[ effect of ocular dominance on stereoacuity in experimentally induced anisometropia]

To evaluate the effect of ocular dominance on stereoacuity in experimentally induced anisometropia. In this clinical trial, 60 healthy adult volunteers 18-37 years of age [mean age: 25.58 years] without any ocular disease were enrolled at Tabriz Nikookari eye hospital over a one-year period. Anisometropia [unilateral myopia] was induced by placing trial lenses over the dominant and non dominant eyes in 1 diopter [D] increments ranging from 1-3 D. Stereoacuity was measured using the TNO, Randot and Titmus stereotests and values were converted into Neperian logarithm [ln] and compared between the two eyes. Of sixty adults including, 25 male and 35 female subjects, the right eye was dominant in 49 [81.7%] of cases. Stereoacuity levels were reduced proportionate to the degree of anisometropia in all participants. Mean stereoacuity was 4.3, 5.5 and 7.4 ln for dominant eyes and 4.1, 5.4 and 7.3 ln for non dominant eyes usig the TNO test by applying 1, 2 and 3 D lenses, respectively [P>0.05]. Corresponding values were 3.5, 4.6 and 6.6 ln for dominant eyes and 3.4, 4.6 and 6.5 ln for non dominant eyes by the circles subcategory of Randot test, respectively [P>0.05]. The scores were 3.8, 4.7 and 6.5 ln for dominant eyes and 3.8, 4.7 and 6.4 ln for non dominant eyes by the circles subcategory of Titmus test, respectively [P>0.05]. Experimentally induced anisometropia could reduce stereoacuity. However, ocular dominance has no effect on the amount of stereoacuity reduction

[Prevalence and characteristics of accommodative esotropia at nikookari eye center form 2004 to 2009]

To study the prevalence and characteristics of accommodative esotropia [AET]. In a descriptive analytic study records of all patients referred from 1383 to 1388 to the strabismus clinic at Nikookari Eye Center were reviewed and demographic data such as age, gender, refractive error, type of AET, mean deviation and amblyopia were analyzed. A total of 2,146 patients were referred during this period. AET comprised 142 [11.55%] patients. 35.9% of these patients were male and 64.1% were female. Mean age at presentation was 5.85 +/- 4.4 years. The frequency of refractive accommodative ET [RAET], non-refractive accommodative ET [NRAET], partially accommodative ET [PAET] were 82 [57.7%], 7 [4.9%] and 53 [37.3%], respectively. Overall, 69 [48.6%] patients were amblyopic and spherical equivalent refractive error was +4.22 +/- 1.82 D. Inferior oblique overaction [IOOA] and dissociated vertical deviation [DVD] were seen in 5 [3.5%] and 2 [1.4%] of patients respectively. RAET is the most common and NRAET is the least common form of AET. Amblyopia is common in AET. The prevalence of associated findings such as DVD and IOOA is low

[Surgical outcomes of partially accommodative esotropia]

To determine the surgical results of partially accommodative esotropia [PAET]. Thirty-eight patients with PAET scheduled for surgery from 2002 to 2008 were enrolled in a descriptive, analytic retrospective study. Patient characteristics including age, gender, refractive error, visual acuity, pre and post operative deviation, technique of surgery and follow up duration were recorded and analyzed. PAET accounted for 38.29% of accommodative esotropia. Mean age and refractive error [spherical equivalent] were 6.32 +/- 3.38 years and +4.1 +/- 1.98 diopters, respectively. The prevalence of amblyopia was 54.04% and patients were followed up for 18.76 +/- 13.58 months. Mean pre and post operative deviation were 30.87 +/- 10.3 and 2.05 +/- 5.7 PD, respectively [P< 0.001]. Mean amount of bilateral medial rectus recession was 5.48 +/- 0.66 mm. In 78.9% of patients, postoperative deviation was within 10PD of orthotropia. Residual esotropia and consecutive exotropia were seen in 18.4% and 2.6% of patients, respectively. Pre-operative deviation, refractive error and amblyopia had no significant effect on outcomes of surgery

[Frequency and clinical features of duane's retraction syndrome]

To evaluate the clinical features of Duane's syndrome in patients who were referred to Nikookari Eye Centre, Tabriz, as a referral centre of northwest of Iran. We retrospectively reviewed medical records of all patients with Duane's syndrome who were referred to the strabismus clinic of our center during a 5-year period [2002-2006]. Clinical and demographic characteristics were evaluated. Overall 63 patients including 36 [57.1%] female and 27 [42.9%] male subjects were enrolled which account for 2.5% of patients referred for any type of strabismus. Mean age at presentation was 10.1 +/- 7.7 [range 1-35] years. Left, right and both eyes were involved in 60.3%, 25.4% and 14.3%, respectively. The most common type of Duane's syndrome was type I [91.6%] followed by type II [6.6%] and type III [1.6%]. The most common presenting sign was eye deviation. The prevalence of amblyopia was 19% and 47.6% of patients underwent surgery. The rate of surgical intervention and the frequency of type III Duane's syndrome was very low is our series as compared to other published studies

[Bilateral medial rectus advancement versus bilateral lateral rectus recession in consecutive exotropia]

To compare bilateral medial rectus advancement [BMRA] and bilateral lateral rectus recession [BLRR] for treatment of consecutive exotropia in terms of final alignment. This randomized clinical trial was performed on 14 patients with consecutive exotropia. Inclusion criteria included history of bilateral medial rectus recession, exotropia >/=20 PD and far-near difference <10 PD. Exclusion criteria included history of operation on the lateral rectus, restriction of adduction, positive forced duction test of the lateral rectus, history of previous medial rectus recession, neurologic disorders and follow-up of less than 6 months. Seven patients underwent BMRA and 7 patients underwent BLRR. Mean age was 11.4 +/- 6.9 [range 5 to 21] years in the BMRA group and 13.7 +/- 7.1 [range 5-22] years in the BLRR group [P=0.44]. Two patients in the BMRA group and 3 in the BLRR group were amblyopic. Mean preoperative exotropia was 27.8 +/- 6.3 PD and 39.2 +/- 14.8 PD [P=0.09] and successful alignment was achieved in 71.4% and 85.7% of cases in the BMRA and BLRR groups, respectively [P=0.94]. All patients with amblyopia had successful alignment. Bilateral medial rectus advancement and bilateral lateral rectus recession are comparable in the management of consecutive exotropia

[Direct and indirect repair in canalicular laceration reconstruction]

To compare the results of two methods of canalicular laceration repair. This clinical trial was performed on 50 eyes of 50 patients with lacerated canaliculi who were randomly assigned to two groups. Direct reanastomosis of the lacerated canaliculus was performed using 8-0 Vicryl suture [25 eyes] and indirect repair was performed by reapproximation of the overlying orbicularis muscle using 8-0 vicryl sutures [25 eyes]. Bicanalicular silicon stent intubation was performed in both groups and the stent was left in place for 3 months. Probing and irrigation of both canaliculi were performed at the time of stent removal and three months later to ensure anatomical patency. Probing and irrigation at final follow up showed patency in 25 and 24 eyes in the direct and indirect groups, respectively [P=1]. Epiphora was completely relieved in 64% of the direct group and 72% of the indirect group [P= 0.5]. Postoperative complications in the direct group vs indirect group were as follows: slit punctum [36% vs 28%, P=0.5], canalicular stricture [16% vs 20%, P=0.7] and granulation tissue [zero vs 4%, P=1]. There are no statistically significant differences in success and complications rates between the two methods of canalicular laceration repair. Since reapproximation of overlying orbicularis muscle is technically easier, we recommend this method for inexperienced surgeons particularly in medial portion lacerations

Comparison of adjustable suture strabismus surgery at 8 hours versus 24 hours

Adjustable sutures as a new method used to increase the success rate of strabismus surgery. There is no consensus regarding appropriate time of adjusting suture. In this study we compare the results of adjustable sutures 8 hours versus 24 hours. In a clinical trials study 25 patiens in each group [8 patients with esotropia and 17 patients with exotropia] underwent strabismus surgery and sutures adjusted 8 hours [group 1] and 24 hours [group 2] after surgery. Minimum follow up was 6 months. In exotropias mean preoperative deviation were 39.8 and 35.2 and 6 months after adjustment were 2.3 and 3.4 prism diopter in groups 1 and 2 respectively. There was not statistically significant difference between two groups. In esotropias mean preoperative deviation were 46.2 and 43.1 and 6 months after adjustment were 2.3 and 2.2 prism diopters in groups 1 and 2 respectively. There was not statistically significant difference between two groups. Adjustable suture technique was an effective method in strabismus surgeries. Adjusting sutures at 8 hours and 24 hours after surgery were comparable and surgeon can be full free in adjusting sutures at those period

[Synergistic divergence: a rare variant of Duane's syndrome]

To report and review a rare variant of Duane's syndrome named synergistic divergence and its surgical results. A 16-year-old girl presented with left face turn and reduced vision in both eyes. Best corrected vision was OD: 3/10 and OS: 10/10. There was severe adduction deficiency of the RE with simultaneous abduction of the RE in left gaze. She had XT= 35 in primary position. She underwent subtotal RLR extirpation with a diagnosis of synergistic divergence. XT, abnormal head posture, and siinultaneous divergence improved satisfactorily. LR extirpation should be considered in the surgical planning of synergistic divergence. In the present case this procedure satisfactorily improved symptoms

Duane's Retraction Syndrome with dry eye

To report a case of Duane's retraction syndrome with dry eye.An 18-year-old girl presented with chief complaint of limited abduction in her right eye. Best corrected visual acuity was OD: 8/10 and OS: 9/10. Ocular motility examination revealed severe abduction limitation [-4], mild adduction limitation [-I], and moderate upshoot and mild downshoot in the right eye on adduction. The patient stated absence of lacrimation during crying in the right eye. Schirmer and basic tear secretion tests revealed dry eye.The same teratogenic factor that induced Duane's syndrome could cause impaired lacrimal gland secretion and dry eye symptoms

[Primary orbital liposarcoma: A case report]

Purpose: to report a case of primary orbital liposarcoma presenting with a conjunctival mass

Patient and findings: a 45-year-old female presented with a mass in left caruncle. She underwent incisional biopsy of the caruncle and orbit. Pathologic examination of the specimen revealed liposarcoma. One year later, she presented with expansion and progression of the tumor and exenteration was performed

Conclusion: although rare, liposarcoma should be considered in the differential diagnosis of conjunctival and orbital masses

[ case of giant osteoma of the frontal sinus with involvement of the orbit, intracranial cavity, and frontal bone]

Purpose: to report a case of giant osteoma of the frontal sinus with involvement of the orbit, intracranial cavity, and frontal bone

Patient and findings: a 23-year-old man presented with downward and lateral displacement of the left globe, upper lid fullness, frontal disfiguration, and diplopia. Clinical examination and CT-scan revealed giant osteoma with involvement of the frontal sinus, orbit, intracranial cavity, and frontal bone. Osteoma of the orbital and frontal bone was removed by two separate operations. Visual and cosmetic signs improved

Conclusion: good cosmetic and visual results can be obtained with surgical removal of giant osteomas of the orbit

[Okihiro syndrome: a variant of Duane's syndrome]

Purpose: to report a case of Duane's syndrome with radial ray deficiency known as Okihiro syndrome

Patients and findings: a 18-year-old female with history of operation for Duane's syndrome presented to our clinic with a complaint of left eye retraction in adduction. Her systemic examination revealed left thumb aplasia. In CT scan, aplasia of the thumb, first metacarpus, and scaphoid bone of the left hand were reported. Other systemic examinations were normal. Systemic and ocular examination of family members were normal

Conclusion: Duane's syndrome is frequently associated with other congenital anomalies and a thorough systemic and ocular examination should be performed in these patients