A Case of Oculocutaneous Albinism

Oculocutaneous albinism resulting from genetic defect of melanin synthesizing system is characterized by pale skin, straw-colored hair, hypopigmentation of the iris, hypoplasia of fovea, photophobia, low visual acuity and strabismus. In general, oculocutaneous albinism can be distinguished by its clinical feature and hair follicle incubation test but should be diagnosed by electron microscopic findings of the skin which is exposed to sunlight. We experienced a case of 6-year-old female oculocutaneous albinism that showed clinical typical features and was diagnosed through electron microscopic finding of many immature melanosomes of the skin in the back of the hand. We report this unusual case with literature review.

Morphology and Distribution of Motor Neurons in Cat Innervating the Orbicularis Oculi Muscle by Retrograde Horseradish Peroxidase

The facial nerve is mainly composed of motor fibers and is distributed to the muscles of facial expressions. In ophthalmology clinics, orbicularis oculi muscle innervated by the facial nerve is involved in spontaneous and voluntary blinking, winking, and more forceful eyelid closure. To understand pathophysiogy of facial nerve palsy due to brain stem lesion involving nucleus, 50% Horseradish Peroxidase (HRP) was injected into nerve stump innervating orbicularis oculi muscle of cat and serial sections of midbrain were studied with light and dark field of light microscope to examine morphology and distribution of the facial nuclei. The HRP-labelled motor neurons were located exclusively within the intermediate division of the ipsilateral facial nuclei and no labelled neurons were found in the contralateral facial nuclei, in the nuclei of the trigeminal nerve, or any other brain stem nuclei. The mean diameter of HRP-labelled motor neurons was 45 micrometer. Most of them were multipolar in shape containing many dendrites. These result suggest that the intermediate division of ipsilateral facial nuclei play an important role in innervating orbicularis oculi muscle.

The Lysozymal Concentration in Tear Film of Contact Lens Us ers

The contact lens wearers are exposed to the risk of permanent visual dysfunction due to various ocular diseases, especially corneal infections. And ocular disease of contact lens wearers are reported to be closely related to the biochemical alterations of tear film. To compare the lysozyme concentration of reflex tear in normal subjects and contact lens wearers, the tear was collected from 38 eyes of 38 normal subjects and 34 eyes of 34 contact lens wearers. The age of the subjects were between 20 to 39 years. The mean concentration of tear lysozyme were 3.55 +/-0.9 6 milligram/milliliter in normal subjects and 3.66 +/-1.02 milligram/milliliter in contact lens wearers. There was no statisti-cally significant difference between the two groups[p>0.05 ]. Though contact lens wearing does not decrease the concentration of tear lysozyme, it seems that this protein serves as a mediator of corneal infection by adhering to the surface of the contact lenses.

Efficacy of Colorado Needle in Lid Surgery

Eyelid has rare infection and good wound healing due to rich blood supply, but often lead to excessive bleeding during surgery. Thus, bleeding control in time of operation is very important to secure operation field and minimize subcutaneous hemorrhage and edema after operation. Retrospectively, we analized intra- and post-operative complications of 92 patients who had undergone eyelid surgeries by one operator using Colorado patients who had undergone eyelid surgeries by one operator using Colorado dissection needle attached to monopolar electrocautery from March to October 1997. there were 49 patients of epiblepharon or entropion, 16 patients of ptosis, 10 patients of dermatochalasis and 17 patients of blepharoplasty. In all 92 patients who had be used with Colorado needle neither complications nor side effects were developed. Therefore, we consider that the colorado needle monopolar electrocautery is an useful instrument in eyelid surgery.

Clinical Evaluation of the Eye Patients Visiting Emergency Medical Center in Sungnam

To examine the clinical characteristics of ocular emergency in Sungnam, we analyzed 3784 of the eye patients who visited emergency medical center of Inha university hospital during 3 years from January 1, 1995 to December 31, 1997 The ambulation rate of eye patients was 3.97% of total patients visiting emergency medical center and the admission rate was 8.30%. Male was more common than female about 2-fold and the patients in the age of 3rd decade(30.8%) and 4th decade(23.7%) were common Regarding the eye in trouble, there was no significant difference between right eye and left eye. September and autumn were most common month and season and visit rate of Sunday(27.7%) was highest in a week. According to the arrival time at emergency medical center, largest group was between 9 PM and 12 AM and within 1 hour from the onset of disease most patients visit emergency medical center. Most frequent cause of visit was beating by fist and common ocular diseases were conjunctivitis(20.4%), orbital contusion(17.9%) and eyelid laceration(13.9%).

The Quantitative Analysis of Tear Total Protein and Lysozyme in Normal and Diabetes

The various ocular diseases affects the components of ocular tear film. And the tear protein analysis may be of considerable diagnostic value s the ocular pathologic marker in the complex systemic diseases such as diabetes. To compare the amounts of the total tear protein and the tear lysozyme concentration in normal persons with those of diabetic patients the tear protein with 141 eyes in 141 normal persons and 86 diabetic patients were analysed. Conclusively, the tear lysozyme concertration is decreased in diabetes. The risk factors are older age, longer duration of diabetes, more severe diabetic retinopathy, and the presence of systemic diabetic complications such as diabetic nophropathy. The tear lysozyme concentration is an good indicator in the diabetic dysfunction of the main and accessory lacrimal gland. And it is suggested that the Qualitative change of tear composition in diabetes is associated with the main and accessory lacrimal gland dysfunction.

Low tear production in patients with Diabetes Mellitus

To evaluate the realtionship of neural regulation of tear production and autonomic neuropathy, this study was assessed using Schirmer test, tear film break up time and diabetic autonomic neuropathy based on cardiovascular responses. 50 patients were recruited. The results were as follows. The more degree of autonomic neuropathy was present, the less tear production was found. There was a statistically significant difference between mean Schirmer test of normal group with autonomic neuropathy and mean Schirmer test of definitive group with autonomic neuropathy. The more degree of autonomic neuropathy was well correlated with the less tear film break up time. there was no statistically significant difference of mean tear film break up time among 3 groups with autonomic neuropathy. If the definitive group with autonomic neuropathy was screened by Schirmer test, the high sensitivity above 80% was achieved.

A Case of Superior Oblique Myokymia

Superior oblique myokymia is an unusual disorder of ocular motility characterized by rapid, small ampulitude and rotary oscillations limited to one eye. Symptoms of monocular oscillopsia and torsional diplopia are experienced by the patient, and the cause remains obscure. We experienced a case of superior oblique myokymia that developed in a 53-year-old male. We report this unusual case with literature review.

Squamous Cell Carcinoma Involving Lacrimal Apparatus

Squamous cell carcinomas arising from the paranasal sinuses are often accompanied by eyeball pain, proptosis, decreased visual acuity and diplopia because of the proximity to the orbit. We report a case of squamous cell carcinoma of maxillary sinus mimicking chronic dacryocystitis and orbital cellulitis due to destruction of lacrimal apparatus.

The Clinical Aspects of Blow-Out Fracture and Lyodura as an Orbital Floor Implants

From April 1989 to April 1993, 85 patients with orbital fractures were analysed. Among them, 10 patients were repaired surgically. Orbital fractures occured most frequently between the aga of 11 and 40 years. The main causes of injury were violence(41%), traffic accident (27%) and falldown injury (19%). Medial wall fractures were most common, followed by fractures of inferior wall, superior wall in order. In combined wall fracture, medial and inferior wall fracture was most frequent. The associated symptoms and signs of orbital fracture were lid laceration (32%), diplopia (29%). orbital edema(27%). traumatic iridocyclitis(22%). The subciliary approach was used for repair of the fracture. Early surgical intervention was done within 10 days in all cases. The insertion of Lyodura was performed in 9 patients. and calvarian bone graft was fashioned and placed over the defect in 1 patient. Insufficient correction of enophthalmos in 1 patient, lower eye lid retraction in 1 patient, residual diplopia in far upgaze in 2 patients were encountered as postoperative complications.

A Cytologic Diagnosis of Bilateral Orbital Malignant Lymphoma

Malignant lymphoma is a malignant tumor involving the lymphoid cells in lymph node, which also involve the gastrointestineal tract, skin, respiratory system and orbit etc. Malignant lymphoma rarely involves the orbit, furthermore, both orbital involvememt is very rare, whether it is primary or systemic. We experienced a case of systemic malignant lymphoma involving both orbits in a 66-year-old female which was diagnosed with needle aspiration cytology and improved with systemic anticancer drugs. We report this unusual case with literature review.

The Clinical Survey on the Prevalence of Eye Diseases in Elderly Patients in Sungnam-Shi Area

We retrospectively surveyed total 628 outpatients(1,256 eyes) of age of 60 or over who visited our department of ophthalmology with review of diagnosis, visiual acuity and associated systemic diseases during 3 years from 1988 to 1990 at the Inha University Hospital. The most prevalent ocular disease was cataract, which was diagnosed in 30.7% of total patients. The other disorders comprised conjunctival diseases(21.5%), retinal disease(18.8%), refractive errors(6.5%), lid and lacrimal diseases(5.7%), corneal diseases(5.1%), vitreous diseases(4.6%), glaucoma(4.0%), optic nerve diseases(0.79%) and uveal diseases(0.79%). The blindess was definded as 0.1 or worse of corrected visual acuity and 28% of examined eyes were conuted as the blindness. Proportion of blindness by causes were as follwed: cataract(56%), corneal diseases(10%), diabetic retinopathy(8%), glaucoma(6%), hypertensive retinopathy(5%) and vitreous diseases(3%). Various systemic diseases were associated with ocular disorders in 24% of total cases. Among them, the most prevalent systemic disease was hypertension, 36%, and diabetes mellitus 30% in next, with the following of respiratory diseases 13%, heart diseases 6%, neurologic diseases 5%, hepatobiliary diseases 5%.

A Case of Posterior Involvement of Eye in Leprosy Patient

Leprosy is a chronic systemic disease with ocular complications including lagophthalmos, uveal diseases, and corneal diseases. Blindness may result unless appropriate treatment is done. The authors report the ocular leprosy with generalized systemic nodules associated with severe proptosis, corneal opacity and retinal pathology.

Primary Localized Amyloidosis of Bulbar Conjunctiva and Cornea

The major forms of amyloidosis affecting the eye are primary systemic and localized amyloidosis. Primary Amyloidosis localized to the conjuctiva is relatively rare, especially involved to bulbar conjunctiva and corn eo scleral limbus and is consiccered to be in the differential diagnosis of other conjunctival diseases. We diagnosed a amyloidosis in which the biopsy from the superior bulbar conjunctiva and superior cornea of the left eye of 68-year-old woman showed histopathologic findings of amyloidosis. There were no evidences of amyloid deposit except conJuntiva and cornea on physical and other systemic examination, including immunelectrophoresis, and cornea on physical and other systemic examination, including immunelectrophoresis, and no evidences of underlying disease that can cause amyloidosis. So we concluded that it was primary localized amyloidosis of bulbar conjunctiva and cotnea.

Primary Localized Amyloidosis of Bulbar Conjunctiva and Cornea

The major forms of amyloidosis affecting the eye are primary systemic and localized amyloidosis. Primary Amyloidosis localized to the conjuctiva is relatively rare, especially involved to bulbar conjunctiva and corn eo scleral limbus and is consiccered to be in the differential diagnosis of other conjunctival diseases. We diagnosed a amyloidosis in which the biopsy from the superior bulbar conjunctiva and superior cornea of the left eye of 68-year-old woman showed histopathologic findings of amyloidosis. There were no evidences of amyloid deposit except conJuntiva and cornea on physical and other systemic examination, including immunelectrophoresis, and cornea on physical and other systemic examination, including immunelectrophoresis, and no evidences of underlying disease that can cause amyloidosis. So we concluded that it was primary localized amyloidosis of bulbar conjunctiva and cotnea.

A Case of Posterior Involvement of Eye in Leprosy Patient

Leprosy is a chronic systemic disease with ocular complications including lagophthalmos, uveal diseases, and corneal diseases. Blindness may result unless appropriate treatment is done. The authors report the ocular leprosy with generalized systemic nodules associated with severe proptosis, corneal opacity and retinal pathology.

A Case of Malignant Peripheral T-cell Lymphoma of the Lid

Malignant T-cell lymphoma is an abnormal tumor of the immune system which generally involves not only the lymphatic system but also the stomach, respiratory system, skin, orbit and, occasionally, the eyelids. The authors experienced a case of eyelid malignant T-cell lymphoma with skin involvement whose characteristic symptoms are anorexia, severe weight loss and systemic lymphadenopathy. Biopsy and immunohistochemical stain to UCHL-1 are the only diagnostic methods for differentiating the diagnosis from Hodgkin's disease. The patient was treated with cyclophosphamide, vincristine and prednisolone with a good prognosis and a 21 month-survival at present.

Solitary Neurofibroma in the Orbit

Neurofibroma is the most important component of neurofibromatosis and may occur as solitary lesion. Solitary neurofibroma is common in the skin but solitary neurofibroma of the orbital region is unusual, whether or not it is associated with von Recklinghausen's disease. In 53-year-old woman who had exophthalmos, we experienced a solitary tumor between right medial rectus muscle and lamina papyracea. The histopathologic evaluation revealed the tumor to be a neurofibroma.