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To our knowledge there have been no previous studies that have examined the effect of short messaging service (SMS) text messaging reminders to both mobile and landlines on the 'did not attend' (DNA) rate in adult hospital clinic attendees. Our aim was to determine the effectiveness of a text messaging reminder in improving attendance in return general ophthalmology clinic patients. Ophthalmology clinic patients requiring a follow-up appointment were invited to enter the study. An information leaflet was provided and patients were contacted two weeks before their scheduled appointment by way of a customized text message to either the mobile phone or landline. The non-attendance rate compared with historic non-attendance rate was recorded. Two hundred and one patients were recruited. The historic DNA rate was 12%. The DNA rate in the SMS text reminder group was reduced to 5.5% (11 patients). The historic 'Could not attend' (CNA) rate of 6% had been reduced to 2% (4 patients). Forty-seven percent of patients used mobile phone technology with text messaging capability and 69% responded to the text reminder. In conclusion, routine SMS texting is a cost-effective means of reducing DNAs and should become standard practice. In addition, two-way messaging could allow for further efficiency as advance notification of patient cancellations facilitates re-scheduling of alternative patients.

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Solitary plasmacytomas rarely develop in the skull, meninges, or brain. Ophthalmic signs as the initial manifestations of solitary intracranial plasmacytoma have rarely been described. We report the neuro-ophthalmologic, imaging, and pathologic findings for two patients. One patient presented with optic neuropathy, the second with bilateral sixth nerve palsies. Plasmacytoma is a treatable intracranial tumor that should be considered in the differential diagnosis of patients who present with optic neuropathy or sixth nerve palsy.

. Introduction:  Lyme disease is a multisystemic disease with protean ocular manifestations. We describe the occurrence of inflammatory choroidal neovascular membrane (CNVM) in two patients suffering from presumed Lyme disease. Methods:  Descriptive review of the clinical records of two patients. Results:  Patient 1: 16‐year‐old healthy male presenting with a visual acuity of counting fingers [oculus dexter (OD)] and 6/6 [oculus sinister (OS)] 3 months after a tick bite. He had papillitis and an exudative subretinal macular lesion OD. Treatment was started with intravenous (IV) ceftriaxone; a week later, IV methylprednisolone was administered with a tapering dose of oral steroids thereafter. Three months later, VA had improved to 3/60 OD. Patient 2: 38‐year‐old healthy female presenting with reduced left‐eye vision (6/24) 6 weeks after a tick bite. She also suffered from erythema migrans and arthralgias. She had left‐eye papillitis, macular haemorrhages and vascular sheathing. Treatment was started with IV ceftriaxone. One month later, there was profound loss of vision with development of CNVM. Treatment was declined by the patient and eventually retinal fibrosis developed. Conclusion:  Inflammatory CNVM has not been described previously in the setting of ocular Lyme borreliosis. We herein describe the occurrence of inflammatory CNVM in two patients whose diagnosis with Lyme disease was clinically based – both were sero‐negative. Visual outcome in the two patients was profoundly impaired because of the ensuing macular scar.

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