The authors report two cases of cicatricial pemphigoid and describe the nature of the cutaneous, oral and ocular lesions, emphasizing the devastating effects of the latter. With regard to the diagnosis, they stress the importance of adequate sampling for direct immunofluorescence reactions. The therapeutic approach is discussed focusing the available tools for the ophthalmologist.

Purpose. To report an unusual case of a retained intra-orbital wooden foreign body in a 6-year-old child. Methods. Case Report. Results. A fragment of wood stick was removed from the left orbit of a 6-year-old with history of proptosis and vision diminishment after probable penetrating eyelid trauma 45 days before the consult. Discussion. Intra-orbital foreign body (IOF) has to be managed with thorough clinical history and ophthalmic examination complemented with broad spectrum systemic antibiotics and adequate imaging studies for a guided surgical intervention. More importantly, organic IOF has to be highly suspected by the clinician when managing pediatric ocular trauma.

Purpose. To evaluate the safety and efficacy of goniotomy as a first-line surgery in cases of open angle pe-diatric glaucoma, other than primary congenital, in which medical therapy had failed or had been judged to be not advisable. Methods. A non-comparative retrospective chart review of a series of gonio-tomies performed in children with refractory secondary glaucoma. Success was defined as an intraocular pressure (IOP) less or equal to 22 mmHg, without need for further surgical intervention with or without additional medical therapy. Results. 12 patients (16 eyes) with underlying diagnoses of Sturge Weber Syndrome, uveitis, infantile and traumatic glaucoma were included. The mean age at the first goniotomy was 5.2-year-old, with a mean follow-up of 35 months. Surgical success was achieved in 9 eyes (56%) with a mean IOP of 16.3 + 4.61mmHg (reduction of 16 mmHg, p<0.001). Complications included different degrees of hyphema and a small iris prolapse. Discussion. Although traditionally limited to management of congenital glaucoma, goniotomy is a relatively gentle and potentially useful first-line surgical procedure for children with refractory glaucoma different than congenital.