Lactoferrin: The Natural Protector of the Eye against Coronavirus-19.

Coronavirus-19 (Covid-19), which has affected the whole world in a very short time, can infect the eye by using the Angiotensin-Converting Enzyme 2 receptor. Viral prevalence in the conjunctiva was reported to be between 3% and 16% in patients with Covid-19. Although Covid-19 has been reported to cause symptoms of conjunctivitis and rash in the eye, no complete evidence has yet been presented that the virus is transmitted from the eye. The low rate of PCR positivity in conjunctival swabs may be due to the effect of lactoferrin (LF), which is among the tear defense systems. LF, the natural protein found in tears, plays a major role in the eye's immune system. The antiviral effect of LF on the SARS-CoV pseudotype, which is in the same family as SARS-CoV-2, has been demonstrated in-vitro.

A New Matrix Therapy Agent for Faster Corneal Healing and Less Ocular Discomfort Following Epi-off Accelerated Corneal Cross-linking in Progressive Keratoconus.

PURPOSE: To investigate the hypothesis that a new matrix therapy agent (ReGeneraTing Agent, [RGTA]) would speed up the corneal reepithelialization, improve stromal healing, and reduce ocular symptoms after epi-off corneal cross-linking (CXL). METHODS: Sixty eyes of 60 patients with progressive keratoconus were enrolled in the study. Epi-off accelerated CXL was performed in all patients. Sixty eyes were randomized into two groups according to use of RGTA eye drops prior to contact lens fitting at the end. Identical medical agents were started postoperatively for the two groups. All participants were monitored on 3 consecutive days after the CXL. Ocular pain, burning, stinging, tearing, photophobia, conjunctival hyperemia, and corneal healing status were evaluated. RESULTS: By day 2, 25 eyes (83.3%) with RGTA revealed complete healing compared to 4 eyes (13.3%) that revealed complete healing in the control group (P < .001). All eyes had complete corneal epithelial defect closure by day 3 in both groups. Ocular pain scores were lower in the RGTA group on days 0, 1, and 2 (all P < .05). Burning scores were lower on days 1 and 2; stinging scores on days 2 and 3; tearing scores on days 2 and 3; and photophobia on days 1 and 2 (P < .05) in the RGTA group compared to the control group. CONCLUSIONS: RGTA ophthalmic solution facilitates corneal healing by reconstructing the extracellular matrix in the wound area, leading to an earlier relief of symptoms for patients. [J Refract Surg. 2017;33(3):163-170.].

Effects of chronic smoking on color vision in young subjects.

AIM: To evaluate the effects of chronic smoking on color vision in young subjects. METHODS: This study included 91 smokers and 88 non-smokers (a total of 179 volunteers) without any ophthalmologic and systemical disorders. The subjects were between 18-40 years of age with a best corrected visual acuity (BCVA) of 20/20, normal anterior and posterior segment examinations and normal intraocular pressure. The color vision of the subjects were evaluated with Farnsworth-Munsell 100 Hue test (FMHT). The total error scores and axis calculation were performed for each subject and the results correlated. RESULTS: Mean age and the standard deviation was 28±5y in the smokers group, and 26.7±5.5y in the control group (P=0.101). Sex distribution was similar in the two groups (P=0.365). There was no significant correlation between age and FMHT total error scores (P=0.069). Median of FMHT total error scores of smokers and non-smokers were 65 and 50.50, respectively. FMHT total error scores was found significantly higher in smokers than non-smokers (P=0.004). There was no statisticaly significant difference between smoker and non-smoker groups with respect to axis ratio calculation (P=0.611). There was no significant correlation with FMHT total error scores with neither smoking duration nor number of cigarettes smoked per day (P=0.405, P=0.454, respectively). CONCLUSION: This study suggested that chronic smoking affects the color vision of young smokers but this may not be sector selective.

Overexpression of vascular endothelial growth factor receptor 2 in pterygia may have a predictive value for a higher postoperative recurrence rate.

BACKGROUND: To investigate the expression levels of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 1 (VEGFR-1) and VEGFR-2 in pterygium and to clarify the prognostic significance of these expressions in pterygia. METHODS: A total of 40 surgically excised pterygia and 9 normal conjunctivae were immunohistochemically studied applying the streptavidin-biotin method in paraffin-embedded tissue sections. Monoclonal antibodies were targeted against VEGF, VEGFR-1 and VEGFR-2 proteins. At the sixth postoperative month, the recurrence rate was graded on a scale of 1-4. RESULTS: The mean percentage of VEGF-positive epithelial cells was comparable in pterygium and normal conjunctivae. However, the pterygium group presented higher expression levels of VEGF in pterygia endothelial cells (p=0.05). In terms of VEGFR-1 expression in epithelial cells, no statistically significant difference was found between two groups (p=0.658). However, normal conjunctivae exhibited higher expression levels of VEGFR-1 in endothelial cells (p=0.002). Epithelial cells in pterygium presented higher combined scores of VEGFR-2 (87.5% and 22.2%, respectively) (p=0.013). While higher expression levels of VEGFR-2 were documented in pterygia endothelial cells, no VEGFR-2 immunoreactivity was observed in the endothelial cells of normal conjunctivae (p<0.001). Expression levels of VEGFR-2 in epithelial cells and endothelial cells were positively correlated with the postoperative recurrence grading system (p<0.001 and τ=0.627, p=0.001 and τ=0.508, respectively). CONCLUSIONS: The results suggest that VEGF may play a key role through VEGFR-2 in the pathogenesis of pterygium. Moreover, overexpression of VEGFR-2 in pterygia may have a predictive value for a higher postoperative recurrence rate.

Clinical spectrum of the pseudotumor cerebri in children: etiological, clinical features, treatment and prognosis.

OBJECTIVE: Pseudotumor cerebri (PTC) is a clinical condition characterized by signs and symptoms of increased intracranial pressure, such as headache and papilledema. Our aim was to investigate the etiological and clinical features of pseudotumor cerebri (PTC) in children. MATERIALS AND METHOD: We performed a comprehensive analysis of epidemiology, diagnostic work-up, therapy, and clinical follow-up in 42 consecutive patients. RESULTS: Totally 42 patients diagnosed with PTC [27 (64.3%) females and 15 (35.7%) males] were included in the study. The average age of the symptoms onset was 10.79±3.43 years (range from 12 months to 17 years). Obesity was found in eleven (26.2%) of them. Two of the patients had familial mediterranean fever, two of them had posttraumatic PTC. The following diseases were one patient, respectively; mycophenolate mofetil-induced PTC, hypervitaminosis A induced PTC, corticosteroid induced withdrawal due to nephritic syndrome, use of oral contraceptives, Guillain-Barre syndrome, urinary tract infection, varicella-zoster virus infection and dural venous sinus thrombosis associated with otitis media. The most common symptom was headache, recorded in 76.2% of the patients. All patients were treated medically. Three patients in our group also required a ventriculoperitoneal shunt. CONCLUSION: Pseudotumor cerebri is an avoidable cause of visual loss, both in adults and children. Pre-pubertal obese girls are more common. Medical therapy appeared to be successful in treating pediatric PTC in most patients. Nevertheless, despite adequate treatment, children can rarely experience loss of visual field and acuity; thus, prompt diagnosis and management are important.

Obstructive sleep apnoea prevalence in non-arteritic anterior ischaemic optic neuropathy.

AIMS: The aim of this study was to show the prevalence of obstructive sleep apnoea (OSA) in non-arteritic anterior ischaemic optic neuropathy (NAION). METHODS: 20 patients diagnosed with NAION were included in the study. 20 age and sex matched subjects with similar risk factors for NAION, such as diabetes mellitus (DM) and hypertension (HT), constituted the control group. All cases underwent polysomnography for investigation of the presence of OSA. Cases with an Apnoea-Hypopnoea Index >5 were accepted as having OSA. RESULTS: Mean ages of the patients and controls were 60.90±8.14 and 61.15±7.23 years, respectively. There were no significant differences between the patient and control groups in terms of age, gender, body mass index, smoking/alcohol consumption or systemic diseases. In the patient group, 85% were diagnosed with OSA compared with 65% in the control group (p>0.05). CONCLUSIONS: We found a high prevalence of OSA in patients with NAION but it was also high in the control group (p>0.05). This may be due to the fact that the two groups were matched for the same risk factors for NAION. The study indicates that OSA is not a risk factor for NAION in itself but is the contributing factor as it has effects on the vascular endothelium in DM, HT and atherosclerosis.

Changes in central corneal thickness, intraocular pressure, and oxidation/antioxidation parameters at high altitude.

BACKGROUND: The authors aimed at investigating ophthalmological changes at high altitude and correlating this with blood oxidation/antioxidation parameters. METHODS: There were 40 volunteers who participated in the study. Initial ophthalmological examinations were performed at 3543 ft (1080 m) and repeated on the following day after the participants climbed to an altitude of 9186 ft (2800 m) on Mt. Erciyes, Turkey. Venous blood samples were taken at both altitudes to evaluate total oxidative system (TOS) and antioxidative system (TAS) levels. RESULTS: IOP-right eyes at 3543 ft (1080 m) was 13.23 +/- 0.43 mmHg and significantly increased to 14.45 +/- 0.56 mmHg at 9186 ft (2800 m). LOP-left eyes at 3543 ft (1080 m) was 13.50 +/- 0.44 mmHg and increased to 14.13 +/- 0.54 mmHg at 9186 ft (2800 m) (P = n.s.). Central corneal thickness (CCT) of the right eyes was 540.98 +/- 4.34 microm at 3543 ft (1080 m) and significantly increased to 549.73 +/- 4.59 microm at 9186 ft (2800 m). CCT of the left eyes was 542.13 +/- 29.01 microm at 3543 ft (1080 m) and significantly increased to 547.23 +/- 4.59 microm at 9186 ft (2800 m). Spherical equivalent refraction of right or left eyes did not show any significant changes. TOS at 3543 ft (1080 m) was 5.33 +/- 0.76 micromol H2O2 equiv/L and significantly increased to 7.55 +/- 0.82 micromol H2O2 equiv/L at 9186 ft (2800 m). TAS at 3543 ft (1080 m) was 2.45 +/- 0.12 micromol H2O2 equiv/L and decreased to 2.22 +/- 0.08 micromol H2O2 equiv/L (P = n.s.) at 9186 ft (2800 m). There was a positive correlation between TAS and LOP at 9186 ft (2800 m). CONCLUSION: Increased CCT can be related to stromal edema caused by hypoxia's effect on corneal endothelial function. Although TOS increased at high altitude, TAS did not show any parallel increase. Since this was nonacclimatized climbing, the antioxidant system could not have reached sufficient levels to counterbalance the observed oxidant stress.

Orbital apex syndrome in herpes zoster ophthalmicus.

Orbital apex syndrome is a rare manifestation of Herpes Zoster Ophthalmicus. Herein we report on a case of orbital apex syndrome secondary to Herpes Zoster Ophthalmicus. A 75 year-old male complained of vision loss, conjunctival hyperemia and proptosis on the left eye, was referred to our clinic. Visual acuity was 5/10 Snellen lines and he had conjunctival hyperemia, chemosis, minimal nuclear cataract and proptosis on the left eye. A diagnosis of orbital pseudotumor was demonstrated firstly. The patient received oral and topical corticosteroids, antiinflammatory and antibiotic agents. On day 2, vesiculopustular lesions were observed, Herpes Zoster Ophthalmicus was diagnosed and corticosteroid treatment stopped, oral acyclovir treatment initiated. Two days later, total ophthalmoplegia, ptosis and significant visual loss were observed on the left. The diagnosis of orbital apex syndrome was considered and the patient commenced on an intravenous acyclovir treatment. After the improvement of acute symptoms, a tapering dose of oral cortisone treatment initiated to accelarate the recovery of ophthalmoplegia. At 5-month follow-up, ptosis and ocular motility showed improvement. VA did not significantly improve because of cataract and choroidal detachment on the left. We conclude that ophthalmoplegia secondary to Herpes Zoster Ophthalmicus responds favourably to intravenous acyclovir and steroids.

The change in ocular higher-order aberrations after pterygium excision with conjunctival autograft: a 1-year prospective clinical trial.

PURPOSE: To investigate the effects of pterygium excision with conjunctival autograft plus corneal polishing on ocular higher-order aberrations (HOAs) and to monitor the changes throughout the first postoperative year. METHODS: A total of 18 eyes of 16 patients with primary pterygium who had an indication for surgical excision were included in the study. All patients underwent a detailed ophthalmologic examination preoperatively and at the third and twelfth postoperative months. Pterygium excision with conjunctival autograft plus corneal polishing was performed by the same surgeon (K.G.). Corneal topography and ocular HOAs were measured by NIDEK optical path difference scanning system ARK-10000 refractive power/corneal analyzer. RESULTS: Root mean square values of total aberrations and total HOAs were found to be significantly decreased both at 3 and 12 months after an uneventful pterygium surgery. Although solely root mean square values of coma and trefoil revealed a statistically significant reduction in the third postoperative month (P=0.043 and P=0.018, respectively), after 1 year, all parameters (total coma: P<0.001; total trefoil: P=0.004; total quatrefoil: P=0.010; and total high astigmatism: P=0.016) except for total spherical aberration (P=0.236) were found to be lower when compared with the preoperative values. CONCLUSION: Uneventful pterygium excision with conjunctival autograft plus corneal polishing can significantly reduce most of the pterygium-induced HOAs. Moreover, the reduced postoperative aberrations continue to change beyond the early postoperative period even into the 1-year postoperative period. Therefore, any refractive procedures should be postponed at least 1 year after the pterygium surgery until corneal stability occurs.

Corneal endothelial characteristics and central corneal thickness in a population of Turkish cataract patients.

OBJECTIVES: The aim was to assess corneal endothelial characteristics and central corneal thickness (CCT) in a population of Turkish cataract patients and to define the impact of age and gender on these parameters. METHODS: Five hundred and seventeen cataract patients were examined with noncontact specular microscope preoperatively. The eye planned to be operated was selected for analysis. The parameters measured were endothelial cell density (ECD), cell area (CA), coefficient of variation (CV) of the CA, percentage of hexagonal cells (PHCs), and CCT. RESULTS: The mean values in ECD, CA, CV, PHC, and CCT in all eyes were 2,258 ± 474 cells per square millimeter, 468 ± 130 µm(2), 39%±7%, 49%±12%, and 500 ± 37 µm, respectively. Regression analysis revealed a statistically significant decrease in ECD (R=-0.169, P<0.0001), increase in CA (R=0.186, P<0.0001), and decrease in the CCT (R=-0.122, P=0.006) with increase in age. The changes in the CV (R=0.008, P=0.861) and PHC (R=-0,060, P=0.177) were not found to be dependent on age. The parameters showed no sex differences. The number of eyes with ECD below 1,000 and 2,000 cells per square millimeter was 5 (0.97%) and 130 (25.1%), respectively. CONCLUSIONS: The data from our study emphasize that age, but not gender, is the main determinant of ECD.

The results of electrophysiological tests in unilateral extensive peripapillary myelinated nerve fibers: report of three cases.

The purpose of this study is to describe clinical and electrophysiological findings of three patients with unilateral extensive peripapillary myelinated nerve fibers. Three patients with unilateral extensive peripapillary myelinated nerve fibers were examined. A complete ophthalmologic examination including uncorrected and best spectacle corrected visual acuities (UCVA, BSCVA) on Snellen charts, dilated fundoscopy, fundus fluorescein angiography (FFA), optical coherence tomography (OCT), perimetry and electrophysiological tests was performed. ERG results of both eyes were normal in all cases. FFA showed hypofluorescence at the myelinated nerve fibers (MNF) area in the affected eyes. We found a visual field defect resembling arcuat scotom at perimetry of the affected eyes. In OCT, there was hyper-reflectivity in reply to MNF. In all cases, pattern ERG results of the affected eyes showed decreased amplitudes and increased latencies of P50 and N95 waves. P100 amplitudes of PVER and FVER were decreased, and latencies were increased in all affected eyes. Extensive peripapillary myelinated nerve fibers may cause changes in PERG and VER.

Evaluation of ocular surface damage and dry eye status in chronic hepatitis C at different stages of hepatic fibrosis.

PURPOSE: The purpose of this study was to explore changes in ocular surface and tear function parameters in chronic hepatitis C at different stages of hepatic fibrosis. METHODS: Fifty-four patients with biopsy-proven chronic hepatitis C and 54 age- and sex-matched healthy control subjects without systemic hepatitis C infection were examined with the Ocular Surface Disease Index questionnaire, Schirmer with and without anesthesia, tear film breakup time, and scoring of ocular surface Lissamine green staining using modified Oxford and van Bijsterveld scoring systems and corneal fluorescein staining. RESULTS: Patients with chronic hepatitis C scored significantly worse than the control subjects on all parameters: modified Oxford scores of Lissamine green staining (5.5/3.0; P <0.001), Oxford and van Bijsterveld scores (4.0/2.0; P <0.001), and corneal fluorescein staining (1.5/0.0; P = 0.001). The chronic hepatitis C group also had higher Ocular Surface Disease Index scores than the control subjects (22.3/13.7; P = 0.001). Schirmer with and without anesthesia and tear film breakup time scores were found to be lower in patients with chronic hepatitis C (P <0.001). Moreover, patients with advanced stages of hepatic fibrosis (stages 4-6) had significantly lower values of tear film breakup time and worse Ocular Surface Disease Index scores and ocular surface vital dye staining than those with initial stages of hepatic fibrosis (stages 0-3). CONCLUSION: Patients with chronic hepatitis C, especially those with advanced stages of hepatic fibrosis, were more likely to exhibit severe ocular surface damage and signs of dry eye.

Topical cyclosporine A as a steroid-sparing agent in steroid-dependent idiopathic ocular myositis with scleritis: a case report and review of the literature.

OBJECTIVE: To report on a case of idiopathic orbital myositis with scleritis that was effectively controlled with topical 0.05% cyclosporine A and to provide a review of the literature on the treatment of ocular myositis with scleritis. METHODS: A case report. RESULTS: A 35-year-old woman presented with a longstanding history of intractable periorbital pain, redness on her left eye, and diplopia during ocular movement. Her medical history revealed that she had the same symptoms for 5 years and had used numerous prescribed medications for migraine and ocular myositis. During this period, her symptoms and signs had been lessened on systemic steroid treatment, which recurred or worsened after discontinuing or tapering the therapy. Magnetic resonance imaging scans demonstrated an isolated enlargement of the left medial rectus muscle. Laboratory examination results showed no evidence of dysthyroid ophthalmopathy or another systemic disease. Because of adverse affects of systemic corticosteroid and cyclosporine treatments, topical cyclosporine A (0.05%) and dexamethasone were administered four times daily. The patient continued to use topical 0.05% cyclosporine A for 6 months. Using only topical cyclosporine A, she currently has no recurrences of disease on the last examination after 6 months of treatment. Moreover, magnetic resonance imaging revealed a completely normal extraocular muscle configuration. CONCLUSIONS: Topical 0.05% cyclosporine A may be a safe and effective long-term treatment of ocular myositis and scleritis. It should be considered as a steroid-sparing agent, particularly in recurrent disease and in those patients who experience adverse effects of systemic medications.

Pattern electroretinographic recordings in eyes with myopia.

PURPOSE: Pattern electroretinography (PERG) is a specific test for the analysis of functions of the central retina. In this study, we investigated the PERG recordings in subjects with myopia. SUBJECTS AND METHODS: This study was performed on 1 eye of 80 subjects with varying degrees of myopia. Four groups were formed according to the refraction values: group 1: between 0.00 and -0.75 diopter (D); group 2: between -1.00 and -3.00 D; group 3: between -3.25 and -6.00 D; and group 4: between -6.25 and -10.00 D. Amplitudes and latencies of transient PERG P50 and N95 waves were recorded in all subjects. RESULTS: P50 and N95 wave amplitudes were lower in higher myopes (groups 3 and 4) when compared with lower myopes (groups 1 and 2; P<0.001). The amount of loss in P50 amplitude was 8% in group 2, 16% in group 3, and 36% in group 4 when compared with group 1. The amount of loss in N95 amplitude was 7% in group 2, 21% in group 3, and 43% in group 4 when compared with group 1. Although P50 wave latencies showed no difference between groups, N95 wave latencies were increased in higher myopes. The elongation in N95 wave latency in group 4 was 3.08 ms. CONCLUSIONS: Increased axial length may contribute to the decrease in PERG amplitudes in our study. PERG recordings must be carefully evaluated when the group in any study that involves myopic subjects.

Pattern electroretinographic results after photodynamic therapy alone and photodynamic therapy in combination with intravitreal bevacizumab for choroidal neovascularization in age-related macular degeneration.

PURPOSE: To evaluate the changes in pattern electroretinography (PERG) 1 month after photodynamic therapy alone and photodynamic therapy in combination with intravitreal bevacizumab for choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). METHODS: This is a prospective series of 45 eyes with subfoveal CNV secondary to AMD. Twenty eyes were treated with photodynamic therapy (PDT) with verteporfin and 1.25 mg of intravitreal bevacizumab, and 25 patients were treated with PDT alone. Visual acuities and serial PERG recordings were performed both before and 1 month after therapy. RESULTS: Following the 1-month therapy period, visual acuity improved in 56% of patients in the PDT group and 76% of patients in the combination group. No significant ocular or systemic adverse effects were observed in either group. According to the PERG results, the mean P50 amplitude was 1.5 +/- 0.9 microV before PDT and improved to 2.1 +/- 1.1 microV at 1 month after PDT. The mean P50 amplitudes in the combination therapy group before and after therapy were 1.6 +/- 0.8 microV and 2.7 +/- 1.2 microV, respectively, and the difference was statistically significant between the groups. CONCLUSIONS: In this small series of eyes with limited follow-up, the combined treatment of PDT with verteporfin and intravitreal bevacizumab seems to be associated with improvement in VA and pattern electroretinographic results when compared to those in the PDT group.

Invasive squamous cell carcinoma of the conjunctiva first misdiagnosed as a pterygium: a clinicopathologic case report.

PURPOSE: To describe the clinical findings of a patient who initially underwent surgery for a pterygium and who was finally diagnosed with invasive squamous cell carcinoma, and to determine the necessity and importance of pathologic investigation in all cases of a presumed pterygium. METHODS: A case report. RESULTS: A 63-year-old man was referred for severe pain, redness, and purulent secretion in his right eye. A year earlier, he had undergone excision of a pterygium in his right eye by a bare sclera technique without any adjunctive antimetabolite in a private eye clinic. Furthermore, 6 months after this operation, he had undergone autologous conjunctival graft surgery because of dehiscence of the surgical site. His visual acuity was only light perception in the right eye. Slitlamp biomicroscopy showed severe nasal corneoscleral melting, purulent secretion, conjunctival hyperemia, corneal edema, hypopyon, intracamaral hemorrhage, and lid swelling. Ultrasonography showed a right hypoechoic mass invading the nasal part of the globe and a totally detached retina. Orbital magnetic resonance imaging showed a large (2 cm in diameter), irregular, lobulated mass invading the globe in the medial part of the right orbit. Results of a biopsy were consistent with squamous cell carcinoma. Because of the extensive intraocular involvement at the time of the diagnosis, subtotal orbital exenteration was performed. CONCLUSIONS: All pterygia should be evaluated meticulously with regard to possible underlying causes, such as carcinoma in situ or squamous cell carcinoma, and all excised lesions should also be evaluated pathologically to prevent such serious adverse outcomes that are mentioned in this case report.

Ocular blood flow in patients with obstructive sleep apnea syndrome (OSAS).

BACKGROUND: Sleep-related disorders are among the important risk factors for neurovascular diseases. Obstructive sleep apnea syndrome (OSAS) is characterized by snoring, excessive daytime sleepiness, and insomnia. Our aim was to investigate the presence of glaucoma in patients with OSAS and to reveal vascular pathology related to the pathogenesis of glaucoma in those patients. PATIENTS AND METHODS: The study included 31 patients with OSAS and 25 control subjects. Orbital Doppler ultrasonography was used to determine the resistivity index (RI) in the ophthalmic artery and central retinal artery. All patients and controls underwent perimetric examination. RESULTS: The prevalence of glaucoma in the group of patients with OSAS was 12.9% (4/31); all of these 4 patients with glaucoma were in the "severe" OSAS group. No statistically significant difference was found between ophthalmic artery resistivity index (OARI), central retinal artery resistivity index (CRARI), and intraocular pressure (IOP) between patients and controls (p > 0.05). There was a positive correlation between OARI and mean defect (MD), CRARI and MD, and CRARI and loss variance (LV) values (p < 0.05). There was also a positive correlation between IOP and the apnea-hypopnea index (AHI) (p = 0.001). CONCLUSIONS: In patients with OSAS, a high prevalence was found and it is interesting to note that all of the four glaucoma patients were in the severe OSAS group. The positive correlation observed between IOP and AHI suggests that increased IOP values may reflect the severity of OSAS. The positive correlation between OARI and MD and also between CRARI and MD as well as LV suggests that visual field defects may be due to optic nerve perfusion defects and these field defects also increase as the RI increases.

Corneal injury from a metallic foreign body: an occupational hazard.

PURPOSE: To describe a patient with a corneal injury from a metallic foreign body caused by negligence, and to highlight the importance of measures that must be taken to prevent corneal injuries. METHODS: A 21-year-old man experienced a foreign body sensation, pain, and redness in his left eye after he cut some iron material without using any eye protection. Slitlamp examination showed a thin, curled piece of iron material stuck into the cornea horizontally. The nasal part had penetrated the nasal tarsal conjunctiva below the upper lid. RESULTS: After removal of the foreign body, the cornea healed without scarring after a short follow-up. CONCLUSIONS: A corneal foreign body is a common cause of ocular morbidity and loss of working hours. Most workers do not use protective eyewear during work. By consistently wearing proper safety eyewear, which is the easiest and most effective preventive measure, loss of sight can easily be prevented after an eye injury.

Multifocal electroretinogram for assessing sun damage following the solar eclipse of 29 March 2006: multifocal electroretinography in solar maculopathy.

AIM: To evaluate the clinical findings and multifocal electroretinography results of cases with solar maculopathy due to eclipse watching. PATIENTS AND METHOD: Eight eyes of six patients (ages ranged 12-42) who presented to our clinic after the solar eclipse of 29 March 2006 were evaluated in the study. All patients underwent a full ophthalmologic examination and multifocal electroretinography (mfERG). RESULTS: Visual acuities at the initial examination were between 20/32 and 20/20; and at final examination between 20/25 and 20/20 respectively. Fundoscopic examination disclosed macular pigmentary changes in almost all patients. Fundus Fluorescein Angiography revealed a window defect in six eyes. The initial findings of the mfERG at the first visit showed a decrease in the P1 and N1 amplitudes of the central responses. The following mfERG recordings showed a recovery in central P1 and N1 amplitudes. CONCLUSION: Decrease in P1 and N1 amplitudes of central macular region can be detected by mfERG in patients with solar maculopathy. Follow-up mfERG test results may recover with the increase of visual acuity.

Nasolacrimal endometriosis. A case report.

Endometriosis is the presence of endometrial tissue outside of the uterine cavity. In this paper, we present a patient with nasolacrimal system endometriosis which is a rare clinical condition.