postoperative follow-up revealed improved visual responses, including fixation and following of light and objects, indicating positive visual development. This case highlights the importance of timely identification, appropriate surgical technique, and tailored postoperative visual rehabilitation in managing pediatric cataracts to optimize functional outcomes.

Regeneration of the Anterior Talofibular Ligament Following PRP Therapy: A Case Report with Serial MRI Evidence

2025-12-31T12:05:06+07:00

Lateral ankle sprain (LAS) is one of the most common lower limb injuries, particularly in individuals involved in sports and recreational activities. The anterior talofibular ligament (ATFL) is the structure most frequently affected. Platelet-rich plasma (PRP) has shown potential in promoting tissue regeneration and accelerating healing. We report a case of a grade 3 ATFL tear treated with a single PRP injection combined with functional rehabilitation therapy, with serial MRI scans demonstrating ligament continuity and clinical recovery. This case highlights PRP hypothesized as a useful adjunct treatment for LAS involving ATFL injury when combined with functional rehabilitation, as it may promote ligamentous healing, improve short-term symptoms, and potentially reduce the long-term risk of developing chronic ankle instability.

Overlapping Neurological Insults: Case Report of Herpes Zoster in Multibacillary Leprosy with Reversal Reaction

2025-12-31T12:05:04+07:00

Herpes zoster (HZ) is a reactivation of the varicella zoster virus (VZV). Low immunity, whether due to advanced age, immunosuppressants such as corticosteroids, or chronic infectious conditions such as Morbus Hansen (MH), is the primary predisposing factor for VZV reactivation. A 48-year-old man, previously diagnosed with Morbus Hansen, presented with a painful, burning, erythematous rash that began 5 days before presentation, followed by the development of grouped, fluid-filled blisters on the left waist, some of which ruptured and formed crusts. In the TZANK test, multinucleated giant cells were identified. The patient was given acyclovir, gabapentin, and mupirocin ointment. Leprosy therapy was continued, but corticosteroids were temporarily discontinued until the HZ lesions improved. After 1 week, improvements were observed in the lesions. Adequate therapy is crucial to prevent severe complications in immunocompromised patients. Clinicians should be aware of the potential for this dual disorder, particularly in immunocompromised patients, to promptly identify and manage this condition, thereby minimizing nerve damage, improving patient outcomes, and preventing disability. This case also underscores the need for careful neurological assessment and tailored strategies and therapies in patients with complex infectious neuropathies.

The Impact of Missed Red Reflex Screening on Binocular Vision Outcomes in a Child with Bilateral Congenital Cataracts

2025-12-31T12:05:03+07:00

Delayed recognition of congenital cataracts during the critical period of visual development can result in permanent neurovisual deficits. This case report describes a 5-year-old child with bilateral congenital cataracts who presented late with alternating exotropia. Ocular evaluation showed bilateral cataracts, alternating fixation on cover testing, and absent stereopsis, indicating long-standing visual deprivation. Despite cataract extraction, binocular function remained poor due to disruption of cortical binocularity beyond the sensitive developmental window. This case underscores the irreversible impact of late intervention and highlights the need for strengthened neonatal red reflex screening and timely referral to prevent avoidable lifelong visual impairment.

Severe Diabetic Ketoacidosis Complicated by RRT-Requiring Acute Kidney Injury in an Adolescent with Newly Diagnosed Type 1 Diabetes

2025-12-31T12:05:01+07:00

Diabetic ketoacidosis (DKA) is a major and potentially life-threatening acute complication of type 1 diabetes mellitus (T1DM), particularly in children and adolescents. We report a 17-year-old male who presented with severe DKA as the first manifestation of previously undiagnosed T1DM. On admission, he was profoundly acidotic, markedly hyperglycemic, hemodynamically unstable, and anuric, with rising creatinine levels. Despite appropriate resuscitation and standard DKA therapy, renal function deteriorated to stage 3 AKI according to KDIGO, leading to the initiation of renal replacement therapy. During the initial phase of dialysis, the patient experienced several episodes of hypoglycemia, requiring insulin dose adjustment and closer glucose monitoring. Renal function gradually improved and patient was discharged in stable condition. This case highlights that DKA as the initial presentation of type 1 DM in adolescents can progress to severe AKI requiring dialysis, and emphasizes the importance of careful monitoring of renal function and glycemic management during renal replacement therapy in pediatric patients.