A Case of Sterile Peripheral Corneal Infiltrative Event after LASIK

Purpose@#To report a rare, sterile, peripheral, corneal infiltrative event after laser in situ keratomileusis (LASIK).Case summary: A 29-year-old male presented with left-eye conjunctival injection and peripheral corneal infiltration 3 days after LASIK. A whitish, oval, peripheral infiltration around the corneal flap was apparent from 6-to-10 o’clock in the limbus. Slit lamp examination revealed conjunctival injection and mild corneal edema but neither a corneal epithelial defect nor an inflammatory reaction of the anterior chamber. Intensive cycloplegic, steroid ointment, steroid drops, antibiotic drops, and artificial tear therapies were prescribed under the impression of a sterile, peripheral, corneal infiltrative event. After 1 month, the symptoms and corneal opacity resolved without any complications. @*Conclusions@#A sterile, peripheral, corneal infiltrative event, namely, an oval infiltration of the periphery of the cornea without pain or epithelial damage can develop after LASIK but responds well to steroid eye drops.

A Case of Allergic Reaction to 0.5% Moxifloxacin Eye Drops

Purpose@#We report a rare case of allergic contact dermatitis after the use of a non-preservative 0.5% moxifloxacin ophthalmic solution.Case summary: A 60-year-old male presented with bacterial corneal ulceration of the right eye. He was treated with 50 mg/mL of fortified cefazolin and 14 mg/mL of tobramycin that were tapered as the corneal lesion improved after 1 month, and 0.5% moxifloxacin application was started. After 2 weeks of moxifloxacin treatment, the patient developed conjunctival injection, lid swelling, redness, and itching in the right eye. An allergic reaction was suspected and moxifloxacin administration was immediately stopped. The symptoms improved after the administration of oral antihistamines, 0.5% loteprednol eye drops, and steroid combination ointment. @*Conclusions@#Patients treated with 0.5% topical moxifloxacin should be monitored for allergic contact dermatitis, even if preservative-free eye drops are used.

A Case of Contact Lens Induced Acute Red Eye

Purpose@#To report a rare case of acute red eye in a contact lens user.Case summary: An 18-year-old female presented with decreased visual acuity and ocular pain in the right eye for 4 days. The patient had used contact lenses for > 8 hours a day, even while sleeping at night, for the past 3 months. Corneal epithelial edema and punctate stromal infiltration along with diffuse conjunctival hyperemia and corneal limbal injection in the right eye were observed in slit lamp examination. The uncorrected and corrected visual acuities of the right eye were 0.02 (20/1000) and 0.16 (20/125), respectively. The right eye had an intraocular pressure of 10 mmHg, and the left eye was within normal range. The patient stopped wearing contact lenses and was prescribed steroid and antibiotic eye drops and artificial tears. The corrected visual acuity increased to 0.5 (20/40) on the first day of treatment and to 1.0 (20/20) after 2 months. The cornea and conjunctiva also returned to the normal appearance. @*Conclusions@#It is important to differentiate contact lens-induced acute red eye from microbial keratitis. Discontinuation of contact lens use and education are required to prevent acute red eye caused by contact lens use.

A Conjunctival Myxoid Stromal Tumor

Purpose@#We report a conjunctival myxoid stromal tumor (CMST), which is a rare benign conjunctival mass.Case summary: A 70-year-old man with a history of hypertension and cerebral infarction visited our hospital with a clear mass ofthe conjunctiva in the left eye. His visual acuity was normal, and no other abnormal findings were noted. A transparent, yellowish,jelly-like, 4 × 3 mm mass with a clear border between it and the surrounding tissue was found at the lower temporal part of theconjunctiva. The mass was mobile and there was no pain or tenderness. Excisional biopsy was performed on the mass.Histopathological examination showed reticular fibers located in an abundant mucus-like matrix with fusiform, astrocytic andscattered inflammatory cells. Immunologic examination revealed CD34 positive and SMA negative findings and we diagnosedthe mass as a CMST. @*Conclusions@#When there is a clear pale yellow to light pink mass with a clear border and a distinct vascular distribution or pigmentationin the conjunctiva, the possibility of a CMST must be considered. Histopathologic and immunologic examinationshould be performed through biopsy and evaluation for systemic disease should be performed as necessary.

The Shortest Radius of Curvature of Bruch's Membrane in Macular Optical Coherence Tomography

PURPOSE: To develop software to measure the shortest radius in curvature of Bruch's membrane from optical coherence tomography (OCT), and then to apply it to various types of eyes. METHODS: Macular OCT images consisting of 12 images of 9 mm radial scans were studied. The horizontal to vertical pixel ratios were changed to 1:1, and Bruch's membrane was marked automatically on each image. Software to measure the radius of Bruch's membrane curvature was developed. The shortest radius on each image was defined as r (mm) and the average r of 12 images was defined as R (mm). The reciprocal of R was multiplied by the constant, 337.5, which was defined as the posterior staphyloma (PS) index. RESULTS: The OCT images of five eyes were analyzed by the software, which could calculate the curvature of Bruch's membrane automatically. The PS indices were 12.7, 23.7, and 66.4 in eyes without refractive error (Case I), in the high myopic group without posterior staphyloma (Case II), and in the high myopic group with posterior staphyloma (Case V), respectively. The PS index gradually increased according to aging in a 37-year-old patient (Case IV) with mild staphyloma from 34.6 to 39.5 over 4 years. CONCLUSIONS: PS index is a novel parameter to reflect the level of posterior staphyloma, but further studies are needed to apply it to clinical patients.