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Idiosyncratic reactions to a large number of drugs have been reported to cause choroidal detachment and secondary angle-closure glaucoma (ACG). We report a case of bilateral acute ACG and peculiar choroidal effusion following the administration of oral acetazolamide immediately after cataract surgery. Few cases of acute secondary ACG with choroidal effusion and anterior shift of the lens-iris diaphragm have been associated with acetazolamide compared with other sulfonamides. As far as we are aware, posterior involvement with retinal folds and papillary edema due to acetazolamide has not been described before.

Context: Postoperative pain(POP) as a consequence of root canal preparation, is a major side effect, of endodontic treatment. It can be prevented by the use of cryotherapy. This randomized control trial was carried out, to test the latter's efficacy, so that it can be recommended, as a preventive measure for POP, during endodontic treatment. Aims: To evaluate the effect of cryotherapy on post-operative pain (POP) during endodontic treatment. Setting and design: Randomized controlled trial was conducted on 40 patients based on inclusion and exclusion criteria [Table 1] in mandibular premolars, diagnosed with symptomatic irreversible pulpitis and normal periapical tissues. Methods & Material: 40 patients were randomly distributed into two groups, Experimental and Control. In the experimental group, 10ml cold saline solution, at -, while in the control group, 10ml of saline solution at room temperature, was used as the final irrigant. Patients were asked to fill a questionnaire, pre-operatively and post-operatively at 6, 24, 48 and 72 hours. Statistical analysis: The obtained data was subjected to statistical analysis using SPSS version ' .0' software. Results: Incidence and intensity of POP, was found to be lower in patients treated with cold saline. Conclusion: Use of cold saline solution as final irrigant, during endodontic treatment, reduces the incidence and intensity of post endodontic pain.

A 32-year-old female came to the outpatient with complaints of headache. She was taking tablet diclofenac over the counter for the same without proper prescription from the doctor. On examination, anterior segment appeared normal with vision in both eyes 6/9 partial not improving with pinhole. Intraocular pressures were 14 mmHg and 13 mmHg in the right and left eye, respectively. Fundus examination by 90 D slit-lamp biomicroscopy showed blurring of disc margins. On fundus photograph examination, it revealed that the disc margins of both eyes were blurred, indicating grade four papilledema (Frisen papilledema grading system). The patient was administered anti edema measures for her condition and after a month; there were symptomatic improvement with the fundus photography confirming the resolution of papilledema. The patient was advised against nonsteriodial anti-inflammatory drugs in the future as there is a likely chance of the same idiosyncratic reaction, after a thorough systemic work-up was done to rule our other causes of the same.

An 8 year old girl was seen in our ophthalmology OPD who had come with complains of mild pain in both eyes since 1 month. Her unaided vision in both eyes was 6/6. Her weight was 20 kilogram. Cyclopentolate 1% was administered twice to the child at 5 minutes interval. Child became restless after 30 minutes of installation of eye drops; she started behaving abnormally and was not allowing to do retinoscopic examination. She had altered behavior, visual hallucination and difficulty in walking. She was disoriented with slurred speech. She had ataxia and frequent tightening of limbs with jerky movements and was plucking her hair. Her pulse rate was 90/minute and blood pressure was 120/90 mm of Hg. Her oxygen saturation was 94% in room air. Child was shifted to nearby hospital where a pediatrician and anesthesiologist were available and was kept under observation. Childs pulse, blood pressure and oxygen saturation were monitored for the next 5 hours. Child recovered completely over the next 8 hours.

Aim: Comparison of peribulbar anaesthesia with sub-Tenon's anaesthesia in manual small incision cataract surgery in relation to time of onset of akinesia of extra ocular movements, pain at the time of administration, end of surgery and 1 hour after surgery and complications. Methodology: A randomized comparative study of 113 patients of which 57 patients received peribulbar anaesthesia and 56 patients received Sub-Tenon's anaesthesia. Results: The average time of onset of akinesia with sub-Tenon's anaesthesia was 2.78 ± 0.958minutes and peribulbar anaesthesia was 9.96 ± 2.141minutes. The difference was statistically significant (p = 0.00).Extraocular movements and ease of procedure between the two groups was almost the same and not statistically significant. Incidence of minor complications like chemosis and sub conjunctival haemorrhage were more in sub-Tenon's technique. Peribulbar anaesthesia ranked higher on pain score (5.12 ± 1.255) at the time of administration compared to Sub Tenon's anaesthesia (3.77 ± 1.716), the difference being statistically significant (p = 0.00). Conclusion: Sub-Tenon's anaesthesia is a safe and effective substitute for preibulbar anaesthesia in intraocular surgeries.

The incidence of eclampsia in developed countries is 1 in 3000 and the incidence of posterior reversible encephalopathy syndrome (PRES) is 1 in 400 eclampsia patients. Not many cases of PRES have been reported from Tamil Nadu. This can be an eye opener for ophthalmologists if a patient comes with a sudden loss of vision. PRES is also known as reversible posterior leukoencephalopathy syndrome. It is a cliniconeuroradiological syndrome associated with various clinical conditions presenting with headache, seizures, and cortical visual disturbance. Imaging predominantly shows parieto-occipital white matter changes with vasogenic edema being the most accepted pathophysiology. We report a 25-year-old primigravida who presented in term pregnancy with pregnancy-induced hypertension, seizures, and blindness. Magnetic resonance imaging showed subcortical signal abnormalities in the occipital lobes, which is a sign of PRES. She was managed by controlling her blood pressure levels, and emergency cesarean section was done. Clinical improvement with complete resolution of visual disturbances was observed with supportive treatment.