Vitreoretinal large B- cell lymphoma (VR- LBCL): Clinical and pathological features and treatment outcomes.

Context: Vitreoretinal large B- cell lymphoma (VR- LBCL) is a type of non- Hodgkin lymphoma confined to the eye and central nervous system (CNS). The clinical manifestations of intraocular lymphoma can precede, occur simultaneously with, or follow disease at CNS sites. It differs from other forms of extra-nodal lymphoma; in that it does not involve systemic sites other than CNS.

Beware the Retrobulbar Optic Neuritis Diagnosis.

A 48-year-old gentleman presented to the ophthalmology department with progressive monocular vision loss, a relative afferent-pupillary defect, decreased color perception, headache, proptosis, and retro-orbital pain. This particular patient's demographics and disease course did not suggest a "typical" retro-bulbar optic neuritis and highlights the importance of avoiding presumptive steroid treatment in such "atypical" cases. Further investigations revealed a compressive optic neuropathy secondary to an orbital tumor (B-cell non-Hodgkin's lymphoma) and were subsequently treated by a multi-disciplinary approach.

Rhegmatogenous retinal detachments: primary reattachment rates and visual outcomes over a 4-year period.

Background And Aims: To describe rhegmatogenous retinal detachment surgery in a Dublin tertiary referral centre over a 4-year period and to examine factors predictive of surgical and anatomical success.

Methods: A retrospective study was performed by reviewing the surgical log and the charts of patients who underwent a primary retinal detachment repair in a specialist centre over a 4-year period between 2012 and 2015. We excluded exudative and tractional cases.

Toll-Like Receptors and Age-Related Macular Degeneration.

Age-related macular degeneration (AMD) is the leading cause of central vision loss in the over 50s worldwide. Activation of the immune system has been implicated in disease progression, but while polymorphisms in genes associated with the immune system have been identified as risk factors for disease, the underlying pathways and mechanisms involved in disease progression remain incompletely characterised. Typically inflammatory responses are mediated by microbial infection; however, in chronic conditions, a form of 'sterile' inflammation exists whereby immune responses occur in areas of the body, in the absence of microbes; 'sterile' inflammation is likely to be central to AMD.

Prevalence of age-related macular degeneration associated genetic risk factors and 4-year progression data in the Irish population.

Background/aims: Age-related macular degeneration (AMD) is estimated to affect 196 million people >50 years old globally. Prevalence of AMD-associated genetic risk factors and rate of disease progression are unknown in Ireland.

Methods: Prevalence of AMD-associated genetic risk variants, complement factor H (CFH) rs1061170, age-related maculopathy susceptibility 2 (ARMS2) rs10490924, component 3 (C3) rs2230199, complement factor B (CFB) rs641153 and superkiller viralicidic activity 2-like (SKIV2L) rs429608 and 4-year progression data in a population-representative cohort (The Irish Longitudinal study on Ageing (TILDA)) were assessed.

Final anatomic and visual outcomes appear independent of duration of silicone oil intraocular tamponade in complex retinal detachment surgery.

Aim: To report anatomic and visual outcomes following silicone oil removal in a cohort of patients with complex retinal detachment, to determine association between duration of tamponade and outcomes and to compare patients with oil removed and those with oil in terms of demographic, surgical and visual factors.

Methods: We reported a four years retrospective case series of 143 patients with complex retinal detachments who underwent intraocular silicone oil tamponade. Analysis between anatomic and visual outcomes, baseline demographics, duration of tamponade and number of surgical procedures were carried out using Fisher's exact test and unpaired two-tailed -test.

Spasm of the near reflex: A case report.

Purpose: Spasm of the near reflex (SNR) is a triad of miosis, excess accommodation and excess convergence. Primary SNR is most often functional in origin We aim to highlight the clinical features which distinguish primary convergence from other conditions with a similar presentation but more sinister underlying aetiology, for example bilateral abducens nerve palsy.

Observations: There is a paucity of published data on SNR, in particular diagnostic criteria and treatment.

Orbital abscess following posterior subtenon injection of triamcinolone acetonide.

Orbital cellulitis is a serious sight threatening and potentially life threatening condition which can be complicated by orbital abscess formation. Posterior subtenon (PST) injection of corticosteroid is commonly used in the treatment of posterior segment inflammation including post-operative macular oedema. We report a case of orbital abscess formation as a late complication of PST triamcinolone acetonide and discuss the presentation, diagnosis and management.

Bilobed flap in ophthalmic plastic surgery: simple principles for flap construction.

This report describes simple principles for constructing the bilobed flap in the periocular region. The results in a prospective series of 23 consecutive patients are presented. All patients achieved satisfactory functional and aesthetic results with the use of this technique.

Low-dose midazolam infusion for oculoplastic surgery under local anesthesia.

Purpose: Oculoplastic surgery with infiltration of local anaesthesia at the operative site performed as a day-case procedure is both efficient and cost-effective. Patients considered unsuitable for this because of fear or apprehension may, however, benefit from per-operative conscious sedation. We sought to study the efficacy and safety of this using midazolam, a water-soluble benzodiazepine.

Blindness in patients with diabetes who have been screened for eye disease.

Purpose: Detection of diabetic retinopathy by screening is a major public health concern. Fundus photography has been shown to be a useful screening tool for the detection of diabetic retinopathy. In this paper the authors assess the incidence of blind and partially sighted registration due to diabetic eye disease in patients screened by a mobile fundus photography unit and identify the factors that contributed to loss of vision in the registered group.

Bimedial rectus recession using the anchored hang-back technique.

Hang-back recession of a rectus muscle offers several advantages over conventional techniques: a reduced risk of scleral perforation, easy intraoperative adjustment, and a convenient site for suturing to the sclera. There are also disadvantages: the muscle tends to collapse, thereby increasing the effective recession and making the result less predictable. In addition, the insertion cannot accurately be displaced upward or downward, as may be required to correct A- and V-patterns, or vertical deviations.

Correction of blepharoconjunctivitis-related upper eyelid entropion using the anterior lamellar reposition technique.

Upper eyelid entropion is a complication of chronic blepharoconjunctivitis which may be easily missed unless careful examination of the lid margin of patients with trichiasis is carried out. Many patients undergo years of unsuccessful treatment for trichiasis because the underlying upper eyelid entropion has not been detected. We would like to recommend the already established procedure of anterior lamellar repositioning as a more permanent solution to this distressing condition and present the results of this procedure on 19 consecutive patients (28 lids).

A clinical study of the hydroxyapatite orbital implant.

The hydroxyapatite orbital implant has been used in the anophthalmic patient to give good motility of the artificial eye and a cosmetic result which matches that of the natural eye. It is thought to reduce the unacceptable complication rate that has been associated with other implants, as its buried, vascularized state deters extrusion and migration of the implant. Eighty consecutive patients were followed, 33 of whom had been referred for primary enucleation or evisceration, and 47 for secondary implant surgery.

The hydroxyapatite orbital implant: a prospective study.

The hydroxyapatite orbital implant was first released for use as an orbital implant in humans in August 1989. It has been shown to be well tolerated, providing good motility of the artificial eye with a low complication rate when used as a primary implant. This prospective study evaluated the hydroxyapatite orbital implant used as both a primary and a secondary implant.

Use of Proplast II as a subperiosteal implant for the correction of anophthalmic enophthalmos.

Background: A variety of autogenous and alloplastic materials have been used as subperiosteal implants to correct anophthalmic enophthalmos. Proplast II is a synthetic porous composite of Teflon polymer and alumina. Proplast II offers a number of advantages over other commonly used alloplastic materials such as silicone and polymethyl methacrylate.