Non-ruptured eyeball: In suspected ruptured eyeball.

The authors studied retrospectively 347 surgical cases of ocular injuries at the Department of Ophthalmology, Faculty of Medicine Siriraj Hospital between January 1990 and December 1992. 337 cases (97.12%) of ruptured eyeball and 10 cases (2.88%) of non-ruptured eyeball were found. 300 patients (86.46%) were male and 47 (13.54%) were female. Age ranged from 2-73 years, mean 26.90 years. The cases of non-ruptured eyeball were studied according to the causes, 6 cases from working, 2 cases from car accidents and 2 cases from assaults. The preoperative findings were chemosis, hyphema, lid edema, subconjunctival hemorrhage and tear of conjunctive all of which indicates a need for surgeons to find any rupture.

Epithelial lacrimal gland tumour.

The authors had studied retrospectively 14 patients with epithelial lacrimal gland tumours at the Department of Ophtalmology, Faculty of Medicine Siriraj Hospital, between January 1991 and December 1994. 10 patients (71.43%) were male and 4 patients (28.57%) were female. In 8 cases (57.14%) the right eye was affected, in 6 (42.86%) the left. The age range was 13-72 years, average 33.57 years. The chief complaints were proptosis and palpable mass. The direction of the globe was downward displacement and downward and medial displacement. The pathological sections showed 9 benign mixed tumours or pleomorphic adenoma (64.29%) and 5 adenoid cystic adenoma (35.71%).

Sport eye injury: A case report.

A case of sport injury of right eye due to baseball is reported. The ocular findings include poor vision, fracture medial wall and floor of orbit, traumatic maculopathy, angle recession are diagnosed. The mechanism of injury and the prognosis are discussed. This is the first case report of sport eye injury due to baseball at the Department of Ophthalmology, Faculty of Medicine Siriraj Hospital.

Malignant melanoma of the choroid.

The authors studied retrospectively the cases of malignant melanoma of the choroids from the Department of Ophthalmology, Faculty of Medicine Siriraj Hospital from January 1987 to December 1994. 6 cases were found, 2 men and 4 women. The age range was 40-56 years, mean 51 years. The chief complaints were due to the complications of the tumor, 2 cases were due to eyes pain secondary from glaucoma, 2 cases were loss of vision due to retinal detachment, 1 case was due to intraocular mass and 1 case was due to proptosis. 5 cases were enucleated, 1 case was exenterated due to extraocular extension and orbital invasion and liver metastasis, finally died.

Quantitative study on normal corneal endothelial cells.

The study of corneal endothelial cells count was carried out by specular microscope among 76 normal subjects (34 male, 42 female) with ages range between 17-76 years (mean 35-88 years). There were 141 eyes included in the study (64 male, 77 female). The endothelial cells count was expressed in cells/mm.2 The findings were 2697 + 346, 2640 + 382, 2327 + 243 and 2334 + 332 among the age groups below 29, 30-39, 40-49 and over 50 years respectively, with the average of 2594 + 381. With sex distribution the findings among age groups classified in male were 2651 + 384, 2647 + 375, 2290 + 97 and 2256 + 290, with the average of 2546 + 392, and in female were 2721 + 322, 2632 + 391, 2366 + 325 and 2419 + 352 respectively with the average of 2634 + 366. The endothelial cells count in female were higher than male and decreased with advancing ages.

Postoperative astigmatism following intraocular lens implantations.

During the period from 1st January 1987 to 31st December 1988, a total of 80 patients (33 males, 47 females) total 100 eyes; right eye 56, left eye 44), age of 43-89 years, underwent extracapsular lens extraction and posterior chamber intraocular lens implantation at the Siriraj Hospital. When 2 months after operation, the refraction were measured by retinoscopy which revealed. Emmetropic eye (4%); 29 Spherical refractive error (29%); 67 Astigmatism (67%). Among the cases with astigmatism under 2 were 27 Sphero-cylinder, 31 Sphero-cylinder with minus cylinder. 54 of astigmentism under 2 diopters of cylinder and 13 over 2 diopters of cylinder. The average of astigmatism was 1.63 diopters of cylinder and the maximum value of cylinder was 4 diopters. The axis of cylinder (the power of cylinder minus lens) was of 90 degrees = 39; at 180 degrees = 14 and at other degree = 14.

Normal intraocular pressure.

A study of the intraocular pressure on 1,000 apparently normal eyes, from 668 women (66.8%) and 332 men (33.2%) in whose ages ranged from 14 to 81 years (mean age = 50.16 years) revealed the mean intraocular pressure of 15.16 + 3.11 mmHg with the highest range at 21.38 mmHg. The maximum pressure among subjects in the 50-59 years age-group was 22.26 mmHg. In women the mean intraocular pressure was 15.04 + 3.07 mmHg, and in men 15.38 + 3.18 mmHg. The maximum intraocular pressure among women aged 40-49 years was 21.64 mmHg, while among men aged 50-59 years was 23.24 mmHg.

Radius of corneal curvature, anterior chamber depth, lens thickness and axial length: Comparison between normal and cataractous eye in monocular cataract patients.

The authors studied monocular cataract patients in the In-patient section, Department of Ophthalmology, Siriraj Hospital, from 1 st April 1987 to 30 th September 1987 or 6 months, to compare normal eyes and cataractous eyes. A total of 70 monocular cataract patients were studied, 24 female (34.29%); 46 male (65.71%). Cataracts occurred in the eight eye of 48 patients (68.57%), in the left eye of 22 patients (31.43%). Ages ranged from 28/81 years, average 58.06. The mean radius of corneal curvature in vertical meridian of normal eye = 7.76 + 0.29 mm. or 43.50 + 1.62 diopters, of cataractous eye = 7.76 + 0.33 mm. or 43.50 + 1.83 diopters. The mean radius of corneal curvature in horizontal meridian of normal eyes = 7.742 + 0.28 mm. or 43.60 + 1.53 diopters, of cataractous eyes = 7.788 + 0.33 mm. or 43.34 + 1.81 diopters. The mean anterior chamber depth of normal eyes = 2.74 + 0.41 mm., of cataractous eyes = 2.80 + 0.39 mm. The mean lens thickness of normal eyes = 4.30 + 0.46 mm., of cataractous eyes = 3.82 + 0.64 mm. The mean axial length of normal eyes = 23.02 + 0.99 mm., of the cataractous eyes = 23.20 + 1.06 mm. The mean lens thickness of the cataractous eyes was statistically sightfcantly less than the mean lens thickness of normal eyes, (p < 0.001).

Acute angle-closure glaucoma.

The authors retrospectively studied patients with acute angle-closure glaucoma from the In-patient section, Department of Ophthalmology, Siriraj Hospital from January 1986 to 31 December 1986. There were a total of 33 cases There were 10 male (30.30%) 23 female (69.70%) with an age range of 30-84 years, average 55.55 years: 13 right eyes (39.39%). 20 left eyes (60.61%). Times from the onset of acute attack until admission were between 1 day to 20 days, average 4.09 days. Intraocular pressure was from 28-101.4 mmHg, average 58.74 mmHg. After per-operative medical treatment the intraocular pressure was reduced and averaged 36.16 mmHg. The type of operations performed were 26 filtering operation (78.79%), and 7 peripheral iridectomy (21.21%). Visual acuity before treatment was lass that 6/60, 19 cases (57.58%); 6/18-6/60, 14 cases (42.42%); 6/6-6/12, 0 case (0%). Visual acuity after treatment was less than 6/60, 5 cases (15.15%); 6/18-6/60, 22 cases (66.67%); 6/6-6/12, 6 cases (18.18%).

Exenteration of the orbit.

A five-year retrospective study of 23 cases of exenteration of the orbit, at Department of Ophthalmology, Siriraj Hospital, from the 1st January 1982 to 31st December 1986 was conducted. The youngest patient was 1 year old and the oldest patient was 66 years old, mean age 4.7 years. The patients were 10 male (43.48%), 13 female (56.52%). In 1982, there were 12 exenterated cases, (52.17%), and in 1983 4 cases, (17.40%). In 1984, there was 2 exenterated cases (8.70%), in 1985 3 cases, (13.03%), and in 1986 2 cases, (8.70%). The predominate age group found was 0-9 years, 17 cases, (73.90%). Retinoblastoma was found in 15 cases (65.21%), mean age 2.5 years. Squamous cell carcinoma was found in 3 cases, (13.04%), sebaceous carcinoma 1 case (4.35%), rhabdomyosar coma 1 case (4.35%), adenocarcinoma 1 case (4.35%), meningioma 1 case (4.35%), and lymphoma 1 case, (4.35%).

Effect of pupillary dilation on intraocular pressure.

A prospective study of the effect of papillary dilation on intraocular pressure was carried out in the Outpatient Section, Department of Ophthalmology, Siriraj Hospital. There were a total 100 cases, 43 male (43%), 57 female (57%) with a total of 200 eyes. Ages ranged from 15-81 years, mean 56.13 years. The mean of the intraocular pressure before papillary dilation was equal to = 15.42 + 2.87 mm Hg, while the mean of the intraocular pressure after papillary dilation was = 16.07 + 2.94 mm Hg. There was no change in the intraocular pressure in 48 eyes (24%). In the increased intraocular pressure group, a range of 2.0-3.9 mm Hg was found in 43 eyes (53.09) and a range of 2.0-3.9 mm Hg, in 14 eyes (29.17%). The change in intraocular pressure after papillary dilation was statistically significant (p < 0.001).

Axial length in senile cataract eyes.

The authors measured the axial length in 100 senile cataract eyes of patients of the Department of Ophthalmology, Siriraj Hospital. There were 44 males, (44%) and 56 females, (56%0. 54 right eyes, (54%) and 46 left eyes, (46%0; Age range was 40 – 86 years, mean 64.39 years. The predominant age ranges were 60 – 69 and 70 – 79 years, each 29 eyes (29%). The axial length in senile cataract eyes was measured as follow: Total 100 eyes = 23.01 + 0.95 mm.; male 23.48 + 0.99 mm., female 22.64 + 0.72 mm.; right eye 22.97 + 0.94 mm., left eye 23.06 + 0.96 mm.; Age 40 + 49 years 23.66 + 1.38 mm., 50 – 59 years 22.71 + 0.90 mm., 60 – 69 years 22.75 + 0.75 mm., 70 – 79 years 23.19 + 0.74 mm., 80 – 89 years 22.82 + 0.57 mm.

Enucleation.

A five-year retrospective study of 410 cases of enucleation at the Department of Ophthlmology, Siriraj Hospital, from the 1st January 1982 to 31st December 1986 was conducted. The patients were male 253 (61.71%), female 157 (38.29%). The youngest patient was 3 months old and the oldest patient was 93 years old, mean age was 35.5 years. The indication found mostly was endophthlamitis, 121 cases (29.51%), the second was deformity of eyeball such as phthisis bulbi and anterior staphyloma, for cosmetic purpose, 101 cases (24.63%). The third was painful blind eye, 87 cases (21.22%). The fourth was extensive rupture eyeball or prevention of sympathetic ophthmities, 63 cases (15.37%). The fifth was intraocular tumour, 38 cases (9.27%). In endopthalmitis, the age group of 60 years or more was found predominant (39.67%). For cosmetic purpose, the age group of 20-29 years was found largest (39.6%). In painful blind eye, the age group of 60 years or more was found largest (33.33%). In traumatic rupture eyeball, age group of 20-29 years was found largest (30.16%). In intraocular tumour, age group of 0-9 years was found largest (81.58%).

Malignant melanoma of the choroid.

Two cases of the malignant melanoma of the choroids were revealed from the in-patient section, Department of Ophthalmology, Siriraj Hospital, from 1978 to 1986. This is a rare disease and frequently found in the white patient rather than in the black. The first case was male and the second case was female. The age was 35 and 33 years respectively one of them came from the Northern province. The presenting symptom was the same (blurring of vision about 2 months). On the eye examination, found secondary retinal detachment from the underlying intraocular tumour both of them. Enucleation was done in both cases. The pathologic whole eye section was confirmed microscopically the malignant melanoma of the choroids with secondary retinal detachment.