Men with idiopathic intracranial hypertension (IIH) are twice as likely as women to develop severe visual loss. Men and women have different symptom profiles, which could represent differences in symptom expression or symptom thresholds between the sexes. Men with IIH likely need to be followed more closely regarding visual function because they may not reliably experience or report other symptoms of increased intracranial pressure.

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Objective-To evaluate racial differences in idiopathic intracranial hypertension (IIH).Methods-Medical records of all consecutive patients with definite IIH seen between 1989 and 2006 were reviewed. Demographics, associated factors, and visual function at presentation and follow-up were collected. Black patients were compared to non-black patients. (197 black, 253 non-black). Obesity, systemic hypertension, anemia, and sleep apnea were more common in blacks than in non-blacks (p≤0.01). Cerebrospinal fluid opening pressure was higher in blacks (40 vs. 34 cm CSF, p<0.001). Visual acuity, visual field loss, and degree of papilledema at presentation and follow-up were worse in blacks (p≤0.01). Diagnostic and therapeutic measures were similar between blacks and non-blacks, except for optic nerve sheath fenestration (p=0.01) and lumbar puncture (p=0.03), both more commonly performed on black patients. The relative risk of severe visual loss for blacks compared with non-blacks was 3.5 (95%CI 2.0-5.8, p<0.001) in at least one eye and 4.8 (95%CI 2.1-10.9, p<0.001) in both eyes. Logistic regression analysis supported race, anemia, body mass index, and male gender as independent risk factors for severe visual loss and suggested that racial differences may be partially accounted for by differences in CSF opening pressure, body mass index, and frequency of anemia. Results-We included 450 patientsConclusion-Black IIH patients were more likely than non-black IIH patients to have severe visual loss in at least one eye. This difference did not appear to result from diagnosis, treatment, or access to care, but may partially relate to differences in other risk factors. Black patients have a more aggressive disease and may need closer follow-up and lower thresholds for early intervention.

Our study suggests that intralesional injection of sodium tetradecyl sulfate under computed tomography guidance is an effective treatment for patients with orbital lymphangioma and is not associated with vision-threatening complications.

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The use of amniotic membrane grafts can be a useful option in forniceal reconstruction with a high success rate, a low rate of complications, and without discomfort of donor sites.

We report 7 cases of syphilitic optic neuropathy during a 2-year period. All patients were newly diagnosed with human immunodeficiency virus (HIV) infection. Six cases (86%) initially presented with swollen optic disc either unilaterally or bilaterally. Blind spot enlargement was the most common type of visual field defect. Final visual acuity of at least 20/25 was achieved together with visual field improvement and resolution of swollen optic disc. Optic nerve involvement can be the first manifestation of syphilis and HIV co-infection. Syphilitic optic neuropathy has an excellent prognosis if the disease diagnosed promptly and treated properly. ARTICLE HISTORY

This study suggests the potential usefulness of topical NSAIDs, corticosteroid, and doxycycline for the clinical treatment of ocular surface epithelial disorders associated with dry eye.