A Novel Method for the Delivery of Antimetabolites During Glaucoma Surgery.

Current techniques for the delivery of antimetabolites, such as mitomycin C, tend to be very variable among surgeons and risk uncontrolled contact with the conjunctivae, which may result in delayed wound healing, wound dehiscence, and wound leakage postoperatively. We describe a novel technique which appear to allow a more precise and reproducible delivery of antimetabolite to the target area with minimal contact with the conjunctival edge. The technique involves the injection of an antimetabolite-soaked wick into the subconjunctival space posterior to the scleral flap using an intraocular lens injector system.

Different strategies and cost-effectiveness in the treatment of primary open angle glaucoma.

Glaucoma is the second highest cause of blindness worldwide with an estimated half of the glaucoma population unaware of their disease. To date, intraocular pressure is the most important modifiable risk factor and lowering it has been proven to reduce progression of visual field loss associated with glaucoma. Different strategies are available to lower intraocular pressure and include medical, laser, or surgical treatment in the form of topical or systemic medications, argon or selective laser trabeculoplasty, and glaucoma drainage surgery such as trabeculectomy, deep sclerectomy, or other drainage devices.

Accidental Unilateral Mydriasis from Hyoscine Patch in a Care Provider.

The hyoscine patch is effective and is frequently used in motion sickness treatment. Not uncommonly, it is used to control excessive respiratory secretions in palliative patients. Patients, healthcare workers, and caregivers who administer these may experience a benign, although worrying, mydriasis should they inadvertently rub their eye after handling the patch.

Botulinum toxin as a postoperative diplopia test - it can also reduce the angle of deviation prior to surgery.

Purpose: To investigate how frequently botulinum toxin, when used as a postoperative diplopia test, reduces the angle of deviation prior to subsequent strabismus surgery.

Methods: A retrospective study of 39 adult patients with constant concomitant horizontal strabismus who had undergone botulinum toxin injections to assess the risk of postoperative diplopia and then subsequently underwent strabismus surgery.

Results: Fourteen out of 39 patients (36%) sustained a reduction of 15 prism diopters or more for near and/or distance when comparing the pre-injection angle of deviation with the preoperative angle of deviation.

Low dose orbital radiotherapy for thyroid eye disease.

Purpose: The use of low dose orbital radiotherapy for thyroid eye disease (TED) remains controversial. This is a review of patients with TED treated with radiotherapy in our department over the last twelve years.

Methods And Materials: Fifty-nine consecutive patients received low dose orbital radiotherapy of 20 Gray (Gy) for active TED at the Beatson Oncology Centre.

The intraocular pressure reducing effect of brinzolamide as adjunctive therapy to latanoprost.

Aim: To determine the intraocular pressure (IOP) lowering effect of brinzolamide when added to latanoprost.

Materials And Methods: Patients who were simultaneously on brinzolamide and latanoprost were identified from the large prospective database of patients diagnosed with primary open angle glaucoma, normal tension glaucoma or ocular hypertension maintained in our glaucoma clinic. Only patients who had been on latanoprost for at least six weeks before introduction of brinzolamide were included.

Leucocytoclastic vasculitis presenting as bilateral marginal keratitis.

Leucocytoclastic vasculitis is an immune-mediated, neutrophil-induced small vessel disease. Clinically, it presents with cutaneous palpable painless purpuric papules on the extremities. Ocular manifestation reported in the literature is rare and includes peripheral ulcerative keratitis, panuveitis and multifocal retinitis all preceded by cutaneous lesions.