[Two sisters with congenital myasthenic syndrome: case report]

To report two sisters with congenital myasthenic syndrome [CMS] masquerading as inyasthenia gravis. Two six and seven years old sisters presented with variable strabismus, ptosis, and fatigue. All symptoms were aggravated with exercise and improved with rest. Intramuscular prostigmin injection decreased their symptoms. A diagnosis of CMS was made according to early onset [infancy], familial pattern, and lack of serum antibodies. Oral neostigmine was begun for treatment. Although CMS is a rare disorder, they should be considered in all cases with variable strabismus and ptosis

[Invisible Cataract]

To report two cases of oil-drop cataract the description of this entity. Two women [one 46 and the other 56 years old] presented with gradual visual loss. Previous studies including CT scan, MRI, VEP and ERG were normal. With the use of simple diagnostic tests including a multiple pinhole occluder and use of visuscope, a diagnosis of oil-drop cataract was made in both cases. In cases with progressive visual acuity loss without definite etiology, negative RAPD and normal color vision, oil-drop cataract should be considered as a possibility. Visuscope and multiple pinholes are effective methods for confirming the diagnosis

[Vitreopapillary traction in non-arteritie anterior ischemic optic neuropathy]

To describe the association between optic disc traction and non-arthritic anterior ischemic optic neuropathy [NAION].eighty three eyes of 83 patients with NAION were evaluated by optical coherence tomography [OCT] for detecting vitreous adhesion to the optic never head with separation form adjacent retina [partial posterior vitreous detachment]. Those who were negative for such adhesion underwent ultrasonography to detect complete PVD. Fifty male and 33 female subjects with mean age of 51.9 +/- 10yr were studied. Partial PVD with optic never head adhesion was found in 54 patients [65.1%] using OCT. Ultrasonography found complete PVD in all eyes with optically empty spaces in OCT. Vitreous traction on optic never head from PVD may play a causative role in some cases of NAION. This traction may impair vascular supply and axoplasmic flow leading to signs and symptoms of NAION

[Peripapillary staphyloma: a case report]

Purpose: to report two cases of peripapillary staphyloma presented to the Rassoul Akram Hospital

Patients and findings: the first case was a 2.5-year-old boy with a large peripapillary staphyloma. Size of staphyloma was 4 disc diameter with a depth of 8 mm. The second case was a 4-year-old girl with a staphyloma measuring 2.5 disc diameter in width and 3 mm in depth in her right eye. There were also multiple cilioretinal vessels and a little glial tissue over the disc in the second case

Conclusion: peripapillary staphyloma is a rare congenital anomaly of the optic disc. Amblyopia-therapy and wearing protective glasses are recommended in unilateral cases