The Management of Refractory Dry Eye With Semi-Scleral Contact Lens.

We presented a case of refractory dry eye management with semi-scleral contact lens. Dry eye was associated with facial nerve (cranial nerve VII) palsy as a result of cerebellopontine angle tumor surgery. She was treated with several topical treatments and punctal plug. Despite the treatments, her symptoms still persisted. Her ophthalmic examination revealed scleral exposure because of lagophthalmos, conjunctival hyperemia, corneal debris, scar, and diffuse punctate epitheliopathy on her right eye. Lissamine green staining showed diffuse conjunctival and corneal staining. Therapeutic semi-scleral lenses were fitted. The corneal findings were resolved and the quality of patient life was improved with the aid of semi-scleral lens after 3 months.

Effect of ocular compression on intraocular penetration of systemic ofloxacin.

Intraocular levels of ofloxacin are documented after topical and systemic administration, but systemic administration of ofloxacin in ocular compression has not yet been studied. This study was undertaken to determine the intraocular penetration of systemic ofloxacin into aqueous and vitreous humor after the application of ocular compression in rabbit eyes. Ocular compression with the Honan balloon was applied for 30 min to the right eyes of 11 albino New Zealand white rabbits. After the application of ocular compression, 2 mg/mL of ofloxacin was administered intravenously. Samples from aqueous and vitreous humor were collected 30 min after infusion. Ofloxacin concentrations were determined through high-performance liquid chromatography. The mean aqueous level of ofloxacin was significantly higher in the compression group (2.40+/-1.00 microg/mL) than in the no-compression group (1.61+/-1.06 microg/mL) (P<.05). The mean vitreous concentrations of ofloxacin were 0.70+/-0.33 microg/mL and 0.50+/-0.18 microg/mL in the compression and no-compression groups, respectively. A significant difference was observed between vitreous levels of ofloxacin in the compression and no compression groups (P<.05). Ocular compression enhanced the penetration of ofloxacin in both aqueous and vitreous humor. The drug level in the aqueous humor was sufficient for the minimum inhibitory concentration for 90% of isolates (MIC90) to inhibit most microorganisms. Although the mean vitreous ofloxacin concentration was increased by previous ocular compression, it was not sufficiently above the MIC90 for most ocular pathogens that caused endophthalmitis.

Acquired retraction of the eye as the first sign of myositis.

The authors report a patient who was diagnosed with idiopathic orbital myositis based on the findings of diplopia, worse on right gaze, globe retraction on adduction and injection at the lateral muscle tendon insertion of the left eye. Although orbital myositis as a cause of acquired retraction of the eye is rare, they wish to emphasize the importance of globe retraction with injection over the recti as an important clue for the diagnosis of orbital myositis.

Phototherapeutic keratectomy in Schnyder crystalline corneal dystrophy.

OBJECTIVE: To emphasize the effectiveness of phototherapeutic keratectomy (PTK) in a patient with Schnyder crystalline corneal dystrophy (SCCD). METHODS: Case report. RESULTS: Two eyes of a patient with SCCD underwent PTK. Best corrected visual acuity (BCVA) increased from 2/10 to 8/10 (plano/-1.50 x 10) in the right eye in a lit room. BCVA of the left eye was 4/10 (-8.00/-1.50 x 170) and did not change after treatment because of anisometropic amblyopia. No recurrence was detected after 68 months of follow-up. CONCLUSION: PTK may be effective in the treatment of SCCD, especially if the crystals are the cause of visual disturbance.

Synthesis and characterization of polymeric linseed oil grafted methyl methacrylate or styrene.

Syntheses of wholly natural polymeric linseed oil (PLO) containing peroxide groups have been reported. Peroxidation, epoxidation and/or perepoxidation reactions of linseed oil, either under air or under oxygen flow at room temperature, resulted in polymeric peroxides, PLO-air and PLO-ofl, containing 1.3 and 3.5 wt.-% of peroxide, with molecular weights of 2 100 and 3 780 Da, respectively. PLO-air contained cross-linked film up to 46.1 wt.-% after a reaction time of 60 d, associated with a waxy, soluble part (PLO-air-s) that was isolated with chloroform extraction. PLO-ofl was obtained as a waxy, viscous liquid without any cross-linked part at the end of 24 d under visible irradiation and oxygen flow. Polymeric peroxides, PLO-air-s and PLO-ofl initiated the free radical polymerization of both methyl methacrylate (MMA) and styrene (S) to give PMMA-graft-PLO and PS-graft-PLO graft copolymers in high yields with Mw varying from 37 to 470 kDa. The polymers obtained were characterized by FT-IR, (1)H NMR, TGA, DSC and GPC techniques. Cross-linked polymers were also studied by means of swelling measurements. PMMA-graft-PLO graft copolymer film samples were also used in cell-culture studies. Fibroblast cells were well adhered and proliferated on the copolymer film surfaces, which is important in tissue engineering.

Ophthalmologic abnormalities in children from a Turkish school for the deaf.

The aim of this study was to determine the nature and prevalence of ophthalmologic abnormalities in deaf children. Complete ophthalmologic examinations were performed on 104 children aged 7 to 20 years from a Turkish school for the deaf. Of 104 children, 42 children (40.4%) had some form of ophthalmologic abnormality, with the vast majority (31 patients, 29.8%) being refractive errors. The prevalence of hypermetropia, myopia and astigmatism was found to be higher over the general population. Of 104 children, 19 (18.2%) had ocular motility disturbances and one had external adnexal anomaly. Two (1.8%) children had anterior segment and nine (8.6%) children had posterior segment pathologies. Routine ophthalmologic examinations should be carried out in this population because deaf children use sight to compensate for hearing problems. Ophthalmologists play an important role in the diagnosis and correction of ophthalmologic abnormalities.

Oculomotor palsy with cyclic spasms: a case report.

Oculomotor palsy with cyclic spasms is a rare, non-progressive disorder in which the muscles innervated by the third cranial nerve undergo alternating rhythmic spasm and paralysis. An 18-year-old male was referred with left upper eyelid ptosis present since birth. On examination we noted cyclic movements of the left eyelid and pupil. The cycle consisted of periods of ptosis and mydriasis alternating with eyelid retraction with miosis. The interpalpebral fissure measured 2 mm in the paralytic phase and 11 mm in the spastic phase. The pupil diameter varied from 3 mm to 6 mm. Six cycles were observed in 5 minutes. The patient had no voluntary control over his left eyelid, nor over the other muscles innervated by the third nerve. The affected eye was deeply amblyopic and exotropic. Systemic evaluation and cranial MRI gave normal results. A therapeutic trial with oral baclofen (30 mg/day), a central muscle relaxant drug, was ineffective in suppressing the cyclic movements.

The effects of atorvastatin and rosuvastatin on oxidative stress in diabetic patients.

AIM: Diabetes is associated with abnormalities in lipid profile and increased oxidative stress. Statins are preferred agents in diabetic patients due to their antioxidant and LDL-C lowering effects. This study is designed to compare the effects of atorvastatin and rosuvastatin on low density lipoprotein cholesterol (LDL-C), lipid hydroperoxide (LOOH), total oxidant status (TOS) and total antioxidant capacity (TAC) in diabetic patients with hyperlipidemia. MATERIALS AND METHODS: Sixty two patients who have type 2 diabetes mellitus with serum LDL levels more than 100mg/dL were randomly assigned to receive atorvastatin 20mg (n=31) or rosuvastatin 10mg (n=31). Blood tests were performed at the beginning of the study and after three months. RESULTS: There were no statistically significant differences in the pre- and after treatment levels of the LDL-C between groups. TAC values were increased in both groups and statistically significant in the former group (p=0.007). There was no difference between the change percentages ((after treatment TAC-pretreatment TAC)/pretreatment level) of TAC between two treatment groups. The effects of two drugs on the other oxidative parameters were not significantly different. CONCLUSION: Both atorvastatin and rosuvastatin may be helpful in reducing increased oxidative stress in diabetic patients with hyperlipidemia.

The effects of sildenafil on ocular blood flow.

PURPOSE: To investigate the effects of sildenafil, a popular new drug in the treatment of erectile dysfunction, on ocular blood flow. METHODS: This study was designed as a prospective, double-blind, placebo-controlled study. Twenty participants with erectile dysfunction were given a single oral dose of 100 mg sildenafil, while 10 participants with erectile dysfunction were given placebo. All the participants underwent routine systemic and ophthalmological examinations. Intraocular pressure, systolic and diastolic blood pressure and ocular blood flow (ophthalmic, central retinal, short posterior ciliary arteries) were measured in both eyes before and 1 hour after the dose of sildenafil or placebo. Ocular blood flow measurements were performed using colour Doppler ultrasonography. RESULTS: None of the parameters were significantly different between the groups before study drug intake. Although central retinal artery velocities were not changed, ophthalmic artery and short posterior ciliary artery peak systolic velocity, end-diastolic velocity, and mean velocity values were significantly increased 1 hour after drug intake in the sildenafil group compared to the placebo group (p < 0.05). CONCLUSION: Sildenafil causes a significant increase in blood flow in these arteries. A possible role of inhibition of phosphodiesterase-5 in vascular smooth muscles by sildenafil is implicated. Further studies are needed to investigate the effects of sildenafil on ocular blood flow in patients with senile macular degeneration, diabetic retinopathy and glaucoma.

Fine mapping of the Schnyder's crystalline corneal dystrophy locus.

Schnyder's crystalline corneal dystrophy (SCCD) is a rare autosomal dominant eye disease with a spectrum of clinical manifestations that may include bilateral corneal clouding, arcus lipoides, and anterior corneal crystalline cholesterol deposition. We have previously performed a genome-wide linkage analysis on two large Swede-Finn families and mapped the SCCD locus to a 16-cM interval between markers D1S2633 and D1S228 on chromosome 1p36. We have collected 11 additional families from Finland, Germany, Turkey, and USA to narrow the critical region for SCCD. Here, we have used haplotype analysis with densely spaced microsatellite markers in a total of 13 families to refine the candidate interval. A common disease haplotype was observed among the four Swede-Finn families indicating the presence of a founder effect. Recombination results from all 13 families refined the SCCD locus to 2.32 Mbp between markers D1S1160 and D1S1635. Within this interval, identity-by-state was present in all 13 families for two markers D1S244 and D1S3153, further refining the candidate region to 1.58 Mbp.