PURPOSE: To compare the anterior segment parameters including precorneal tear film thickness (PTFT) using Pentacam(R) (Oculus, Wetzlar, Germany) between normal control and dry eye groups and to examine the relationships between the PTFT and other parameters for dry eye. METHODS: The present study included 23 normal controls (31 eyes) and 25 patients with dry eyes (31 eyes). We compared measurements including PTFT, corneal thickness and astigmatism using Pentacam(R) and analyzed the correlations among the PTFT and fluorescein tear break-up time (FBUT), Schirmer I test (without anesthesia), and ocular surface disease index (OSDI). RESULTS: The mean PTFT in dry eyes (21.1 +/- 2.0 microm) was significantly thinner than in normal eyes (37.6 +/- 2.0 microm; p < 0.01). In the dry eye group, the corneal thickness was thicker than in the normal eye group but there were no clinically significant differences. The dry eye group experienced more frequent and severe corneal astigmatism compared with the normal group. OSDI scores showed a weak negative correlation with objective clinical measures of dry eye (FBUT, Schirmer I test) but was not statistically significant. However, OSDI was statistically significantly negatively correlated with PTFT (r = -0.46, p < 0.01). The PTFT showed a weak positive correlation with FBUT and Schirmer I test without statistical significance. CONCLUSIONS: The mean PTFT using Pentacam(R) in the dry eye group was thinner than in the normal group. Additionally, the PTFT was correlated with subjective symptoms. Therefore, the PTFT measurement using Pentacam(R) could be considered a useful method for diagnosis and treatment of dry eye.
Astigmatism ; Diagnosis ; Fluorescein ; Humans ; Tears*

This study was performed to evaluate epidemiology and progression of keratoconus in Korean. 122 patients(223 eyes)who visited Kang-Nam St.Mary's Hospital and Bu-Pyung our lady of mercy hospital with keratoconus from 1989 to 1998 were reviewed retrospectively. At the time of diagnosis, prevalence in male(75 patients)was greater than that in female(47 patients)and the rate bilateral involvement was 84.4%(103 patients). The average age was 18.33+/-6.79 years and there is no difference between that of male and female. The greatest number of patients(63 patients, 51.6%)had been diagnosed from 15 to 24 years old. The mean astigmatism was 3.92+/-1.91 diopters. Of the 19 patients with unilateral keratoconus, 10 patients were followed up over three years(average follow period: 61months)and four reported that the disease had later been diagnosed in the contralateral eye. The greatest number of patients(107 eyes, 47.9%)had been examined from 0.02 to 0.1 in visual acuity without correction and 58 eyes(26.0%)achieved visual acuity with hard contact lens correction. Corneal findings included thinning(158 eyes), scarring(62 eyes), Fleischer ring(119 eyes), Vogt's striae(78 eyes). On corneal topography, a half of apex of cone(57 eyes of 107 eyes, 53.2%)was located in inferior temporal quadrant and highest rate of steepening(corneal power change away from the apex to the periphery along its semimeridian)was 2.70+/-1.48 diopters.
Astigmatism ; Corneal Topography ; Diagnosis ; Epidemiology ; Female ; Humans ; Keratoconus* ; Male ; Prevalence ; Retrospective Studies ; Visual Acuity ; Young Adult

PURPOSE: To investigate the trend of refractive change in hyperopic patients according to increases in age. METHODS: Eighty-eight children who had hyperopia of more than +1.50 diopters (D) and could be followed up for at least 5 years were included in this study. We divided the patients into two groups according to the level of initial hyperopia and retrospectively analyzed hyperopic refractive changes over a 5-year period according to age at initial diagnosis, presence of esotropia, amblyopia, astigmatism and anisometropia. RESULTS: We gained the following formula about the aspect of hyperopic reduction in 88 patients over a period of 5 years: Diopter (D)=7.99-2.14 Ln (age). The presence of anisometropia and amblyopia did not affect hyperopic reduction. Hyperopic reduction amounts in the group with a hyperopic eye of more than +5D at initial diagnosis were greater than in the group with a hyperopic eye less than +5D, and greater in the group with an astigmatic eye of more than 1D. The presence of esotropia and the age at initial diagnosis did not affect hyperopic reduction. CONCLUSIONS: We show that emmetropization in hyperopic children occurs according to the following formula: Diopter (D)=7.99-2.14 Ln (age). Both the initial level of hyperopia and the concurrent presence of astigmatism affected hyperopic reduction. However, the presence of anisometropia, amblyopia, esotropia and the age at initial diagnosis did not significantly affect hyperopic reduction.
Amblyopia ; Anisometropia ; Astigmatism ; Child ; Diagnosis ; Esotropia ; Follow-Up Studies* ; Humans ; Hyperopia ; Retrospective Studies

This experimental study sought to determine the repeatability of a Video Keratography System specially designed for animals with small eyes. From day 5, ten newly hatched White Leghorn chicks were reared with monocular hyperopic defocus using -5.0D (n = 3), -10.0D (n = 3), -15.0D(n = 4) spherical PMMA lenses on their right eyes; the left eyes served as controls. Two sets of corneal topographical measurements, each set separated by about 5 minutes apart, were collected from both eyes of each animal at the end of 2-wk treatment period (i. e., 19 days of age). Each set of measurements consisted of five consecutive readings of corneal astigmatism. Bland-Altman plots were used to evaluate the repeatability of 3, 4 or all 5 readings from each set of data. When all 5 consecutive readings were used, the mean difference (95% limits of agreement) for the right treated and left untreated eyes were, respectively, -0.09D (-0.81, 0.64) and -0.02D (-0.86, 0.82). There was a tendency that lesser readings from each set of data produced greater difference between the two sets of measurements, although the differences (-0.19D) were not clinically significant. The Video Keratography System specially designed for animals with small eyes produced repeatable measurements for both treated and untreated eyes in chickens. Further studies are needed to validate other biometric features associated with corneal changes during normal and abnormal eye growth.
Animals ; Astigmatism ; diagnosis ; Chickens ; Cornea ; anatomy & histology ; Corneal Topography ; instrumentation ; Equipment Design

PURPOSE: To inform the necessity of mass screening, we performed a mass screening for the detection of ocular disorders of preschool children. METHODS: Ocular examination was performed on 60, 827 children in Korea (3-6 years of age) during the period from March to October, 2000. The total of 3, 254 children were shown to have either visual acuity of less than 0.5 or anisometropia of over 2 lines. Detailed eye examination was conducted on those 3, 254 children. RESULTS: The numbers of first mass screening were 60, 826. Diagnosis consisted of refractive errors in 2, 216, amblyopia in 664, and strabismus in 235. Among the types of refractive errors, myopic astigmatism was the most common type (34.0%). Astigmatism was combined with all other types in 1, 659 children. Refractive error was the most common cause of amblyopia (88.0%) CONCLUSIONS: To prevent and treat amblyopia or strabismus, early detection and adequate care at preschool age seemed to be very effective. Participation rate for this mass-screening of eye disease during preschool age will be more increased by efforts of constiutional support and parental cooperation.
Amblyopia ; Anisometropia ; Astigmatism ; Child* ; Child, Preschool ; Diagnosis ; Eye Diseases ; Humans ; Korea* ; Mass Screening ; Parents ; Refractive Errors ; Strabismus ; Vision Screening* ; Visual Acuity

PURPOSE: To prevent permanent visual disturbance, we performed a mass screening for the detection of ocular disorders of preschool children. METHODS: Ocular examination was performed on 33,955 children in Seou(3~6 years of age)l, during the period from January to December, 2000. 435 children were shown to have either visual acuity of less than 0.5 or anisometropia of over 2 lines. Detailed Eye examination. was conducted on those 435 children. RESULTS: Diagnoses consisted of refractive errors in 325(74.7%), amblyopia in 91(20.9%), strabismus 21(4.8%) and anterior segment abnormalities in 34(7.8%). Among th types of refractive errors, hyperopic astigmatism 98(30.4%) was the most common type. Astigmatism was combined with all other types in 257(79.9%) children. In cases of strabismus, exotropia was 12(57.1%) and esotropia was 4(19.0%). Refractive error was the most common cause of amblyopia(88(96.7%)). CONCLUSIONS: To prevent and treat amblyopia or strabismus, easily detection and adequate care at preschool age seemed to be very effective. Participation rate for this mass-screening of eye disease during preschool age will be more increased by efforts of constitutional support and parental coperation.
Amblyopia ; Anisometropia ; Astigmatism ; Child* ; Child, Preschool ; Diagnosis ; Esotropia ; Exotropia ; Eye Diseases ; Humans ; Mass Screening ; Parents ; Refractive Errors ; Seoul* ; Strabismus ; Vision Screening* ; Visual Acuity

Keratoconus (conical cornea) is a condition, beginning about puberty and developing mainly in females, in which the apex of the cornea thins gradually and usually bilaterally. The etiology is unknown. The presenting symptom is a reduction of the patient's vision owing to the development of a high degree of irregular myopic astigmatism. Early in the course of the disease the cornea does not look conical. The diagnosis of Keratoconus is confirmed by the distorted reflex observed with a Placido's disc and abnormal keratometer readings. In more advanced stages, signs include the obvious cone-shaped cornea and indentation of the lower lid by the cornea. By slit lamp biomicroscopy, vertical lines are noted in the deep layers of the stroma: the corneal nerve fibers are increasingly visible; and in about 50% of cases a yellow or green line is present around the base of the corn (Fleischer's ring). In advanced cases Bowman's membrane and Descemet's membrane rupture. Microscopically there is thinning of the tissue spaces between the corneal lamellae, fragmentation of the basement membrane of the comeal epithelium, fibrillation of Bowman's membrane, and folds or ruptures in Descemet's membrane. Acute hydrops may occur when Descemet's membrane ruptures. This is characterized by sudden cloudiness of vision due to imbibition of aqueous in the corneal stroma. However, as Descemet's membrane regenerates, the edema subsides. Permanent scarring may result if Bowman's membrane ruptures. Acute hydrops of the cornea was developed respectively in left eye on Oct, 1976 and in right eye on Dec, 1976 in a 13 year old Korean girl with Keratoconus O.U.
Adolescent ; Astigmatism ; Basement Membrane ; Bowman Membrane ; Cicatrix ; Cornea* ; Corneal Stroma ; Descemet Membrane ; Diagnosis ; Edema* ; Epithelium ; Female ; Humans ; Keratoconus* ; Nerve Fibers ; Puberty ; Reading ; Reflex ; Rupture ; Zea mays

PURPOSE: We report two cases of Cohen syndrome associated with ophthalmologic findings, which is the first such report from Korea. METHODS: A 14-year-old boy and a 13-year-old girl, a brother and sister, who had visited the department of pediatrics for evaluation of developmental disorders was transferred to the department of ophthalmology due to evidence of nyctalopia and decreased visual acuity. There, refraction, ultrasonography, and fundus examinations were performed. RESULTS: The children had high myopia, and refractive astigmatism. Bull's eye maculopathy with a pale disc was found on the fundus examination. There were characteristic facial appearances including wave-shaped, down-slanting palpebral fissures and short philtrum. They also had grimacing expressions upon smiling. Neutropenia was identified in the female patient. CONCLUSIONS: Cohen syndrome should be suspected and considered in the differential diagnosis of patients with high myopia, nyctalopia, and decreased visual acuity.
Adolescent ; Astigmatism ; Child ; Diagnosis, Differential ; Female ; Humans ; Korea ; Lip ; Male ; Myopia ; Neutropenia ; Night Blindness ; Ophthalmology ; Pediatrics ; Siblings ; Smiling ; Ultrasonography ; Visual Acuity

PURPOSE: To investigate the biometric risk factors for corneal surface complications associated with hydrogel soft contact lens (SCL) fitting in myopic patients in Korea. METHODS: This is a retrospective case-control study. The records of 124 subjects (124 eyes) who wore SCLs on a daily basis were reviewed. Thirty-one patients (31 eyes) who were diagnosed with corneal neovascularization (NV) while wearing SCLs were included in the complication group. Ninety-three age- and sex-matched patients (93 eyes) who wore SCLs, who did not have corneal NV and who visited our clinic for correction of refractive errors were included in the control group. The degree of spherical equivalent, astigmatism and corneal base curve radius (BCR) were compared in both groups. RESULTS: Patients with NV exhibited poorer best corrected visual acuity and more myopia than controls (p = 0.008 and 0.006, respectively). In univariate analysis, highly myopic patients (-9 diopters [D] or higher) were more likely to experience NV (odds ratio [OR], 2.232; 95% confidence interval [CI], 1.602 to 3.105). High astigmatism (> or =2 D) increased the risk of complications (OR, 2.717; 95% CI, 1.141 to 6.451). Steep cornea, in which BCR was <7.5 mm, also raised the risk of complications (OR, 4.000; 95% CI, 1.661 to 9.804). Flat cornea was not a risk factor for the development of NV. CONCLUSIONS: High myopia, high astigmatism, and steep cornea seemed to be risk factors in the development of corneal NV in SCL wearers.
Adult ; Astigmatism/diagnosis ; Biometry ; Case-Control Studies ; Contact Lenses, Hydrophilic/*adverse effects ; Corneal Neovascularization/diagnosis/*etiology ; Female ; Humans ; Hydrogel ; Male ; Myopia/diagnosis/*therapy ; Prosthesis Fitting ; Retrospective Studies ; Risk Factors ; Visual Acuity

We investigated pseudophakic residual astigmatism in order to minimize postoperative refractive astigmatism. We examined 110 eyes of 87 patients who had undergone phacoemulsification with small incision and posterior chamber intraocular lens (IOL) implantation. Corneal astigmatism was measured using an autokeratometer (RK-5, canon), refractive astigmatism by manifest refraction, and residual astigmatism by vector analysis. Mean pseudophakic residual astigmatism was +0.47 X 176degrees, predominantly against-the-rule. Variations of pseudophakic residual astigmatism according to sex, age and IOL type were not statistically significant. When performing cataract surgery as refractive surgery, we may consider that pseudophakic residual astigmatism is approximately 0.50D against-the-rule.
Adult ; Aged ; Aged, 80 and over ; Astigmatism/diagnosis/*etiology ; Comparative Study ; Female ; Humans ; *Lens Implantation, Intraocular ; Lenses, Intraocular ; Male ; Middle Aged ; *Phacoemulsification ; *Postoperative Complications ; Postoperative Period ; Pseudophakia/diagnosis/*etiology ; Refraction, Ocular ; Retrospective Studies