Poppers retinopathy.

We present a case of a 52-year-old man with sudden, bilateral central loss of vision as a result of inhalation of 'poppers'. He was found to have characteristic changes on optical coherence tomography. With conservative treatment, the patient's vision improved marginally at 3 months follow-up. An overview of previous published cases is also included.

Effective rehabilitation of reading by training in the technique of eccentric viewing: evaluation of a 4-year programme of service delivery.

BACKGROUND/AIMS: Central visual loss caused by conditions such as age-related macular degeneration (ARMD) is the commonest cause of blindness in the UK. Eccentric viewing training aims to teach patients how to utilise the functioning areas of macula or adjacent retina and establish a 'pseudofovea'. This technique has yet to gain acceptance in the UK despite evidence of success. Subjects with ARMD in Glasgow, UK, have received such training, and the outcome of training for this group is described. METHODS: Retrospective analysis auditing the outcome of eccentric viewing training to read was carried out in 300 subjects with ARMD. RESULTS: The data for 300 patients were reviewed. Fifty-eight subjects were excluded due to incomplete final data. Reading speed, font size, degree of comprehension, duration of reading, and age and number of lessons were recorded before and after training. The mean age was 75.4 (SD 12). The mean number of 1-h lessons required was 3.8 (SD 1.6). The starting mean number of corrected words per min (WPM) reading speed was 48 (SD 35) and this increased to 71.9 (SD 30.5) (p=0.000). The starting Arial font size that could be read fluently was 14.3 (SD 7.6) and this improved to 11.5 (SD 2.4). The starting mean duration of comfortable reading was 1.7 (SD 2.0) min. This increased to 15.8 (SD 14.6) min. The mean percentage of material read that was understood by the patients was 73.7 (SD 36.9)%. This improved to 92.7 (SD 16.2)% (p=0.000). Overall, the majority of patients exhibited improvement in one or more of the vision-related tasks measured. CONCLUSION: Eccentric viewing training is successful in improving the reading ability of individuals with a central scotoma. This paper shows evidence of the success of training provided by the voluntary sector and funded by adult literacy funding. The results are comparable with those reported in the literature.

Orbital rhabdomyosarcoma masquerading as a mucocele.

The authors describe a case of orbital rhabdomyosarcoma masquerading as a lacrimal mucocele in a newborn infant. Rhabdomyosarcoma is one of the few life-threatening diseases that an ophthalmologist may be the first to diagnose. This case highlights the importance of close monitoring of such presentations in the newborn.

Changes in corneal sensitivity and tear physiology after phacoemulsification.

PURPOSE: To identify any changes in corneal sensitivity and tear physiology after phacoemulsification and to evaluate the effectiveness of the use of ophthalmic lubricants. METHODS: The design of the study was longitudinal, parallel, randomised and double masked. Eighteen patients (average age 70.83 +/- 10.66 years, 7 males and 11 females) undergoing phacoemulsification were recruited and divided into three groups of six. In addition to the prednisolone acetate 1% and chloramphenicol 0.5% routinely given to patients postoperatively, the first two groups were given a tear lubricant (Refresh Soothe and Protect, Allergan Inc., Irvine, CA, USA) and saline (Chauvin Pharmaceuticals Ltd, Essex, UK), respectively, and the third was a control group and did not receive any additional eye drops. Tear production, evaporation, lipid layer interferometry and osmolarity along with corneal sensitivity were measured before and 3 days, 2 weeks, 1 month and 3 months after the surgery. RESULTS: Statistically significant detrimental changes were seen in all parameters of corneal sensitivity and tear physiology immediately after phacoemulsification. Tear physiology recovered within 1 month. Corneal sensitivity did not return to normal levels in 3 months, but a trend towards full recovery was seen. Saline and the tear lubricant were not found to have an effect on the improvement of tear physiology and corneal sensitivity post-surgically. CONCLUSIONS: Deterioration in corneal sensitivity and tear physiology is seen immediately after phacoemulsification. Corneal sensitivity does not return to preoperative levels until 3 months postoperatively whereas the tear functions recover within 1 month.

Bilateral subacute angle-closure glaucoma in association with tonic pupils post-coronary artery bypass graft.

Anterior and posterior visual pathway disturbances have been reported post-coronary artery bypass graft surgery. Acute angle-closure glaucoma after general anaesthesia has also been well described in the literature. To date, however, there are only two cases of angle closure caused by tonic pupils. The case is reported herein of bilateral subacute angle-closure glaucoma that occurred following coronary artery bypass graft surgery in association with tonic pupils.