A Case of DeMorsier Syndrome Misdiagnosed as Amblyopia

PURPOSE: We report a 32-year-old man with DeMorsier syndrome, who was referred for seizures, esotropia and visual disturbance of left eye. METHODS: Fundus examination, visual field examination and the visual evoked potential were performed, and other diagnostic studies included endocrine determinations, the electroencephalogram and MR imaging. RESULTS: Ophthalmic examination revealed left optic nerve hypoplasia with the "double ring" sign. Axial MR T1 weighted image showed tiny left optic nerve and absence of the septum pellucidum. Subsequent evaluation revealed temporal visual field defect, abnormal VEP and deuteranomaly of left eye.

Keratitis in Measles

PURPOSE: To determine the natural history and clinical characteristics of keratitis associated with measles which is currently epidemic in Korea. METHODS: Eighty-four hospitalized patients with measles were prospectively examined between December 2000 and March 2001, during their admission period. Ocular and adnexal examination was performed with a slit lamp biomicroscope. Fundus examination and corneal sensitivity test were also performed. RESULTS: The age and sex distributions were not significant. Age of patients ranged from 18 months to 19 years. All patients with measles have conjunctivitis signs, such as follicles and injection. Superficial keratitis was detected in 7 of 84 patients (8.3%). Corneal lesions were bilateral, well demarcated, round, multiple and 0.2 to 0.4 mm in size. The mean duration of keratitis was 10.1+/-2.9 days in this study. All keratitis resolved spontaneously using artificial tears and prophylactic antibiotic eyedrops CONCLUSIONS:Keratitis associated with measles developed frequently (8.3%), so careful ophthalmic examination should be performed in measles.

A Case of Left Ophthalmic Artery Occlusion and Right Carotid Cavernous Fistula after Illegal Rhinoplasty

PURPOSE: In spite of appropriate management, ophthalmic artery occlusion has a poor prognosis and eventually progresses to the blindness or phthisis bulbi. We report one unusual cause of ophthalmic artery occlusion for the preventive purpose. METHODS: A 44 year-old woman visited emergency room with an acute visual loss in the left eye and right hemiplegia. She had undergone illegal augmentation rhinoplasty using liquid silicone one day prior to the presentation. RESULTS: Angiogram showed that injected liquid silicone entered the systemic circulation via nasal vein and induced the left cerebral infarction and left ophthalmic artery occlusion. On the 30th hospital day, right carotid cavernous fistula was developed with right ocular pain.

A Case of Progressive Recurrent Symblephron, Treated with Amniotic Membrane and Autograft Limbal-conjunctiva

Although both medical and surgical approaches have been investigated, recurrent symblepharon due to chronic ocular surface inflammation is a difficult disease to manage.This condition can also result in many complications such as cosmetic and visual deteriorations.In this condition, we can use the amniotic membrane transplantation that has a biological contact inhibition effect for the prevention of recurrent symblepharon. We treated successfully a case of a progressive symblepharon involving central cornea from 2-year old. The 14 year-old male patient had suffered from serious cosmetic problem and undergone multiple dissection, argon laser photocoagulation, using cyclosporin eyedrops. He was treated using allograft amniotic membrane, autograft limbal-conjunctiva, and buccal mucosa transplantation. we think that amniotic membrane transplantation was very effective method for the prevention of recurrent symblepharon.

The Evaluation of the Endothelial Cells after Cataract Extraction and IOL Insertion in Patients with Corneal Guttata

When the corneal endothelium is injured by intraocular surgery, corneal edema occurs above the threshold level. Preoperative examination of corneal endothelium is valuable in prediction the degree of transparency of the cornea. We conducted this study to elucidate what factors affect corneal endothelial cells in performing the cataract extraction and IOL insertion and what is necessary to minimize the corneal endothelial damage. We performed pacoemulsification and IOL insertion in guttata patients, and preoperative and postoperative endothelial examination was done by using specuar microscope and pachymeter. Although the mean of endothelial cell density was diminished from 1498.7cells/mm2 to 1301cells/mm2 after operation. visible edema was not detected by slit lamp examination and visual acuity was improved from 0.15 to 0.48. The older the patient`s age, the longer the time of phaceemulsification; as the ages of the patients are increased, postoperative corneal thicknesses were increased and postoperative endothelial cell densities were decreased. The endothelial cells were relatively well preserved after cataract operation in patients of preoperative diminished endothelial cells. We suggest that when performing the cataract operation in patients of decreased endothelial function, one must use appropriate large amount of viscoelastic substances, and minimize phacoemulsification power and time in as short operation time as possible by accurate surgical technique. We also believe that periodic postoperative endothelial examination is necessary in patients with decreased endothelial function.

The Evaluation of the Influences of the Patient's Characteristics in Performing the Pinpoint Anesthesia

Local anesthesias such as retrobulbar anesthesia, peribulbar anesthesia and topical anesthesia are commonly preferred as intraocular surgical anesthesia. We evaluated the efficacy of pinpoint anesthesia described by Hidefaru Fukasaku in 1993. We performed in point anesthesia in 57 cataract patients from March 1995 to May 1995 at Kangnam St, Mary's Hospital. The younger the patients and the higher the education level, the smaller intraocular pressure increase and the better patient's compliance. Pinpoint anesthesia might be substituted with other currently used local ocular anesthesia might be substituted with other currently used local ocular anesthesia when patient's selection is appropriate and it is carried out by the well-trained doctors.