No abstract

3 cases of acute optic neuropathy in juvenile diabetics are reported. The neuropathy included initially optic disc edema (ODE), usually with prominent, dilated and frequently telangiectatic vessels over the disc, and later, generally, development of optic disc-related visual field defects. On resolution of the neuropathy, the disc was normal in all eyes except for a mild pallor in one, and the visual acuity and fields recovered to normal. 2 of the patients also had early diabetic retinopathy. The nature of the optic neuropathy is discussed. We feel the available evidence indicates that the condition most likely represents a mild or subclinical anterior ischemic optic neuropathy (AION) despite the youth of the patient. It is pertinent to note that AION can vary widely not only in severity (from sub-clinical to severe) but also in age distribution (from juvenile to elderly), and the subject is discussed. The clinical significance of early detection of this optic neuropathy, and the dangers of confusing it with proliferative diabetic retinopathy or ODE due to other causes, are stressed.

Summary A patient is described who developed co-existent Reiter’s disease and bilateral non-traumatic retinal detachment. Although numerous ophthalmological disorders are associated with Reiter’s disease and HLA-B27, to our knowledge this is the first report of co-existent retinal detachment. Although this relationship may be fortuitous, there are a number of immunological mechanisms common to both entities. Retinal detachment, unlike bilateral conjunctivitis and acute anterior uveitis, may be clinically asymptomatic and its sequelae prevented by appropriate ophthalmological assessment.