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Purpose: To describe the anatomical landmarks of the retro-caruncular approach and its clinical applications based on a cadaveric study., Patients and Method: A dissection of 8 orbits providing from 4 fresh cadavers was carried out at the anatomical laboratory of the University Hospital of Nice, France between October 2018 and January 2019., Results: Main anatomical relationships encountered are anteriorly the Duverney-Horner muscle and the lacrimal sac, posteriorly the anterior and posterior ethmoidal arteries, superiorly the pulley of the superior oblique muscle, inferiorly the lacrimonasal duct and the tendon of the inferior oblique muscle. The retro-caruncular approach allows a safe surgical access behind the lacrimal sac and Duverney-Horner muscle. Many oculoplastic surgical procedures can be performed through this approach: dacryocystorhinostomy, medial orbital fractures repair, "médial" orbital "décompression", biopsy of medial and extraconal tumours, medial periosteal fixation in third-nerve palsy., Conclusion: The retro-caruncular approach is a safe procedure avoiding skin incision. It allows a wide surgical space even if it is reduced compared to a more conventional skin route. It requires a great anatomical knowledge and a longer surgical learning curve., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Purpose: Since 2006, French general practitioners have had to carry out an ophthalmological screening for children, using a methodology contained within the child's health record (carnet de santé). The purpose of this screening is to allow an early diagnosis of sight-threatening as well as potentially life-threatening conditions (e.g., retinoblastoma). The aim of the present study was to evaluate the theoretical knowledge and the clinical skills of practitioners implementing the screening, with regards to two specific items of the health record screening schedule, by means of a questionnaire., Material and Methods: From December 2013 to September 2014, 42 practitioners (16 general practitioners, 14 pediatricians, 12 resident physicians) from four distinct locations in Normandy, France, were questioned using a questionnaire on two ophthalmological items of the French health record: one on red reflex and one on eyeball size., Results: Only four of 42 practitioners provided correct answers on the red reflex color. Thirty of 42 practitioners reported difficulties performing the red reflex test, mostly because they did not know the normality criteria and the purpose served by this test. Thirty-three of 42 practitioners declared that they found it difficult to know whether or not eyeball sizes were normal, mostly because they were unaware of the normality criteria. None of the practitioners provided the correct (to within ± 1 mm) mean horizontal cornea diameter in full-term newborns and adults., Conclusion: This study demonstrates that there is poor theoretical knowledge and a low level of clinical skill for practitioners performing the ophthalmological screening based on the French health record schedule. This schedule therefore does not seem to meet its purpose., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

The radiation dose received by the eye depends on the pathology, tumour location (ocular globe, orbit, neighboring structures) and the radiation technique. The major complication is the complete loss of vision, which is often multifactorial. This article, based on a literature review, describes the radiation effects and the tolerance doses for all eye structures: cornea, lens, retina, optic nerves, orbit and ocular adnexa., (Copyright (c) 2010 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

Leonardo da Vinci's Manuscript D consists of five double pages sheets, which, folded in two, comprise ten folios. This document, in the old Tuscan dialect and mirror writing, reveals the ideas of Leonardo on the anatomy of the eye in relation to the formation of images and visual perception. Leonardo explains in particular the behavior of the rays in the eye in terms of refraction and reflection, and is very mechanistic in his conception of the eye and of the visual process. The most significant innovations found in these folios are the concept of the eye as a camera obscura and the intersection of light rays in the interior of the eye. His texts nevertheless show hesitation, doubts and a troubled confusion, reflecting the ideas and uncertainties of his era. He did not share his results in his lifetime, despite both printing and etching being readily available to him.

Objective: To compare the angles of cyclotorsion measured by central campimetry and scanning laser ophthalmoscopy., Methods: Both methods were applied to each eye of 44 healthy volunteers, aged between 22 and 55 years. The line passing through the fovea and the center of the papilla was drawn on images from the scanning laser ophthalmoscope (SLO); the line passing through the fixing point and the center of the blind spot was drawn on the charts of the central visual field (VF). Torsion was estimated by the angle between these lines and the horizontal., Results: With the VF method, the excyclotorsion was 5.6+/-2.9 degrees on the right eye and 7.2+/-2.9 degrees on the left eye. With the SLO method, these values were 4.7+/-2.6 degrees and 6.8+/-2.5 degrees , respectively. The measures obtained with both methods correlated significantly, for the right eye and the left eye, as well as for the difference between them., Conclusion: Data were in good agreement with the literature. Though slightly greater, values obtained with the scanning laser ophthalmoscope were coherent with campimetric measures. The origin of the greater excyclotorsion of the left eye remains an open issue. This phenomenon must be kept in mind when looking for a pathological between-eye difference.

Introduction: The international literature seldom refers to eye measurements of the black African patient. Therefore, the various patterns where biometry elements are used as constituents deserve reconsideration as they may not correspond to the eye of the black patient of our region. This study provides true measurements for the black African patient in Ivory Coast. It also establishes hypotheses by extrapolating the role of measurements in pathologies such as glaucoma., Material: and method: The study included 325 eyes of 217 male and female patients. All the patients underwent ocular keratometrics and echo biometrics to measure the depth of the anterior chamber, the width of the lens, and the total axial length with the ultrascan biometer using the contact method in A echometrics., Results: The mean keratometry in women was significantly higher than in men (43.99 +/- 1.62 diopters vs 43.46 +/- 1.45 diopters). The anterior chamber was deeper in men (2.69 mm +/- 0.54 vs 2.53 mm +/- 0.48). The men's eyes were significantly longer, with an axial length of 23.26 mm +/- 1.07 vs 22.56 mm +/- 0.90., Conclusion: Significant biometric differences between men's and women's eyes, on the one hand, and between black African and white patients' eyes, on the other hand, can be observed. The reasons for these differences are several: they are natural, socioeconomic, and technical. If standard implant of a different power for black and white patients can be imagined, can we also infer that the biometrics of a black African patient predisposes him to a disorder such as glaucoma more than a white patient? Further in-depth studies could provide an answer to this question.

Purpose: The aim of this study was to determine whether eye length measurements obtained with the IOL Master (Zeiss Humphrey) before and after phakic IOL implantation would show any changes., Methods: In a prospective study, we used the IOL Master to measure optical biometry in 25 myopic eyes of 15 patients before and after phakic IOL implantation (PRL, ICL, Artisan). The differences between both axial length measurements were calculated and compared using a nonparametric Wilcoxon test., Results: The difference between the preoperative and postoperative measurements ranged from -0.16 mm to 0.06 mm and averaged -0.016 mm, which was not statistically significant (p=0.20). Both measurements correlated in a highly positive manner (r=0.999; p<0.0001). The reproducibility of the preoperative and postoperative axial length measurements was very high (coefficient of variation=0.09% and 0.07%, respectively). The precision was 26 microm for preoperative measurements and 19 microm for postoperative measurements., Conclusion: Our results showed that postoperative measurements of axial length are highly comparable to preoperative measurements and that optical biometry can achieve highly precise and reliable axial length measurements in eyes with phakic IOLs. This application becomes clinically relevant in evaluating eyes with phakic IOLs that might require cataract surgery. Hence, accurate axial length measurements in eyes with phakic IOLs will be extremely important when cataract occurs in these eyes and when the preoperative measurements are no longer available.

The role of the eyes, and more precisely that of the ommatidian pigments, in the control of daily rhythms of movement of Daphnia longispina is investigated. In the laboratory, under permanent light (LL), the pigmentary modifications observed are globally similar to those observed in situ, except in their timing, around dusk, LL cycles do not coincide with the ascent of daphnids but precede it. This is the expression of an endogenous free-running rhythm. Therefore, in D. longispina, an internal oscillator controls DVMs, which are circadian and not nycthemeral, and, in situ, illumination at dawn suffices to synchronize migrations on dark/light alternation.

Tenon's capsule is at the forefront of today's strabismus news. Its function as a muscle pulley was recognized by Tenon himself in 1806. Neiger, then Koornneef, and more recently Demer gave a more modern description of Tenon's capsule. The anterior or muscular part is made up of collagen, elastic, and smooth muscle fibers. It forms a sleeve around extraocular muscles from the Tenon foramen to their scleral insertion. Directly in front of the foramen, it includes a zone of strong capsular-muscular adherence, which is also solidly suspended by ocular suspension system to the periosteum of the orbit; the intermuscular membrane consolidates the adherence zones of the rectus muscles. The posterior part is simply a condensation of collagenous fibers. The function of Tenon's capsule is essential. At the place where it adheres to the muscles, the sleeve that it forms around the muscles plays the role of a pulley diverting the muscle's path, with the pulley representing the proximal functional insertion of the muscle. The position of a rectus muscle's pulley is stable during ocular movements perpendicular to the axis of this muscle because of the transversal and radial fastening of the capsular-muscular adherence zone. During movements along the muscle axis, the pulley moves with the ocular globe. In fact, it is positioned actively to accompany the ocular globe's movements. The anomalies of these pulleys can contribute to or be responsible for an extraocular muscle imbalance: a position anomaly, an instability, a displacement, or a pathological adherence of one pulley can be the cause. Surgery of Tenon's pulley has always been an integral part of extraocular muscle surgery. Any intervention on the muscular level involves, to a lesser or greater extent, the operated muscle's pulley. Different examples demonstrate this.

Purpose: To evaluate the accuracy and reproducibility of iridocorneal angle measurement obtained with a slit-lamp method (Orbscan)., Methods: The iridocorneal angle was measured in 100 normal eyes of 50 patients using the Orbscan II device. Angles were measured in eight meridians using both the "plane" and "polynomial" modes. For each eye, two exams were taken successively and the reproducibility was calculated by analyzing the difference between both measurements. Angle value was correlated with subjective spherical equivalent and other biometric measurements obtained by Orbscan (i.e., anterior chamber depth, axial length, corneal diameter)., Results: Reproducibility of the angle measurement was significantly better with the plane mode than with the polynomial mode (5.4%+/-4.7 versus 7.2%+/-6.2; p<0.001). Reproducibility significantly varied with localization (p<0.001). Significant differences were found between reconstruction modes (49.3 degrees +/-4.6 degrees for plane mode versus 42.8 degrees +/-6.7 degrees for the polynomial mode; p<0.001) and according to localization (p=0.02). Correlation with the other biometric measurements was higher for the plane mode than for the polynomial mode. Angle measurement with the plane mode showed significant correlation with subjective spherical equivalent (r(s)=-0.59; p<0.001), the anterior chamber depth measurement (r(s)=-0.74; p<0.001), the axial length measurement (r(s)=-0.34; p<0.002), and the corneal diameter measurement (r(s)=-0.34; p<0.002)., Conclusion: The iridocorneal angle measure obtained with the plane mode showed high reproducibility and it significantly correlated with clinical parameters. It appears to be useful for clinical application.

A morphofunctional analysis of the bill apparatus was conducted on some African forest flycatchers (Muscicapidae, Platysteiridae, Monarchidae) in relation to detailed eco-ethological data available on these species. The aim was to evaluate relationships between anatomical structures and habitat constraints and also identify the most pertinent trophic adaptations. If forest Muscicapidae have essentially conserved the generalized passerine structures and occupy open-habitat niches in the forest, Platysteiridae and Monarchidae have adapted to forest conditions and show a key-adaptation based on specific changes in the structure of the bill apparatus in response to particular light patterns and habitat clogginess, constraints that require speed and precision for the capture of prey and protection of the skull against collisions.

The different positions of the corneal reflex and the center of the pupil demonstrates the decentration of the ocular structures. The optic axis and the visual axis are different. They form a angle (defined as angle alpha) important for appreciation of strabismic deviation. This phenomenon is well-known since the nineteen century. This review discusses the different definitions of the optico-visual axes and angles (angle alpha, gamma, kappa, lambda). A possible clinical application is discussed.

The immunological status of the eye, like the one of the brain, is generally considered as an "immune privilege" site because of the presence of a strong blood-ocular barrier, the lack of lymphatic drainage and, last but not the least, the absence of professional antigen-presenting cells. This dogma is now challenged by recent studies indicating that presentation of endogenous (as in autoimmune uveitis) or exogenous (like in ocular cysticercosis) antigens occurs. The local immune response seems regulated by active immunosuppressive mechanisms, in order to limit the destructive effect of inflammatory reactions.

Measurements of outer orbital distance, inner canthal distance and of interpupillary distance and proptosis were performed on 95 healthy Zairian subjects. The subjects were aged from 2 1/2 to 18 years. There were 47 boys (mean age +/- SD, 9.74 +/- 4.4 years) and 48 girls (mean age +/- SD, 9.07 +/- 4.1 years). No statistically significant difference was found between the two sexes for the mean age. Subjects were divided in four age groups: the first age group included children aged from 2 1/2 to 6 years (mean age +/- SD, 4.62 +/- 1.31 years), the second age group included children aged from 7 to 10 years (mean age, 8.32 +/- 1.22 years), the third included subjects aged from 11 to 14 years (mean age +/- SD, 12 +/- 1.06 years) and the fourth included subjects aged from 15 to 18 years (mean age +/- SD, 17 +/- 3 years). The measurements were performed with the Hertel exophthalmometer for the proptosis and the outer orbital distance, with the pupillometer model PD-2 meter for the interpupillary distance; with a ruler for the inner canthal distance. The mean +/- SD inner canthal was 27.4 +/- 2.7 mm for the first age group, 29.7 +/- 3.1 mm for the second age group, 30 +/- 2.4 mm for the third age group and 32.2 +/- 3.1 mm for the fourth age group. The mean +/- SD outer orbital was 100.0 +/- 4.4 mm for the first age group, 106.5 +/- 4.6 mm for the second age group, 111.7 +/- 6.8 mm for the third age group and 118.5 +/- 6.4 mm for the fourth age group.(ABSTRACT TRUNCATED AT 250 WORDS)

The computation of eyeball growth has a wide field of applications in orbital and ocular pathology. An anatomic, macroscopic, histologic and RMI study has correlated the different oculo-orbital signals with the anatomy: a study of compute eyeball growth has been done. The anatomic study was made to determine the best MRI parameters to calculate the ocular surface. The surface was computed by MRI T2 weighted in the neuro-ocular plane in children aged from 0 to 13 years. The curve of eyeball growth shows rapid growth in utero until 18 months and then a phase of slower growth. A second study with fetuses RMI of pregnant women showed the neuro-ocular plane of fetus. Application in antenatal pathology are interesting. Two cases of orbital tumor, with fetal diagnosis are analysed and histologically explained.

After having been the subject of several studies during the first half of the 20th century, the anatomical and morphological measurements of the ocular rectus muscles have recently been reinvestigated (e.g. L. Apt). At the Anatomy Institute in Geneva, similar measurements were performed on 25 human orbits as well as the depth of the subtenon space. The results show a large variation from one individual to another, although the "Tillaux spiral" was always respected. We have also shown that the ratio of the arc between each pair of opposed rectus muscles is a constant equal to 1 (0.997 +/- SD = 0.031). The subtenon space was defined morphometrically and confirmed histologically. All these measurements are important for practical aspects involved in the surgery of strabismus.

Scanner examination of the oculo-orbital region of 20 squinting children shows, by mean of precise measures, in a first part abnormalities of orbital development (these abnormalities are always moderate). In a second part, this examination demonstrate asynergies of the horizontal oculomotor muscles, particularly an isolated hypermotricity of one medial ocular muscle in patent induction movements. Despite of irradiation of the crystalline lens this examination can be helpful in a preoperatory check-up.

This work deals with dynamic anatomy of human body explored by magnetic resonance imaging (MRI). Recent development of MRI pulse sequences allow very fast data acquisition. Using an 1,5 Tesla system (General Electric--CGR, Signa), different body segments have been explored, in two different ways. The first approach consisted in a cinematographic display of anatomical sections of an articulation obtained in different positions. The result shows the movement of the articulation. The second approach consisted in the examination of a single slice several times, with cardiac synchronization ("gating"). the result is the evaluation of phase desynchronization, measuring the flow directions and the velocity of circulating fluids. The results are shown as a video tape with commentary. It starts with the joints: the ankle, the knee, the wrist, the hand, the cervical spine, de cervico-occipital junction, the temporo protrusion during deglutition and the ocular movements (normal and pathological), according to different planes, are successively proposed. Finally, flow kinetics are shown: cardiac movements and supra-aortic arterial flow, the intracranial cerebro-spinal fluid circulation, in normal and pathologic (intra-cranial hypertension) cases. The exposition is concluded by showing a work in progress on urine flow during micturition.

We have developed a method to estimate foveal visual acuity (VA) through analysis of VEPs. It consists in determining the smallest check size in a pattern reversal that elicits a significant cortical response. The VEP is regarded as significant if the P 100 amplitude reaches a pre-established level in the signal to noise ratio. A valid criterion to determine normal VEP-VA emerges from the testing of 84 emmetropic and ametropic eyes: within our stimulation and recording conditions, a significant VEP response to the reversal of seven minutes checks corresponds to normal foveal acuity. This criterion has also proved pertinent to discriminate between normal VAs of 20/20 and decreased VAs (20/40 or less) with four other groups of subjects: 14 adult eyes whose VAs of 20/20 are decreased through Bangerter occlusives, 32 emmetropic and ametropic eyes belonging to five-years-olds children, 28 emmetropic and ametropic eyes of twelve-years-olds. In order to guarantee the validity of our results we carried out a double-blind study with ophthalmologists. The relevance of the method we suggest is related to that of the method which consists in extrapolating the regression line between VEP amplitudes and the pattern element sizes. At least we have aimed at establishing VEP norms for the maturation of VA. We have collected data from the following subjects: 5 infants tested monthly between 1 and 6 months, 31 infants ranging in age from 1 to 16 months, 10 five-year-old children, 13 twelve-year-olds, and 11 subjects aged 20. Within our stimulation and recording conditions a significant evoked response to the reversal of seven minute checks can be observed from 8 months onward. With an eight-month-old infant this response to the reversal of seven minute checks cannot be identified to the same response with an adult. There are two major differences: the latency of the major positive component is longer, and the structure of the evoked response consists of fewer components.

The axial length of 68 eyes has been measured before radial keratotomy. This measurement can influence the decision of a procedure. In 49 cases, a postoperative measurement was done, and a mean variation of the length of the eyeball of -0.1 mm is demonstrated.

Ocular biometry tests were conducted in approximately 100 full-term neonates (of both sexes) during the first five days following birth. Measured parameters included the dimensions and shape of the ocular globe, and optic component refractions. For the first time, individual values were determined for the corneal curvature radius, corneal refraction, and the transverse diameter and shape of the globe. Results are analyzed statistically, and the most important correlations calculated.

Biometric modifications were observed on eyeballs operated upon using the indentation method of Lincoff. The biometric modification of the anteroposterieur axis of the eye was studied by an opticoechographic method. 30 eyeballs with retinal detachment were operated upon using the Lincoff method with silastic implants. The length of the eyeball is not modified. But the analysis of the results indicates a significant reduction of the depth of the anterior chamber. This is entirely neutralized by a slight augmentation of the axial length of the vitreous body. The orientation of the implant has an influence on the biometric data. If it is a radial one, the anteriorposterior axis is lengthened; when it is parallel to the limbus, there a shortening with a reduction in the depth of the anterior chamber.