A comparison of NCT, Goldman application tonometry values with and without fluorescein.

PURPOSE: The aim of the study was to statistically compare intraocular pressure (IOP) values measured using noncontact tonometer (NCT), Goldmann applanation tonometry (GAT) with fluorescein (fGAT), and GAT without fluorescein (nGAT). The study was also performed to test whether the values obtained using each technique change in accordance with the central corneal thickness (CCT) and refractive and keratometric values. STUDY DESIGN: This study was a prospective study of 188 eyes of 94 healthy volunteers. Methods: IOP was measured using fGAT, nGAT and NCT. CCT, refractive values, and keratometric values were measured, and the correlations and differences in the IOP for each tonometer were investigated. RESULTS: The mean IOP values obtained with the NCT, nGAT, and fGAT were 17.5±3.7, 12.3±2.7, and 12.5±2 mmHg. The mean CCT was 538.2±34.4 µm, the mean refractive value was 0.9±1.2 D, and the mean keratometric value was 43.5±1.5 D. NCT was positively correlated with fGAT and GAT values and was significantly higher than both the values. There were no differences between fGAT and GAT values. No correlation was observed between the CCT and keratometric and refractive values and the difference between NCT and nGAT or fGAT. CONCLUSION: Differences in the measurements obtained using nGAT and fGAT were insignificant (P>0.05). Both values were positively correlated with NCT measurements (r =0.354, P<0.05) and were independent of CCT, keratometry, and refraction values. nGAT appears to be suitable for use in routine clinic practice.

Cervicofacial emphysema following unilateral external dacryocystorhinostomies: A case report.

Cervicofacial emphysema (CFE), mostly seen after trauma or dental procedures, is an unexpected, extremely rare condition after uncomplicated dacryocystorhinostomy (DCR). It may be misdiagnosed as angioedema or necrotizing fasciitis. In this article, we present the case of a 40-year-old female with CFE twice after uncomplicated unilateral DCR for left and right sides on different operative days. CFE was confirmed by computed tomography, demonstrating extensive air within subcutaneous tissues of the face, neck, and orbital cavity. Subcutaneous crepitation supported the diagnosis. This is the first case report, to the best of our knowledge, describing a patient with recurrent massive CFE after each unilateral DCR.

Association of extensive myelinated nerve fibers and high degree myopia: case report.

Unilateral extensive myelination of the peripapillary nerve fibers may be associated with anisometropic myopia, strabismus, and reduced vision. Myelination of optic nerve fibers terminate at lamina cribrosa. Yet in some patients, myelination progresses into the peripapillary retinal nerve fibers and may affect the visual acuity. In this report, we described 4 patients. All patients presented extensive peripapillary myelinated nerve fibers associated with myopic anisometropia. After routine ophthalmic and orthoptic examinations, all patients underwent treatment for amblyopia through correction with spectacles, contact lenses, and the occlusion of the good eye. Corrected visual acuity improved in 1 patient, but 3 patients had no increase in visual acuity despite treatment with full cycloplegic refraction and appropriate patching. Probably because of structural abnormalies of the macula, visual results are often disappointing with appropriate correction of the refractive error and occlusion.

Refractive errors of medical students in Turkey: one year follow-up of refraction and biometry.

PURPOSE: This study was conducted to determine the prevalence of refractive errors in Turkish medical students as well as to determine the change in refractive status of medical students within 1 year. Besides general refractive characteristics of the students, the possible relationship between the occurrence of myopia and several factors was also determined. METHODS: Two hundred and seven medical students (114 female/93 male) were checked for their refractive status as determined by cycloplegic autorefraction. In addition to keratometric and biometric measurements students also answered a detailed questionnaire. One year later, medical students who participated to the study were re-examined. RESULTS: Myopia occurred in 32.9% of medical students with low myopia (spherical equivalent between -0.75 diopters [D] and -2.99 D) being the most common type (81%). The frequency of myopia was not significantly different between female and male medical students (37.7 and 26.8%, respectively; p=0.13). Adult onset myopia (onset at age 18 years or older) comprised 14.7% of all myopia cases. Myopic students were significantly more likely to report parental myopia. The percentage of myopes and nonmyopes reporting having one or two myopic parents was 51.5 and 28.8%, respectively (p=0.002). Parental myopia was also an independent risk factor associated with the occurrence of myopia on multivariate analysis (odds ratio [OR]=3.69, 95% confidence interval [CI]=1.98-6.87). Nonmyopes also reported a significantly higher prevalence of outdoor activity before and at age seven (68.4%) than did myopes (48.6%), (p=0.009). Outdoor activity during early childhood was found to be protective for myopia on multivariate analysis (OR=0.44, %95 CI=0.23-0.82). There was no significant difference between myopes and nonmyopes with respect to amount of close-up activity. No significant shift of refraction occurred within 1 year. CONCLUSIONS: About one-third of Turkish medical students had myopia. Parental myopia was more common among myopic students and was a risk factor for the occurrence of myopia suggesting a familial predisposition. Outdoor activity in early childhood has had a protective role against the development of myopia in this study sample.