Progression of Myopia in the Patients with Astigmatism over 3.0 Diopters

PURPOSE: To compare myopia progression in patients with astigmatism over 3.0 dipoters and in patients with astigmatism with less than 1.0 diopter. METHODS: Between March 2001 and March 2006, regular refraction was performed in patients without amblyopia or strabismus. Patients with astigmatism over 3.0 diopter were classified into subject group, and patients with astigmatism less than 1.0 diopter were classified into control group. We performed cycloplegic refraction at the first visit, and manifest refraction at follow-up examination. Minimal follow-up period was 12 months. Data analysis was performed with T-test and ANOVA. RESULTS: There was no difference in myopia progression in patients with astigmatism over 3.0 dipoters and in patients with astigmatism with less than 1.0 diopter. Age, sex, type of astigmatism, spherical equivalent, age to start wearing glasses, and time to watch television and computer didn't show significant influence on myopic progression in subject group and control group. Patients with astigmatism over 3.0 diopters in one eye and astigmatism less than 3.0 diopters in the other eye were evaluated and there was no difference in myopia progression between both eyes. Eyes with non-progressive astigmatism over 3.0 diopters showed similar myopia progression with eyes with progressive astigmatism over 3.0 diopters. CONCLUSIONS: There was no difference in myopia progression between patients with astigmatism over 3.0 dipoters and patients with astigmatism with less than 1.0 diopter.

Therapeutic Effect of Botulinum Toxin Injection in Eyelid Myokymia Patients

PURPOSE: To evaluate clinical manifestations and effects of botulinum toxin in eyelid myokymia patients. METHODS: Between March 2001 and March 2005, botulinum toxin injection therapy was performed in 12 eyelid myokymia patients. We evaluated duration of disease, systemic disease, drug history, and range, grade, frequency of myokymia at the first visit. Botulinum injections were performed in patients with normal results of blood tests and neuroimaging tests. Improvement of symptoms, duration of effectiveness, and complications were evaluated after the botulinum toxin injection therapies. Data was analyzed with the Mann-Whitney U test. RESULTS: Improvement of symptoms was noticed in 10 patients (83.3%). Among the 10 patients, 5 patients were decided as cured patients because they did not require any retreatment. Range and grade of myokymia didn't affect on effect of treatment. Pain, edema, excessive tearing, and unnatural face were noticed as complications of treatment, but all complications disappeared 2 weeks after the treatment. CONCLUSIONS: Botulinum toxin injection therapy is noninvasive and effective treatment in benign eyelid myokymia patients without causal neurologic disease.

Surgical Result of Intermittent Exotropia According to Angle of Deviation at Lateral Gaze

PURPOSE: This study investigated the surgical result of intermittent exotropia according to the difference between primary gaze and lateral gaze, where the extent of surgical treatment was decided by the angle of deviation in primary gaze. METHODS: The subjects of this study were 128 patients who had intermittent exotropia and were operated on by the same surgeon. Deviation angle of strabismus was checked at near and distance and primary and 30-degree lateral directions of gaze. The Worth 4 dot test and Titmus test were performed. Refixation time and axial length were measured. Either the cycloplegic refraction test or manifest refraction test was done depending on the patient's age. The extent of surgery was decided by the criteria recommended by Parks. Patients were classified into 2 groups. Group 1 included patients with 5-PD or smaller differences in the angle of deviation in the primary and lateral gaze. Patients who had differences greater than 5-PD in the angle of deviation according to the direction of gaze were classified as group 2. Clinical data were verified by Pearson Chi-square test. RESULTS: Age, sex, angle of deviation at near and distance, oblique muscle function, spherical equivalent, astigmatism, axial length, stereopsis, and refixation time did not affect the difference in the angle of deviation according to the direction of gaze. The non-fusion group showed a large difference in the angle of deviation according to the direction of gaze. The extent of surgery was determined by the deviation angle in primary gaze. Both group showed similar surgical results. CONCLUSIONS: To determine the degree of surgery needed, it is reasonable to measure the deviation angle in primary gaze for patients with intermittent exotropia.

A Case of Conjunctival Benign Lymphoid Hyperplasia associated with Ptosis of the Eyelid in a Child

PURPOSE: Benign lymphoid hyperplasia of the conjunctiva occurs infrequently in children. We report a case of benign lymphoid hyperplasia, accompanied by ptosis and conjunctival injection. METHODS: A nine-year-old girl showing ptosis and conjunctival injection underwent examination. RESULTS: There was ptosis of the right eye. Ophthalmologic findings included nodules which seemed like salmon's patch in the conjunctiva. The function of the levator muscle and the Neostigmine test were normal. There was no specific finding in fundus and orbital CT. Biopsy of the nodules was done under local anesthesia, and the pathologic result was benign reactive lymphoid hyperplasia. Ofloxacin and fluorometholone eye drops were used for 6 weeks, and oral prednisolone was used for 2 weeks. The ptosis was improved 3 weeks after surgery and follow-up survey was continuing at 10 months after surgery at the time of writing. CONCLUSIONS: We report one case of a child with benign lymphoid hyperplasia of the conjunctiva who showed ptosis and conjunctival injection, and present a literature.