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Pregnancy may be associated with ocular changes, which most often are transient in nature. It can exacerbate preexisting conditions or be associated with development of new conditions. The ocular effects of pregnancy may be divided into physiologic changes, pathologic conditions, or modifications of preexisting conditions. Pathologic conditions include entities such as preeclampsia and eclampsia, along with conditions that are seen with increased frequency during pregnancy such as central serous chorioretinopathy. The most significant modified preexisting condition is diabetes mellitus. The various effects of pregnancy on the eye will be reviewed throughout this chapter.

Objective To the report 20-year follow-up data for patients receiving a scleral buckle for treatment of a primary rhegmatogenous retinal detachment (RRD). Methods Nonconsecutive, retrospective case series. We identified 227 eyes with primary RRD who were treated with a scleral buckle, and for whom at least 20 years of follow-up data were available. Results were classified into 3 subgroups: retina reattached with 1 procedure; retina reattached with 1 or more additional vitreoretinal procedures; or retina detached at 20 years. Results One hundred eighty-six eyes (82%) achieved retinal reattachment with 1 scleral buckling procedure and with a median final visual acuity of 20/40 at 20 years of follow-up. An additional 30 eyes (13%) achieved retinal reattachment after 1 or more additional vitreoretinal procedures, with a median final visual acuity of 20/50. Eleven eyes (5%) were detached at the 20-year follow-up examination, with a final visual acuity in all eyes of no light perception. Conclusions Scleral buckling for primary RRD achieves anatomical efficacy and preservation of central vision in the majority of eyes at 20 years' follow-up. The 1-operation success rate was 82%, overall success rate was 95%, and median final visual acuity was 20/40. This study may serve as a basis for comparison with the long-term results of other surgical techniques used in the treatment of primary RRDs.

Objective To report the incidence of acute postinjection endophthalmitis following intravitreal injection of triamcinolone acetonide (IVTA) as an office procedure. Methods Retrospective, noncomparative, consecutive, interventional case series of all patients who had received IVTA at 2 clinical centers between January 1, 2000, and January 30, 2004. Results A total of 1006 eyes received IVTA. None of the eyes developed acute, culture-positive, postoperative endophthalmitis in the 6 weeks following the procedure. One patient developed acute, culture-negative, postoperative endophthalmitis 4 days after receiving IVTA, resulting in an incidence of 0.10%. In this case, the presenting symptoms were decreased vision and acute conjunctival erythema. The case was notable for the absence of pain or hypopyon. Conclusion Although acute postoperative endophthalmitis may follow IVTA, our experience suggests that this is a relatively uncommon event.