Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare primary headache disorder characterized by severe intractable stabbing headache and accompanying tearing and conjunctival injections. In this report, we present a case of a patient with SUNCT who achieved sustained remarkable improvement more than 6 months following successful treatment with a single session of botulinum toxin A, after being refractory or intolerant to several preventives for 4 months.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare primary headache disorder characterized by severe intractable stabbing headache and accompanying tearing and conjunctival injections. In this report, we present a case of a patient with SUNCT who achieved sustained remarkable improvement more than 6 months following successful treatment with a single session of botulinum toxin A, after being refractory or intolerant to several preventives for 4 months.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare primary headache disorder characterized by severe intractable stabbing headache and accompanying tearing and conjunctival injections. In this report, we present a case of a patient with SUNCT who achieved sustained remarkable improvement more than 6 months following successful treatment with a single session of botulinum toxin A, after being refractory or intolerant to several preventives for 4 months.

Purpose: To compare the structural features of the optic nerve head (ONH) in moderate glaucoma patients with single-hemispheric and bi-hemispheric visual field (VF) defects. Methods: Patients with open-angle glaucoma (OAG) and a VF mean deviation between -6 and -12 dB were retrospectively enrolled. Based on VF defect patterns, eyes were classified into two groups: those with single-hemispheric VF defects and those with bi-hemispheric VF defects. Structural features analyzed included Bruch’s membrane opening area, lamina cribrosa (LC) thickness, temporal β-zone parapapillary atrophy with and without Bruch's membrane (βPPA+BM, βPPA-BM, respectively), and peripapillary retinal nerve fiber layer thickness using spectral-domain optical coherence tomography. Results: Out of 137 eyes from 124 patients, 80 eyes had single-hemispheric VF defects and 57 eyes had bi-hemispheric VF defects. The bi-hemispheric group exhibited longer axial length (p = 0.038), thinner central corneal thickness (p = 0.003), thinner LC (p < 0.001), and larger temporal βPPA+BM (p = 0.002) compared to the single-hemispheric group. Conclusions Among Korean OAG patients with moderate VF defects, those with bi-hemispheric VF defects showed more structurally vulnerable optic discs characterized by longer axial lengths, thinner central corneal thickness, thinner LC, and larger β PPA+BM compared to those with single-hemispheric VF defects. These findings underline the importance of evaluating ONH structures in monitoring glaucoma progression particularly in patients with extensive VF damage.