Preschool Vision Screening in Korea: Preliminary Study

Vision Screening of 1211 preschool children at 6-year-old was done by the visual acuty test, the cover test, and the stereoacuity test primarily. Secondarily, the corrected visual acuity, the refractive state. the amount of ocular deviation, and the cause of amblyopia were evaluated if the monocular acuity was 0.6 or less, or the difference of two or more lines on the Han's chart between right and left eye with the best optical correction was present, or the strabismus was detected on the primary screening. One hundred and thirty-eight children(11.4%) were abnormal on the primary screening. Seventy-nine children showed myopia. 46 hyperopia, and 3 alisometropia with the cycloplegic refraction, and 79 children also had astigmatism. Twelve children showed strabismus with the cover test. Among those, 8 belonged to exotropia and 4 to esotropia. Six children showed amblyopia and the causes of amblyopia were astigmatism, exotropla, and anisometropia. Among these 6 amblyops, 3 showed abnormal findings with the cover test and 2 showed stereocuity over 1200 seconds of arc. Therfore, among these three tests as primary vision screening, the cover test and the stereoacuity test to be inadequate to detect the amblyopia.

Surgical Results for Rhegmatogenous Retinal Detachment

It was not until 1919 that the treatment of retinal detachment began to plan on rationale line by Jule Gonin, Who was the first to appriciate the pathological significance of retinal break and therapeutic effect of closing these. Since after the first Gonin's suggestion, various surgical techniques for rhegmatogenous retinal detachment was reoprted in the literatures. Recently the authors had been experienced good surgical results of 45 eyes, beililg operated. The authors employed encircling procedurs and segmental buckling procedure with implants. The segmental buckling procedure was modified from the pocket technique, being employed in the case of simple posterior vitreous detachment. The encircling procedure followed the Crock and Galbraith technique modified from Schepens, being employed in the case of to tal posterior vitreous detachment with collapse. 36 eyes out of 45 eyes was much successful, and no postoperative complication was occurred.

A Case of Ophthalmic Migraine

The author had been experienced one case of ophthalmic migraine recently and was reviewed the liturature. Variability of symptoms and periodicity are characteristic feature of the migraine Syndroms. In this case, periodic scintillating scotoma, which developed abruptly, was revealed congruous in the right homonymous fields, lasting about 30 minutes. Scintillating scotoma refers to the migraneous scotoma with the shimmering border. This illuminated dancing border takes the form of "fortification figures". The Author was concerned particularly about the variable symptoms and pathogenesis of aphthalmic migraine.

Clinical Studies on Ischemic Optic Neuropathy

The author observed 9 cases of ischemic optic neuropathy and the following clinical findings were obtained. 1) Probable underlying causes of them were arteriosclerotic four cases, syphilitic two cases and oral contraceptives, acute carbon monoxide and undetermined one case, respectively. 2) To detect this disease in the early stage was hard because of systemic and/or other ocular diseases were associated. 3) The prognosis was better in patients to whom early diagnosis and treatment was given. 4) The best diagnostic procedure was to check visual field. 5) Good therapeutic effects were obtained by administration of corticosteroids and vasodilators.

Purtscher's traumatic retinal angiopathy Pathogenesis and sequelae

In 1910 Purtscher first presented his original report of "angiopathia retinae traumatica" before the German Congress of Ophthalmology in Heidelberg. Since then many varying fundus pictures have been described as "Purtscher's Disease" and many theories have been advanced as to the cause. In 1962 Marr and Marr provided an extensive review of the literature on traumatie retniopathy and pointed out that the cause of Purtscher's retinopathy was an abrupt rise of intravascular pressure in the vessel entering and leaving the orbit, and in most cases the mechanism of the injury was a sudden and violent compression of the chest. Recently we have experienced a case of bilateral Purtscher's traumatic retinal angiopathy leading to optic nerve atrophy and macular degeneraion. Our patient is a 36-year-old previously healthy Korean male. who had his left chest compressed by a truck when he was working in the country farm. Just after the accident he fall into an unconscious state for a short time. Two days after admission he was referred to our ophthalmologic department because of visual impairment. Funduscopic examination revealed Purtscher's retinopathy in both eyes. His chest X-ray examination showed several fractured ribs anterolaterally. Within several days after the accident the whitish retinal exudates and hemorrhages gradually disappeared in the left ocular fundus, but in the right fundus the retinal edema, situated at posterior pole, persisted for about 7 months duration. During this period optic nerve atrophy developed ill the right fundus. As soon as the retinal edema subsided, retinal degeneration of the macular area appeared in the right fundus. Five months after the accident temporal optic nerve atrophy appeared and the patient complained of marked visual impairment in the left eye. We could not find any similar cases in the literature, that is, after the retinopathy and impaired vision recovered, later, the vision was markedly impaired again due to secondary optic nerve atrophy and development of macular Degeneration. In a survey of literature we want to say that the pathogenesis of Purtscher's traumatic retinal angiopathy is due mainly to the result of a sudden and severe increased intravascular pressure. particularly in the upper portion of body. Following points influenced our thought. 1. The ocular fundus changes similar with Purtscher's retinopathy could be seen in hydrostatic pressure syndrome and compression cyanosis syndrome. 2. Purtscher's retinopathy could developed in minor chest compression which is not strong enough to fracture ribs or other banes. 3. Usually Purtscher's retinopathy is developed in both eyes. If unilateral development occurs, it is almost on the right eye. If bilaterally the right eye is more severe than the left. This is postulated due to the shorter venous path to the rijsht eye. In addition, the prognosis of Purtscher's retinopathy seems to be good but poor result such as in our case and other previously reported cases are also possible.

A Case of Ocular Changes due to Acute Carbon Monoxide Poisoning

The authors had recently experienced a case of optic nerve atrophy leading to blindness caused by acute carbon monoxide poisoning and reviewed the literatures of ocular changes secondary to the poisoning. The major findings were intraorbital bleeding, exophthalmos, ptosis, impairment of the ocular movement, superficial retinal hemorrhage and narrowing of the retinal vessels, the last two being thought to be degenerative changes leading to thrombosis of central retinal artery. At the 21th day after the accident exophthalmos, ptosis and ocular movement were recovered to normal but in the fundus retinal vessels could be found hardly and disc was pale.