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Background: The clinical presentation of reduced pupillary responses in orbital apex syndrome is currently not well understood clinically. The pupillary light reflex (PLR) is determined using dynamic pupillometry., Case Details: A newly diagnosed 35-year-old diabetic female patient had ocular symptoms including orbital pain and ptosis, but no visual loss. Cranial nerve autonomic impairment was identified with dynamic pupillometry and compared with cardiac autonomic activity using heart rate variability (HRV)., Results: PLR showed that pupil size and response were severely affected, with a small resting pupil size, and minimal response to a bright white light flash was seen, due to decreased sympathetic activity. However, HRV showed normal cardiac sympathetic activity., Conclusion: These findings suggest that orbital apex syndrome may lead to changes in pupil size and response due to compression of sympathetic fibers at the apex of the orbit. Quantitative PLR measurements help to reveal relevant information on anatomical reflex pathways., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Purpose: The purpose was to record the causes of leukocoria among children under 10years of age and to determine the proportion of rare causes of leukocoria., Patients and Methods: This retrospective study was conducted over a period of ten years, from January 1, 2004 to December 31, 2013, in patients under 10years of age who were referred for leukocoria., Results: Leukocoria represented one of the ten reasons for consultation among children under 10years of age. The mean age of our patients was 42.5months. In 76 % of cases, the leukocoria patients were children under 6years of age. Male patients were affected more commonly, with a sex-ratio of 1.5. Patients coming from Dakar and its suburbs represented two thirds of the total. Bilateral involvement represented 53.7 % of the total. Cataracts were responsible for 74.3 % of cases, retinoblastoma 20.58 %, retinal detachment 0.96 %, retinopathy of prematurity 0.96 %, pupillary membrane persistence 0.96 %, persistent hyperplastic primary vitreous 0.64 %, endophthalmitis 0.64 %, optic nerve coloboma 0.32 %, iris heterochromia 0.32 % and ametropia 0.32 %., Discussion: The total percentage of rare causes was 5.12 % in our study, including one case of hyperopia. These etiologies, although rare, do exist., Conclusion: Rare causes of leukocoria require special attention. The discovery of leukocoria necessitates rigorous etiological work-up. Ametropia must be a diagnosis of exclusion., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Purpose: To evaluate the refraction in children measured with Plusoptix ® without cycloplegia vs. Retinomax ® apparatus with cycloplegia., Patients and Methods: Measure of refraction with Plusoptix ® in children>1year old referred for systematic vision screening, then measurement after cycloplegia with cyclopentolate by the Retinomax ® device., Results: Thirty-three children were included, i.e. 66eyes. Mean age was 40.7months (minimum 12; maximum 114). The Spearman correlation coefficient for the spherical equivalent was 0.52 (Plusoptix ® vs. Retinomax ® comparison; P<0.0001=moderate correlation). The Spearman correlation coefficient was 0.73 for astigmatism (Plusoptix ® vs. Retinomax ® comparison; P<0.0001=strong correlation). The Plusoptix ® sensitivity for measurement of refraction was 57%, 43% and 43% respectively for spherical equivalent, sphere and astigmatism., Discussion and Conclusion: The correlation of astigmatism values is strong, whereas the correlation of sphere values is moderate. Plusoptix ® seems to be unable to measure the exact refraction, because there is too large a dispersion of refraction measurements with Plusoptix ® , compared to the exact refraction measured with the Retinomax ® . Moreover, the sensitivity of Plusoptix ® is low. Cycloplegic refraction remains indispensable in children., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)