Poliosis of Eyelashes as an Unusual Sign of a Halo Nevus

A 39-year-old man with poliosis of his lower eyelid lashes visited our clinic. He reported that his symptoms began with a few central lashes and then spread along the adjacent lashes during the ensuing 2 weeks. A pigmented nevus, approximately 4 mm in diameter, was identified just above the white lashes without surrounding skin depigmentation. No specific findings were identified with regard to the patient's general health or serologic and radiologic testing. Excisional biopsy of the pigmented nevus was performed. On histopathologic examination, infiltration of the dermis by numerous lymphocytes and melanophages was observed. The poliosis was ultimately diagnosed as a presenting sign of the halo phenomenon in the regressive stage of a melanocytic nevus.

Long-term Result of Fat Orbital Decompression

PURPOSE: To evaluate the long-term results of orbital fat decompression with or without lateral wall decompression in Grave's ophthalmopathy. METHODS: The authors studied retrospectively the 24 thyroid-related orbitopathy patients (32 eyes) who had undergone fat removal decompression or combined orbital decompression (lateral wall decompression with fat removal) based on average exophthalmometric values for Koreans. The patients were followed for over six months postoperatively, from December 2000 to December 2008. RESULTS: The average amount of exophthalmos reduction was 4.13+/-2.60 mm in the fat removal decompression group and 5.79+/-2.02 mm in the combined orbital decompression group, respectively (p<0.001). The final postoperative BCVA (best corrected visual acuity) in patients with compressive optic neuropathy improved in all cases. Intraocular pressure decreased significantly in all groups after operation (p<0.001). Except for one patient who had newly onset diplopia, which was transient, no patient's diplopia worsened. CONCLUSIONS: The authors obtained excellent surgical results in the treatment of orbital decompression and cosmesis without complications that can result from fat removal decompression or combined orbital decompression.

Tuberculous Blepharitis Following Removal of Intracanalicular Lacrimal Plug

PURPOSE: Diagnosis of tuberculous blepharitis may be delayed because of its nonspecific symptoms such as periocular edema, nodule, and papule. By investigating the route of infection and clinical course of tuberculous blepharitis, it was attempted to emphasize the importance of early diagnosis and treatment. METHODS: After the trial of intracanalicular plug removal, lid edema and nodule were developed in the patient who had been implanted a intracanalicular plug for dry eye. Excisional biopsy of the lesion was performed after treatment trial with local injection of triamcinolone acetonide. Many acid-fast bacilli were found in the microscopic examination. The patient underwent 9-month-scheduled anti-tuberculous medication. RESULTS: The lesion has improved with the medication. Lid ectropion occurred at the site of biopsy. CONCLUSIONS: Tuberculous blepharitis can be developed as a complication of intracanalicular plug procedure for dry eye. Tuberculous infection should be considered as a possible cause of longstanding blepharitis that is unresponsive to supportive treatment. It is emphasized that early diagnosis and proper management are important.

Corneal Edema Induced by Balafilcon A Contact Lens in Rabbits

PURPOSE: To compare the increase of corneal thickness by Balafilcon A (PureVision(R)) with that by HEMA hydrogel in rabbits. METHODS: 15 eyes of New Zealand white rabbits were divided into three groups. Each group was as follows: Group 1 recieved tasorraphy without contact lens insertion, group 2 had PureVision(R) lens insertion with tasorraphy and group 3 had New hypa day(R) lens insertion with tasorrhaphy. After anterior segment examination, tasorrhaphy was performed in group 1 and corneal thickness was measured at 24 and 48 hours. Five PureVision lenses were applied to left corneas of group 2 and transient tasorrhaphy was performed. After 24 and 48 hours, corneal thickness was measured. Same procedure was made in group 3 by applying five New hypa day(R) lenses on left eyes. Anterior segment was reexamined with slit lamp at 24 and 48 hours in all three groups. RESULTS: Baseline corneal thickness showed no statistical difference among three groups (p>0.05). At 24 hours, the corneal thickness of group 3 (New hypa day(R) lens inserted) increased significantly than that of the other groups (p0.05). CONCLUSIONS: Balafilcon A contact lens which has high oxygen transmissibility of silicone with high water content of hydrogel, induce less corneal swelling than conventional extended wear contact lens, HEMA hydrogel in short-term period. However long-term evaluation about Balafilcon A contact lens is required to get more data on corneal swelling and complications after long-term wearing.

Superficial Punctate Keratopathy after LASIK

PURPOSE: To evaluate the clinical characteristics of superficial punctate keratopathy following LASIK and to estabilish the management and prevention of superficial punctate keratopathy. METHODS: We retrospectively analyzed the medical records of 476 eyes followed up for more than 6 months after LASIK. RESULTS: Of the 476 eyes, the SPK has deveolped in 118 eyes (24.8%). The incidence was higher when there was a history of dry eye symptoms or contact lens intolerance (p<0.05%). In 68 eyes (57.6%), SPK has developed within 1 month after LASIK and the inferior cornea (85.6%) was the most frequently involved site. Most cases were asymptomatic and treated with preservative-free artificial tear solution. There were no visually significant complications. CONCLUSIONS: Corneal sensitivity decreases after LASIK by cutoff of the sensory innervation. As LASIK-induced neurotrophic epitheliopathy has an influence on tear film dynamics, it may be a possible cause of dry eye syndrome or epithelial keratopathy after LASIK. Careful attention should be taken into the contributing factors such as pre-existing dry eye syndrome, contact lens intolerance, previous history of blepharoplasty, lagopthalmos and so on. Adequate hydration of cornea preoperatively, careful manipulation during procedure, conservative treatment with artificial tears may be helpful in reducing symptoms and preventing further complications.