Surgical and Perioperative Considerations for the Treatment of Cataract in Eyes with Glaucoma: A Literature Review.

Cataract surgery in the presence of glaucoma poses certain challenges that need to be addressed to offer the maximum benefit without complications. In this paper, we are reviewing the preoperative assessment, surgical options, the planning, and postoperative care. Cataract surgery can help reduce the intraocular pressure alone or combined with MIGS. When performed in patients with glaucoma, it can transiently increase the intraocular pressure and later on decrease the IOP to levels lower than the postoperative. The preoperative IOP and biometric characteristics are the main predictors of the postoperative course of IOP. The combination of cataract surgery with trabeculectomy remains controversial, in terms of best timing of each operation.

Saint Ioannis Lampadistis, the first possible case of blindness due to organic mercury poisoning in history.

Saint Ioannis Lampadistis is a Cypriot saint of the Greek Orthodox Church, widely venerated in his island of origin. He lived during the 11th century and was blinded by ingesting contaminated fish in the mountainous area of Galata, withdrew from civil life when he was 18, and died at the age of 22. The reason for his blindness remains unknown, though it is widely attributed to an unknown poison related to the copper mines of the region. As fish is the end reservoir of organic mercury, it is quite possible that his blindness was the result of heavy metal toxicity. Organic mercury is associated with CNS atrophy and hypoplasia, and blindness is a frequent presenting symptom. While not much is known about the saint's clinical symptoms (as his ecclestiastical biography focuses on his example and miracles), organic mercury poisoning could explain his sudden loss of vision, thus possibly making him the first-recorded case of organic mercury poisoning in history.

Optic pathway glioma in children: 10 years of experience in a single institution.

Optic pathway glioma (OPG) is a rare brain tumor that occurs more commonly during early childhood and is frequently associated with neurofibromatosis type 1 (NF1). In this study, our aim was to describe the characteristics, management, and outcome of patients with OPG. We retrospectively analyzed the clinical charts of all children diagnosed with OPG at our institution from 2003 to 2013. Twenty children (11 boys and 9 girls, median age: 5 and 3/12 years; NF1: 15/20) were diagnosed with OPG. The diagnosis was based on magnetic resonance imaging (MRI) findings. A biopsy was useful in 3 patients. The main reason for seeking medical advice was decreased vision (7/20 patients), whereas in 10/20 patients, the diagnosis was established during the routine follow-up for their NF1. Fifteen patients demonstrated MRI findings of optic nerve involvement and/or chiasmal tumor, whereas in 5 children, postchiasmal structures were also involved. Sixteen patients (16/20) received carboplatin-based regimens, whereas 4/20 patients were only under close observation. Six patients showed deterioration of visual acuity and/or imaging findings at the end of treatment and/or during their follow-up. Three of them (3/6) underwent tumor resection, whereas 1 (1/6) received radiation treatment. None of our patients had total blindness from both eyes. Half of our patients were diagnosed during follow-up for their NF1, the incidence of which was high in our group. Our data suggest that chemotherapy helps in the preservation of vision in the majority of children.