Diplopia as the primary presentation of foodborne botulism

Foodborne botulism is a serious condition caused by Clostridium botulinum neurotoxin. Clinically, botulism presents as bilateral cranial nerve neuropathy and descending paralysis. We report a unique presentation of botulism to remind clinicians of this potentially fatal condition. In this observational case report initial evaluation showed only esodeviation. This progressed to unilateral cranial nerve six [CN VI] paresis along with systemic signs. Clinical diagnosis was made based on in-depth history and concurrent symptoms in three other patients. Foodborne botulism presenting as diplopia and unilateral motility deficits is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist

Comparison of the level of difference between cycloplegic and noncycloplegic refraction in different age groups

The goal of this study was to compare the level of difference between cycloplegic and noncycloplegic refraction in different age groups. This correlation study was performed on 400 eyes of 200 participants in Khatam Al-Anbia hospital. For all participants, non cycloplegic refraction was done. Cycloplegia was performed, using Cyclopentolate 1%. Then cycloplegic refraction was done with the same autorefractometer. The amount of accommodation suppressed by the drug and possible effects of age, gender, type of refractive error and occupation on this amount was compared in different age groups. SPSS ver.13 statistical software was used for data analysis. P-value less than 0.05 considered as significant. Average age of participants was 20.11 +/- 15.50 [range 2-59]. The amount of accommodation suppressed by cyclopentolate 1% was significantly different among various age groups [p < 0.001]. The amount of accommodation suppressed by Cyclopentolate 1% showed no difference between myopic and hyperopic patients in any age groups [p > 0.10 for each eye]. Also, there was no correlation between occupation, sex and the amount of accommodation suppressed during cycloplegia [p = 0.45 and p > 0.10 respectively]. Cycloplegic refraction is an effective procedure for patients under 50 years old. The type of refractive error, sex and occupation had no effect on the amount of accommodation suppressed by Cyclopentolate 1%