Neuropathic Pain in Multiple Sclerosis Improved With Oral Famciclovir: A Case Report.

Multiple sclerosis can be a debilitating disease that is often associated with neuropathic pain and discomfort in the trigeminal region. This can pose a therapeutic challenge as the benefits of the treatment options have to be outweighed against significant side effects. The authors present the case of a 67-year-old man, whose control of trigeminal neuralgia with botulinum toxin A injections was lost after an episode of herpes labialis and herpes zoster infection. The pain management of the patient during the episodes of herpes simplex and varicella zoster infections was greatly improved with famciclovir treatment, and subsequently control of trigeminal neuralgia was regained with botulinum toxin A injections. This case serves to highlight the potential association of multiple sclerosis with herpetic infections as well as the treatment challenges, especially management of pain, which they can possess.

Non-arteritic Anterior Ischaemic Optic Neuropathy after Uneventful Cataract Extraction.

We present the case of a 74-year-old Caucasian female who suffered sudden visual loss after routine phacoemulsification cataract surgery. The patient was subsequently diagnosed with non-arteritic anterior ischaemic optic neuropathy. The case is described in detail, and a concise review of the literature is presented together with the authors' view on the subject outlined. This is a very rare complication after cataract surgery even in high-risk patients with associated systemic co-morbidities. We suspect that the previous history of obesity, coronary artery disease, and arteriosclerosis contributed to the development of this serious ocular complication. We suggest appropriate measures to reduce the risk of its occurrence.

Hydration of the anterior stroma in phacoemulsification cataract surgery.

We describe a simple technique to hydrate the anterior stroma in cataract surgery using a 30-gauge needle. At the end of phacoemulsification, the needle is inserted into the stroma to create a watertight seal of the clear corneal incision.

Subconjunctival triamcinolone acetonide in the management of ocular inflammatory disease.

PURPOSE: To review the existing evidence that supports the subconjunctival use of triamcinolone acetonide (TA) in the treatment of various ophthalmic diseases. METHODS: A literature search was performed for published articles about the pharmacokinetic (PK) and pharmacodynamic characteristics of triamcinolone, as well as its potential ophthalmic use, focused mainly in the subconjunctival mode of delivery. Search terms included corticosteroids, triamcinolone, ocular, subconjunctival, and ophthalmic. RESULTS: Corticosteroids represent the mainstay of treatment of ocular inflammation, exerting their action by affecting multiple pathways of the inflammatory response, making them particularly effective in the majority of cases. However, due to the number and severity of the side effects associated with their use, they have to be given with caution. Corticosteroids can be given topically, subconjunctivally, intraocularly, and systemically to treat a variety of ocular diseases with specific pharmacological and PK characteristics. Triamcinolone is one of the most widely used corticosteroids in the treatment of ocular inflammation. This glucocorticoid used subconjunctivally was proven to be particularly safe and effective in some common and important inflammatory ophthalmic diseases such as anterior scleritis, uveitis, and corneal graft rejection. Further, there are other indications for its successful use where data exist, but somehow less abundant. CONCLUSIONS: This article highlights the potential of TA to complement the treatment armamentarium of anterior segment inflammation.

Surgical iridotomy in aphakic eyes and eyes with anterior chamber intraocular lenses.

UNLABELLED: We describe a simple technique to create a peripheral surgical iridotomy using a microvitreoretinal blade. The blade passes perpendicular to the iris dilator fibers to create a permanent opening. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

"PhacoTracking": an evolving paradigm in ophthalmic surgical training.

Motion analysis has been validated as a tool to evaluate surgical skill. We investigated a novel computer vision-based tool for the evaluation of surgical movements during cataract surgery. A prospective cohort analysis of 2 groups was performed. Ten videos of junior surgeons (ie, those with <200 cases) and 10 videos of senior surgeons (ie, those with >1000 cases) were analyzed. Movement parameters were measured over an entire procedure. Significant statistical differences were found between novice and expert surgeons for total path length (P = .002), number of movements (P = .05), and total time (P = .004). Our study has shown that computer vision-based motion analysis can be successfully applied to video recordings of cataract surgery to provide robust measurements of instrument motion. Further work needs to be done to evaluate its usefulness in training and feedback.