Conjunctival tuberculosis is a very rare disease, but importance of tuberculosis in Korea is high. We experienced a 49 year-old female patient with a small mass like lesion at inferior fornix with conjunctivitis. We performed excisional biopsy. Biopsy result was conjunctival tuberculosis. So we searched other body tuberculosis focus, but, not found. we emphasize differential diagnosis chronic conjunctivitis and conjunctival tuberculosis. Brief clinical history and clinical findings will be presented with pictures of the pathology findings and some literatures will be reviewd.
Biopsy ; Conjunctiva ; Conjunctivitis ; Diagnosis, Differential ; Female ; Humans ; Korea ; Middle Aged ; Pathology ; Rare Diseases ; Tuberculosis*

When blow-out fracture repair is performed, many implants including Silastic, Supramid, Porous polyethylene and others have been used to pervent reherniation of orbital tissue. Complications associated with implants include implant extrusion, orbital infection, fistula formation, implant migration, extraocular muscle entrapment, globe elevation, protosis and orbital cyst formation. The latter was known as a rare late complication of blow-out fracture repair. We report two cases of orbital cyst which developed after blow-out fracture repair with alloplastic implants. These patients developed diplopia and unliateral proptosis 7 and 10 years after repair of blow-out fracture, respectively. In these cases, orbital CT scan revealed retrobulbar cyst-like structures surrounding the orbital implant. At sufgery, a fibrous capsule surrounded the previously inserted orbital implants and was filled with dark brown mucoid material in both cases. These cysts were lined by squamous epithelium with cholesterol cleft and hemosiderin laden macrophage collection. Proptosis and diplopia were resolved after surgical removal of the cyst. These cases illustrate that it is important for us to be aware of the complication of late cyst formation around alloplastic implants after repair of blow-out fracture.
Cholesterol ; Diplopia ; Epithelium ; Exophthalmos ; Fistula ; Hemosiderin ; Humans ; Macrophages ; Nylons ; Orbit* ; Orbital Fractures* ; Orbital Implants ; Polyethylene ; Tomography, X-Ray Computed

The isolated abnormal arterial tortuosity in a 65 year old male patient with the branch retinal vein occlusion was found in non-perfusion area near the macular region. The arterial tortuosity anastomosed with the vein across the median raphe. It was what is called the the arteriovenous anastomosis. The author deduced the pathogenesis of the arterial tortuosity in arteriovenous anastomosis as following. The sclerosis of the arterial branch occurs in the severe ischemic state in the non-perfusion area following the branch retinal vein occlusion. The arterial blood easily have to flow to the unoccluded vein through only one or a few collateral channel(s). Such a arterial flow need the reduction of arterial pressure and the pathologic changes of the artery. As a result, the artery have to reduce the radius and to increase the length.
Aged ; Arterial Pressure ; Arteries ; Arteriovenous Anastomosis ; Humans ; Male ; Radius ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Sclerosis ; Veins

Color Doppler imaging(CDI) facilitates the study of orbital vasculature by color encoding the Doppler frequency shifts of blood flow, superimposing this color on B-scan anatomic detail. In a patient with ocular ischemic syndrome, maximal systolic velocity of the ophthalmic artery in the ischemic eye was reduced markedly when compared with the contralateral control eye. CDI revealed no detectable blood flow velocities within the mass in cavernous hemangioma of the orbit. In a patient with carotid-cavernous fistula, CDI demonstrated a typical low-resistance blood flow pattern of the arterialized vein. Noninvasive CDI may be helpful diagnostic aid for disorders of the eye and orbit.
Blood Flow Velocity ; Carotid-Cavernous Sinus Fistula ; Fistula ; Hemangioma, Cavernous ; Humans ; Ophthalmic Artery ; Orbit ; Veins

To investigate the tissue-specific and stage-specific expressions of porteins relatedto cell death or survival in development of rat eye, Bcl-2, Bax and p53 as well as PCNA were studied from 14th day of embryonic stage(E14) to 22th day of opstnatal stage(P22) every other day in Spragur-Dawley(SD) rats. Expression of these gene proteins was studied by immunohistochemistry. At E14, Bcl-2, Bax and PCNA were expressed on the surface ectoderm and anterior lens epithelium. p53 was highly expressed in theposterior lens epithelium and in the inner layer of retina. PCNA was highly expressed in the middle layer of retina. In postnatal stage, In the retina, Bax and PCNA were expressed throughout whole layers and p53 was stained in the middle layer, However, Bax, p53 and PCNA disappeared after P14, wherase Bcl-2 still remained by P22. In the lens, p53 expression was detected by P14 and then disappeared. In the iris. Bax and PCNA were highly expressed between P0 and P22. These results indicate that Bcl-2, Bax and p53 may contribute to the development of rat eye. The expressions of Bcl-2, and Bax, p53 are not conducted step by step but overlapped and expressed in different stages depending on ocular tissue.
Animals ; Cell Death ; Ectoderm ; Epithelium ; Immunohistochemistry ; Iris ; Proliferating Cell Nuclear Antigen ; Proteins ; Rats* ; Retina

The authors studied retrospectively on the surgical results of modified Fasanella-Servat operation for blepharoptosis. The 58 patients underwent modified Fasanella-Servat operation for blepharoptosis and were followed for at least 6 months. We obtained 74.1% primary success rate in the 58 cases of blepharoptosis. The undercorrection, the most common complication, could be correctable by any other ptosis procedures such as levator resction. However, severe complications such as overcorrection and eyelid contour abnormalities were very rare. We also obtained good surgical results even in groups of moderate degree of ptosis and fair levator function which had not been indicated for Fasanella-Servat operation in general.
Blepharoptosis ; Eyelids ; Humans ; Retrospective Studies

Anterior transposition is one of the most commonly used inferior oblique weakening procedures. It has been known to be effective in the case of dissociated vertical deviation with inferior oblique overaction or hypertropia due to superior oblique palsy.this study was undertaken to determine whether anterior transposition is effective in the correction of vertical deviation and head tilt in 19 patients with hypertropia due to superior oblique palsy. Preoperative average scale of inferior oblique overaction was +2.4+/-0.7mm, and the elimination of overaction was noted in 14 patients(74%). Preoperative prism-cover for hypertropia in primary position averaged 12.7+/-6.2, and the mean reduction of hypertropia in primary position was about 10. Head tilt was uniformly eliminated in 9 of 12 patients(75%). Therefore, we can expect the reduction of hypertropia about 10 and the elimination of head tilt, using only anterior transposition in hypertropia and inferior oblique overaction due to superior oblique palsy, especially when the amount of vertical deviation is within 13.
Head ; Humans ; Paralysis* ; Strabismus*

Vertical deviation may sometimes coexit with a large horizontal strabismus. If the vertical component is small and comitant, it may be treated by vertical displacement of the horizontal rectus insertions during a monocular recession-resection procedure. A series of 17 patients had vertical displacement of horizontal rectus muscle insertion monocularly combined with recession-resection surgery. Using a surgical plan of 1mm displacement of both medial and lateral rectus insertion to correct each prism diopter of vertical deviation, 12 patients had no residual vertical strabismus. Minimum follow-up period was 3 months. The linear correlation equation between the amount of corrected vertical strabismic angle and that of vertical displacement of medial and lateral rectus muscle is Y=0.67X+0.22(Y=Prism diopter of correction by vertical displacement, X=millimeter of vertical displacement of medial and lateral rectus muscle). These surgical results showed unsatisfactory effect on vertical deviation of more than 6 prism diopters.
Follow-Up Studies ; Humans ; Strabismus*

Nine patient with paralyzed strabismus of large deviation(Seven patients with lateral rectus or medial rectus muscle palsy and two patients with double elevator palsy) had full tendon transposition procedure. If remained strabismus was large postoperatively, recession of anatagonist of paralyzed muscle and botulinum toxin infection was performed respectively. Five patients achieved single binocular vision within central 10 degree of visual field. And six patients achieved less than 10 prism diopter of deviation in primary position. Our method compares favorably with previously descrived transposition procedure for muscle palsy in terms of the amount of correction and the extent of the window of single binocular vision with low risk of anterior ischemia syndrome.
Botulinum Toxins ; Elevators and Escalators ; Humans ; Ischemia ; Paralysis ; Strabismus* ; Tendons* ; Vision, Binocular ; Visual Fields

The fat adherence syndrome(FAS) is a severe form of the restrictive strabismus resulting from the adherence of orbital tissues to the globe of extraocular muscles and their attachments, for which no successful treatment currently exists. we developed anexperimental model for the FAS in the rabbit eyes and then evaluated the effects of polyurethane film with sustained release dexamethasone on the prevention of experimental FAS. Thirty eyes of fifteen white rabbits had a fat autograft placed between the inferior rectus and the periosteum of the inferior orbital rim and then, the inferior rectus, the fat and the periosteum were sutured to create an experimental FAS. In Group I the experimental FAS was only induced as a control group. The polyurethane film with no released substance and the polyurethane film with sustained release of dexamethasone were inserted between the inferior rectus and the fat in Group II and Group III, respectively. The force required to move the eyeball superiorly 4mm, 6mm, and 8mm was measured preoperatively and 4 weeks ostoperatively. At postoperative 4 weeks the surgical dissection to evaluate the degree of the adhesion and the histologic examination were performed. A significant increase in forced duction(postop-preop) was found at all levels of ocular rotation in Group I and it means that the induction of experimental FAS was successful. Histology revealed a moderate inflammatory response with partial loss of normal adipose tissue replaced by fibrovascular tissue. Group III had significantly less restriction than Group I and Group II. Group II had less restriction than Group I, but statistically not significant. In conclusion, the use of the polyurethane film with sustained release of dexamethasone may have a role in the prevention of experimental FAS.
Adipose Tissue ; Autografts ; Dexamethasone ; Muscles ; Orbit ; Periosteum ; Polyurethanes* ; Rabbits* ; Strabismus