Optic neuritis is an inflammation of the optic nerve and may be related to different systemic conditions. The clinical presentation of this pathology usually includes sudden loss of visual acuity (VA) which may be unilateral or bilateral, visual field restriction, pain with eye movements, dyschromatopsia, a relative afferent pupillary defect and optic disk swelling. Optic neuritis in children has specific clinical features and a better prognosis than in adulthood. Although usually appears an underlying viral disease, the main concern for practitioners is the relationship of optic neuritis with multiple sclerosis. In addition to the classical techniques as magnetic resonance imaging (MRI), current tendencies of diagnosis for eye practitioners include new imaging devices as optical coherence tomography (OCT), useful to show a thinning of the retinal fibers layer (RFL) after the inflammatory episode. Regarding the management of these patients, short-term intravenous steroid dosages seem to be the best option to treat acute attacks characterized by a very poor bilateral VA.

A retrospective study was conducted to evaluate preliminarily the efficacy of perceptual learning (PL) visual training in medium-term follow-up with a specific software (Amblyopia iNET, Home Therapy Systems Inc., Gold Canyon, AZ, USA) for visual acuity (VA) and contrast sensitivity (CS) recovering in a sample of 14 moderate to severe amblyopic subjects with a previously unsuccessful outcome or failure with patching (PL Group). This efficacy was compared with that achieved in a patching control group (13 subjects, Patching 2). At one-month follow-up, a significant VA improvement in the amblyopic eye (AE) was observed in both groups, with no significant differences between them. Additionally, CS was measured in PL Group and exhibited a significant improvement in the AE one month after the beginning of treatment for 3, 6, 12, and 18 cycles/º (p = 0.003). Both groups showed long-lasting retention of visual improvements. A combined therapy of PL-based visual training and patching seems to be effective for improving VA in children with amblyopia who did not recover vision with patching alone or had a poor patching compliance. This preliminary outcome should be confirmed in future clinical trials.

We describe the case of an eight-year-old girl with complaints of headaches and blurred vision (uncorrected visual acuity: 0.1 decimal) that showed on examination miotic pupils, pseudomyopia, no ocular motility restrictions, and no associated neurological disease. After initial treatment with cyclopentolate for two months, pseudomyopia persisted with an intermittent and variable esotropia. Spectacles of +1 both eyes and atropine 1% one drop daily were then prescribed. The situation improved and remained stable for several weeks, with pseudomyopia and esotropia reappearing later. Finally, botulinum toxin (2.5 iu Botox) was injected in the medial rectus muscle on two occasions and a visual therapy program based on the stimulation of fusional divergence, diplopia, and stereopsis consciousness was recommended. This prescription was combined with the use of atropine during the first few weeks. Orthotropia and corrected distance visual acuity of 1.0 were found three months after treatment. The evolution and clinical results of this case report suggest that botulinum toxin in combination with other therapeutic alternatives may be useful in the treatment of spasm of the near reflex.

Solar retinopathy (SR) is a clinical condition associated with prolonged exposure to sunlight that may lead to a damage of the outer segment of photoreceptors, histologic changes of the retinal pigment epithelium (RPE), 1,2 and increased choroidal thickness. 3 The combination of photochemical effects and thermal energy on the retina explain the physiopathology of this condition. 1,4 Traditionally, SR has been attributed to an exposure to solar eclipse, 1,5 but other causes, like surgical microscope lightning, exposure to arc welding, or sunbathing also have been suggested as potential sources of injury. 4 Currently, anamnesis and fundoscopic appearance are the main clues for SR diagnosis. However, other techniques such as spectral-domain optical coherence tomography (SD-OCT) or fundus autofluorescence (FAF) can provide further structural analysis, being noninvasive tools to characterize and monitor this condition. 6-8 To the best of our knowledge, only a few reports have studied both FAF-and SD-OCT-monitored SR. 5,9 We provide a new case series showing the clinical usefulness of these technologies in SR. METHODS We present a prospective, observational case series of 6 eyes from 3 patients who were followed over 3 years in the Department of Ophthalmology of Marina Baixa Hospital (Villajoyosa, Spain). In all cases, SR appeared after sun gazing or sunbathing without appropriate eye protection. Corrected distance visual acuity (CDVA) and demographic data were collected. Likewise, slit-lamp biomicroscopy and fundus examination were performed twice in the first month, once at 6 months, and at the end. Structural analyses were done using the Topcon 3D OCT-2000 system and FAF with the Topcon TRC-NW8F System. OCT examinations were performed twice in the first month and once at the end of the first year of follow-up, and FAF was evaluated in the first visit. Electroretinogram (ERG) was performed at 1 month after the injury in only 2 cases. The follow-up in this small case series ranged from 7 months to 3 years.