This study suggests that 360-degree SLT is more efficacious in achieving smaller IOP fluctuations than treatment with 180-degree SLT.

We think that the topical use of chlorhexidine gluconate 0.02% may have resulted in a progressive ulcerative keratitis in our patient.

No abstract

ABSTRACT.Purpose: To report an unusual case of Terson's syndrome caused by a ruptured intracranial aneurysm presenting as an ophthalmic emergency with visual loss, without any neurological features at the time of presentation. Methods: Case report. A 38-year-old man was referred to the eye emergency department with sudden loss of vision in both eyes. Vitreous haemorrhage was noted in both eyes. There was no history of loss of consciousness or headaches and no signs of meningeal irritation at presentation. The patient subsequently developed progressive neck stiffness and headache. Results: Neuro-imaging studies revealed a subarachnoid haemorrhage resulting from a ruptured carotid-ophthalmic artery aneurysm. Conclusions: It is important to consider Terson's syndrome, a potentially lifethreatening condition, in any patient presenting with bilateral vitreous haemorrhage. Some patients may not show any headache, neurological deficits or signs of meningeal irritation at presentation but may develop them later on.

Laser photocoagulation of the human trabecular meshwork (TM) to reduce the intraocular pressure (IOP) has been performed since the early 1970s. 1 However, it was not until 1979 that Wise and Witter 2 described a modified technique to perform argon laser trabeculoplasty (ALT) that ALT became an established treatment modality for primary open angle glaucoma. Although the precise mechanism by which ALT lowers the IOP is not known, histologic studies show that coagulative thermal damage to the TM is associated with ALT. 3 Similar changes are seen after laser trabeculoplasty with Nd:YAG laser (1064 nm) in a freerunning, thermal mode, and the diode lasers. 4,5 With all these lasers, laser energy is absorbed primarily by the melanin contained within the pigmented TM cells present in the irradiation zone. However, these are continuous wave lasers with pulse duration in the milliseconds range or greater. These pulse durations result in dissipation of the heat from pigmented cells to surrounding tissues, which can denature the proteins and cause coagulative damage to the nonpigmented cells and tissues within the zone of laser irradiation. 3,4,6 In 1995, Latina and Park 7 conducted a study to selectively target the pigmented TM cells while sparing adjacent tissues from collateral thermal damage. This study formed the basis of the currently available 532 nm, frequency doubled, Q-switched: Nd:YAG selective laser trabeculoplasty (SLT) laser. In this study, we will review the histopathologic changes after SLT, compare these changes to that seen after ALT, and discuss the possible mechanism of action of SLT.