Toxic glaucoma is open angle glaucoma with an unexplained significant rise of intraocular pressure following unknown pathogenesis. Intraocular pressure can sometimes reach 80 mmHg (11 kPa). It characteristically manifests as ciliary body inflammation and massive trabecular o edema that sometimes extends to Schlemm's canal. This condition is differentiated from malignant glaucoma by the presence of a deep and clear anterior chamber and a lack of aqueous misdirection. Also, the corneal appearance is not as hazy. A reduction in visual acuity can occur followed neuroretinal breakdown.
The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.
Diagnosis of reactive arthritis (including the condition formerly called Reiter’s syndrome) is mainly clinical. There are no validated diagnostic criteria, however some guidance for diagnosis is available. [18, 19, 20, 10] In 1995, the Third International Workshop on Reactive Arthritis established criteria for diagnosing reactive arthritis. The main criteria involve the pattern of joint involvement and the timing of the onset of the condition (such as soon after an infection). Diagnosis of Reiter’s syndrome has essentially been replaced with diagnosis of the broader category in which it resides: Reactive Arthritis.