Occurrence of A Miller Fisher Syndrome After Insect Bite

Miller Fisher syndrome is characterized by ophthalmoplegia, ataxia and areflexia and usually develops after respiratory tract viral infection. Other various events that precede neurologic symptoms are GI tract infection, vaccination, digitalis intoxication, insect bite, and delivery. The clinical course is usually benign with complete recovery. Miller Fisher syndrome is rare and occurred after insect bite is even more rare. The authors experienced a case of Miller Fisher syndrome in 7-year-old female who had the sudden onset of ophthalmoplegia, ataxia and areflexia. These symptomes developed after insect bite.

The Measurement of Ocular Blood Flow Velocity using Doppler Ultrasound in Normal Tension Glaucoma Patients

To evaluate the implication of vascular factors in normal tension glaucoma, the authors measured ocular blood flow velocity in normal tension glaucoma patients using Doppler Ultrasound. Seventeen consecutive patients(29 eyes) of normal tension glaucoma were studied. The peak systolic and diastolic velocities of ophthalmic artery in normal tension glaucoma were 25.48 +/- 4.09cm/sec and 5.48 +/- 1.16cm/sec, respectively; there were statistically significant decrease of blood flow velocities compared to those of primary open angle glaucoma(30.83 +/- 5.38cm/sec, 9.10 +/- 3.25cm/sec)(p<0.05) and normal group(38.12 +/- 6.42cm/sec, 9.77 +/- 2.64cm/sec)(p<0.05). The peak systolic and diastolic velocities of central retinal artery in normal tension glaucoma were 5.95 +/- 1.05cm/sec and 2.14 +/- 0.83cm/sec, respectively; there was statistically no significant decrease of blood flow velocities compared to those of normal group and primary open angle glaucoma group. Above results imply that the blood flow velocity of ophthalmic artery decrease significantly in normal tension glaucoma and local vascular factors are somewhat related to the development of the normal tension glaucoma. Further studies are necessary to validate these preliminary findings.

Acanthamoeba Keratitis in Contact Lens Wearer

We experienced a case of chronic keratitis with corneal ulcer and conjunctival injection while wearing contact lens. In spite of broad-spectrum antibiotics therapy, corneal lesion was not improved, and bacterial smear and culture were negative. Specimens from corneal scraping were examined with Giemsa-Wright stain and H and E(Hematoxylin-Eosin) stain. We could find double walled acanthamoebic cysts. The specimens were cultured on 1.5% non-nutrient agar with E, coli suspension, and aeanthamoebic cysts and trophozoites were found with H and E stain. Aeanthamoebic cysts and trophozoites were cultured from the specimens of ulcered cornea. So we report this case.