Osteoradionecrosis of the exenterated orbit.

Osteoradionecrosis (ORN) occurs in an estimated 2% of head and neck-irradiated patients. It is seen most commonly in the mandible with other reported sites including the maxilla, temporal bone, clavicle, and vertebrae. It is defined as an area of exposed devitalised irradiated bone, with failure to heal during a period of at least 3 months, in the absence of local neoplastic disease.

PAX6 mutation in association with ptosis, cataract, iris hypoplasia, corneal opacification and diabetes: a new variant of familial aniridia?

Background: We report a family with ptosis, cataract, iris hypoplasia and gradual corneal opacification occurring in association with a PAX6 mutation.

Design: Case-series.

Participants: Fourteen family members - 8 affected, 6 unaffected controls.

Permacol in eyelid reconstruction -- a novel use.

Background: Reconstruction of a full-thickness lower eyelid defect is not an uncommon procedure and requires repair of both the anterior and posterior lamella. The modified Hughes procedure is commonly used for large defects, however this requires a second procedure and since the flap must be left in place for at least 3 weeks prior to the second-stage separation, it is not suitable for patients with only eyes or of amblyogenic age. In such situations, a free tarsoconjunctival graft from the opposite upper eyelid or a mucoperiosteal graft from the hard palate is more appropriate.

Cardiac pacemakers and electrocautery in ophthalmic surgery.

The aging of the population and our ability to care for a patient with increasingly complex disease suggest that we will be caring for many more patients with pacemakers and implantable cardioverter-defibrillators. Using surgical diathermy or electrocautery on these patientscan present the additional risk of electrical interference and appropriate precautions need to be considered. We summarise the different type of pacemakers and electrocautery, and how electrocautery can interfere with such devices.

Orbital apex syndrome from blunt ocular trauma.

Orbital apex syndrome (OAS) is a rare condition due to a range of pathological processes around the optic nerve foramen and the superior orbital fissure causing characteristic functional loss. It is a rare complication of trauma and results from penetrating injuries as well as those involving bony fractures. We present a case of OAS from non-penetrating ocular trauma without bony involvement.

External dacryocystorhinostomy for the treatment of epiphora in patients with patent but non-functioning lacrimal systems.

Aims: To assess the outcome of external dacryocystorhinostomies (DCRs) in patients with patent but non-functional lacrimal drainage systems and to identify any preoperative clinical or dacryocystography (DCG) and lacrimal scintigraphy (LS) factors associated with successful surgery.

Methods: A retrospective study of 46 DCRs with silicone intubation performed for patients with epiphora associated with a clinically patent lacrimal drainage system. All patients underwent preoperative DCG and LS which were evaluated for presence, site and severity of delayed clearance.

Comparison of dacryocystography and lacrimal scintigraphy in the investigation of epiphora in patients with patent but nonfunctioning lacrimal systems.

Purpose: To assess and compare dacryocystography and lacrimal scintigraphy in the management of patients with epiphora and patent but nonfunctioning lacrimal systems.

Methods: Data were collected retrospectively over a 3-year period from all patients having both dacryocystography and lacrimal scintigraphy for epiphora where clinical examination indicated delayed tear clearance but the lacrimal system was patent. Both investigations were evaluated for presence, site, and severity of delayed clearance.

Optic disc and visual field progression in ocular hypertensive subjects: detection rates, specificity, and agreement.

Purpose: To examine the detection rates, specificity, and agreement between visual field (VF) progression and Heidelberg Retina Tomograph (HRT; Heidelberg Engineering, GmbH, Heidelberg, Germany) rim area (RA) progression in subjects with ocular hypertension (OHT).

Methods: One hundred ninety-eight OHT and 21 control subjects were examined prospectively (1994-2001) with regular Humphrey VF (Carl Zeiss Meditec, Inc., Dublin, CA) and HRT testing.

Visual function following transpupillary thermotherapy with adjusted laser parameters for the treatment of exudative age-related macular degeneration: a pilot study.

Purpose: To evaluate the efficacy of transpupillary thermotherapy (TTT) using adjusted laser parameters for the treatment of choroidal neovascularization (CNV) secondary to age-related macular degeneration.

Methods: TTT was performed on patients with CNV using a diode laser (810 nm) for 60 s in a subthreshold manner. Power settings were varied between 460 and 1200 mW, depending on lesion size, presence of pigment epithelial detachment and the amount of fundal pigmentation and subretinal fluid.