Tobacco-alcohol optic neuropathy--clinical challenges in diagnosis.

Part of the large group of nutritional and toxic optic neuropathies, tobacco-alcohol optic neuropathy is a disease often underdiagnosed or detected at a stage when the full recovery of vision is not possible. This article summarizes its signs and symptoms, describes the pathophysiological processes involved and provides the necessary information for diagnosis and treatment of the entity previously known as tobacco-alcohol amblyopia, reporting in the end, a challenging case along with its findings.

Use of amniotic membrane in bullous keratopathy palliative care.

BACKGROUND: Assessment of efficiency of amniotic membrane covering in the improvement of bullous keratopathy symptoms. MATERIAL AND METHOD: The paper represents a clinical prospective study, which includes 42 patients diagnosed with bullous keratopathy and operated between January 2009 and November 2013 in the Department of Clinical Ophthalmology from "Dr. Carol Davila" Central Military Emergency Hospital. Follow up between 6 and 48 months, with an average of 22 months. Subject to research: corneal re-epithelisation, epithelial bullae, pain and photophobia relapse. RESULTS: In 37 cases, the symptoms improved, in 8 cases the minimum symptoms persisted and in 29 cases the symptoms completely disappeared. In 5 cases, there were no significant improvements, symptoms reappeared briefly after membrane resorption. CONCLUSIONS: Amniotic membrane covering represents an efficient palliative care means in oedematous keratopathy.

The importance of alcohol abuse and smoking in the evolution of glaucoma disease.

BACKGROUND: Diagnosing glaucoma by clinical and paraclinical selection, monitoring the patients who present glaucoma, smoke and consume high quantities of alcohol. We wish to demonstrate the influence of smoking and alcohol consumption on the progression of glaucoma. MATERIAL AND METHOD: The paper represents a clinical prospective observational and interventional study within a period of 11 months (September 2011- August 2012), which includes 214 patients diagnosed with glaucoma, by clinical and paraclinical examination, and, who were administrated prostaglandin analogues. The group was divided into 4 homogeneous subgroups according to age, without ocular and systemic associated pathology: Group A- patients diagnosed with glaucoma who do not smoke or drink alcohol (witness group). Group B- patients diagnosed with glaucoma who smoke but do not drink alcohol. Group C- patients diagnosed with glaucoma who drink alcohol but do not smoke. Group D- patients diagnosed with glaucoma who smoke and drink alcohol. The patients in the 4 groups were supervised by monthly periodical examinations in the first 3 months, then at 3 months by clinical examination (anterior pole examination, eye background) and paraclinical examination (gonioscopy, aplanotonometry Goldman, pachymetry, retinography, computerized perimetry, optical coherence tomography - OCT). RESULTS: Tensional variations in all the 4 groups under treatment were between (+2;-2mmHg). Retinography failed to point out significant changes from the enrolment to the moment of the paper presentation. The visual field has registered important changes in groups B and D and has not registered significant changes in groups A and C. OCT changes were registered particularly in group D. CONCLUSIONS: The progression of the glaucoma disease is more influenced by smoking than by alcohol consumption. The association between smoking and alcohol consumption certainly represents an agent of major risk in the progression of glaucoma.