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Two patients with mild, adult-onset diabetes mellitus developed a painful ophthalmoplegia and ipsilateral optic neuropathy that was relatively unresponsive to steroids. Histopathological study of the optic nerve of one patient revealed an extensive ischaemic infarct. There was ultimate recovery from the cranial nerve palsies in both patients and the optic neuropathy in one patient. Ischaemic polyneuropathy involving the cranial nerves may cause an orbital apex/cavernous sinus syndrome in patients with diabetes mellitus. [ABSTRACT FROM PUBLISHER]

Five patients with evidence of severe bilateral carotid artery disease and increased intraocular pressure have been followed up for 3 to 12 years without the development of glaucomatous disc or field changes. Although it is frequently stated that glaucoma patients with low systemic or ophthalmic artery blood pressures show rapid progression of their eye disease, our patients show that this is not necessarily true. Other more important and largely unknown susceptibility factors determine the occurrence of glaucoma in patients with raised intraocular pressure. [ABSTRACT FROM PUBLISHER]

Radiation is a commonly used treatment modality for head and neck as well as CNS tumours, both benign and malignant. As newer oncology treatments such as immunotherapies allow for longer survival, complications from radiation therapy are becoming more common. Radiation-induced optic neuropathy is a feared complication due to rapid onset and potential for severe and bilateral vision loss. Careful monitoring of high-risk patients and early recognition are crucial for initiating treatment to prevent severe vision loss due to a narrow therapeutic window. This review discusses presentation, aetiology, recent advances in diagnosis using innovative MRI techniques and best practice treatment options based on the most recent evidence-based medicine., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)