A Case of Cyclic Exotropia

A cyclic squint is a rare, interested in ocular motility disturbance. It appears regular and alternate-day rhythmic cycle, most frequently at 48 hours The cyclic squint was reviewed approximately 50 Cases in literatures since it was first reported by Burian in 1958. These all was presented with cyclic ESOTROPIA but authors have not found a description of cyclic EXOTROPIA as described here. The biological clock mechanism which induces a cyclic squint is unknown. This case had recession of the bi-lateral recti and obtained constant orthophoria.

The Comparision of the Quantitative Accuracy Analysis between the Dioptron and Streak Retinoscopy

Currently, three different automated objective refractors are available commercially and are being used throughout the world. The most recently developed objective refractor. Dioptron, is an electro-optical instrument for measuring the refractive state of the eyes. The computer in this instrument takes the measurements and calculates automatically his objective refraction in term of sphere, cylinder and axis corrected for 12mm vertex distance. The motivation for this investigation was the need for a quantitative evaluation of Dioptron to determine how it may be utilized most effectively in clinical practice. The results in this study are based on comparisions of differences between Dioptron and streak retinoscopy which were examined the random samples of 800 eyes. In this analysis, authors found that the Dioptron proved to be more accurate in the cylinder and axis and equivalent in sphere findings when compared to streak retinoscopy although Dioptron could not replace physician's judgement.

Four Cases of the Cyclic Esotropia

In the practice of pediatric ophthalmology there is opportunity to exam four cases of comitant, convergent malalignments which recur within a regular and alternat-day rhythmic cycle. The cases would awake on the morning with straight eyes that remained all of a day and re-crossed through the next day. The deviations measured comitant 45, 55, 45 and 40 prism diopter on the strabismic days. Cyclic esotropia (circadian esotropia) is a rare and interesting unusual form of ocular motility disturbance. It was first reported by Burian in 1958 and approximately 50 cases have been reported with an incidence of one case in 3,000-5,000 of strabismus. The etiology of the clock-work mechanism remains unknown. Surgery is the treatment of choice and may be undertaken at any time and in almost any from to achieve good cosmetic and functional results. Post-operatively and for 12 months of follow-up, the alignment in the case one has remained orthophoric.

Statistical Obserbations of Comitant Horizontal Squint Surgery

Numerous authors published tables showing the amount of strabismus surgery and the effectivity. Although Scobee and Knapp etc. stressed the difficulty of making an accurate prediction of strabismus surgery. the standardized formula of the surgical treatment of strabismus has long been the ambition of ophthalmologist. Author agreed with the opinion of Dyer who provided the ophthalmologist with excellent tables suggesting combinations of muscles and amount of surgery to correct various types of strabismus and so 132 cases of comitant horizontal strabismus treated surgically with Dyer method at Kong Eye Clinic from August 1975 to July 1976 were analyzed. With author's data. this paper present a mathematical formula to estimate the amount of strabismus surgery.

Three cases of the necrotizing scleritis

Rarely necrotizing scleritis has been reported as a complication of the pterygiectomy and author experienced that three cases of the scleral ulcerations developed after pterygiectomy were successfully treated by medical management. The cases had histories of beta irradiation, instillation of mitomycin and cauterization with silver nitrate solution respectively during the post operative course for the purpose of preventing recurrence. The ulcer showed small punched-out scleral lesions 3 X 4, 5 X 8, and 3 X 5mm. respectively in size and situated just anterior to the insertion of the medial rectus muscle. The sclera is essentialiy collagenous, avascular and scanty of cellular components thus a proliferative reaction to injury rarely occurs, but rather healing is primarily dependent on neighbouring mesenchymal tissue. Beta ray and mitomycin suppress the mitotic activity and inhibit the healing process of the injuried sclera. It is stressed that caution should be exerted in application of noxious agents for the purpose of preventing recurrence especially in the bare scleral method, as these seemed not only to interfere with the healing of the collagen structures but sometimes resulting in a scleral ulceration.

Three cases of the necrotizing scleritis

Rarely necrotizing scleritis has been reported as a complication of the pterygiectomy and author experienced that three cases of the scleral ulcerations developed after pterygiectomy were successfully treated by medical management. The cases had histories of beta irradiation, instillation of mitomycin and cauterization with silver nitrate solution respectively during the post operative course for the purpose of preventing recurrence. The ulcer showed small punched-out scleral lesions 3 X 4, 5 X 8, and 3 X 5mm. respectively in size and situated just anterior to the insertion of the medial rectus muscle. The sclera is essentialiy collagenous, avascular and scanty of cellular components thus a proliferative reaction to injury rarely occurs, but rather healing is primarily dependent on neighbouring mesenchymal tissue. Beta ray and mitomycin suppress the mitotic activity and inhibit the healing process of the injuried sclera. It is stressed that caution should be exerted in application of noxious agents for the purpose of preventing recurrence especially in the bare scleral method, as these seemed not only to interfere with the healing of the collagen structures but sometimes resulting in a scleral ulceration.

The Fundus in Tuberculosis in Children

The authors presented the fundus findings of 25 cases with ocular lesions among 67 tuberculosis in children who were referred to our ophthalmic department from pediatric ward at Busan National University Hospital and Busan Christian Children's Hospital within a year from October 1971 to September 1972. These 67 cases were composed of 33 tuberculous meningitis, 8 hilar lymphadenopathy, 17 active pulmonary tuberculosis, 2 miliary tuberculosis and 7 tuberculous arthritis and spondylitis. The results were; 1. Of 67 tuberculosis in children 25 cases (37.3%) were shown ocular lesions, some of which were multiple. 2. 19 cases of 33 tuberculous meningitis were shown eye lesions of which cases combined with hilar lymphadenopathy or miliary tuberculosis had frequently ocular complications. 3. The common findings in fundi of tuberculosis in children were pale in optic disc and small tubercles in choroid. 4. A case of bilateral tuberculous endophthalmitis in a 3 year aged orphan was presented of which case was developed in the process of tuberculous meningitis and miliary tuberculosis.

Goldenhar's Syndrome

The authors presented a case of Goldenhar's Syndrome which was shown the following findings, such as epibulbar dermoid, bilateral colobomas of upper eye lids, pretragal blind fistulas, preauricular appendages, skin tags, lacrimal fistula, persistant pupillary membrane, myopia and alopecia atropicans with bulae.