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Utilization of antibiotics for endoscopic dacryocystorhinostomy (endo-DCR) is largely dependent on individual surgeon preference. This study aimed to investigate prescribing practices of pre-, peri-, and postoperative antibiotics and effects on postoperative infection rates in patients who underwent endo-DCR. A retrospective chart review of institutional data at two academic centers of endo-DCR cases from 2015–2020 was performed. Postoperative infection rates for patients who received pre-, peri-, and postoperative antibiotics, individually or in combination, and those who did not, were compared via odds ratio and ANOVA linear regression. 331 endo-DCR cases were included; 22 cases (6.6%) had a postoperative infection. There was no significant difference in the infection rates between patients without an active preoperative dacryocystitis who received different permutations of peri- and postoperative antibiotics. Patients who received preoperative antibiotics within two weeks of surgery for preexisting acute dacryocystitis, but did not receive peri- or postoperative antibiotics, had a higher rate of postoperative infections (p = 008). Our data suggest antibiotics may be beneficial only when patients have a recent or active dacryocystitis prior to surgery. Otherwise, our data do not support the routine use of antibiotic prophylaxis in endo-DCR. [ABSTRACT FROM AUTHOR]

Thyroid eye disease (TED), an autoimmune inflammatory disorder of the orbit, presents with a potential array of clinical sequelae. The pathophysiology behind TED has been partially characterized in the literature. There remain certain elusive mechanisms welcoming of research advances. Disease presentation can vary, but those that follow a characteristic course start mild and increase in severity before plateauing into an inactive phase. Diagnosis and evaluation include careful physical examination, targeted laboratory work up, appropriate imaging studies, and tailored treatment regimens. Special consideration may apply to certain populations, such as pediatric and pregnant patients. [ABSTRACT FROM AUTHOR]

Objective: There is value in understanding the common etiologies of epiphora within different patient populations as well as identifying barriers to adequate treatment and symptom relief. The primary goal of the study is to report common etiologies of epiphora and the impact of treatment in patients of a large, inner-city hospital. Methods: This is a retrospective review of 10 years of data from the charts of 516 adult patients. The most common diagnoses and interventions linked to this symptom were evaluated. Subjective symptom improvement and adherence to follow-up were also analyzed. Results: Three hundred (58.1%) patients carried a diagnosis of dry eye syndrome and, of these, 40.1% did not have other ocular findings to explain their epiphora. Conservative management (CM) was recommended to the majority (86.4%) of the study population. 27.5% of the 357 patients who received CM as the only intervention reported symptom improvement. 90.1% of patients who underwent DCR reported symptom improvement. Nearly half of the patients were lost to follow-up. Conclusion: Epiphora is a common symptom that may be multifactorial in etiology, making effective treatment a challenge. Reflex tearing secondary to ocular surface dryness was the most common etiology linked to epiphora in this study. Low rates of follow-up limit the ability to fully assess the impact of current interventions on symptoms. Addressing the socioeconomic barriers that lower patient adherence to follow-up should allow more effective treatment of epiphora. [ABSTRACT FROM AUTHOR]

We report a case of a newborn with unilateral retinal detachment that could not be repaired. At examination under anesthesia, the retina was markedly abnormal and a presumptive diagnosis of retinal dysplasia was made. Several years later, the eye was enucleated because it was blind and painful. Final pathology was consistent with familial exudative vitreoretinopathy (FEVR). The literature describing unilateral retinal dysplasia is sparse. This case adds to the clinical spectrum of pathologic findings in FEVR. [ABSTRACT FROM AUTHOR]

BACKGROUN: Non-arteritic anterior ischemic optic neuropathy (NAION) is a common cause of optic neuropathy with the exact pathophysiology unknown. Risk factors include advanced age, small optic nerve head, hypertension, diabetes mellitus, and sleep apnea.6 High altitude is considered another risk factor, although only few cases have been reported. No cases of NAION have been reported to occur during flight. CASE REPORT: A 41-yr-old male pilot presented with vision change while performing high G-force maneuvers in an A10 fighter jet. He developed a paracentral visual field defect superiorly in the left eye. Contrasted MRI was within normal limits. The left optic nerve showed blurred margins while the right was sharp, but cupless. The left eye had similar episodes 16 mo before and 8 mo after, but not during flight. DISCUSSTION: Our case may be the first reported NAION during flight in an airplane pilot. Our patient was an active U.S. Air Force pilot whose second episode of NAION occurred while performing maneuvers in a fighter jet. The patient is younger than expected for NAION and he did not have any of the commonly associated risk factors. His nonflight episodes suggest he was predisposed to NAION. G-force maneuvers, which restrict blood flow and force blood to the extremities away from the optic nerve head, were the precipitant of his second NAION. With a single case, whether high G maneuvers in general are a risk factor for NAION is unknown. [ABSTRACT FROM AUTHOR]