Benzalkonium chloride in glaucoma medications.

Benzalkonium chloride (BAK) is the preservative used most commonly in eye drops. Although it is effective as an antimicrobial and antifungal agent, both in vitro and in vivo studies have demonstrated adverse effects on surface epithelial cell populations. This is of particular concern with regard to topical medications used over long periods for chronic conditions, such as glaucoma. Newer non-BAK-containing drops are becoming increasingly available, providing an alternative for patients needing long-term eye drop therapy.

Selective Laser Trabeculoplasty as Primary Treatment for Open-Angle Glaucoma.

Open-angle glaucoma is a silent, chronic disorder which results in progressive and permanent vision loss. Designing the optimal treatment regimen can be particularly challenging in the management of high-risk patients with frequent loss to follow-up or a longstanding history of medication noncompliance. In this article we aim to review fundamental techniques in glaucoma diagnosis and treatment with emphasis on the strengths and weaknesses of selective laser trabeculoplasty, a technique in modern therapy which may mold the future of primary treatment in open angle glaucoma management. [Full article available at http://rimed.org/rimedicaljournal-2016-06.asp, free with no login].

Recurrent enterococcal endophthalmitis seeded by an intraocular lens biofilm.

A case of endophthalmitis following uneventful phacoemulsification and posterior chamber intraocular lens (IOL) implantation in a 77-year-old diabetic man was culture-positive for Enterococcus faecalis. After successful treatment with intravitreal, topical, and systemic antibiotic agents, the infection seemed to clear and the patient achieved a corrected visual acuity of 20/25. Four months after the initial presentation, the patient again developed signs and symptoms of endophthalmitis, with regrowth of E faecalis. The antibiotic therapy was repeated. One month later, the IOL was removed surgically and found to harbor a biofilm of the strain demonstrated by DNA analysis. The microbiologic and DNA analyses support that a biofilm on an IOL could be a vector for a cause of recurrent endophthalmitis. Intraocular lens exchange in cases of postoperative endophthalmitis caused by E faecalis may be considered to decrease the risk for recurrent infection.

Sclerochoroidal calcifications: wide-field imaging.

PURPOSE: To report the clinical and angiographic appearance of sclerochoroidal calcifications utilizing Optos wide-field fundus imaging. METHODS: Case Report. RESULTS: An 80 year-old white female presented with blurred vision in her right eye. On examination she was found to have arc-shaped lesions that were superior to the macula in each eye. Diagnostic studies included ultrasonography, optical coherence tomography (OCT), and wide-field fundus imaging with fluorescein angiography. These studies confirmed the diagnosis of sclerochoroidal calcifications. Metabolic studies were performed, as these may be a manifestation of abnormal calcium metabolism. CONCLUSION: Sclerochoroidal calcifications are an unusual fundus lesion, and we have found Optos wide-field fundus imaging to be an important asset in the diagnosis of this rare entitiy.