Type III Usher Syndrome in the Republic of Korea

Purpose@#To report a case of type III Usher syndrome that has not been previously reported in the Republic of Korea.Case summary: A 39-year-old female visited the local eye clinic for ophthalmic evaluation and then visited our ophthalmologydepartment due to a need for further evaluation and proper management. She complained of night blindness after she becamean adult. She underwent a funduscopic examination, which revealed decolorization and atrophy of the retinal pigment epithelium,bony spicule pigmentation in the retina, and thinning of the retinal arteriole. Results of an electroretinogram and electrooculogramrevealed that responses were weak. She was diagnosed with the fourth grade of hearing impairment according to hermedical history. There was no mental retardation. According to her family history, her mother had hypermetropia, and her brotherhad astigmatism. There was no other medical history, including ophthalmic history. She was diagnosed with type III Usher syndromebased on ataxia and the dynamic visual acuity test. @*Conclusions@#It may be necessary to consider a genetic disease by assessing other systemic symptoms when a patient with retinitispigmentosa is diagnosed.

Corneal Ulcer Caused by Corynebacterium macginleyi

PURPOSE: To report a case of a Corynebacterium macginleyi-infected corneal ulcer of a patient who had been treated for conjunctivitis for more than 3 months. CASE SUMMARY: A 72-year-old female was transferred from a private ophthalmic clinic for evaluation of herpetic keratitis with progressive corneal edema and infiltration in the left eye. She had a history of conjunctival hyperemia and eyeball pain in her left eye 3 months prior to her visit. She was treated with levofloxacin eye drops and acyclovir ointment (Herpesid®, Samil, Co., Ltd. Seoul, Korea). On slit lamp examination, 5.4 × 4.0 mm corneal epithelial defects and stromal infiltrations were observed in the upper to central cornea, and endothelial keratic precipitates were found. Gram positive bacteria were detected on Gram staining and Corynebacterium macginleyi was identified on bacterial cultures from the conjunctiva and cornea. She was treated with topical vancomycin eye drops. After 3 months of treatment, the corneal ulcer was completely resolved, leaving mild superficial opacity on the cornea. CONCLUSIONS: While Corynebacterium macginleyi, normal flora of the conjunctiva, is considered a major causative agent for conjunctivitis and blepharitis, Corynebacterium macginleyi should also be considered a possible cause of slowly progressive keratitis in patients with chronic conjunctivitis.

Correlation between Seasons, Climatic Factors and Acute Angle Closure Attack Incidence

PURPOSE@#To investigate seasonal variations in the incidence of acute primary angle closure (PAC) attack and to identify climatic factors associated with the frequency of angle closure attack.@*METHODS@#A retrospective analysis of proven cases of acute PAC attack from hospital records over a 10-year period from January 2009 to December 2018 at a tertiary hospital. The study was performed to identify and analyze sex, age on diagnosis, onset timing of symptoms. And then, compared the seasonal occurrence rates and analyzed the correlation between climatic factors and occurrence frequency.@*RESULTS@#A total of 227 patients of 227 eyes were diagnosed as acute PAC attack. There were 57 men and 170 women, mean age was 67.0 ± 9.1 years and the highest rate was in the 60s (38.3%). There was a statistically significant increase of acute angle closure attack incidence in women in winter (p = 0.002). In the case of climate factors, there was a negative correlation with the average temperature and the sunshine time (r = −0.657, p = 0.030; r = −0.583, p = 0.046, respectively). There was no significant correlation with the average humidity and the rate of sunshine (r = −0.288, p = 0.364; r = 0.021, p = 0.948, respectively).@*CONCLUSIONS@#Acute PAC glaucoma occurred more frequently in winter. Especially in women, it seems to be more affected by seasonal changes. Acute PAC attack incidence was associated with mean temperature, sum of hours of sunshine.

Loss of Reflex Tearing after Maxillary Orthognathic Surgery Case Report and Literature Review

PURPOSE@#To report a case of unilateral loss of reflex tearing after double-jaw surgery with anatomy and mechanism.CASE SUMMARY: A 32-year-old woman complained of a 3-year history of loss of tearing in her left eye. She had undergone double-jaw surgery 3 years prior to correct her malocclusion. In orbital computed tomography (CT) images, there were no specific findings, with the exception of a fractured left pterygoid plate, possibly caused by the double-jaw surgery. The tear break-up times of both eyes were similar, with non-specific findings on slit lamp examination. We diagnosed loss of reflex tearing due to pterygopalatine ganglion injury based on her history, physical examination and orbital CT findings.@*CONCLUSIONS@#Nerve damage due to artificial fracture may occur during double-jaw surgery and may result in loss of reflex tearing, thus, pre-operative evaluation of basic lacrimal secretion and a reflex tearing test are important. Once the loss of reflex tearing due to nerve injury occurrs, orbital CT scans are needed for diagnosis. Ophthalmologist examination is necessary to confirm the mechanism of loss of reflex tearing and changes in the anatomical structure.