PURPOSE: To describe unusual case of aggressive stage IVE1 non- Hodgkin lymphoma involving extensively the sinonasal tract but presenting for the first time with acute swelling of the lids and conjunctiva with vertical diplopia without any other systemic signs and symptoms. DESIGN: Observational case report. METHOD: 78 years old male was referred with 10 days duration of swollen lids conjunctiva, watering right eye and vertical diplopia. RESULTS: The patient was found to have high grade Large B cells non-Hodgkin's lymphoma involving the maxillary, frontal, ethmoidal sinuses, erosion of the bony nasal septum, erosion of the orbital floor and extension into the orbit, large right and left axillary lymph nodes, and enlarged right mediastinal lymph nodes. CONCLUSION: Although rare but it is possible for the eye surgeon to be the first to diagnose many life threatening disease that starts somewhere in the body and just present solely as eye problem. An example of which is this reported case of extensive lymphoma. The patient has responded very well to urgent chemotherapy treatment and now is asymptomatic, with 100% recovery of the eye signs and symptoms as well as inducing remission of the whole disease process.

Purpose: To introduce a new surgical technique in treating presbyopia associated with refractive errors with simultaneous LASIK and corneal inlay. Methods:The non-dominant eyes of five patients with hyperopia or myopia associated with presbyopia were included in the study. The new surgical technique was performed in a nine-step two-level procedure. Low energy of femtosecond was used in flap and pocket creation. Results:Based on pre-operative and one month post-operative data, significant improvements were noted in uncorrected intermediate visual acuity (UIVA) (0.16 ± 0.09 vs. 0.04 ± 0.05) and uncorrected near visual acuity (NDVA) (0.22 ± 0.11 vs. 0.06 ± 0.05). Pre-operatively, UNVA was J2 in one patient (20%), J4 in three patients (60%) and J6 in one patient (20%). Post-operatively, UNVA was J2 in three patients (60%) and J1 in two patients (40%). All results were similar at 1 month and three months post-operatively. No complications were recorded, none of the inlays were explanted, none of them were necessary to be re-centered intra- or post-operatively