Although ocular side-effects of Viagra are rare, they are potentially blinding. Patients should be warned about the side-effects and against misuse of this agent.

Ocular chrysiasis is well recognized after systemic gold administration and is normally considered inert, but in this case exogenous gold deposition might have been a contributing factor to very localized and repeated episodes of stromal erosion in this man, many years after the original injury. To the best of our knowledge this is the first such reported case.

Purpose: To determine incidence, demographics, management, and outcomes of topical steroid-induced ocular hypertension after penetrating keratoplasty (PKP) and to establish effects on intraocular pressure (IOP) and graft rejection when alternate corticosteroids are used. Methods: A single-center, retrospective review of 568 consecutive PKPs performed between 1997 and 2010 was conducted. Data were collected on demographics, best-corrected visual acuity, surgical indications, lens status, IOP, postoperative management, and incidence of rejection. Results: Eighty eyes (14.1%) of 74 patients were included. The most common indication was keratoconus (28.8%). Twenty-seven eyes (33.8%) were phakic, 46 (57.4%) had a posterior chamber intraocular lens, and 7 (8.8%) had an anterior chamber intraocular lens. Mean postoperative IOP increase was only significant in the anterior chamber intraocular lens group (18.7 mm Hg, SD 10.4; P = 0.02). The average time for developing hypertension was 9.8 months (SD 14.8) postoperatively, with an average IOP increase of 13.3 mm Hg (SD 5.9). Prednisolone acetate 1% was switched to rimexolone 1% in 64 eyes (80%) and to fluorometholone 0.1% in 16 eyes (20%), which alone achieved IOP normalization in 26 eyes (32.5%) (P < 0.01). Fifty-four eyes (67.5%) required additional antiglaucoma medication. An average IOP reduction of 12.3 mm Hg (SD 6.9) was achieved at an average of 2.3 months (SD 5.2) after the switch. Seventeen eyes (21%) developed glaucoma and 13 eyes (16.3%) developed graft rejection after switching formulations, with no statistically significant differences between rimexolone and fluorometholone (P > 0.05). Conclusions: The use of alternate topical corticosteroids may be considered in cases of steroid-induced ocular hypertension after PKP because they offer good antiinflammatory prophylaxis with reduced hypertensive response.

Methods, Intervention or Testing: A 32 question online survey using a survey monkey web link was sent to the UKEGS members. All non-responders and partial responders were sent a reminder to complete the survey. Main Outcome Measures: Responses relating to the surgical & non-surgical aspects of trabeculectomy surgery. Results: The response rate was 67.6% (142/210) and the vast majority of the respondents (88%) were glaucoma consultants. Eighty percent of the respondents performed > 10 trabeculectomies per year and 70% performed primary trabeculectomy, majority of which (> 2/3) only did this rarely & in cases of late presentation. Progressive visual field loss was the most common indication for trabeculectomy. Majority (48.39%) use sub-tenon's block without digital massage/ weight/Honan's balloon. About 89% used antimetabolites of which 99% used Mitomycin C (MMC) and the majority (60%) use this just after conjunctival peritomy. Most (80%) use 0.2 mg/ml of MMC and 58% use this for 3 minutes. Majority (57%) used their own self modified Moorfield's safe surgery technique & 88% perform a PI during trabeculectomy whereas 12% don't (in pseudophakes, myopic and where patients are on anticoagulation). Most (56%) use an AC maintainer (1/3 of them always). Only 29% performed phaco trab' regularly (2/3rd used different sites), 44% never. Conclusion: This survey highlights a varied spectrum in the practice of trabeculectomy. This may reflect some paucity of good evidence to guide uniformity in the various aspects of trabeculectomy.