The Amblyopia and Strabismus Accompanied with Anisometropia

PURPOSE: To study the characteristics of the accompanying amblyopia and strabismus in patients with anisometropia. METHODS: We retrospectively reviewed the medical records of 193 patients, who had either spherical or cylindrical anisometropia of more than 1.00D. Patients were divided into four groups: spherical hyperopic anisometropia, spherical myopic anisometropia, cylindrical hyperopic anisometropia, and cylindrical myopic anisometropia. We investigated the accompanying amblyopia and strabismus. Amblyopia was treated with lens correction and patch therapy and we analyzed the results for 78 patients who fulfilled six-month follow-up examinations. RESULTS: There was no significant difference in the frequency of amblyopia between spherical and cylindrical anisometropia. Spherical myopic anisometropia of more than 3.00D showed a significant increase in the incidence of amblyopia (p=0.001). Spherical hyperopic anisometropia of more than 1.00D, cylindrical hyperopic anisometropia of more than 2.00D, and cylindrical myopic anisometropia of more than 2.00D showed an increased tendency for amblyopia. Between spherical and cylindrical anisometropia, there were no significant differences in the results and duration of amblyopia treatment, and type and frequency of strabismus. CONCLUSIONS: In spherical anisometropia, hyperopic anisometropia has a higher risk for developing amblyopia. We could find the threshold for the development of amblyopia.

Factor Influencing Anatomical Failure of Simple Rhegmatogenous Retinal Detachment

PURPOSE: This study analyzes the factors influencing anatomical failure of the primary operation for simple rhegmatogenous retinal detachment. METHODS: The patients in this study were diagnosed with simple rhegmatogenous retinal detachment and operated on by a single physician. The success group comprised 251 eyes and the failure group comprised 29 eyes. The factors analyzed between the two groups were the type of primary procedure, the type of retinal defect; the numbers of retinal defects; the extent of retinal detachment; the duration of retinal detachment; the existence of peripheral degeneration; carrying out of subretinal fluid drainage; the type of tamponade material used and the position of retinal defects. RESULTS: The anatomical success rate of the primary operation for simple rhegmatogenous retinal detachment was 89.64%. Patient sex, the type of tamponade material used and the position of the retinal defect showed significant differences between the success and failure groups. There was a higher percentage of male patients in the failure group than in success group (p=0.034). Silicone oil used as the tamponade material resulted in a greater chance of failure than success (p=0.017). Analysis of the position of the retinal defect showed that, defects distributed in the inferior retina or through multiple area led to a greater likelihood of anatomical failure (p=0.036). CONCLUSIONS: Due ti the greater possibility of anatomical failure of the primary operation when retinal defects are distributed in the inferior retina or through multiple area, clinicians should consider intensive treatment for such cases.

Treatment of Subperiosteal Abscess of the Orbit in Children

PURPOSE: The subperiosteal abscess in the orbit, caused mostly by sinusitis, has the major clinical finidings such as lid swelling, proptosis, limitation of the eye movement, and so on. The combined systemic administration of antibiotics and surgical drainage are the cornerstone of the treatment for the subperiosteal abscess. However, recent studies have shown that the systemic antibiotic therapy without any surgical intervention can effectively treat the disease. Therefore, this paper presents the case studies based on the treatment results of subperiosteal abscess. METHODS: The medical files of six patients are reviewed in detail, focused on the clinical findings and treatment results. The subjects had the subperiosteal abscess in the orbit and treated from June 1, 1996 to July 31, 2001. RESULTS: Five out of six patients were under the age of fifteen; 2 in the nasal side, 2 in the inferior side, and 1 in the superior side of the orbit. All of the five patients were treated effectively by the intravenous antibiotic therapy only. CONCLUSIONS: The subperiosteal abscess of the orbit in pediatric patients was treated by the intravenous antibiotic therapy only, including the one in the superior side. It is suggested that the intravenous antibiotic therapy can be enough to treat the subperiosteal abscess. However, we also recommend close monitoring of the patients to see whether the surgical intervention might be needed or not.

Topographic Anatomic Difference of the Eyelid According to Age in Korean

PURPOSE: To analyze the morphologic changes of the eyelids among different age groups in Korean, and also th find out factors that influence there changes. METHODS: Tow hundred thirty six subjects without any ocular diseases were selected, and sorted by the age (ranging from teenage to the sixties and above), the gender, and according to the existence of the double fold. The pictures of frontal and lateral side of the subjects were taken. After scanning the pictures, MRD1 (marginal reflex distance 1), MRD2 (marginal reflex distance 2), the vertical distance from upper eyelid to eyebrow, the vertical and horizontal distance from medial to lateral canthus, and the horizontal distance between lateral canthus and corneal center were measured using computer-based AutoCAD R14. The measured distances were compared in each subjects. RESULTS: MRD1, MRD2, the vertical distance between medial and lateral canthus, and the horizontal distance between lateral canthus and corneal center were longest in people of the 3rd and 4th decade, and decreased. The horizontal distance between medial and lateral canthus was longest in people of the 5th decade, and decreased thereafter. The vertical distance between upper eyelid and eyebrow was shortest in people of the 4th decade and increased with aging. CONCLUSIONS: It is essential to acknowledge and understand the morphologic changes of the eyelids according to aging so that more satisfactory surgical outcomes may be achieved in cosmetic eyelid operation.

Factors Influencing Final Visual Outcome in Intraocular Foreign Bodies

PURPOSE: To evaluate the relationship between final visual outcomes and other factors such as sex, age, right or left eye, initial vision, initial findings, kinds of IOFB(intraocular foreign body) and size, entry site, and final location of IOFB, preoperative retinal lesion and postoperative retinal detachment. METHODS: We analyzed the records of 36 eyes of 36 patients of perforating ocular injury with IOFB retrospectively from September, 1995 to May, 1999. RESULTS: The preoperative factors which were associated with final visual outcome were vitreous hemorrhage, hyphema, preoperative retinal lesion and postoperative retinal detachment. CONCLUSIONS: The factors influencing final visual outcome in intraocular foreign bodies are hyphema, vitreous hemorrhage, preoperative retinal lesion.