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Objectives: This study aimed to evaluate whether conjunctival flora is different in patients with chronic renal disease (CR) among its subgroups and healthy subjects. Methods: A total of 105 adult CR patients; 35 hemodialysis (HD), 35 diabetic hemodialysis (DHD), 35 renal transplantation (RT), and 40 healthy subjects were enrolled. After ophthalmologic examination, a swab was taken from the lower fornix of the right eye using a cotton-tipped applicator and directly sub-cultured on 5% sheep’s blood agar, chocolate agar, and eosin methylene blue agar. Differences in both bacterial growth and flora diversity of the groups were compared. Results: The order of bacterial growth rates in the groups are RT 65%), DHD (57%), HD (56%), and control (48%). The RT group had a statistically significant difference from the control group (p

Horner's Syndrome (HS) is a disease characterized by miosis, ptosis, and ipsilateral lack of sweating. It can occur with any injury at the level of the ocular sympathetic system neurons from the hypothalamus to the cervical postganglionic fibers. We present here a case of HS that developed after heart surgery in a 9-year-old boy. Ventricular septal defect, aortic and mitral valves repair, and pacemaker implant procedures were noted in his medical records. Preganglionic HS was diagnosed with bilateral unresponsiveness to a 0.1% adrenaline and positive result in the right eye to 0.5% apraclonidine tests. HS is often related to injuries of the brain stem, upper spinal cord, lung apex tumors and lesions, aortic coarctation, cervical lesions, and carotid lesions have been reported. However, it is rare secondary to heart surgery among the pediatric age group.

Objectives: Evaluation of the clinical characteristics of patients with post-traumatic canalicular laceration and the results of surgical repair of these patients with Monoka® tube intubation. Materials and Methods: Medical records of 15 patients who underwent surgical repair with Monoka® tube implantation due to canalicular laceration in our clinic between 2009 and 2013 years were analyzed retrospectively. Patients were analyzed in terms of their demographic characteristics, leading cause of injury, accompanying ocular injuries along with anatomical and functional success. Results: The mean age was 25 (1-56) years. Twelve patients (80%) were males and 3 (20%) were female. Twelve (80%) eyes presented with lower canalicular laceration, 1 (6.7%) eye-with upper canalicular laceration, and 2 (13.3%) eyes had bicanalicular laceration. Five of injuries (33%) were due direct sharp objects and 10 of injuries (66%) occurred due to blunt trauma. Six of patients were operated under general anesthesia and 9 of patients were operated under local anesthesia. The mean time duration between canalicular injury and surgery was found to be 14 hours (4-39 hours). The mean duration of the tubes’ residence time was 5.26 months (1-6 months). Patients were followed averagely 14 months (6-32 months) in the postoperative period. The open status of lavage was considered as anatomical success, and the absence of fluorescein dye pooling and epiphora was considered as functional success. Except for 1 patient with tube protrusion in the early postoperative first month, anatomical and functional success was achieved in 14 patients (93.3%) during the follow-up period. Conclusion: After traumatic canalicular lacerations, Monoka® tube intubation is an easily applicable and effective method with low risk of damage. (Turk J Ophthalmol 2015; 45: 14-17)

DOI: 10.4328/JCAM.1361 Received: 31.10.2012 Accepted: 19.11.2012 Publihed Online: 21.11.2012 Corresponding Author: Selim Bozkurt, Kahramanmaras Sutcu Imam Universitesi Tip Fakultesi, Acil Tip AD. Kahramanmaras, Turkiye. T.: +90 3442211431 F.: +90 3442212371 GSM: +905363661789 E-Mail: selimbozkurt01@yahoo.com Ozet Eczanelerden recetesiz temin edilen topikal anestezikler gecici rahatlatici etkilerinden dolayi ozellikle sanayide calisan isciler tarafindan bilincsiz kullanilmaktadir. Zamanla kullanicilarin bir kisminda bu tur ilaci daha sik kullanma ihtiyaci ortaya cikmaktadir. Bu ilaclar kornea uzerine direkt toksik etkileri ile veya gozyasi stabilitesini bozarak toksik keratopatiye yol acmaktadirlar. Zamaninda mudahale edilmeyen basit keratopatiler ilerleyerek kornea-skleral incelme, kalici korneal opasite ve hatta perforasyona neden olabilmektedir. Kontrolsuz topikal anestezik kullanan ve ilac bagimliligi gelisen toksik keratopatili bir olguyu sunmayi amacladik.

A 44-year-old woman presented to our clinic with reduced vision in the right eye for two weeks. Visual acuity was 4/10 in the right eye. A swelling optic disc, vascular attenuation in the optic nerve head, a few splinter hemorrhages around the optic disc, and moderate vitritis were detected in the right eye. The left eye was normal. She had a diabetes mellitus (DM) history for five years. Serum IgM and IgG found a high titer for toxoplasmosis. A papillitis was diagnosed that was caused by primary toxoplasmosis without any chorioretinal focus. The patient was treated with an appropriate systemic antibiotics for toxoplasmosis and per oral corticosteroid. Optic disc swelling resolved within four weeks. Visual acuity was 9/10 two months later. We aimed to emphasize that the unusual placement of toxoplasmosis should be kept in mind in the differential diagnosis of papillitis in diabetic patients. [Arch Clin Exp Surg 2015; 4(2.000): 111-113]

BACKGROUND To evaluate the effect of human milk on ocular morbidity in infants who did not breast feed during the first 6 months of life. MATERIAL AND METHODS This retrospective randomized study included 154 subjects who were first or second grade elementary school students, 66-84 month of age. These children were randomly selected from 2080 students during health screenings. All of them were born at term and were normal birth weight. The study was composed of 3 age- and sex-matched groups. Group 1 included 52 subjects who had never been breast fed. Group 2 included 42 subjects who were breast fed and also received additional food (infant formula). Group 3 included 60 subjects who were only breast fed until 6 months old (no formula) except for the first month of life. All subjects underwent a complete ophthalmic examination and any morbidity was recorded. Frequencies of ocular morbidity were compared among the groups by using the chi-squared test. RESULTS We found significant refractive errors in 12 (23%) subjects in Group 1 (no breast feeding). There was no significant refractive error in Group 2 (breast feeding and formula) and Group 3 (breast feeding only). The difference among the groups was statistically significant (p=0.014, chi-squared test). Allergic conjunctivitis was found in 5 subjects in Group 1, 3 in Group 2, and 2 in Group 3. There was no significant difference among the groups (p=0.395). CONCLUSIONS Refractive errors were more frequent in Group 1 (no breast feeding) than in Group 2 (breast feeding and formula) or Group 3 (breast feeding only). There is a need to confirm this finding by performing studies with larger sample sizes.

To assess the preventable visual impairment in children with nonprofound intellectual disability (ID). A total of 215 children with IDs (90 Down syndrome [DS], 125 nonprofound ID) and 116 age- and sex-matched healthy subjects were enrolled in this study. All participants underwent ophthalmologic examinations including cycloplegic refraction measurements, ocular movement evaluation, screening for strabismus (Hirschberg, Krimsky, or prism cover test), slit-lamp biomicroscopy, funduscopy, and intraocular pressure measurements. All data were recorded for statistical analysis. Ocular findings in decreasing prevalence were as follows: refractive errors 55 (61.1%), strabismus 30 (33.2%), cataract 7 (7.8%), and nystagmus 7 (7.8%) in children with DS; refractive errors 57 (45.6%), strabismus 19 (15.2%), cataract 7 (6.4%), nystagmus 5 (4%), and glaucoma 1 (0.8%) in children with other ID; and refractive errors 13 (11.2%) and strabismus 4 (3.5%) in controls. Cataracts, glaucoma, and nystagmus were not observed in the control group. The most common ophthalmic findings in children with DS compared with other ID and controls were with hyperopia (p0.03 and p0.001, respectively) and esotropia (p0.01 and p0.01, respectively). The pediatric population with ID has a high prevalence of preventable visual impairments, refractive errors, strabismus, and cataracts. The prevalence of strabismus and refractive errors was more frequent in children with DS. The importance of further health screenings including ophthalmic examinations should be utilized to implement appropriate care management and improve quality of life.

Purpose: To report a case of unusual coexistence of keratoconus and optic disc pit. Methods: A 29-year-old male patient followed up because of the left established and right subclinical keratoconus presented with blurred vision on the left eye that occurred within days. In addition to a comprehensive ophthalmic examination, computerized corneal topography (CT), corneal pachymetry, and optical coherence tomography (OCT) examination were performed. Results: The corneal CT showed a mild keratoconus pattern, with a minimum corneal pachymetry of 472 in the right eye and moderate keratoconus pattern with a minimum pachymetry of 435 micron in the left eye. The OCT scans showed the presence of the optic disc pit and related maculopathy. Conclusions: This is the second report of the coexistence of keratoconus and optic disc pit in the literature. The association of these two entities is therefore less likely to be accidental. Further histopathological studies will be necessary to explain this relationship ...

Purpose To report the results of switching from intravitreal bevacizumab to ranibizumab or vice versa in the treatment of choroidal neovascularization (CNV) due to age-related macular degeneration. Methods Twenty eyes of 18 patients that underwent switch from intravitreal bevacizumab to ranibizumab and 10 eyes of 8 patients that underwent switch from ranibizumab to bevacizumab were retrospectively analyzed. The results were compared with 41 eyes of 37 patients treated with ranibizumab only. All eyes initially received 3 injections of ranibizumab or bevacizumab, which were repeated as needed (PRN dosing). Anti–vascular endothelial growth factor therapies were switched because of general health insurance applications and cost problems. The main outcome measures were best-corrected visual acuity (BCVA), injection number, and central macular thickness (CMT) obtained by optical coherence tomography. Results Once all patients evaluated together at the final visit, the mean BCVA improved and CMT decreased. When switching groups were taken into consideration, switching yielded improved BCVA and reduced CMT following switching. After switching, BCVA continuously improved in the bevacizumab to ranibizumab group, but stayed stable in the ranibizumab to bevacizumab group. The CMT was reduced at the switching time in both groups, but did not change after the switch. Final visual acuity improved or stabilized in all eyes in the ranibizumab-only group. The BCVA worsened in 20% of eyes in the bevacizumab to ranibizumab group and in 40% of eyes in the ranibizumab to bevacizumab group. Conclusions The ranibizumab-only group and the switching from bevacizumab to ranibizumab group seemed superior to the ranibizumab to bevacizumab group.

Purpose: The aim of this paper was to assess and compare the effects of intravitreal ranibizumab and bevacizumab on retinal vessel diameter in eyes with neovascular age-related macular degeneration (AMD). Methods: Patients with neovascular AMD who underwent intravitreal injection of either ranibizumab or bevacizumab were included. Noninjected fellow eyes served as a control. The main outcome measures were central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and the artery-vein ratio (AVR). Results: In the ranibizumab group, the mean CRAE value decreased significantly at 1 week and 1 month (p = 0.002). The AVR value decreased significantly at 1 month (p = 0.028). CRVE values did not change at 1 week and 1 month (p = 0.083). In the bevacizumab group, the preinjection CRAE, CRVE, and AVR values did not change through the study period (p = 0.128, p = 0.600, and p = 0.734, respectively). Conclusion: These results suggest that intravitreal ranibizumab led to significant retinal arteriolar vasoconstriction in eyes with neovascular AMD.

Keratoconus affecting young population is a progressive eye disease. This disease may remain silent until complain of visual impairment is appeared. By using the high-quality imaging techniques disease now can be diagnosed earlier. The goal of keratoconus treatment is to improve visual acuity and to prevent the progression of the disease. Although the previous treatment methods initially provided slightly improvement of visual acuity, could not prevent keratoconus progression. However, collagen cross-link (CCL) treatment both halts the progression of the disease and provides an increased vision. Since the side effect of the treatment is less and implementation is easier, CCL provides an important advantage for these patients and this technique becomes common day by day.

Keratoconus affecting young population is a progressiveeye disease. This disease may remain silent untilcomplain of visual impairment is appeared. By using thehigh-quality imaging techniques disease now can be diagnosedearlier. The goal of keratoconus treatment is toimprove visual acuity and to prevent the progression ofthe disease. Although the previous treatment methods initiallyprovided slightly improvement of visual acuity, couldnot prevent keratoconus progression. However, collagencross-link (CCL) treatment both halts the progression ofthe disease and provides an increased vision. Since theside effect of the treatment is less and implementation iseasier, CCL provides an important advantage for thesepatients and this technique becomes common day by day.Key words: Keratoconus, cross-linking, cornea.

Relations among handedness, eye dominance, and lateralisation in the formation of cataract were investigated in 35 male and 21 female patients with cataract. In right-handed patients, cataracts formed earlier in the right eyes than in the left eye; this was reversed in left-handed patients. For both right- and left-eye dominant patients, cataracts formed earlier in the dominant eye.

There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean+/-SD; 19.72+/-0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study.

To evaluate early corneal changes using a Scheimpflug imaging (SI) system (Pentacam) in a pediatric population with Down syndrome. Materials and methods: This study was carried out in a prospective and nonrandomized fashion. Twenty-seven children with Down syndrome and 30 healthy subjects were enrolled in the study. Corneal measurements were done using a Scheimpflug topography system. Central corneal thickness (CCT), minimum corneal thickness (CTmin), central corneal power (CP), difference of central corneal power (DCP) between 2 eyes, inferior superior steepening (I-S), and keratoconus indices were tested with a SI device. Results: Mean CCT and CTmin values were significantly lower in the patient group than in the control group (P < 0.01). Mean CP and DCP values were higher in the patients than in the control group (P < 0.001). Although mean I-S values were not statistically different, 11 eyes in the Down syndrome group and 3 eyes in the control group had 1.20 or higher I-S. Eleven eyes (21.1%) in the patient group and 1 eye (1.7%) in the control group had subclinical keratoconus (P < 0.01), and 20 eyes (38.4%) in the case group and 2 eyes (3.3%) in the control group had at least 1 abnormal parameter (P < 0.01). Conclusion: Corneal abnormalities and subclinical keratoconus are more common in children with Down syndrome.

The study was undertaken to investigate whether anterior segment findings are different in children with Down syndrome (DS) to normal children and to focus on its clinical significance.A cross-sectional case control study was conducted in a total of 38 children with DS and 42 healthy children. This is the first report in the literature stating that. All subjects underwent ophthalmologic examination including slit-lamp biomicroscopy, cycloplegic refraction, intraocular pressure measurement and Scheimpflug imaging measurement. Customized software for Pentacam was used to analyze structural indices of anterior segment parameters. The mean anterior segment values of right eyes were compared between the groups.The mean anterior chamber parameters of patients with DS and controls were measured respectively: Corneal thickness was 502.31 ± 40.5 and 541.8 ± 37.42 mm (p 0.001), corneal volume was 56.63 ± 4.5 and 61.02 ± 4.3 mm³ (p 0.001), corneal radius curvature was 7.41 ± 0.29 and 7.67 ± 0.34 mm (p 0.001), iridocorneal angle was 39.7 ± 6.2 and 39.5 ± 6.4° (p = 0.944), anterior chamber volume was 181.65 ± 27.38 and 185.77 ± 32.53 m³ (p = 0.528), anterior chamber depth was 3.08 ± 0.24 and 3.02 ± 0.31 mm (p = 447), pupil size was 2.95 ± 0.48 and 3.29 ± 0.45 mm (p 0.05).The majority of the anterior segment parameters were found to be different in children with Down syndrome. While pupil size, corneal thickness, corneal volume and corneal curvature in DS were less than normal, iridocorneal angle, anterior chamber depth and anterior chamber volume were close to controls. The most important parametric differences in children with DS were seen on the cornea.

Purpose: We aimed to measure peripapillary retinal nerve fiber layer (RNFL) thickness in children with thalassemia major (tha-major), children with iron deficiency anemia (IDA), and children in a healthy control group. Materials and Methods: A total of 47 children with tha-major and 22 children with IDA were selected from two pediatric hematology outpatient clinics as our experimental groups, while 35 healthy children were randomly selected from a primary school to act as a control group. After a complete eye examination was conducted and intraocular pressure measurements were obtained, RNFL measurements were performed using optical coherence tomography, and the information was recorded for statistical analysis. Results: The mean age of the participants was 9.65 +/- 4.13 years in the tha-major group, 9.14 +/- 2.53 years in the IDA group, and 9.13 +/- 3.29 years in the control group, respectively, with no statistically significant difference among the three groups (p>0.05). Mean peripapillary RNFL thickness was 119.38 +/- 35.49 microns in the tha-major group, 184.00 +/- 31.14 microns in the IDA group, and 187.73 +/- 27.36 microns in the control group. It was significantly thinner in all quadrants in the tha-major group vs. the other two groups (p0.05). Conclusion: The study revealed that peripapillary RNFL is thinner in tha-major in all quadrants and in only the inferior quadrant in IDA. Thinning of the RNLF correlated with hemoglobin value and ferritin level, but not with number of transfusions and visual acuity.

To evaluate the relationship between laterality and perceived pain and cooperation during phacoemulsification under combined topical and intracameral anesthesia.University ophthalmology clinic and eye hospital, Kahramanmaraş, Turkey.Cohort study.Seventy-eight patients with senile cataracts who had ocular surgery were included prospectively. The dominant side was determined with the Edinburg Handedness Inventory. Phacoemulsification and intraocular lens implantation were performed. The surgeon graded the patient's cooperation from 0 (best) to 3 (worst). The duration of surgery was recorded. Another researcher rated perceived pain from 0 (no pain) to 10 (unbearable pain) using a visual analogue scale (VAS). Pain scores and the degree of cooperation for dominant-side and nondominant-side surgery were the primary outcomes.Forty-six patients had surgery in the dominant eye and 32 in the nondominant eye. The 2 groups were similar in age, sex, and severity and type of cataract. The mean VAS score was significantly higher in patients having dominant-side surgery than in those having nondominant-side surgery (P.01). Similarly, the mean cooperation score was significantly poorer in the patients having dominant-side surgery (P.05). Visual analogue scores were correlated with patient cooperation (r = 0.890, P.0001).Pain scores were higher in dominant-side surgery for cataract under topical and intracameral anesthesia, which should be kept in mind when selecting anesthesia and in studies in which pain is scored.No author has a financial or proprietary interest in any material or method mentioned.

Welding workers' ophthalmic problems resulting from their professions are frequently observed in ophthalmic emergencies and can cause severe visual impairment. We aimed to investigate the use of topical anesthetic and non-medical alternatives of this population regarding ophthalmic problems in this study.The study included 204 welding workers randomly selected from a population of 1852 people who had at least one-year experience as a welding worker and who were members of a chamber of welding workers. Data were collected at face to face interviews with a questionnaire composed of questions about ophthalmic problems caused by their profession and about how they eliminated these problems. Obtained data were analyzed with SPSS.Of 204 workers, 38.7% preferred non-medical alternatives including application of potatoes (22%), dressing with tea (17%), rinsing with cold water (3.4%) and closing eyes (2%). 30.5% of the participants used topical anesthetics (72% commercial and 28% prepared in pharmacies). There was a significant relation between use of non-medical methods and topical anesthetics, and workers' education, duration of work experience and receiving training from their seniors (p 0.05).Use of non-medical methods and topical anesthetics by welding workers was found to be associated with low-education levels and insufficient knowledge about ophthalmologic problems due their professions and their treatment. They should be provided with appropriate training for the issue and precautions should be taken to prevent people from buying drugs without a prescription.

The aim of this study is to report ophthalmic findings of acute mercury poisoning in 48 adults referred to emergency department. Full ophthalmologic examination including the best corrected visual acuity, external eye examination, reaction to light, a slit-lamp examination, funduscopy, intraocular pressure measurements, and visual field (VF) and color vision (CV) tests were performed at the presentation and repeated after 6 months. The parametric values of VF test, the mean deviation (MD), and pattern standard deviation (PSD) were recorded in order to compare patients and the 30 healthy controls. The mean parameter of color confusion index in patients was found to be statistically different than controls ( p

In this study, which investigates the relationship between the levels of stereopsis with eye and hand dominance or interpupillary distance, 120 healthy young volunteers were investigated. Eye dominance was determined by modified Miles technique following a complete eye examination. Handedness was assessed with the Edinburgh handedness inventory. Interpupillary distance was measured with millimetric ruler. Stereoacuity was measured in both contour (Titmus test) and random dot (TNO test) stereograms. The stereopsis scores were evaluated in terms of hand or eye dominance. The correlation between stereopsis score and interpupillary distance was assessed. Main outcome measures were stereopsis scores according to hand and eye dominance. As a result, right- and left-handed individuals showed no differences in terms of stereopsis. No differences were found in stereopsis scores between right- and left-eye dominant people. There was a correlation between interpupillary distance and the depth of stereopsis (r=-0.248,P<0.05). Contrary to the expectation, the left and right dominant individuals did not differ in levels of stereopsis. Interpupillary distance has a positive effect on stereopsis.

Pterygium is an abnormal fibrovascular tissue extending on the cornea which is a degenerative and hyperplastic disorder. A stromal overgrowth of fibroblast and blood vessels is accompanied by an inflammatory cell infiltrate and abnormal extracellular matrix accumulation. The surgical excision is the main treatment method of pterygium, but recurrence is the most common postoperative complication. In the present study, we aimed to compare the wide conjunctival flap and the conjunctival autografting techniques in pterygium surgery according to time of operation, safety, and effectiveness. Results showed that the effect of wide conjunctival flap techniques on primary pterygium surgery was found close to the conjunctival autograft techniques. In addition, the flap technique has a shorter surgical time, the surgery does not require extreme experience, feeding of the flap is provided with own vessels since the vascular structure is protected on the upper temporal conjunctival area, reverse placement of the flap is not seen, it needs fewer sutures, so that suture disturbances may reduce, and it is less traumatic than autograft technique during conjunctival transport. Therefore, this technique may be preferred in suitable cases.

Purpose: To report ophthalmic findings in acute mercury poisoning in the primary school students. Methods: Seventy two children exposed to mercury vapor and 42 healthy controls were enrolled in the study. Full ophthalmologic examination including best corrected visual acuity, external eye examination, a slit-lamp examination, funduscopy, intraocular pressure measurements, Visual Field (VF), Visual Evoked Potential (VEP) and Color Vision (CV) tests were performed at the presentation and after six months. The parametric values of VF, Mean Deviation (MD) and Pattern Standard Deviation (PSD) were compared between groups. Results: The visual acuity less than two lines in ETDRS chart in 7(9.7%) patients, color vision impairment in 6(8.3%) patients were determined with ophthalmic examination. There were a significant difference in the color confusion index of patients, (p

The aim of this study was to investigate the pain experience and the cooperation of patients during consecutive cataract surgery.In this prospective, randomized study, 60 consecutive adult patients with bilateral senile cataracts were recruited. All operations were performed with clear corneal phacoemulsification (phaco) technique under topical and intracameral anesthesia without sedation. The first surgery was performed in the eye with high-grade cataract. The other eye was operated within 3 months. Every patient was graded using a visual analogue scale (VAS) from 0 (no pain) to 10 (unbearable pain) after the surgery. The cooperation of the patient was graded from 0 (no event) to 3 (marked eye and head movement and lid squeezing) by the surgeon. The VAS scores and cooperation of patients were the main outcome measurements.The mean VAS score was 1.50± 0.81 in the first surgery and 2.15±0.79 in the other eye surgery (p0.001). The patient cooperation score was 1.50±0.81 in the first surgery and 2.18±0.77 in the other eye surgery (p0.001). The VAS and patient cooperation scores were positively correlated (r=0.633, p0.001) in the study group. The VAS and patient cooperation scores were similar based on sex and laterality.Patients who previously underwent phaco surgery in one eye experience more pain and have worse cooperation during the other eye phaco surgery.

To measure corneal thickness via the use of a Scheimpflug imaging system (OCULUS Optikgeräte GmbH, Wetzlar, Germany) in children with Down syndrome.This prospective, nonrandomized, clinical trial included children with Down syndrome and age- and sex-matched healthy controls. All subjects received a complete ophthalmologic examination. Corneal topography measurements were acquired by means of Scheimpflug imaging. Central corneal thickness (CCT), thinnest point of cornea (TP), and corneal volume (CV) were analyzed.A total of 27 children with Down syndrome and 37 control subjects were included in the study. In children with Down syndrome, the mean CCT was 494.27 ± 47 μm, the mean TP was 487 ± 49 μm, and the mean CV was 56.2 ± 6. In the controls, the mean CCT was 539.3 ± 40 μm, the mean TP was 538.0 ± 40.8 μm, and the mean CV was 61.3 ± 4. For all 3 parameters, the difference was statistically significant (P0.001). In the Down syndrome group, the CCT was500 μm in 16 subjects (59.2%) and450 μm in 5 (18.5%). In the control group, the CCT was500 μm in 14 subjects (37.8%) and450 μm in 2 (5.4%).In this study, corneal thickness was less in children with Down syndrome than in healthy control subjects. Decreased corneal thickness may be an early sign of a degenerative corneal disease such as keratoconus in children with Down syndrome.

TAYSI, Seyithan/0000-0003-1251-3148; KOC, MEHMET/0000-0003-1504-2900; yilmaz, adnan/0000-0001-9769-9791 WOS: 000260573400003 PubMed: 18979314 Purpose: The aim of this study was to evaluate the antioxidant role of melatonin against radiation-induced cataract in the rat lens after total cranial irradiation with a single 5 Gray (Gy) dose of gamma irradiation. Materials and methods: Twenty-eight Sprague-Dawley rats were used for the experiment.The rats were randomly divided into four equal groups. The control group did not receive melatonin or irradiation but received both 0.1ml physiological saline intraperitoneally and sham irradiation. The irradiation (IR) group received 5 Gy gamma irradiation to the total cranium as a single dose plus 0.1ml physiological saline intraperitoneally. The melatonin plus IR group received irradiation to the total cranium plus 5mg/kg/day melatonin intraperitoneally. The melatonin group received only 5mg/kg/day melatonin plus sham-irradiation. Biochemical parameters measured in murine lenses were carried out using spectrophotometric techniques. Results: Lens antioxidant capacity, as measured by levels of total superoxide scavenger activity (TSSA), non-enzymatic superoxide scavenger activity (NSSA) and glutathione reductase (GRD) activity, significantly increased in melatonin, control and melatonin plus IR groups when compared with the IR group. Lens glutathione-S-transferase (GST) activity significantly increased in control and melatonin groups when compared with the IR group. Lens malondialdehyde (MDA) levels significantly increased in the IR group when compared with control, melatonin and melatonin plus IR groups. Lens TSSA and NSSA activities significantly decreased in control and melatonin plus IR groups when compared with the melatonin group. Lens GST activity significantly increased in the control group when compared with melatonin plus IR group. Lens GRD activity significantly increased in melatonin and melatonin plus IR groups when compared with control group. Conclusions: Melatonin reduces oxidative stress markers and augments anti-oxidant capacity in the rat lens.

Alport's syndrome is a familial disease affecting basement membrane collagen and characterized by progressive kidney disfunction, hearing disorder and ocular abnormalities. Twenty four years old man presented with visual impairment in our outpatients clinic. Bilateral anterior lenticonus were seen in ocular slit lamp examination. After clinical examinations, audiological tests and nephrological evaluation, the case was diagnosed as Alport's syndrome. Although males and females are affected equally in this disease, males have poorer prognosis than females owing to renal failure. It is intended to remind this uncommon disease and create awareness for ophthalmologists in the present article.

We present a case of Horner's syndrome occurring as a complication of thyroidectomy. A 42-year-old female patient presented with eyelid drop which developed immediately after thyroidectomy for goitre. Ophthalmic examination revealed eyelid ptosis, miosis and anhidrosis. Preoperative ultrasonography showed multiple isohyperechogenic solid nodules in each lobe, consistent with multinodular goitre. Therefore, the patient underwent subtotal thyroidectomy. The ophthalmic findings did not improve at the end of 6 months follow-up. Similar cases have been reported related to neck tumours or their surgery, mediastinum-located goitre and retropharyngeal abscess surgeries, but not after benign nodular goitre surgery. Several possible mechanisms have been proposed to explain this phenomenon; anatomical variations making the patient susceptible to damage to the sympathetic chain seem to be most likely in our patient.

A 72-year-old man was admitted to our clinic because of pain in the right eye. Corneal oedema, peripheral anterior synechiae formation and intraocular lens were determined in the right eye. The left eye was normal except for nuclear sclerosis. Intraocular pressure was 35 mm Hg in the right eye and 14 mm Hg in the left eye. The patient was diagnosed as having bullous keratopathy and glaucoma. He was treated with antiglaucoma drugs and artificial tears as an outpatient. Persistent keratopathy was observed at follow-up, despite adequate therapy. In the detailed anamnesis of the patient, we discovered that he had used a topical anaesthetic instead of the prescribed medicine owing to ocular pain. The patient was still using topical anaesthetic eye drops, despite warnings. Finally, evisceration was performed on his right eye because of corneal melting and perforation.

Lokman Aslan, Adnan Aksoy, Murat Aslankurt, Murat Özdemir Ophthalmology Department, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey Purpose: This study aimed to compare lens capsule-related problems in mature versus non-mature senile cataracts in patients undergoing phacoemulsification surgery. Methods: A total of 295 patients with senile cataract were divided into two groups according to lens maturation: 105 patients with mature senile cataract comprised Group 1 (study group) and the remaining 190 with non-mature senile cataract comprised Group 2 (control group). Prior to surgery, ophthalmological examination was undertaken. Patients’ best-corrected visual acuity and intraocular pressure were measured and a slit-lamp examination and funduscopy performed. All examination data were recorded and any capsule-related problems during surgery were also recorded. Patient files were reviewed retrospectively and compared between groups. Fisher’s exact test was used in the statistical analysis. Results: In Group 1, the capsule-related problems found were: inability to complete capsulorhexis (seven eyes [6.6%]), posterior capsular perforation (three eyes [2.8%]), and conversion to extracapsular surgery (one eye [0.9%]). A posterior capsular perforation was seen in one eye (1%) in the control group. An intraocular lens was inserted into the sulcus in six eyes (5.7%) and one anterior chamber (0.9%) in Group 1 and into the sulcus in one eye (0.5%) of Group 2. The lens was inserted into the capsular bag in all other patients. Conclusion: Delaying surgery in patients with cataracts creates a high risk for capsule-related surgical complications. Although capsule dyes make capsulorhexis easier, capsulorhexis is the most problematic phase of phacoemulsification in mature cataracts. Keywords: mature senile cataract, non-mature senile cataract, capsulorhexis

Sex-related differences in intraocular pressures of the right and left eye was studied in 64 men and 61 women, all young and right-handed. Intraocular pressures of the right and left eye were higher for women than men. Sex-related difference in intraocular pressure may be associated with presence of the sex hormone, oestrogen, in women which reduces sympathetic activity.