Is The Nonsurgical Treatment Effective on Intermittent Exotropia in Children of School-Age?

We studied whether patching, overcorrecting minus lenses(loverminus lenses) and combination of both(combined therapy) can reduce and prevent the progression of exodeviation in schoolchildren with intermittent exotropia. Short-term patching of the good eye for one to three hours, overminus lenses added by -0.50 ~ -3.00 diopters and combined therapy were given to the 50 children between 7 and 15 years of age with intermittent exotropia. The average correction of exodeviation by each therapy was 11.8PD(Prism Diopters), 11.9PD and 13.6PD at distant respectively in patients who showed improvement of exoangle of 6PD or more. Among them, the combined therapy was the most effective. At distant, the improvement of exoangle more than 6PD was shown in 56% and more than 10PD in 26%. Eighty-two percent improved the exoangle more than 6PD at near or distant, and 57.7% more than 10PD. The largest reduction of exoangle was obtained at 6 months after treatment. Thereafter the improved exoangle was rather maintained than increased. The authors recommend the short-term patching of one to three hours, overminus lenses added by -0.50 ~ -3.00 diopters and combined therapy may be used as an effective tools on decreasing and preventing progression of exoangle before surgery and on treating the recurrent small angle exotropia less than 20PD in schoolchildren more than 7 years of age with intermittent exotropia.

Clinical Observation on Silicone Intubation in Obstruction of lacrimal Drainage System

We report 23 cases of silicone stents intubation for obstruction of lacrimal drainage system in 23 patients with tearing and mucopurulent material discharge from January 1985 to April 1988. The success rate of silicone stents intubation was 47.4% and the most common site of obstruction was nasolacrimal duct(56.5%). 30.3% of patients had complications related to silicone stents, conjunctivitis, punctal erosion etc. With these results, we consider that congenital dacryostenosis, partical and complete nasolacrimal duct obstruction is mainly indicated for silicone stents intubation and better results will be gained if be done with acryocystorhinostomy to prevent complications related to silicone stents.

Clinical Study of Indirect Traumatic Rupture of the Choroid

Indirect traumatic rupture of the choroid is a common sequela of contusion of the globe. Choroid is more prone to rupture than the other ocular coats because of the greater toughness of the sclera and the greater elasticity of the retina. Initially, a choroidal rupture may be obscured by a subretinal hemorrhage caused by tearing of the choriocapillaris. Later, after the blood has resorbed, a white curvilinear streak concentric to the optic disc is seen. Ophthalmoscopically, detection may be difficult, and fluorescein angiography may be required to reveal the presence or true extent of the choroidal rupture. The authors evaluated the clinical course of 34 cases of indirect rupture of the choroid at Department of Ophthalmology, Pusan Paik Hospital Inje University from January, 1984 to April, 1988. The results were as follows: 1. The sex distribution revealed 28 male(82.4%) and 6 female(17.6%) but there was no significant difference in the laterality of affected eye. 2. The most prevalent age group was the twenties(35.3%). 3. The most common site of choroidal rupture was found in T group, which was the worst group in the final visual acuity.

Leber's Hereditary Optic Neuropathy in Two Brothers of a Family

The Leber's hereditary optic neuropathy, which affects mainly males in the late teens or in the early twenties, is a rare inherited disorder characterized by bilateral rapid loss of central vision. Leber's disease undergoes like optic neuritis in acute stage, but in late stage it results in optic atrophy with severe impairment of visual acuity and absolute central scotoma. Recently the authors have experienced two cases of Leber's optic neuropathy in a family. We observed a patient whose visual acuity of right eye was 0.8 at first examination, but reduced to 0.04 by 2 months after onset in spite of medical treatment, So we described the characteristic clinical findings of Leber's disease with brief review of the literatures.