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Evaluation of the clinical, epidemiological and cost aspects of contact lens related infectious corneal ulcers requiring hospitalisation.A retrospective analysis was performed on the files of patients hospitalised for contact lens induced corneal ulcer in the eight Belgian University Hospitals over a seven-year period (January 1997 until December 2003). For all hospitalised patients registration of the diagnosis is compulsory using the International Code of Diagnostics (ICD-9).107 patients with contact lens related corneal ulcer were included. The great majority, 99 subjects, used soft contact lenses, of which 9 were disposables, 73 planned replacement and 17 conventional lenses. Only 6 patients were night and day wearers. Three patients used daily disposable lenses. The most frequently cultured organisms were Pseudomonas and other Gram-negative germs (70%) and Acanthamoeba (16%). The majority (77%) of the corneal ulcerations were localised centrally which resulted in an average visual loss of 4 lines. In 16 patients a corneal graft was performed and one eye had to be eviscerated.Despite important technological improvements in contact lens materials and care systems, the problem of infectious ulceration has all but disappeared. On the contrary, during the study period, the number of patients hospitalised increased from 5 in 1997 to 22 in 2003, which is only partially explained by the increasing prevalence of lens wearers: 3,5% of the Belgian population in 1995 and 6,5% in 2003.

Central retinal artery occlusion can be caused by excessive extrinsic pressure on the eyeball during surgery. It is a rare and severe complication after elective spinal surgery. The authors report a case of central retinal artery occlusion in an adult after posterior lumbar spinal fusion in which a rectangular headrest was used.

We reviewed the medical records of 30 eyes of 27 patients needing Nd-YAG laser capsulotomy for posterior capsular opacification after extracapsular cataract extraction using the phaco-emulsification technique with anterior continuous circular capsulorhexis. Associated ocular and/or systemic disorders were reported and the possibility of preselection of patients at risk for posterior capsular opacification and their eligibility for posterior circular continuous capsulorhexis will be emphasized.

We describe a family with an autosomal dominant form of retinal-cerebellar atrophy. There is an extreme variability in age of onset and severity of the clinical symptoms: some patients remain nearly asymptomatic throughout their entire life; others develop severe retinal and cerebellar symptoms after the age of 35 years; others suffer from a severe disorder with onset in adolescence and death during the third decade of life; in others the onset is in early childhood with prevalence of cerebellar symptoms. There is neither dementia nor epilepsy in any of the patients. Four out of five autopsies showed, a severe retinal atrophy, and all five autopsies were also characterized by (1) a cerebellar atrophy affecting the spinocerebellar and olivocerebellar tracts, the cerebellar cortex and the efferent cerebellar pathways, (2) an involvement of the pyramidal pathways and of the motor neurons of brain stem and spinal cord, and (3) an atrophy of the subthalamic nucleus and to a much lesser extent of the pallidum, with also some damage to the substantia nigra. The posterior columns are much less affected except in one patient. In this family, we have excluded linkage with the two loci for spinocerebellar ataxia, i.e., SCA1 on chromosome 6p and SCA2 on chromosome 12q as well as with the locus for Machado-Joseph disease (MJD) on chromosome 14q. A genome-wide search is currently being performed to detect the disease locus responsible.

Twenty-eight eyes were followed for at least 6 months after phacoemulsification, posterior capsulorhexis and intracapsular lensimplantation. No case of clinical significant macular edema, retinal tear or retinal detachment was noted during this period.

Three eyes with preretinal macular fibrosis (PMF) were treated with the Q-switched Nd-YAG laser. The PMF was idiopathic in two eyes and associated with a vitreous hemorrhage, due to ocular trauma, in the third eye. The three eyes had in common a partial posterior vitreous detachment with vitreous traction on the macula. The Nd-YAG laser beam was focused on the detached posterior hyaloid in front of the macular region. Some holes were made in this membrane or in the adjacent collapsed vitreous cortex. Treatment increased the visual acuity in the three eyes; the vitreous remained partially detached in the two eyes with idiopathic PMF and detached completely in the eye with the secondary PMF. The disentanglement of the fovelar area was revealed by the unfolded appearance of the retinal vessels on fluoangiography.

A case is presented with irreversible blindness in one eye and restriction of the infratemporal visual field in the other eye, due to electrocoagulation performed for delayed bleeding after functional endoscopic sinus surgery (FESS). Although blindness due to rhinosurgery is a well-known, but rare complication, a review of the recent literature did not reveal a similar incident. The use of electrocoagulation especially under conditions of poor visualization, that may be the case in post-operative bleeding following (endoscopic) sinus surgery, is strongly discouraged.