Angioid Streaks of the Retina Associated with Pseudoxanthoma Elasticum

Angioid streaks are a peculiar spoke-like distribution of dark-colored broad lines in the retinaradiating out from the optic nerve in a fashion similiar to the branching of blood vessels. It is thought to be due to breaks in the elastic lamina of Bruch's membrane. Their colour may be reddish-brown. dark-brown, grey or even in parts white. During a ophthalmoscopic examination they may be mistaken for retinal vessels. The lesion, however, lies beneath the retinal and above the choroidal vessels. Angioid streaks are most commonly seen in pseudoxanthoma elasticum, Paget's disease of bone and sickle cell anemia. Angioid streaks with pseudoxanthoma elasticum have been reported in all races and in all decades of life. The peak age lies between 30 and 50. Pseudoxnnthoma elasticum is a dermatologic condition characterized by changes in the elastic tissue of the skin. A 21 year old Korean lady with pseudoxanthoma e!asticum has been found to have angioid streaks in her both fundi.

Adenoid Cystic Carcinoma in Lacrimal Gland

Neoplasms are the most common among the diseases of the lacrimal gland. Mixed tumor is the commonest tumor of the lacrimal gland. And adenoid cystic carcinoma is the most common in malignancy of lacrimal gland. Adenoid cystic carcinoma appears past middle life and has no sexual prevalence. The first important clinical sign is proptosis with eventual displacement of the globe downwards and inwards. Limitation of ocular movements may be noted to up and out. Often the vision is not greatly disturbed. The fundus is usually normal. The adenoid cystic carcinoma is seldom rapidly fatal. Metastasis may occur in the regional lymph nodes the pre-auricular, cervical and mediastinal-and occasionally general dissemination may appear in other organs as the liver and lungs. Intracranial spread of the tumor results in death. The treatment of choice is surgical removal of the tumor. However, if they are not completely removed, it will recur repeatedly. It is important to save the eyeball when the tumor can not be removed completely. Radiation therapy may be tried preoperatively and post-operatively, but response to radiation therapy is generally unsatisfactory. A 27 year old Korean woman has been healthy until October, 1975, when she began to complain of painful progressive exophthalmos (O.D.). On physical examination, she was found to have a tender and hard mass in superior and temporal region of right orbit. Her visual acuity was 20/50(O.D.) and 20/20 (O.S.). There were no other abnormalities in her both eyes. On July 15, 1976, the surgical removal of the tumor was followed by radiation therapy. The tumor was reported to be a adenoid cystic carcinoma, She has been in good health for about 2 years since she received operation.

Acute Hydrops of the Cornea in Keratoconus

Keratoconus (conical cornea) is a condition, beginning about puberty and developing mainly in females, in which the apex of the cornea thins gradually and usually bilaterally. The etiology is unknown. The presenting symptom is a reduction of the patient's vision owing to the development of a high degree of irregular myopic astigmatism. Early in the course of the disease the cornea does not look conical. The diagnosis of Keratoconus is confirmed by the distorted reflex observed with a Placido's disc and abnormal keratometer readings. In more advanced stages, signs include the obvious cone-shaped cornea and indentation of the lower lid by the cornea. By slit lamp biomicroscopy, vertical lines are noted in the deep layers of the stroma: the corneal nerve fibers are increasingly visible; and in about 50% of cases a yellow or green line is present around the base of the corn (Fleischer's ring). In advanced cases Bowman's membrane and Descemet's membrane rupture. Microscopically there is thinning of the tissue spaces between the corneal lamellae, fragmentation of the basement membrane of the comeal epithelium, fibrillation of Bowman's membrane, and folds or ruptures in Descemet's membrane. Acute hydrops may occur when Descemet's membrane ruptures. This is characterized by sudden cloudiness of vision due to imbibition of aqueous in the corneal stroma. However, as Descemet's membrane regenerates, the edema subsides. Permanent scarring may result if Bowman's membrane ruptures. Acute hydrops of the cornea was developed respectively in left eye on Oct, 1976 and in right eye on Dec, 1976 in a 13 year old Korean girl with Keratoconus O.U.

A Study of Pterygium on Cheju Island

Pterygium is said to be a common disease in many countries. The etiology of pterygium has given rise to much discussion; anatomic, neoplastic inflammatory and degenerative theories have been proposed but its geographical incidence makes it almost necessary to assume that environmental irritation must have something to do with its development. It is generally thought that the pterygium is provoked by irritating substances entering the eye. This may be true, but what that substance is remains obscure. It is a condition found chiefly in the sunny, hot, dusty regions of the world ,mostly between the latitudes of 37 degrees north and south of the equator. The incidence a1so varies with the amount of exposure to these climatic conditions. It is thus most common in workers out-of-doors and therefore more among men than women (at least 2 to 1) except in localities where the exposure of the two sexes is equal. Cheju Island is located approximate1y between 33 degrees and 33 degrees 30' north latitudes. The climatic conditions of this island are characterized by sunny, high temperature, high winds and humid areas. We have observed that the inhabitants of the north coast of Cheju Island are frequent1y affected with pterygia. The 112 cases of clinical pterygia among 969 adult out-patients at the eye clinic of Lazarus Hospital in Cheju City from August 1, 1976 to April 30, 1977 were evaluated statistically. The incidence of pterygium evaluated in Lazarus Eye Clinic was remarkably high (11.56%) as compared with other reports.

Two Cases of Limbal Dermoids

Dermoid tumors of tbe corneal limbus are failYly common congenital lesions. They are noted -at birth and may grow slowly in size and encroach upon the pupillary area occupying a site partly over the cornea and partly over the sclera. The tumors are yellowish, elevated and variable in size. Histologically the tumor consists of fibrofatty tissue covered by epidermoid epithelium and are invaded by ectodermal derivatives such as hair follicle, sebaceous and sweat glands. Trauma, irritation and puberty may hasten their growth. About 30% of patients with. corneal dermoid exhibit other congenital anomalies of ocular tissue, face, teeth, jaw, ear, spine, skull, and so on. Recently two cases of limbal dermoids were seen in our clinic. Histologically hair follicles and sebaceous glands are shown in one specimen, and cartHage and sebaceous glands in the other specimen.