Our country has a dual medical system and as the importance of medical devices in medical practice has grown, oriental medical doctors have sought to use modern medical devices to broaden the scope of their oriental medical practice. Case No. 2012Hun-Ma551·561, which supports the use of modern medical devices by oriental medical doctors contains 3 important errors. First, its finding that a slit lamp microscope automatically provides examination results is erroneous. Second, the Court also mistakenly finds that medical service technologists, etc. Act does not prohibit the usage of devices in the instant case; thus, there is no need for the regulation of said devices. Finally, its finding lacks the proper procedure of considering the opinions of related professional groups. Thus, Case No. 2012Hun-Ma551·561 should not be considered a precedent supporting the use of modern medical devices by the oriental medical practitioners.
Slit Lamp

To realize the remote operation of the slit lamp microscope for department of ophthalmology consultation, and visual display the real-time status of remote slit lamp microscope, a remote slit lamp microscope consultation system based on B/S structure is designed and implemented. Through framing the slit lamp microscope on the website system, the realtime acquisition and transmission of remote control and image data is realized. The three dimensional model of the slit lamp microscope is established and rendered on the web by using WebGL technology. The practical application results can well show the real-time interactive of the remote consultation system.
Internet ; Ophthalmology ; methods ; Remote Consultation ; Slit Lamp ; Technology

PURPOSE: In the present study, two cases of intraoperative acute opacification of hydrophilic intraocular lens were reported. CASE SUMMARY: (Case 1) A sixty-seven year-old female presented with chronic visual impairment. Slit lamp examination revealed nuclear cataract of the left eye. Cataract surgery for her left eye was performed. A hydrophilic intraocular lens was checked before implantation and no defect was noted. Immediately after the implantation of the intraocular lens, acute whitish opacification of the intraocular lens occurred. However, the intraocular lens was not explanted, and the opacification cleared after one day. (Case 2) A 65 year-old male presented with chronic visual impairment of the left eye. Nuclear cataract of his left eye was noted, and he went through cataract surgery of the left eye. After the implantation of intraocular lens, acute whitish opacification of the intraocular lens was noted but it disappeared a day after. CONCLUSIONS: Intraoperative acute opacification of intraocular lens seems to occur due to radical temperature change. There is no need to remove or exchange the intraocular lens as opacification tends to clear within a day. No structural or mechanical change of intraocular lens was noted after opacification. Careful management of temperature for intraocular lens storage is necessary for prevention of intraoperative intraocular lens clouding.
Cataract ; Female ; Humans ; Lenses, Intraocular ; Male ; Slit Lamp ; Vision Disorders

PURPOSE: To evaluate the short-term changes in tear film dynamics with non-invasive infrared imaging measurement before and after cataract surgery as a pilot study. METHODS: Seventeen eyes of 17 patients without preoperative dry eye were enrolled in this study. Non-invasive keratograph tear break-up time (NIK-TBUT) and non-invasive keratograph tear meniscus height (NIK-TMH) were measured before and 1 day, 1 week, and 1 month after cataract surgery using a keratograph. RESULTS: The mean patient age was 64.47 ± 10.28 years, and 78.95% were female. Although the mean postoperative 1 day NIK-TBUT-first value was not significantly different from the preoperative value, the mean postoperative 1 week and 1 month NIK-TBUT-first values were significantly lower than preoperative values (p < 0.05). The postoperative 1 day, 1 week, and 1 month NIK-TBUT-average and the NIK-TMH values were not different from preoperative values. CONCLUSIONS: Our study showed that cataract surgery can lead to tear film instability. And it is important to determine the long-term outcomes of surgery and whether NIK-TBUT and NIK-TMH correlate with slit lamp examination tear break-up time (SLE-TBUT) and slit lamp examination tear meniscus height (SLE-TMH).
Cataract ; Female ; Humans ; Phacoemulsification* ; Pilot Projects* ; Slit Lamp ; Tears*

PURPOSE: To analyze blinking patterns when watching an ultra-high definition (UHD) television and to compare the results between normal eyes and dry eyes. METHODS: A total of 59 participants aged from 13 to 69 years were instructed to watch a colorful and dynamic video on a UHD television for 10 minutes. Before and after watching the UHD television, we measured the best corrected visual acuities, autorefraction, tear-break-up-time, degree of corneal erosion and conjunctival hyperemia via slit lamp biomicroscopy. In addition, questionnaires for the evaluation of eye fatigue and symptoms of a dry eye were completed. The definition of dry eye syndrome was that the tear-break-up-time of one of the eyes was less than 5 seconds, conjunctival injection, or marked corneal erosion. The number of blinks and the duration of blinking were both measured and analyzed at the early and late phases of video-watching. RESULTS: After watching the UHD television in the normal eye group, the tear-break-up-time was significantly decreased (p < 0.001) and the degree of corneal erosion was significantly increased (p = 0.023). However, the subjective symptoms of participants were not aggravated (p = 0.080). There were no significant differences in blinking patterns in the dry eye group. On the other hand, in the normal eye group, the mean blinking time was significantly increased (p = 0.030). CONCLUSIONS: Watching an UHD television changes the tear-break-up-time, degree of corneal erosion, and blinking pattern in normal eyes, which may increase the risk of dry eye syndrome.
Asthenopia ; Blinking* ; Dry Eye Syndromes ; Hand ; Hyperemia ; Slit Lamp ; Television* ; Visual Acuity

PURPOSE: To investigate the relationships between tear osmolarity and other ocular surface parameters and to determine the diagnostic value of tear osmolarity in primary Sjögren's syndrome (SS) using tear film break-up time, Schirmer I test, and cornea/conjunctiva staining. METHODS: We included 310 eyes of 155 patients diagnosed with dry eye disease (39 primary SS and 116 non-Sjögren dry eye disease) at Seoul St. Mary's Hospital from August 2010 to January 2015. All subjects completed the Ocular Surface Disease Index (OSDI) questionnaire and underwent ocular examinations including tear osmolarity (TearLab Osmolarity System), Schirmer I test, slit lamp examination for tear film break-up time, and corneal and conjunctival fluorescein staining. We used the mean value of both eyes for all parameters. Fluorescein staining was assessed using the Sjögren's International Collaborative Clinical Alliance ocular staining score (OSS). RESULTS: In primary SS patients (n = 39), the mean subject age was 52.5 ± 11.9 years, and 94.9% of the subjects were women. Mean tear osmolarity in SS was 311.1 ± 16.4 mOsm/L, with 16 (41.0%) subjects having values ≥316 mOsm/L. In SS, there was a positive correlation between mean tear osmolarity and OSDI score (ρ = 0.405, p = 0.011) and OSS (ρ = 0.592, p < 0.001). There was a negative correlation between mean tear osmolarity and the Schirmer I test (ρ = −0.625, p < 0.001). There was no significant correlation between mean tear osmolarity and tear film break-up time in SS (ρ = 0.110, p = 0.505). CONCLUSIONS: Tear osmolarity measurements using the TearLab Osmolarity System can reflect both symptom severity (OSDI) and objective signs (Schirmer test and OSS) in SS.
Dry Eye Syndromes ; Eye Diseases ; Female ; Fluorescein ; Humans ; Osmolar Concentration* ; Seoul ; Slit Lamp ; Tears*

PURPOSE: Following planned posterior continuous curvilinear capsulorrhexis (PCCC) during cataract surgery in adults, we evaluated the clinical effects of visual acuity and prevention of posterior capsule opacity. METHODS: The clinical results were studied retrospectively by comparing 43 eyes of 43 patients who underwent cataract surgery with PCCC (the experimental group) and 46 eyes of 31 patients who underwent cataract surgery without PCCC (the control group). Preoperative and postoperative best corrected visual acuities (BCVAs) of patients were measured. BCVA (using log MAR) and the occurrence of posterior capsule opacity were closely monitored in both groups preoperatively, two months postoperatively, and at each group's final visit (14.6 months postoperatively for the experimental group and 15.7 months for the control group). One-piece plate intraocular lens was used in cataract surgery. RESULTS: Preoperative BCVA was lower in the control group but not significantly. The 2-month mean postoperative BCVA showed improvement in vision in both the control and experimental groups. In both groups, the BCVA was decreased at the final examination compared with the 2-month postoperative BCVA, and significant differences between the two groups were not observed. Under slit lamp examination, anterior hyaloid opacity was observed in 13 of 43 eyes that underwent PCCC. The decrease in BCVA in 13 eyes with anterior hyaloid opacity was significantly different (p < 0.05) compared with the 2-month postoperative BCVA. CONCLUSIONS: Considering the effort and operation skills required for PCCC, the clinical benefits are negligible. Since cataract surgery with PCCC can cause reduced vision due to anterior hyaloid opacity, side effects should be disclosed before PCCC is performed.
Adult* ; Capsulorhexis* ; Cataract ; Humans ; Lenses, Intraocular ; Retrospective Studies ; Slit Lamp ; Vision, Low ; Visual Acuity

PURPOSE: To report one case involving Thelazia callipaeda subconjunctival infestation. CASE SUMMARY: A 52-year-old man came in with left eye discomfort that started about a month prior to hospital visit. Slit lamp examination identified a live white translucent parasite about 10 mm in length and about 0.3 mm in width moving under the lower left eye subconjunctiva. No other abnormal findings were found in the front or fundus. An incision of about 5 mm in the conjunctiva where the parasite was located was carried out, and after opening the area, the parasite was slowly pulled out using a clamp. Then, the bottom of the conjunctiva was washed with normal saline. Further, five additional parasites were found in the conjunctival sac and were removed. The parasite was identified as Thelazia callipaeda, and through outpatient follow-up for 1 month after removal, additional parasites were not found. CONCLUSION: The authors report this case of intraocular Thelazia callipaeda infestation because it is not known to be common; however, the authors witnessed a number of parasites in the conjunctival fornix, as well as Thelazia callipaeda in the subconjuctiva.
Conjunctiva ; Follow-Up Studies ; Humans ; Lacrimal Apparatus ; Middle Aged ; Outpatients ; Parasites ; Slit Lamp ; Thelazioidea

PURPOSE: To report cases of oil droplet cataract, one cause of decreased vision of unknown etiology. METHODS: We performed a retrospective chart review analysis of patients referred to the neuro-ophthalmology clinic due to unknown etiology of decreased visual acuity and diagnosed with oil droplet cataract. Clinical features including history, result of ophthalmologic examinations, and clinical course were evaluated. RESULTS: Among the patients referred to the neuro-ophthalmology clinic due to unknown etiology of decreased visual acuity, 6 patients were diagnosed with oil droplet cataract. The patients ranged from 38 to 63 years of age and their best corrected visual acuities at their first visits were between 0.1 and 0.7. Ophthalmologic examinations including neuro-ophthalmologic tests were normal except for changes in lens nucleus and peculiar fundus reflexes were observed using retinoscopy in all patients. Five eyes of 4 patients underwent cataract surgery and all 5 eyes achieved the best corrected visual acuity of 1.0 or higher. CONCLUSIONS: Oil droplet cataract is a cause of decreased visual acuity of unknown etiology that can be missed. The disease abnormalities are difficult to observe because only subtle changes in lens nucleus are apparent on slit lamp examination; however characteristic fundus reflexes can be identified using retinoscopy. Ophthalmologists should thoroughly understand the oil droplet cataract and diagnose it in the early stages to avoid misdiagnosis and unnecessary costs.
Cataract* ; Diagnostic Errors ; Humans ; Reflex ; Retinoscopy ; Retrospective Studies ; Slit Lamp ; Visual Acuity

PURPOSE: Superior oblique myokymia is intermittent spontaneous contractions of the superior oblique muscle presenting as rapid and small-amplitude intorsions and depressions of the eye. The authors report a case of superior oblique myokymia that was objectively and quantitatively diagnosed with slit lamp examination and video-oculography and completely resolved with medical treatment. CASE SUMMARY: A 44-year-old woman presented with a seven-year history of intermittent oscillopsia which continued for few seconds. She had no history of head trauma or systemic ocular disease, and the anterior segment and fundus examination were unremarkable. Right eye intorsion lasting for a few seconds as detected by slit lamp examination. Eye movements were recorded using video-oculography, which showed a torsional nystagmus of 5 to 10 degrees with 2 to 5 vertical components in the right eye. Based on these findings, the patient was diagnosed with superior oblique myokymia. The patient was prescribed topical timolol ophthalmic solution, one drop twice per day, but the symptoms persisted. Timolol ophthalmic solution was stopped and replaced with carbamazepine, 200 mg twice a day, which resolved her symptoms. CONCLUSIONS: Slit lamp examination and video-oculography can be used as objective and quantitative diagnostic tools in order to confirmed a diagnosis and lead to proper treatment.
Adult ; Carbamazepine ; Craniocerebral Trauma ; Depression ; Diagnosis* ; Eye Movements ; Female ; Humans ; Slit Lamp ; Timolol ; Trochlear Nerve Diseases*