Search

Purpose: To show conditions where a vertical deviation, an A- or a V-pattern or cyclotropia can appear after surgery on the horizontal rectus muscles, with or without oblique muscle surgery. Our purpose is also to show conditions when a vertical deviation can be anticipated before horizontal rectus muscle surgery and realignment of the ocular deviation. Finally, our purpose is to stress on some surgical precautions one should take to avoid such complications., Case Reports: We report two cases who showed significant vertical deviations due to complications that followed surgical weakening procedures of the inferior oblique muscles., Conclusion: 1. Vertical deviations, A and V patterns and cyclotropia can occur, can be anticipated or can be avoided in pure horizontal rectus muscle surgeries 2. Vertical deviations are common following complicated oblique muscles surgery if the surgeon blindly sweeps the muscle hook into the area. They can be avoided if the weakening technique allows direct visualization of the inferior oblique muscle.

A 49-year-old woman presented with visual loss in the right from optic nerve metastatic disease and asymptomatic choroidal lesion at the inferior arcade. Throughout 22 months of follow-up, she developed a total of five different sequential choroidal metastases to the left eye that were non-responsive to chemotherapy but showed prompt tumour regression by fundus examination and fluorescein angiography within 2 weeks after a single intravitreal bevacizumab. The control of the lesion with a single intravitreal injection of bevacizumab reflects the superior choroidal bioavailability of the drug. The persistence of subretinal fluid at the site of prior metastases may be thought to be one sign of persistence of malignant cells, but in the current case and in the literature, it seems a reflection of a diseased retinal pigment epithelium with probable damage from the tumour invasion.

Beta-thalassemia requires life-long treatment, including regular blood transfusion and daily iron chelation by desferrioxamine, which places considerable burden on the social and psychological life of patients. It is expected that oral chelation therapy, which is easier to administer, would improve their psychosocial status. In this sutdy, interviews were conducted with a series of 44 patients recently placed on oral chelation therapy to evaluate their reactions to the new treatment. Eighty-six per cent of patients complied better with the oral chelation therapy. Fifty per cent of patients mentioned that relief from the desferrioxamine pump was the major improvement, while 47% felt psychologically better. Fifty per cent of patients noted improvements in their relationships, while 63% noted increased social activities. Evaluation of a larger sample of patients over a longer period of time is needed in order to confirm the favourable results obtained in this study.