[Causes of severe visual impairment and blindness in the school for the blind in Ahvaz]

To determine the anatomical sites and causes of severe visual impairment [SVI] and blindness in children attending a school for the blind in Ahvaz. In this case series study, all 51 students of the only school for the blind in Ahvaz were examined by two ophthalmologists. Blindness and SVI were defined according to the World Health Organization [WHO] criteria as visual acuity less than 3/60 and 6/60, respectively. Visual acuity was measured by snellen chart; slit lamp biomicroscopy and dilated fundus exam were performed for all children. Of 51 examined students aged 7 to 16 years, one child was not visually handicapped and therefore excluded. Causes of blindness and SVL in 50 students [100 eyes] in order of frequency were: optic atrophy 7 [14%], retinitis pigmentosa 7 [14%], chorioretinal coloboma 6 [12%], severe myopia 4 [8%], macular dystrophy 4 [8%], old retinal detachment 1 [2%], cataract 5 [10%], microcornea 6 [12%], corneal opacity 4 [8%], persistent hyperplastic primary vitreous [PHPV] 1 [2%] and hypotonia and phthysis bulbi 5 [10%]. The most common causes of SVI and blindness were rare inheritable causes including congenital disease of the retina, optic nerve and cornea which resembles the pattern of childhood blindness in developed countries

[Epidemiology of orbital and preseptal cellulitis over a 10-year period at labbafinejed medical center, Tehran, Iran and a review of literature]

To evaluate the epidemiology of orbital and preseptal cellulitis in patients admitted to Labbafinejed Medical Center from 1997 to 2007. Hospital records of patients were reviewed. Personal and clinical characteristics of the patients together with results of treatment and complications of the disease were evaluated. During the study period, 93 patients including 54 cases of preseptal cellulits were admitted. Male to female ratio was 2 for orbital cellulitis and 1 for preseptal cellulitis. Mean age was 27.4 +/- 23.9 years [range, 6 months to 98 years] in patients with orbital cellulitis and 19.1 +/- 23.3 years [range, 1 month to 82 years] in patients with preseptal cellulitis. Most of the cases [97.8%] were unilateral. Mean time from onset to referral was 4 days. Mean duration of hospitalization was 6 days for orbital cellulitis and 4.5 days for preseptal cellulitis. Most cases occurred during spring. The most common underlying disease was sinusitis which was present in 53.8% of cases of orbital sinusitis and 24.1% of cases of preseptal cellulitis with the ethmoid sinus being the most common involved sinus. An overage of 2 antibiotics were used for treatment. Surgical intervention was required in 48.7% of orbital and 14.8% of preseptal cellulitis cases. Extraocular muscle palsy occurred in one case as the only complication leading to surgical management. Orbital and preseptal cellulitis are seen most frequently in young patients in spring and sinusitis is the most common underlying disease. Timely treatment of sinusitis may prevent orbital and preseptal cellulitis

[Rose-K versus conventional RGP contact lenses for management of keratoconus]

To compare Rose-K and conventional RGP contact lenses in terms of visual acuity, visual function and comfort in keratoconus patients. Fifty-four patients with keratoconus were randomly fitted with Rose-K and conventional RGP contact lens [Wohlk contact lens], by one experienced ophthalmologist using a standard [three touch point] approach. General and demographic information, KR values, far and near visual acuity without and with contact lenses, daily contact lens wearing time, daily need for lens removal, patient comfort with contact lens, and visual function score[based on VFQ-25 questionnaire] at initial and follow up visits were measured and compared. Both Rose-K and conventional RGP [Wohlk] lenses improved far and near visual acuity in all patients and there was no statistically significant difference between the two groups [P=0.88].Daily contact lens wearing time and patients comfort with lenses was greater in the Rose-K group [P<0.001]. Daily need for lens removal was almost equal in the two groups [mean=1.4 hr, P=0.83]. There was significant improvement in visual function in all patients with use of contact lenses, but there was no significant difference between the two groups [p=0.45]. Both lenses improve visual acuity and function in patients with keratoconus, but Rose-K lenses are a good therapeutic alternative for rehabilitation of keratoconus patients; they offer more comfort in comparison to conventional RGP contact lenses

[Efficacy of botulinum Toxin A injection in treatment of congenital esotropia]

Congenital esotropia is one of most common ocular disorder in children with genetic origin. Amblyopia, decreased streopsis and cosmetic problems are its complication that affect person's fate in terms of career psychological issues. The aim of this study was to determine the effect of botulinum toxin A [Dysport] injection in subconjunctival space near medial rectus insertion of both eyes for treatment of congenital esotropia. Thirty babies [aged 6-54 months] with congenital esotropia who were otherwise systemically and neurologically normal were enrolled in this study. Ten units of toxin [Dysport] were injected [under sedation] into the subconjunctival space near medial rectus insertion of both eyes. The angle of deviation was measured six times: after 3 days, 1 week, 1, 3, 6 and 12 months after injection. Twelve months after injection, angle of deviation decreased from 52 +/- 17 PD to 27.8 +/- 21.29 PD in 86.3% of patients. Success of treatment achieved in 23.3% of patients [P=0.008] .In seventeen cases [56.6%] with angle of deviation

[ incidence and causes of enucleation and evisceration in Khuzestan province]

Enucleation is surgical removal of the eye to enhance patients comfort and cosmetics, to protect vision in the fellow eye, or to safeguard life. In evisceration the eye content is removed. This procedure will affect the psychological and socioeconomic activity of the patients. The present study was undertaken to determine the incidence and causes of enucleation and evisceration in hospitals of Khuzestan province. This retrospective study was carried out to determine the incidence and causes of enucleation and evisceration in Khuzestan from 2002 to 2007, based on patients' medical records and additional information received by calling the patients. This study included 283 eyes [265 enucleated and 18 eviscerated cases] with or without hydroxyl opatite. There were 162 males and 121 females [age range 1 to 98 years; mean 44 years]. The mean incidence was 13 cases per 1,000,000 in the general population. The indications for enucleation were: trauma [n=85], infection [corneal ulcer, endophthalmitis] [n=41], blind painful eye [n=35] phthisis bulbi [n=30], advanced glaucoma and high IOP [n=29], tumors [n=25], corneal opacity and vascularization [n=16], congenital dysgenics [n=11] and unknown causes [n=11]. This study showed that the main causes of enucleation were trauma, infection and advanced glaucoma. Furthermore, the incidence of this procedure could be reduced by appropriate medical care, early diagnosis and treatment. Propaganda for prevention of eye trauma through the use of protective devices in industrial, educational and sports centers and use of safety belts and airbags in cars can be useful preventing measures