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Multiple myeloma is a neoplastic plasma-cell disorder resulting from malignant plasma cells in the bone marrow. It can cause a hyperviscosity syndrome secondary to the paraproteinaemia associated with the disease. The increased hyperviscosity can lead to retinal vein occlusions and other ocular problems that may challenge clinicians. In patients with multiple myeloma and hypertension and/or diabetes mellitus, retinal changes appear similar and changes due to one disease or the other may be difficult to determine. A 48-year-old white female presented to the clinic with a complaint of blurry vision in her left eye. A full comprehensive ocular examination revealed a central retinal vein occlusion presumably from the patient's history of hypertension, diabetes mellitus and hypercholesterolaemia. Further bloodwork revealed monoclonal protein in the patient's serum and an increased percentage of plasma cells in the bone marrow. She was diagnosed with monoclonal gammopathy of undetermined significance, part of the multiple myeloma disease spectrum. She was referred to a retinal specialist for initiation of intravitreal injections of anti-vascular endothelial growth factor. Multiple myeloma has been implicated in younger patients as an underlying cause of retinal vein occlusions. Multiple myeloma should be considered as a differential diagnosis in young patients with retinal vein occlusions, even if other risk factors for venous occlusion like hypertension, diabetes mellitus and hypercholesterolaemia are present. Timely referral to the patient's primary care physician and haematologist is important for appropriate treatment and control of underlying systemic conditions.

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The death of a child can be an overwhelming experience for parents. Hospitals are often the first place to get information or to seek services, yet little is known about what types of bereavement services, information, or support are typically available. This study was designed to identify types of bereavement support offered to parents whose child died at a pediatric hospital, to ascertain who provides support and to see how those services are institutionally organized and funded. The investigation gathered data using an online, custom-designed survey completed by bereavement providers at 122 of the 188 pediatric hospitals invited to participate. This article summarizes the ways hospitals follow-up with families, from provision of educational materials to a menu of support services including memorial services, counseling, and community referrals.

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Some reports have outlined many different treatment strategies for superior oblique myokymia (SOM) that attempt to reduce or eliminate patients' symptoms of monocular oscillopsia and/or diplopia. Most treatment strategies have focused solely on oral medications or invasive surgery. The following is a current and critical review of SOM along with its clinical findings/symptoms, demographics, theories of its pathogenesis, management/treatment options, new observations in SOM, as well as a case report to highlight a relatively novel idea for the treatment of SOM: topical timolol eye drops. It also highlights evidence of a new "localized theory" regarding topical β-blockers' mechanism of action in SOM compared to the previous systemic hypothesis proposed in 1994. The case report shows a 29-year-old female patient who suffered with SOM symptoms for 8-10 years and then experienced a worsening of her symptoms shortly postpartum. The patient was prescribed topical timolol eye drops by the author in the affected eye based on one case report(12) from 1994, which completely eliminated her symptoms within 1-2 days of starting the treatment with any recurrence with the daily use of the drop at the time of this article. Given the robust effect in this case, topical timolol may be a potentially useful drug in the management of SOM given its affordability and safer side effect profile in comparison to the oral medications traditionally used in SOM.