Induced Myopia Secondary to Blunt Trauma

A 28-year-old young man presented with sudden and severe visual loss in the left eye, starting three days ago following blunt head trauma from a closed fist. Vision was not improved to better than 0.4 in the left eye. Slit lamp examinations revealed asymmetric anterior chamber depth (ACD) with shallow ACD in the left eye. The key learning in this report is the use of anterior segment optical coherence tomography (AS-OCT) to better document the anterior segment changes following the blunt trauma. AS-OCT was used to visualize the forward displacement of the iris-crystalline lens diaphragm secondary to ciliary body anterior rotation and ciliochoroidal effusion. There was a temporary myopic shift about 7.00D which resolved after 15 days

3D Printed Models for Teaching Orbital Anatomy, Anomalies and Fractures

Purpose: The aim of this study was to determine the efficacy of using 3D printing models in the learning process of orbital anatomy and pathology by ophthalmology residents. Methods: A quasi-experimental study was performed with 24 residents of ophthalmology at Mashhad University of Medical Sciences. Each stratum was randomized into two groups. The educational booklets were distributed, and various forms of orbital 3D models were printed from orbital computed tomography (CT) scans. Knowledge enhancement on the topics was measured by comparing pretest and posttest scores. Results: Thirteen residents who were trained using traditional methods were deemed the control group; while 11 residents who were trained using the 3D printed models were classed as the intervention group. The control group was younger than the intervention group (P = 0.047). The results showed that there was a statistically significant difference in the total posttest scores between the two groups. Based on the repeated measures of the analysis of variance (ANOVA), score variables were significant between the two groups (P = 0.008). Interestingly, the use of the 3D educational model was more effective and statistically significant with the year one residents as compared to the year two residents (P = 0.002). Conclusion: This study is the first one in Iran quantifying the effects of learning using 3D printed models in medical education. In fact, 3D modeling training is seemingly effective in teaching ophthalmic residents. As residents have never encountered such technology before, their experience using 3D models proved to be satisfactory and had a surprising positive effect on the learning process through visual training

The Effect of Cycloplegia on the Ocular Biometric and Anterior Segment Parameters: A Cross-Sectional Study

INTRODUCTION: To evaluate the effects of cycloplegia on the biometric components and anterior segment parameters of the eye. METHODS: In this cross-sectional study, changes to axial length (AL), anterior chamber depth (ACD) lens thickness, anterior chamber angle (ACA) and volume, corneal thickness in the pupil center (PC), corneal curvature (CC) and white-to-white (WTW) following cycloplegia induced by tropicamide 1% in 42 eyes of patients aged 23-58 years were assessed. Biometric components and anterior segment parameters were measured using an IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany) and a Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany), respectively. RESULTS: Significant statistical changes in ACD (increased by 0.06 ± 0.05 mm; p  0.05). Also, a significant inferior displacement of the PC along the vertical axes was seen (p = 0.020). CONCLUSION: Cycloplegia resulted in a deeper ACD and thinner lens thickness. These changes should be considered in determining intraocular lens (IOL) power to prevent refractive surprises in cataract surgery and also in the phakic IOL implantation

Periorbital Ecthyma Gangrenosum Due to Pseudomonas Aeruginosa Septicemia in an Infant with Sepsis: A Case Report

Purpose: This article aimed to report an infant case of congenital neutropenia (CN) with periorbital ecthyma gangrenosum (EG) due to pseudomonas aeruginosa septicemia.Case report: A previously healthy six-month-old male infant with fever, diarrhea, poor feeding, pancytopenia, periorbital swelling, and eyelid ulcers in the left eye was admitted in pediatric intensive care unit (PICU). He had positive blood and eyelid wound cultures for pseudomonas aeruginosa. He was treated with broad spectrum intravenous antipseudomonal antibiotics and debridement of periorbital lesions and discharged after 18 days with a stable condition. Adequate hematologic workup for pancytopenia revealed the diagnosis of CN.Conclusion: There is a possibility that EG be developed in patients with immunodeficiency as preseptal cellulitis with isolated typical lesions, and this should be considered in the treatment

Correlation between Interpupillary and Inner-Outer Intercanthal Distances in Individuals Younger than 20

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 </style> <![endif]--> <p>PURPOSE: To determine the correlation between interpupillary distance (IPD) and inner-outer intercanthal distance (IOICD) and to find a regression equation for calculating IPD based on IOICD measurements. METHODS: The study subjects were randomly selected from individuals aged 3 months to 20 years who were referred to our ophthalmology clinic, health care centers and children attending kindergartens. Participants were divided into 4 age categories: younger than 3, 3-5, 5-12.5 and 12.5-20 years. IPD was measured by a PD meter (PD2, Oculus, Germany); other parameters including IOICD, nasal limbus to temporal limbus (NLTL), inner intercanthal distance (IICD) and outer intercanthal distance (OICD) were measured using a translucent plastic ruler. RESULTS: The study included 254 female (60.6%) and 165 male (39.4%) subjects with mean age of 87.7±73.2 (range 3-240) months. Significant correlation was observed between IOICD and IPD in the 3-5 yr and 12.5-20 yr age groups. In the younger than 3 and 5-12.5 year age groups, NLTL had the best correlation with IPD. The regression equations for calculating IPD according to IOICD were as follows. In male subjects, near IPD= 0.941×IOICD (r²= 0.98, P < 0.001) and for female subjects, near IPD= 0.948×IOICD (r²= 0.98, P < 0.001). CONCLUSION: IPD and IOICD measurements are strongly and positively correlated; IOICD measurements are simpler to obtain and may be used to calculate IPD readings which are more difficult to measure by usual methods in children.</p> <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!--[if !mso]><object classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui></object> <style>
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Intraorbital Arteriovenous Malformation Treated by Transcatheter Embolization; a Case Report

<!--[if gte mso 9]><xml> Normal 0 false false false MicrosoftInternetExplorer4 </xml><![endif]--><!--[if gte mso 9]><xml> </xml><![endif]--> <!--[if gte mso 10]> <style>
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 </style> <![endif]--> <p>PURPOSE: To report the clinical and radiological findings and management of a patient with intraorbital arteriovenous malformation (AVM) treated by transcatheter embolization of the feeding artery. CASE REPORT: A 15-year-old female patient was referred with a one year history of left eye proptosis without prior trauma. Orbital CT scan and MRI demonstrated a large intraconal mass lesion extending to the extraconal space in the inferior orbit; angiograms revealed an intraorbital AVM. Superselective catheterization of the feeding artery and embolization with absorbable gelatin particles (Gelfoam) and non-absorbable polyvinyl alcohol particles were performed in two separate sessions followed by surgical debulking. Signs and symptoms were diminished after 14 months. CONCLUSION: Intraorbital AVMs can be treated by embolization of the feeding artery followed by surgical removal of the AVM nidus when the lesion is accessible.</p> <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Font Definitions */ @font-face {font-family:Palatino; mso-font-alt:"Book Antiqua"; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:7 0 0 0 147 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:72.0pt 90.0pt 72.0pt 90.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <style>
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Accommodative Ability in Prepresbyopic Diabetic Patients

Introduction: To compare various accommodative parameters in prepresbyopic diabetic patients with age-matched healthy individuals. Materials and Methods: Study populationconsisted of 32 younger-onset diabetic patients (30-40 years of age) and 28 age-matched healthy normal individuals. Using the best correction for distance visual acuity (20.20 by Snellen chart), multiple accommodative ability tests such as near point of accommodation, accommodative amplitude, negative or positive accommodative facility and near point of convergence were measured in both groups. Results: Mean near point of accommodation in diabetic patients was significantly greater than the control group (18.5±4.4 centimeters [cm] versus 9.5±2 centimeters, p= 0.000). Mean accommodative amplitude was (5.93±1.75) Diopter (D) and (10.95±2.16) Diopter in diabetics and normal individuals, respectively (p=0.000). Mean accommodation facility was (3.19±3.04) cycle/minute [cyl/min] in patients and 10.01±5.09 cycle/minute in the control group (p= 0.000). Mean positive relative accommodation was (–3.37±1.19) D in diabetic and (-2.11±0.99) D in healthy participants (p=0.000). Mean negative relative accommodation was lower in diabetic patients compared with the control group, however, this difference did not reach statistical significance (2.61±0.65) D versus (2.61±0.60) D, p= 0.23). Mean near point of convergence was (8.23±1.43) cm and (7.13±0.67) cm in normal and diabetic groups, respectively which had insignificant difference (p= 0.45). Conclusion: Majority of accommodative ability functions decreased in prepresbyopic diabetic patients. Early detection and rehabilitation of such patients with corrective near spectacles are strongly recommended

Pediatric photorefractive keratectomy for anisometropic amblyopia: A review

Amblyopia is one of the most important reversible eye disorders in children and different treatments are suggested. Early diagnosis and effective treatment in amblyogenic age are important criteria. These critical periods correspond to the period when the child’s developing visual system is sensitive to abnormal input caused by stimulus deprivation, strabismus or significant refractive errors. Traditional treatments such as glass wearing, contact lens used with patch therapy have limitations. Laser corneal refractive surgeries introduce an alternative for the treatment of anisometropic amblyopia. Current indications for refractive surgery include anisometropia, bilateral high myopia and accommodative esotropia. Several reports confirmed that with recent development in keratorefractive surgery, it could be a safe method to be used in children. The goal of the permanent surgical treatment is to reduce refractive errors, treat amblyopia and make better the binocular function. Corneal haze is certainly a major concern in children receiving surface ablation, especially in high myopic treatments. However, controversies still exist on whether it could be done in this population or not. This article reviews the available data about refractive surgery for treating anisometropic amblyopia