Indirect Traumatic Optic Neuropathy – Two Case Report

The aim of the study was to evaluate the treatment of indirect traumatic optic neuropathy (ITON). ITON is defined as traumatic loss of vision that occurs without external or initial ophthalmoscopic evidence of injury to the eye or its nerve. The optimal management of ITON remains controversial. History, clinical findings and treatment of two cases of ITON with high-dose corticosteroids are described. Improvement of visual acuity after treatment with high-dose corticosteroids was achieved in both cases. The treatment is evaluated in comparison to endorsed treatment modalities found in literature. We concluded that was clinically reasonable to decide to treat or not to treat the indirect optic neuropathy on an individual patient basis

Surgical Repair of Descemet’s Membrane Detachment

The aim of the study was to demonstrate a successful repair of Descemet membrane detachment (DMD). A 73-year-old woman with pseudoexfoliative glaucoma underwent phacoelmulsification with flexible posterior chamber intraocular lens implantation. Because of inadequate pupillary dilatation flexible iris retractors were used. Four days after cataract surgery, a large DMD was recognized. One day later, the patient underwent surgical repair. Three long full-thickness 10–0 nylon sutures were used to fixate DM to the cornea. The next day, DM was completely attached and the cornea was clear. Final best-corrected visual acuity was 0.9. Iris retractors may increase the risk of DMD because the iris is more anterior to the cornea. Bimanual manipulation is recommended to avoid accidental separation. No clinical case of DMD repair has been previously reported, associated with flexible iris retractors and phacoemulsification. To achieve good visual results in extensive DMD we recommend early surgical treatment