The Refractive Errors of Dominant and Non-dominant Eyes

PURPOSE: To evaluate differences between dominant and non-dominant eyes through analyzing refractive factors in determination of the dominant eye. METHODS: Sixty-two subjects without underlying ocular disease were recruited. Ocular dominance was determined using the hole-in-the-card test. Uncorrected visual acuity, refractive error, and intraocular pressure (IOP) were checked in both eyes. RESULTS: Mean uncorrected visual acuity of the dominant and non-dominant eye were 0.41 and 0.39, respectively. The number of patients whose uncorrected visual acuity of the dominant eye was superior to the non-dominant eye was 18(29%), and inferior to the non-dominant eye was 18(29%). Mean refractive power in the dominant eye was -3.2 diopter and -3.43 diopter degrees in the non-dominant eye, therefore no difference in degrees of myopia between the groups (P=0.282) was observed. The number of patients whose dominant eye had a greater degree of myopia than the non-dominant eye was 24(39%) and the patients with a lower degree of myopia in the dominant eye was 32(52%). Astigmatism of the dominant eye was lower than the non-dominant eye in 35(56%) of the patients, thus a significant relationship was shown between astigmatism and the dominant eye (P=0.0014). The mean IOP of the dominant eye was 15.4 mmHg and the non-dominant eye was 15.7 mmHg, showing no significant difference between eyes. CONCLUSIONS: The dominant eye showed a lower degree of astigmatism than the non-dominant eye. The previous belief that myopia is more progressed in the dominant eye than the non-dominant eye because of excessive accommodative use of the dominant eye requires further study.

Microscopic Anatomy of the Lower Eyelid in Koreans

PURPOSE: To study the microscopic anatomic relation of capsulopalpebral fascia, orbital septum, and tarsus of the lower eyelid in Korean. METHODS: Foureteen normal Korean lower eyelids from 14 formalin-fixed cadavers (mean age of 66.5 years) were harvested and studied with light microscopy after staining with hematoxylin and eosin. Dimensions of the structures and distances between them was measured by analyzing the digital photographs. RESULTS: There was no fusion of the orbital septum and the capsulopalpebral fascia at the lower border of the tarsal plate in 10 specimens and limited fusion of these tissue in 4 specimens. The average distance from the inferior tarsal border to the first identifiable smooth muscle nuclei of the inferior tarsal muscle was 1.38 mm. The average tarsal plate thickness was 0.98 mm and the average tarsal plate height was 3.96 mm. CONCLUSIONS: The Korean lower lid anatomy differs from that of their non-Asian counter parts. Furthermore, there was a difference in tarsal plate thickness in comparison to Chinese lower lids. There was no consistent fusion between the capsulopalpebral fascia and the orbital septum. No extension of the capsulopalpebral fascia to the skin was observed.

The Effect of Cycloplegia on Vision and Stereopsis: Comparison between before and after Cycloplegia

PURPOSES: To evaluate the effect of cycloplegia on the visual acuity and stereopsis according to the refraction and age. METHODS: This study included 112 eyes of 56 patients, which were divided into three groups according to the refraction. The best corrected visual acuity and stereopsis were compared between without and with cycloplegia in all groups according to age. RESULTS: After cycloplegia, at near, naked visual acuity decreased in 0.53 logMAR, average and stereopsis also deceased from 93 seconds to 343 seconds. At far, the naked and best corrected visual acuity had less decreased than near visual acuity. At near, there was no significant difference on the degree of decreased visual acuity and stereopsis according to refraction, but in emmetropic patients, the visual acuity at near significantly decreased. Patients younger than ten years old had more decreased visual acuity at near compared with older than forty-five years old. CONCLUSIONS: After pupil dilatation, there significant decreased near visual acuity and stereopsis, there was little change at far. The degree of decreased vision was different according to the refraction and age, therefore it would be helpful to explain the anticipating result.

A Case of Orbital Abscess following Porous Orbital Implant Infection

PURPOSE: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis. METHODS: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medpor(R)) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed. RESULTS: After partial orbital exenteration, the wound finally healed well without any additional abscess formation. CONCLUSIONS: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.

Change in Proptosis Following Extraocular Muscle Recession in Thyroid-Related Orbitopathy

PURPOSE: To evaluate the effect of strabismus surgery on proptosis in thyroid-related orbitopathy METHODS: The medical records of 22 consecutive patients (38 eyes) undergoing strabismus surgery were reviewed. Data pertaining to number of muscles operated, the length of muscle recession, prior orbital decompression, and exophthalmometry (by either Hertel or Naugle devices) were evaluated. RESULTS: Thirty-eight eyes in 22 patients with thyroid-related orbitopathy were studied before and after the muscle surgery. The mean change in exophthalmometry for all eyes was an increase of 0.6 mm (p<0.01). Eyes with prior decompression averaged a 0.9 mm increase following strabismus surgery (p<0.01); those without decompression averaged a 0.2 mm decrease, although not statistically significant. For eyes with multiple muscles operated on a given eye averaged 1.2 mm increase; in those with one muscle operated the average increase was 0.2 mm. In cases where the inferior rectus muscle was operated on, the average increase was 0.9 mm. When the total length of muscle recession was less than or equal to 5 mm, the mean exophthalmometric change was a increase of 0.3 mm. If more than 5 mm, the mean was an increase of 0.8 mm. CONCLUSIONS: Strabismus surgery on patients with thyroid-related orbitopathy can worsen proptosis, especially those with prior decompression. When planning for orbital decompression, the surgeon should consider this effect. Patients should be made aware of possible changes to their appearance.

A Case of Conjunctival Malignant Melanoma with Extensive Corneal Displacement

PURPOSE: To report a patient with malignant conjunctival melanoma with extensive corneal invasive growth. METHODS: A 63-year-old woman with 9 x 7 mm sized dark brown colored conjunctival mass with extensive corneal invasive growth over a 3-month history was seen. The mass was removed and biopsy was done. Fontana-Masson, S-100 protein, and HMB stainings were used to confirm the diagnosis of malignant melanoma. RESULTS: The tumor was easily separated from the corneal surface and adjacent conjunctiva was excised. Fontana-Masson, S-100 protein, and HMB stainings revealed corneally-displaced malignant conjunctival melanoma. There was no evidence of metastasis. CONCLUSIONS: Corneally displaced malignant conjunctival melanoma was very rare. A good surgical result was obtained with its removal.

Two Cases of Acute Acquired Comitant Esotropia after Occlusion Therapy

PURPOSE: To describe the new type of acute comitant estropia with dual cause of fusional dysfunction due to occlusion and refractive-accommodative factors. METHODS: We experienced two case of acute, acquired comitant esotropia in the course of occlusion therapy. The patients had mild hyperopia and severe accommodative tendency. RESULTS: After strabismus surgery, the patients have orthophoria and stereopsis recovery. CONCLUSIONS: We believe that the patients with acute comitant esotropia and abrupt diplopia should undergo thorough ophthalmological, neurological evaluations. And, acute comitant esotropia might occur during the occlusion therapy for amblyopia.

Two Cases of Photic Retinopathy by Excessive Exposure to Light of Sun and Operating Microscope

PURPOSE: To report two cases of photic retinopathy induced by excessive exposure to sunlight and operation microscope during cataract surgery. METHODS: Two cases of photic retinopathy(case 1: a 33 year old woman exposed to excessive sun light, case 2: a 66 year old woman exposed to direct operating microscope during cataract surgery) were followed and observed with visual acuity, fundus examination and fluorescein angiography without specific treatment. RESULTS: In both cases, best corrected visual acuity was improved to 1.0 and central scotoma decreased significantly.

Ultrastructral Changes of Acanthanmoeba Cyst after Treatment with Polyhexamethylene Biguanide

No Abstract Available.

Clinical Evaluation of Epiblepharon and Congenital Entropion

We retrospectively reviewed the sex distribution, age at oepration, chief complaints, peroperative and postoperative refractive errors, and corrected visual acuity in 160 previously operated patients to evaluate the clinical manifestations, reractive error, frequency of amblyopia, age at operation, and the postoperative factors affected by the operation of epiblepharon and congenital entropion itself that influence visual acuity and refractive error. The average age at operation was 7.9 years. The chief complaint was ocular discomfort, followed by visual disturbance, photophobia, eyelid rubbing and epiphora. One hundred thirty-three wyws(41.6%) whose preoperative corrected visual acuity was below 0.6 had a mean visual acuity of 0.7. Ninety-five eyes (29.7%) were preoperative myopes above -1.0D, 77 eyes(24%) were hyperopes above +1.0D, and 163 eyes were astigmatic above -1.0D. Twenty-two out of 76 eyes who were followed up for more than one year had a corrected visual acuity of below 0.6. The difference between the older and less than 7 years groups was significantly not significant. Astigmatic changes were not statistically different at any age group. However, the mean significantly visual acuity at postoperative one year was 0.73, which was significantly different from the preoperative value(P=0.006). In conclusion, concurrent postoperative glasses correction and amblyyopia therapy is indicated because the incidence of refractive errors and amblyopia is higher in epiblepharon and congenital entropion.

In Vitro Amoebicidal Efficacy of Hexamidine, Polyexamethylene Biguanide and Chlorhexidine on Acanthamoeba Ccular Isolates

To evaluate amoebicidal efficacy of various disinfectants, we treated ten ocular isolates of Acanthamoeba with polyhexamethylene biguanide(PHMB), chlorhexidine and hexamidine. Acanthamoeba cysts were collected from axenic nonnutrient agar plates from 4 week culture. Cyst suspension(100microliter) was inoculated on 96-well microplate with concentration of 105 cys/ml. Each well was treated with two-fold diluted hexamidine, PHMB and chlorhexidine(100microliter each, 8 and 48hrs). Each well was examined under the inverted microscope until 7 days after treatment. Minimal cysticidal concentration(MCC) of each disinfectant qas measured after five experiments. MCC of hexamidine, chlorhexidine and PHMB against ten ocular isolates ranged 6.07-500microgram/ml, 3.12-12.50microgram/ml, 1.17-4.68microgram/ml respectively in 48hr treatment. In 8hr treatment, MCC of PHMB and chlorhexidine ranged 4.42-12.50microgram/ml and 4.67-17.71microgram/ml, but hexamidine did not demonstrate cysticidal effect. For proper disinfection of contact lens, disinfectants having cysticidal efficacy should be included in the composition of contact lens solution. Among the currently used topical amoebicidal agents, PHMB showed the greatest cysticidal activity on ten ocular strains of Acanthamoeba in invitro study.

A Case of Ocular Rosacea Treated with Oral Tetracycline

Rlsacea is chronic disease of the eye and facial skin, which is common in Caucasian. Ocular rosacea is often difficult for ophthalmologists to diagnose, especially when skin manifestations are not evident yet. Early diagnosis and early treatment is important to prevent its serious complications including corneal opacity and corneal perforation. A case of ocular rosacea in a 52-year-old Korean lady is reported. The patient was presented with hyperemic conjunctiva and vascularization, infiltration and thinning of the peripheral cornea. She did not have any specific skin lesion. But 20 years ago, she had suffered from rosacea. After administation of oral tetracycline and topicale and topical corticosteroid, the signs and symptoms of the ocular rosacea was markedly improved.

A Case of Ocular Rosacea Treated with Oral Tetracycline

Rlsacea is chronic disease of the eye and facial skin, which is common in Caucasian. Ocular rosacea is often difficult for ophthalmologists to diagnose, especially when skin manifestations are not evident yet. Early diagnosis and early treatment is important to prevent its serious complications including corneal opacity and corneal perforation. A case of ocular rosacea in a 52-year-old Korean lady is reported. The patient was presented with hyperemic conjunctiva and vascularization, infiltration and thinning of the peripheral cornea. She did not have any specific skin lesion. But 20 years ago, she had suffered from rosacea. After administation of oral tetracycline and topicale and topical corticosteroid, the signs and symptoms of the ocular rosacea was markedly improved.

In Vitro Amoebicidal Efficiencies of Various Disinfectants Against Four Ocular Isolates of Acanthamoeba Keratitis

To evaluate amoebicidal efficacy of various disinfectants, we treated four ocular isolates of Acanthamoeba with three kinds of commercial available contact lens(CL) disinfectants, chlorhexidine, thimerosal, polyhexamethylene biguanide(PHMB) and hexamidine, Acanthamoeba cysts were collected from axenic nonnutrient agar plates from 4-week cultures. Cyst suspension(100microliter) was inoculated on 96-well microplate with concentration of 5x103 cyssts/ml. Each well was treated with three kinds of CL disinfectants(100microliter each, 4, 8, 12, 24hrs) and two-fold diluted chlorhexidine, PHMB and hexamidine(100microliter each, 8 and 48hrs). Only one CL disinfectant containing chlorhexidine(0.005%) and thimerosal(0.001%) showed cysticidal effect. Minimal cysticidal concentration(MCC) of PHMB, chlorhexidine, hexamidine ranged 1.17-3.12microgram/ml, 3.12-12.50microgram/ml, 8.64-52.07microgram/ml respectively with 48hr treatment. In 8hr treatment, MCC of PHMB and chlorhexidine were 4.42-12.50microgram/ml and 9.31-25.0microgram/ml respectively, but hexamidine did not demonstrate cysticidal effect. Therefore for proper sterilzation of contact lens and CL caes, effective disinfectant should be included in the composition of CL cleaning solution. Among the currently used topical amoebicidal agents, PHMB was the most potent cysticidal agent in in vitro study with four ocular stains of Acanthamoeba.

Evaluation of Multifactorial Factors Contributing to The Myopic Regression after PRK

The thirty four patients(60 eyes) of the same age group, sex and refractive error receiving eximer laser photorefractive keratectomy(PRK) from April 2, 1991 to May 2, 1993 were studied to evaluate the possible factors influencing the myopic regression. In this study, we didn't find any difference between regressed and nonregressed group in the individual parameters such as IOP, keratometer, corneal thickness, occupation, surgeon, hyperopic peak after PRK, and topographic analysis preoperatively and postoperatively. But, the increased tendency of myopic regression one the another eye experiencmg myopic regression on one eye showed statistically significance(P=0.005) and the same tendency was applied on the corneal haziness(P=0.012). We suggest corneal haziness is likely related to causing the myopic regression following PRK. Therefore, the surgeon should particularily try to prevent myopic regression in patients experiencing myopic regression on his one eye by minimizing coneal haziness following PRK.

The Complex Choristoma with Ectopic Lacrimal Gland in Bilateral Bulbar Conjuntivas

Complex choristoma with a predominance of lacrimal gland tissue is known as unusual congenital and developmental abnormality. Several cases of ectopic lacrimal gland have been reported in Korea. But complex choristoma with ectopic lacrimal gland on both eyes has never been reported. The authors have experienced a case of complex choristoma with ectopic lacrimal gland in lower and lateral quadrant of bulbar conjuntiva on both eyes in a 12-year-old boy.

Chromosomal Translocation Occuring Congenital Coloboma in Both Eyes

The congenital coloboma represents failure in closure of fetal fissure, which may involve iris, ciliary body, choroid, retina or optic nerve. It is classified into typical and atypical type. The authors have experienced a case of typical coloboma of the occuring on the iris, choroid, and optic disc of both eyes which have chromosomal abnormality, 46, XY, t(4, 13)(p;q), and the literatures relating to this disease were briefly reviewed.

Chromosomal Translocation Occuring Congenital Coloboma in Both Eyes

The congenital coloboma represents failure in closure of fetal fissure, which may involve iris, ciliary body, choroid, retina or optic nerve. It is classified into typical and atypical type. The authors have experienced a case of typical coloboma of the occuring on the iris, choroid, and optic disc of both eyes which have chromosomal abnormality, 46, XY, t(4, 13)(p;q), and the literatures relating to this disease were briefly reviewed.