A Case of Subconjuntival Sparganosis

The subconjuctival sparganosis is rare tissue helminthiasis which develops frequently in. orbital, abdominal, urethral, ureteral and vertebral cases. Authors reported a case of sparganosis which complained conjuntival hyperemia, chemosis, subconjuntival mass in the right eye for 10 months. The patient was a 37 years old male who had a history of having eaten raw snake in the So-Re Gun. Gyeonggi Do for the purpose of tonics 3 years ago. In the winter of 1977, he had experienced edematous changes in the right cheek intermittently. A few months later, he noticed the apperence of the congestion and a mass on the right eye. On surgical exploration, one larvae (5.8 cm in length and 5 m min width) was extracted from the right upper temporal subconjunctiva. It was actively motile in the bottle filled with saline, so this larvae was consulted to parasitology department of Korea University from our clinic under the impression of subconjunctival sparganosis. The sources of infection of some formely reported sparganosis in Korea were discussed. It is most probable that human sparganosis is acquired by consuming of raw snakes and frogs in this country.

Fluorescein Study of Angioid Streaks with Pseudoxanthoma Elasticum

Angioid streaks appear ophthalmoscopically as a network of red or dark brown streaks emanating from the optic disc. Angioid streaks may occur alone or in association with various. systemic diseases including pseudoxanthoma elastic urn CGroenblad-Strandberg syndrome), Senile elastosis of the skin, sickle cell cell anemia, some hypertensive cardiovascular disorders, lead poisoning, thrombocytopenic purpura, and familial hyper phosphatemia. PXE is complicated by the formation of angioid streaks in the fundi of approximately 85% of patients and this form of the disease is known as the Groenblad-Strandberg syndrome. PXE is transmitted as an autosomal dominant or recessive trait, the disease usually appears by age 30, although it may appear in childhood or in old age. Usually the incidence in woman is twice that in man. It is characterized by loss of central vision in 70% of patients and peaud' orange skin lesions. located on the neck, abdomen, axilla, perineum, thighs and groin areas. Author presented a study of two cases of PXE, which fluorescein pattern showed hyperfluorescence of angioid streaks, choroidal neovascularization and hemorrhagic serous detachment of the sensory retina involving the fovea. Recently sealing of the choroidal neovascularization by argon laser may be effective in preventing the visual loss. But unfortunately this case was not performed photocoagulation due to danger of central vision loss.

The Effects of Argon Laser Photocoagulation in Diabetic Retinopathy

Diabetic retinopathy is said to be the 10% of cause of blindness added each year to the blindness registers in the world. The use of photocoagulaiton to treat proliferative diabetic retinopathy has gained widespread acceptance in ophthalmic practice since its introduction in 1959 by Meyer-Schwickerath, Neovascularization on the optic disk is a serious complication of diabetic retinopathy since it frequently leads to vitreous hemorrhage and blindness. The purpose of photocoagulation is thought to reduce the stimulus for the vessel formation so charicteristic of proliferative retinopathy. The technique of peripheral retinal ablation by photocoagulation involves production of many burns scattered over all but the central retina. Meyer-Schwickerath showed that regression could occur in newly formed vessels at retinal level even though treatment was remote from the lesion. This trial was initiated in May 1978 to attempt elimination of optic disk or retinal neovascularization in the diabetic retinopathy by peripheral retinal ablation or focal retinal ablation and to evaluate the effects of Argon laser photocoagulation on the course of the disease. In Kong's Eye Clinic I have treated the proliferative diabetic retinopathy by argon laser pan retinal photocoagulation(PRP) or focal retinal photocoagulation. I have found significant neovascular regressive changes in angiografic findings in four cases in which proliferative retinopathy was treated by Argon laser photocoagulation compared to the untreated angiografic findings. Follow-up study of treated patients will continue to allow long-term comparison between the pre and post photocoagulation treatment employed.

Three Cases of Stargadt's Disease

Stargardt's disease, first described in detail by Stargardt in 1909, is a recessively inherited macular dystrophy which evidences itself by reduced visual acuity, bilaterality, slowly progressive lesion, occurring familially, starting in youth (8 to 15 years). We have recently seen macular dystrophies occurring in siblings, three out of six. All developed this disease between 9 to 15 years and vision deteriorate progressively to the adult hood. Ophthalmoscopic examination revealed slight pale dise, narrowing of retinal vessels, definite alterations in the macular region associated with the development of red-yellow flecks in the center surrounded by yellow-white flecks in the paracentral region. Angiogram showed the evidence of marked alteration in the retinal pigment epithelium on the macula bilaterally. All cases were noted by ring shaped area of mottled hyperfluorescene but central flecks were nonfluorescent. Field examination showed the central scotoma to a small targets and ERG the subnormal in photopic and scotopic responces. The Ishihara test disclosed a mild to moderate red-green dyschromatopsia.

A Case of Human Thelaziasis Concomitantly found with a Reservoir Host

The 8th Korean case of human thelaziasis was recorded with the description of the most probable source of infection of the case. The patient was 23-year-old Korean Army soldier who had been in mountainous vicinity of Seoul for 6 months and complained of moving foreign body sensation, photophobia and epiphora of the left eye during past 7 days before the ophthalmological consultation. Total 3 worms were removed from the eye, two by a friend, one by the ophthalmologist. The latter one waS parasitologically identified as a female worm of Thelazia callipaeda. The dogs in the military compound were examined and one eye of them was found to be infected with 11 male and 20 female of oriental eye worms under the nictitating membrane. The significance of dog as a reservoir host of T. callipaeda infection was discussed.

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.

Clinical Review On Unilateral Exophthalmos

The author presented a clinical review on 38 cases of unilateral exophthalmos who were entered to Taegu Dong San Presbyterian Hospital from Jan. to Mar. 1974. The results obtained are summarized as followings: There were no prominent predilection between male and female. The age incidence was highest in teenage group (21.1%) and followed by fifth decade (18.5%). The degree of exophthalmos calculated with Hertelos exophthalmometer ranged from two mm up to 13mm, and 12 cases (31.1%) of five mm were the largest group. Those cases with marked exophthalmos had mostly unilateral orbital tumor. The duration of exophthalmos of this series were between 24 hours and 10 years range, the cases of less than six months were caused exceedingly by inflammatory diseases, but the cases with tumor origin has had history of longer than one year duration; Among the various etiology of this study, tumor was the principal cause, and the next in order were inflammatory, metabolic and vascular origin.

+50 Method in Contact Lens Fitting

We fitted contact lenses in 216 eyes of 120 patients uniquely 0.50 D. steeper than the flattest meridian between January 1, 1971 and June 30, 1973. In this study all those patients, who had astigmatism less than 3.00 D. and were followed adequately, were included. In 87 per cent (188 eyes) patients were able to wear them without any problem and in 7 per cent(16 eyes) with some irritation or occasional burning over 10 hours. In 6 per cent(12 eyes) they could not wear their contact lenses long enough. We realize that there was rather high incidece of remanufacturing lenses in this series. I think this is due to AO Ophthalmometer which we used for keratometry in first several months and unskillfulness of the modification.

Congenital Total External Ophthalmoplegia

A 20 years old, male presented to us to have a surgical correction of his ptosis which he had ever since he was born. His mother and two other siblings had a similar condition. Ophthalmological examination revealed 20/100 vision in both eyes which was not improved with glasses, and total external ophthalmoplegia including ptosis and absence of Bell's phenomenon. Nevertheless, pupillary function and accommodation were normal. The surgical correction of the ptosis was not considered.

Ocular Adnexal Tumors

Eighty seven cases of ocular adnexal tumors were excised and studied histologically between January 1, 1967 and March 31,1974 at Department of Ophthalmology, Dong San Presbyterian Medical Center. The incidence of ocular adnexal tumors among 22,420 out-patients was 0.38%. The Sexual distribution revealed 49 males (56.3%) and 38 females (43.7%). The benign tumors were more frequent in 2nd and 3rd decades, but the malignant tumors, on the other hand, after 5th decade. Location-wise, the eye-lid was largest in number (38 cases, 43.7%) followed by the conjunctiva (24 cases, 27.6%), orbit (23 cases, 26.4%) and lacrmal apparatus (2 cases, 2.3%) in order. As asingle disease, the nevus, pseudotumor and malignant melanoma were impressively high in incidence. Over all incidence of malignant tumors was 31% (27 cases) and that of benign tumors 69% (60 cases). Of malignant tumors the eye lid tumors were largest in number (12 cases), the orbit 9 cases and conjunctiva 6 cases.