Acute angle closure is an emergent ophthalmic condition that develops as a result of an obstructed outflow of aqueous humour between the anterior and posterior chambers of the eye, leading to a sudden rise in intraocular pressure and secondary optic neuropathy if left untreated. The most common primary cause is a pupillary block in patients with pre-existing narrow angles, such as those who are long-sighted. However, awareness should be raised to identify secondary causes of angle closure, including the use of commonly prescribed medications. A detailed interrogation is essential to exclude other possible confounding disorders that present similarly, especially those originating in the CNS. Angle closure should be excluded in all patients presenting with sudden onset of red eye associated with pupillary dilation, dull pain and headache. Basic examination of the eye should include assessment of the anterior segment with a bright light, measurement of intraocular pressure and a full neurological exam. Immediate treatment must be initiated whenever there is high clinical suspicion of acute angle closure, with the administration of systemic ocular hypotensive therapy to prevent damage to the optic nerve and limit visual loss. An urgent referral to the ophthalmologist is mandatory to dictate definitive management.

The precise pathophysiological mechanism of stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) is unknown. This study demonstrates an association between SNIFR and incomplete posterior hyaloid detachment, indicating a possible tractional etiology, as well as a relationship with peripheral retinoschisis and extramacular absolute scotoma, despite retention of good central visual function.

Varied options are available for the implantation of secondary intraocular lens implants in the absence of zonular or capsular support. Loss of the capsule can occur in the context of complicated cataract surgery, trauma or inherited conditions such as Marfan syndrome or pseudoexfoliation. Approaches to overcome this include optical measures such as the use of spectacles or contact lenses, and surgical therapy incorporating the use of anterior chamber, iris-fixated or scleral-fixated lenses. Surgical techniques to implant scleral-fixated lenses have undergone various modifications, since the first publication of sutured intrascleral fixation described in the 1980s. However, despite the advances in surgical techniques, studies are limited either by their retrospective nature, small sample size and most importantly small duration of follow-up. This comprehensive review aims to amalgamate the evolution of various surgical techniques with regards to intrascleral lens fixation and suggests areas for future development.