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Our study aimed to determine pain levels and the state of welfare connected to laser-based procedures in the treatment of patients diagnosed with uncontrolled glaucoma. The study group included 100 eyes of 100 patients diagnosed with glucoma, 50 of them being treated with micropulse transscleral laser cyclophotocoagulation, and the other 50 eyes being treated with continuous transscleral laser cyclophotocoagulation. We used visual analog scale to gather information from each patient. After analysing the individual information the following results were obtained: the pain level for the micropulse transscleral laser cyclophotocoagulation was 60.23 mm, signifying moderate pain; and the pain score for the continuous transscleral laser cyclophotocoagulation was 76.34 mm, corresponding to moderate-intense pain. Pain level generated by minimally invasive laser procedures is discussed.

Typically in glaucoma the injuries in the retinal ganglion cells are irreversible and mostly due to high intraocular pressure. Currently there are also accepted pathogenic theories that go beyond high intraocular pressure in the area of neuro-inflammatory molecules, autoimmunity or vascular dysfunction. Yet it is very difficult to quantify these new pathogenic aspects as easy as in the case of visual field testing or optical coherence tomography. Our study tried to identify and compare levels of inflammatory cytokines IL-1Ra (Interleukin-1 receptor antagonist), IL-1a (Interleukin-1a), IL-1b (Interleukin-1b), IL-10 (Interleukin 10) and IFN-g(interferon-gamma) levels in open angle glaucoma and compare them to healthy subjects, matched for age and sex. The results proved an increased expression of inflammatory molecules with neurotoxicity capabilities in primary open angle glaucoma patients.

Severe infections with C. albicans should be treated promptly with antifungal agents, any delay in treatment increases the risk of endophthalmitis. The systemic Amphotericin B therapy is the gold standard in the treatment of endophthalmitis, but in the case of fungal infections it has not yet been determined. Numerous studies have shown that the use of Fluconazole is effective in the treatment of fungal endophthalmitis. In this paper, we report two cases (3 eyes) that have been presented for the same accusations of significant decrease of AV (visual acuity), ocular pain and blepharospasm suddenly installed, both of which required urgent antibiotic and intravenous antifungal treatment. Both are diagnosed with endogenous endophthalmitis and vitreous biopsy + VPP (pars plana vitrectomy) are performed, with a negative result of the vitreous culture. In both situations the treatment was with antibiotic and systemic antifungals. Postoperatively, evolution was favorable in the first case and less favorable in the second one. The prognosis depends on the virulence of the microorganisms and the time elapsed until initiation of the treatment. Also, the presence of risk factors such as diabetes, sepsis, recent abdominal surgery (C. Albicans is part of the comesary flora of the digestive tract) have influenced the prognosis decisively. Severe infections with C. albicans should be promptly treated with antifungal agents, any delay in treatment increases the risk of endophthalmitis. Even when prolonged treatment of candidemia is instituted, 3% of patients can develop endogenous endophthalmitis, so ocular evaluation is particularly important for patients immobilized in anesthesia and intensive care units.

Methylene blue (MB) has many uses in medicine, being applied as a treatment for infections, malaria, methemoglobinemia, as a dye for diagnosis and for staining of cells, tissues and bacteria. In elderly patients with associated high anaesthetic risk, dacryocystectomy is an alternative to dacryocystorhinostomy. This is an observational clinical study for two cases of chronic dacryocystitis where dacryocystectomy combined with MB (1%) staining of lacrimal sac was performed. Case no.1 - an 81-year old female patient with arterial hypertension, atherosclerosis, pulmonary fibrosis, and lower limb varices complainted of recurrent epiphora, muco-purulent secretions in both eyes, inflammatory oedema of the left perisacular region for the past 6 months. Case no. 2 - a 74-year old female patient with hypothyroidism suffered from chronic epiphora in the left eye with a purple-red oedema of the inferior eyelid and perisacular region. Symptoms reoccurred in the last 10 months despite topical and systemic therapy with antibiotics and anti-inflamatory drugs. Dacryocystectomy was performed under local anaesthesia in both patients. MB (1%) was used to irrigate the lacrimal sac in order to facilitate its localisation, dissection and excision. Results: Case no.1. Ectopic lacrimal sac. Case no.2. Enlarged lacrimal sac (7.5/14 mm). The histopathological examination revealed a trachomatous dacryocystitis, respectively a chronic non-suppurative non-granulomatous dacryocystitis. Their postoperative evolution was without complications, except for a mild epiphora. In conclusion, dacryocystectomy appears to be a less traumatising alternative to dacryocystorhinostomy. The staining of the lacrimal sac with MB (1%) in dacryocystectomy facilitates its identification and dissection, especially when it is ectopic.

Levodopa is a medication used in treatment for Parkinson�s disease, which is associated with low levels of a chemical called dopamine in the brain. Levodopa is turned into dopamine in the body and therefore increases levels of this chemical. Levodopa was used as a treatment of amblyopia alone or in combination with classical treatment of occlusion. Visual acuity is improved after treatment with oral Levodopa. When is used as an adjunct to the occlusion therapy, Levodopa can be associated with long-term improvement in the vision, and may have also better compliance for patching. Levodopa stimulates the brain plasticity in adult age and can be used in treatment for amblyopia. Patients have also an increase of the visual acuity after orthoptic treatment for amblyopia and when Levodopa is administered, the vision increases much more. Contrary to the classical conception, according to which amblyopia cannot be treated after 10-12 years of age and it is untreatable in adults, studies about treatment with Levodopa in amblyopic eyes, may allow the improvement of the visual acuity in adults, as well.