Visual Acuity Changes with a Position Shift in a Patient with an Endocapsular Hematoma

Purpose@#To report a vitrectomy performed on a patient with an endocapsular hematoma whose visual acuity changed with her position.Case summary: A 92-year-old woman visited our hospital complaining of a visual acuity change in her left eye with good visibility while standing but poor visibility when lying. She was taking aspirin, had underlying hypertension, diabetes, and heart failure, and underwent left eye cataract surgery 15 years previously. At presentation, her best-corrected visual acuity in the left eye was 0.5, with an intraocular pressure of 23 mmHg. An endocapsular hematoma that partially covered the fundus in the left eye was found. The left eye was observed for 3 months. However, there was no change in the endocapsular hematoma and the discomfort persisted with the position shift; therefore, a vitrectomy, posterior capsulotomy, and anterior chamber irrigation were performed. One month postoperatively, the visual acuity in the left eye was 0.4 and there was no longer a change in the visual acuity with position. @*Conclusions@#A patient with an endocapsular hematoma may have changes in visual acuity with position, and a vitrectomy can be used to treat the endocapsular hematoma.

Effect of Dominant Eye and Contextual Background on Binocular Rivalry

PURPOSE: We investigated the effects of dominant eye and contextual background on predominance during binocular rivalry. METHODS: 10 subjects were recruited for the present study. Dominant eye was determined using the hole-in-the-card test. In experiment 1, subjects viewed the stimuli through anaglyph filters and reported the predominance of color. The subject's responses were compared with the color on the dominant eye. To investigate the influence of color dominance and contextual color, we conducted the experiment with added contextual color information target through switched-anaglyph filters. In experiment 2, the subject viewed the stimuli through the polarized filters and reported the predominance of orientation. The subject's responses were compared with the grating on dominant eye. To rule out the effect of stimulus size, we conducted the experiment with a smaller target. We designed the additional experiment to investigate the influence of contextual grating information on binocular rivalry. RESULTS: 10 subjects were evaluated. In experiment 1, 8 of 10 subjects reported that eye preference was highly correlated with dominant eye. This finding is significant without reference to color. In experiment 2, 7 of 10 subjects reported that eye preference was highly correlated with dominant eye. This finding is significant without reference to size. In experiment 1-2 and 2-2, all subjects reported that predominance of context contradictory target increased. CONCLUSIONS: We found the relationship between the dominant eye and eye preference. Experiment 1-2 and 2-2 showed that contradictory contextual information increases target predominance during binocular rivalry. Overall, our results indicate that the contextual background reduce the stimulus strength of the context-congruent target; it would correspond to an increase in the dominance duration of the context-contradictory target.

Comparison Results of Silicone Tube Intubation According to Syringing and Dacryocystography

PURPOSE: To compare the surgical success rate of silicone tube intubation according to the preoperative lacrimal syringing test and dacryocystography (DCG) in adult patients with epiphora. METHODS: Medical records of 142 patients who underwent silicone tube intubation were retrospectively reviewed. The surgical results were divided into 3 groups based on postoperative symptoms and the syringing test results: Good, Fair, and Fail. Good and Fair were classified into the surgical success groups. We compared the surgical success rate according to the preoperative syringing test and stenosis site observed on dacryocystography. RESULTS: The success rates of silicone tube intubation were 88.4% and 87.4% in eyes with preoperative syringing results of totally-passed and partially-passed syringing tests, respectively, revealing no statistically significant differences (p = 0.838, chi-square test). However, in eyes with the preoperative syringing results of partially-passed syringing tests, the success rates were 66.7% in patients with canalicular stenosis, 83.3% in patients with nasolacrimal duct stenosis, and 94.5% in those with diffuse stenosis (p = 0.018, chi-square test). CONCLUSIONS: No significant differences were found in the success rates of silicone tube intubation according to preoperative syringing test results. However, when considered together with DCG findings, the lowest success rate was found in eyes with the partially-passed syringing test and simultaneously showed canalicular stenosis on DCG. The syringing test results considered with DCG findings may help predict the success rates of silicone tube intubation.

Outcomes of Isolated Medial Orbital Wall Fracture Reconstructions

PURPOSE: To evaluate surgical results after the reconstruction of isolated medial orbital wall fractures. METHODS: We performed a retrospective chart review of patients with isolated medial orbital wall fractures who underwent reconstruction using the transcaruncular approach from March 2012 to October 2013. Computed tomography (CT) was performed before and after surgery. Postoperative follow-ups were conducted at 1 week, 1 month, and 3 months. Diplopia, ocular motility, postoperative complication, and exophthalmometry were recorded at each follow-up visit. Preoperative and postoperative enophthalmos was quantified using Hertel exophthalmometry and a quantitative method for the area of the circular sector under the chord (CA)/orbital area (OA) ratio at the CT scan. Patients were divided into either the incomplete or complete reduction groups based on the degree of reduction observed on postoperative CT. RESULTS: We evaluated 55 patients (42 males, 13 females) with an average age of 36 years. Five of 55 patients with preoperative enophthalmos of more than 2 mm obtained good symmetry after surgery. Diplopia at primary gaze was resolved in 9 of 9 patients and 2 patients had residual diplopia on lateral gaze. The difference of exophthalmometry and CA-to OA ratio between before and after reconstruction was not significantly changed in either the incomplete or complete groups. CONCLUSIONS: Enophthalmos and diplopia were well corrected in all subjects. If reduction was successfully performed in the anterior portion of medial orbital wall fracture, clinically significant enophthalmos might be preventable even if complete reduction was not obtained.