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A 40-year-old woman noted fullness of her right upper eyelid for 3 months (Fig A). She had a history of recurrent conjunctival melanoma with multiple excisions over 7 years. One year earlier, she had unrelated filtering surgery for elevated intraocular pressure. Orbital biopsy confirmed the diagnosis of melanoma, and she underwent orbital exenteration. The specimen demonstrated orbital and intraocular extension of conjunctival melanoma (Fig B) with replacement of the choroid (Fig C) and retina (Fig D) with melanoma cells.
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The following Letter to the Editor (Ophthalmology 2015;122:e18) was posted without the Reply. Below please find the Letter and Reply.
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A 60-year-old man with Fuchs' endothelial dystrophy underwent Descemet's stripping endothelial keratoplasty (DSEK) in his right eye because of corneal edema and deterioration of visual acuity to 20/100. Six years earlier he underwent DSEK in his left eye due to pseudophakic bullous keratopathy.
Read more: Unusual Histopathological Views of Fuchs' Endothelial Dystrophy
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The report by Chan et al1 in the current issue (p. 2278) details how screening for both diabetic retinopathy and age-related macular degeneration (AMD) can be conducted using fundus photographs obtained with nonmydriatic cameras. Exactly how cost-effective is such a screening? Could this be a recommendation for the future? Herein, we explore the potential for such a model for the management of 2 of the leading causes of blindness worldwide.
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We are glad that Dr. Rao and colleagues have shown interest in our paper1 and raise some interesting questions about possible differences in intraocular pressure (IOP) between eyes with threat to fixation (TTF) and eyes without TTF. We did not include IOP in the original analysis. One reason was that we firmly believe that TTF has rarely been considered an important factor when determining target IOP, as opposed to the magnitude of field loss, rate of progression, and IOP. We also knew that it would be impossible to reliably determine reasons for treatment decisions because of the retrospective nature of the study.