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Periocular xanthogranuloma is a rare inflammatory condition characterised by histiocytes and Touton giant cells. It is encountered in several settings: juvenile xanthogranuloma, Erdheim–Chester disease (ECD) and necrobiotic xanthogranuloma. Recently, cases with an adult onset not associated with ECD have been described, with frequent involvement of the eyelids and orbit.1–3 In this report, we describe a unique case of adult-onset periocular xanthogranuloma precipitated by blepharoplasty. A 57-year-old woman was referred for persistent postoperative oedema/inflammation 18 months after bilateral upper and lower blepharoplasty. On the basis of a review of her medical record and a conversation with her cosmetic surgeon, there was no suggestion of disease before surgery: her periocular involutional changes were typical and no abnormalities were noted intraoperatively. Her …

Ethambutol (EMB) has been used as an antimycobacterial agent against tuberculosis since 1961, and its principal side effect is toxic optic neuropathy, which can be seen in up to 6% of patients.1,2 Through the use of optical coherence tomography (OCT), we can document evidence of reversible changes in nerve-fibre layer (NFL) secondary to EMB-induced optic neuropathy. A 70-year-old man weighing 70 kg, who was being treated for Mycobacterium avium intracellulare complex pneumonia, initially presented with a 3-month history of gradual, painless loss of vision in both eyes. He had received EMB treatment for 7 months at 2 g/day (29 mg/kg/day). His visual complaints began 7 months after initiation of EMB treatment, and continued to worsen up to his presentation to our clinic. Before EMB treatment, his best-corrected vision was 20/30 OU (with mild nuclear sclerotic cataracts), but with normal subjective colour and contrast sensitivity. Our patient underwent a full neuro-ophthalmological examination, which included an assessment of colour vision using the eight-plate Ishihara Color Vision Test, Humphrey Field Analyzer (HFA) 30-2 (SITA Fast test, Humphrey-Zeiss Medical Systems, …