Sports-Related Concussion: The Eyes Have It

Concussion is a form of mild traumatic brain injury (TBI) owing to structural, metabolic and functional changes involving white mater tracts of the central nervous system in the absence of macroscopic findings. Sports-related concussion is a rapidly evolving condition stimulating interest among lay and scientific communities. 

Recent studies have shown a high rate of under reporting of concussion signs and symptoms by athletes and side line personnel. Accordingly, reliable and validated testing strategies are necessary to insure timely detection and removal from play for individuals suspected of concussion. Vision and visual motor problems are commonly reported among athletes following concussion. This is to be expected as it is estimated that approximately 50% of the brain is devoted to vision and visual motor processing. As such, testing of vision and ocular motility function are critical to the evaluation of a concussed individual.

Photodynamic Therapy with Verteporfin, a Novel Treatment Option for Retinal Arterial Macroaneurysm

First described by Robertson in 1973. RAMs are acquired, localised dilatations of an arteriole within the radius of the 3rd branch of the retinal arterial tree. Current treatment options are controversial and of unproven benefit. We present the case of a 76-year old gentleman with progressive vision loss from a unilateral RAM who responded favourably to treatment with PDT using Verteporfin. To the best of our knowledge, there are no previously published reports on the use of PDT in treating RAM. 

In accordance with the declaration of Helsinki, the patient provided informed consent prior to participation. We certify that all applicable institutional and governmental regulations concerning the use of human volunteers were followed during this research.

Impact of Amblyopia Treatment on Vision-Related Quality Of Life

Treatment of amblyopia during childhood can have both positive and negative impacts in later life. The treatment of amblyopia could influence Vision-related Quality of Life in adults and children, particularly social relationships and emotions. For example, children with a history of occlusion were 35% to 37% more likely than children without visual defects to have suffered from verbal or physical bullying at school. Many parents associate occlusion treatment with a decrease in children’s self-confidence because of poor vision during occlusion and report greater distress and more conflict at home.

Koklanis et al. conducted a study in Australia on the psychosocial impact of amblyopia and its treatment from both the children’s (aged 3 to 15 years) and parents’ perspectives. The investigators performed a semi-structured interview with both children with amblyopia andtheir parents. In addition, parents were asked to complete a psychological inventory, the Behaviour Assessment System for Children. 

Mini Monoka Stent Insertion for the Management of Epiphora Secondary to Canalicular Obstruction or Stenosis

Epiphora is a common presenting problem in ophthalmological clinical practice. There are multiple causes for epiphora. Canalicular obstruction/stenosis is common and increases with age with a female preponderance. Treatment for epiphora is often controversial and notalways successful. The gold standard of treatment involves retrograde silicone intubation most commonly with Lester Jones bypass tubes plus or minus dacryocystorhinostomy (DCR) or sometimes more complex procedures such as canaliculodacryocystorhinostomy or conjunctivodacryocystorhinostomy if there is total canalicar obstruction. 

DCR with retrograde intubation is reported to alleviate or reduces epiphora in 60-70% of patients with proximal or mid-canalicular disease. There is a poorer prognosis for more distal obstructions, with successin the range of 50%. Other complex procedures such as canalicular trephinationwith silicone stent intubation, balloon canaliculoplasty and endocanalicular laser surgery have also recently been described with varying success rates (43 to 84%). Finally, canaliculodacryocystorhinostomy has a reported success rate of approximately 80% if there is common canalicular obstruction whilst conjunctivodacryocystorhinostomy has success rates of around 90% if performed correctly, with unfortunately high complication rates (as high as 50%).