Comparison of Clinical Features in Refractive Accommodative Esotropia According to the Presence of Anisometropia

PURPOSE: To compare the clinical features according to the presence of anisometropia in refractive accommodative esotropia patients. METHODS: Forty-five refractive accommodative esotropia patients were divided into 2 groups : patients who had anisometropia of more than 1.00D (anisometropia group), and patients who had anisometropia of less than 1.00D (isometropia group). Age at onset, age when glasses were first worn, the initial and final angle of esotropia with or without hyperopic correction, the recovery time to orthophoria after hyperopic correction, the degree of stereoacuity and the frequency of amblyopia, the prevalence of deterioration, and the ratio of accommodative-convergence to accommodation were retrospectively reviewed. RESULTS: There were no statistical differences between the 2 groups in the frequency of amblyopia, the prevalence of deterioration, and the ratio of accommodative-convergence to accommodation at the initial and final visit. The angles of deviation with hyperopic correction at the 1-month follow-up visit in the anisometropia group and the isometropia group were 8.80 +/- 5.63 PD for near, 8.67 +/- 5.42 PD for distance, and 4.54 +/- 6.59 PD for near 5.19 +/- 6.7 PD for distance, respectively; the difference was statistically significant (p = 0.042). The recovery time to orthophoria after hyperopic correction in patients associated with anisometropia was 2.20 +/- 1.01 months, significantly longer than 1.47 +/- 0.86 months in patients associated with isometropia (p = 0.017). CONCLUSIONS: In refractive accommodative esotropia patients associated with anisometropia, the recovery time to orthophoria after hyperopic correction was significantly prolonged but there were no statistical differences in other clinical manifestations.

Achromobacter xylosoxidans Keratitis after Contact Lens Usage

To report on Achromobacter xylosoxidans keratitis in two healthy patients who had worn contact lenses foran extended period of time. A 36-year-old female and a 21-year-old female visited our hospital with ocular pain and blurred vision. Both patients had a history of wearing soft contact lenses for over fve years with occasional overnight wear. At the initial presentation, a slit lamp examination revealed corneal stromal infiltrations and epithelial defects with peripheral neovascularization in both patients. Microbiological examinations were performed from samples of corneal scrapings, contact lenses, contact lens cases, and solution. The culture resulting from the samples taken from the contact lenses, contact lens cases, and solution were all positive for Achromobacter xylosoxidans. Confrming that the direct cause of the keratitis was the contact lenses, the frst patient was prescribed ceftazidime and amikacin drops sensitive to Achromobacter xylosoxidans. The second patient was treated with 0.3% gatifoxacin and fortifed tobramycin drops. After treatment, the corneal epithelial defects were completely healed, and subepithelial corneal opacity was observed. Two cases of Achromobacter xylosoxidans keratitis were reported in healthy young females who wore soft contact lenses. Achromobacter xylosoxidans should be considered a rare but potentially harmful pathogen for lens-induced keratitis in healthy hosts.

A Case of Periocular Capillary Hemangiomas Treated With Propranolol as a Single Therapy

PURPOSE: To report a case of periorbital infantile capillary hemangioma treated with propranolol as a single therapy. CASE SUMMARY: A 3-month-old girl with a growing red-purple mass on the right lower eyelid visited our clinic. The patient was diagnosed with capillary hemagioma by imaging studies. The mass had grown rapidly, and the visual axis was obscured in the follow-up. Oral propranolol therapy was initiated at a starting dose of 0.17 mg/kg at 8-hour intervals. After 2 doses, the propranolol was doubled, and after another 2 doses, the daily dose of 0.67 mg/kg divided into 3 was maintained. Three days after the initiation of the treatment, the color of the hemangioma had changed from red-purple to light purple, and the hemangioma had softened. The hemangioma continued to respond well with no side effects in the following 10 months. CONCLUSIONS: The authors suggest that oral propranolol treatment as a possibility of an effective and safe option for the vision-threatening periorbital capillary hemangioma as a single therapy.

A Case of Periocular Capillary Hemangiomas Treated With Propranolol as a Single Therapy

PURPOSE: To report a case of periorbital infantile capillary hemangioma treated with propranolol as a single therapy. CASE SUMMARY: A 3-month-old girl with a growing red-purple mass on the right lower eyelid visited our clinic. The patient was diagnosed with capillary hemagioma by imaging studies. The mass had grown rapidly, and the visual axis was obscured in the follow-up. Oral propranolol therapy was initiated at a starting dose of 0.17 mg/kg at 8-hour intervals. After 2 doses, the propranolol was doubled, and after another 2 doses, the daily dose of 0.67 mg/kg divided into 3 was maintained. Three days after the initiation of the treatment, the color of the hemangioma had changed from red-purple to light purple, and the hemangioma had softened. The hemangioma continued to respond well with no side effects in the following 10 months. CONCLUSIONS: The authors suggest that oral propranolol treatment as a possibility of an effective and safe option for the vision-threatening periorbital capillary hemangioma as a single therapy.

A Statistical Observation of Corneal Laceration and Factors Influencing Visual Prognosis

PURPOSE: To investigate the regional characteristics and the factors that influence final visual acuity in corneal laceration and use the results for prevention and treatment of corneal laceration. METHODS: Sixty-eight patients who visited the Chosun University Medical Center from January 1, 2006 to December 31, 2010 were retrospectively surveyed. The incidence of corneal laceration, sex, age, monthly and seasonal distribution, cause, site and length of corneal laceration, secondary operation, complications, and ocular trauma score were reviewed statistically. In additional, the factors influencing visual prognosis were investigated. RESULTS: The incidence was more common in males (94.1%) and in the 6th-decade of life (29.4%). The corneal laceration was more common in the summer (38.2%) and in September (26.5%) and the most common cause was stone (39.7%) and metal (35.3%), respectively. The corneal laceration tended to occur at the corneal center. The most common first operation was primary closure (81.9%), and the secondary operation was most often performed due to a traumatic cataract (32.1%). The factors that significantly influenced the final visual acuity were initial visual acuity, length and site of laceration, and secondary operation. CONCLUSIONS: The present survey investigated the regional characteristics and important factors influencing final visual acuity. Results show initial visual acuity, the length and site of laceration, and the secondary operation significantly influenced final visual acuity.

Keratoconjunctival Chemical Burn due to Chemical Light

PURPOSE: Chemical lights, also called Luminous Sticks, consist of a solution of diphenyl oxalate (C14H10O4) and hydrogen peroxide (H2O2). Human tissue can be damaged when the mixed solution contacts the human body. The authors report a single case of chemical injury of keratoconjunctiva by exposure to chemical lights. CASE SUMMARY: A 47-year-old man's right eye accidentally contacted the fluorescent material when breaking a Luminous Stick 7 days before being referred to our clinic. He had pain in the right eye and experienced visual loss. The patient's best corrected visual acuity in the right eye was 20/50. An ulcerative lesion with edema at the inferior bulbar and palpebral conjunctiva and coneal epithelial defect was observed upon biomicroscopic examination. The patient was hospitalized and antibiotics, steroids, mydriatic and artificial tear eye drops were applied for treatment. After 9 days of treatment, the best corrected visual acuity of the patient recovered to 20/20, and the conjunctiva and cornea were mostly healed. No complication was observed. CONCLUSIONS: Chemical lights are commonly used in concerts and festivals. If the contents contact the eyes when breaking he chemical lights, various chemical burns can occur and cause ophthalmologic complications. Since no regulations have been passed regarding chemical lights, safety education and supervision are considered to be necessary for children.