PURPOSE: To analyze and compare the clinical characteristics of patients with herpes zoster ophthalmicus (HZO) by age groups on the basis of the age of 60. METHODS: Medical records of patients with HZO who visited Chonbuk National University Hospital from February 1, 2002 to February 28, 2011 were reviewed. The patients with follow-up of three months or more were divided into two groups: patients under 60 and patients with 60 years old and over. The clinical characteristics between two groups were examined through the analysis of their medical records. RESULTS: Among a total of 63 patients, 29 patients (46%) were under 60 years old, and 34 patients (54%) were 60 years old and over. Incidence of HZO highest in the sixties. The sex and intrusion of each group showed no difference. Younger patients had a higher incidence of pseudodendrite by HZO (86.2% vs. 58.8%, p = 0.014) compared with older patients who showed a higher incidence of post herpetic neuralgia (13.8% vs. 35.3%, p = 0.046). As patients showed Hutchinson's sign, they often had more ocular complications such as pseudodendrite (100% vs. 64.7%, p < 0.05), uveitis (41.7% vs. 7.8%, p = 0.04), and conjunctivitis (100% vs. 90.2%, p = 0.02). CONCLUSIONS: Herpes zoster ophthalmicus shows different clinical characteristics according to patients' age and requires appropriate treatment. Especially elderly patients showing Hutchinson's sign should be treated early and aggressively enough.
Aged ; Conjunctivitis ; Follow-Up Studies ; Herpes Zoster ; Herpes Zoster Ophthalmicus ; Humans ; Incidence ; Medical Records ; Neuralgia ; Neuralgia, Postherpetic ; Uveitis

PURPOSE: We compared the outcomes of laser iridotomy and primary phacoemulsification when treating acute angle-closure glaucoma. METHODS: This study was conducted with 61 patients diagnosed with acute angle closure glaucoma from January, 2005 to January, 2015. The patients received either laser iridotomy or primary phacoemulsification. The age and gender of each patient, differences of intraocular pressure (IOP) before and after treatment, visual acuity, need for IOP lowering agents and complications were analyzed retrospectively at 1-day, 1-month, 6-month and 12-month after the treatment. Patients who received laser iridotomy with phacoemulsification or trabeculectomy were excluded from this study. Additionally, we included only cases in which treatments were given within 3 days after the onset of symptom. RESULTS: Among the 61 patients, 45 patients received laser iridotomy and 16 patients received primary phacoemulsification. One day after the treatment the laser iridotomy group showed better outcome in their visual acuity (log MAR 0.62 +/- 0.51; p = 0.048). At 6-month postoperatively, the primary phacoemulsification group showed better visual acuity (log MAR 0.07 +/- 0.15; p = 0.013). However, at 12-month postoperatively, the visual acuities were not significantly different between the 2 groups. Regarding IOP, at postoperative 1-month, the group of primary phacoemulsification shows significantly lower IOP (9.5 +/- 1.3 mm Hg), compared with the group of laser iridotomy. A significant difference was observed in the number of IOP lowering agents that patients at 12 month after the treatment. There were no severe complications in either group. CONCLUSIONS: Following the initial treatment of acute angle-closure glaucoma, the primary phacoemulsification showed no significant differences in postoperative visual acuity, IOP and complications compared to the outcomes of laser iridotomy. Additionally, the need for IOP lowering agents was less in the primary phacoemulsification groups at 1 year after the operation.
Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Phacoemulsification* ; Retrospective Studies ; Trabeculectomy ; Visual Acuity

PURPOSE: To report a case of corneal ulcer caused by Achromobacter xylosoxidans in a farmer. CASE SUMMARY: A previously healthy 68-year-old man presented with unilateral redness and irritation after his eye was grazed by a cow's tail. The patient had previously been treated in a local clinic for four days without improvement. Bacterial staining, culture, and an antibiotic sensitivity test were performed from a corneal scrape. The cultures revealed growth of A. xylosoxidans. The patient was treated with moxifloxacin and ceftazidime eyedrops. After three months of treatment, the infection was resolved with mild scarring. CONCLUSIONS: Although it is a rare pathogen, A. xylosoxidans should be considered as a potential pathogen in patients presenting with corneal ulceration due to trauma from an object contaminated by soil or animal feces and having a slowly progressive disease and localized infiltrate but showing Gram-negative bacilli on smear examination.
Achromobacter ; Achromobacter denitrificans ; Aged ; Animals ; Aza Compounds ; Ceftazidime ; Corneal Ulcer ; Eye ; Feces ; Humans ; Keratitis ; Ophthalmic Solutions ; Quinolines ; Soil ; Tail

PURPOSE: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. METHODS: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. RESULTS: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG (χ²=6.15, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. CONCLUSION: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.
Aged* ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip* ; Blood Pressure* ; Blood Sedimentation ; Body Temperature Regulation ; Body Temperature* ; C-Reactive Protein ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypothermia ; Incheon ; Incidence ; Inflammation* ; Korea ; Shivering*

BACKGROUND: There are many rating scales for assessment of geriatrics. But each of these scales were not sufficient to evaluate comprehensive geriatric assessment, physical and psychologic efforts for care. METHODS: We developed new scales to comprehensive geriatric assessment for care of geriatric patients. The Geriatrics Physical Support Scale(GPSS) evaluates physical effort consists of 10 areas and the Geriatrics Global Support Scale(GGSS) evaluates general condition of patients consist of 6 areas. Eighty probable and possible AD patients received the Clinical Dementia Rating Rating Scale(CDR), Korearn version of Mini-Mental State Examination(K-MMSE), Barthel Activity of Daily Living Index(B-ADL) GPSS, GGSS. We tested internal consistency, correlation among dementia rating scales. RESULTS: The GPSS correlated to CDR -0.63(p<0.01), B-ADL -0.90(p<0.01) and the GGSS correlated to CDR -0.60(p<0.01), B-ADL -0.75(p<0.01). The internal consistency were 0.69(GGSS), 0.92(GPSS). CONCLUSION: The Geriatrics Global Support Scale evaluate general condition of patients and the Geriatrics Physical Support Scale evaluate physical efforts needed for care of geriatric patients. These scales an also brief and easy rating scales to grade degree of caregiver`s burden.
Dementia ; Geriatric Assessment ; Geriatrics* ; Humans ; Physical Exertion ; Reproducibility of Results* ; Weights and Measures

PURPOSE: To report the clinical manifestations and prognoses in 5 cases of mixed Candida and bacterial keratitis and present a literature review on mixed fungal and bacterial keratitis. CASE SUMMARY: Five eyes of 5 patients (1 male, 4 female) diagnosed as mixed Candida and bacterial keratitis by corneal smear and culture were included in the present study. Patient mean age was 62.80 years. All patients had preexisting ocular or systemic conditions as predisposing factors for mixed Candida and bacterial keratitis. The most common Candida species isolated was Candida albicans (3 eyes, 60%), while Staphylococcus (3 eyes, 60%) was the most common mixed bacterial species. The average size of ulceration was 7.02 mm2. In 2 eyes (40%), the lesions were located at the corneal center. The depth of the infiltration was significant in all cases, and hypopyon was present in 2 eyes (40%). On the initial visit, the visual acuity was counting fingers or worse in all cases. Four eyes (80%) unresponsive to the topical and systemic treatment underwent surgical intervention but only 1 eye (20%), which had responded to the topical and systemic treatment, showed acuity improvement of more than 1 line on the final visit. CONCLUSIONS: In managing chronically compromised cornea, the possibility of mixed infections with Candida and bacterial organisms should be considered as keratitis shows poor prognosis.
Bacteria ; Candida ; Candida albicans ; Coinfection ; Cornea ; Eye ; Fingers ; Humans ; Keratitis ; Male ; Prognosis ; Staphylococcus ; Ulcer ; Visual Acuity

PURPOSE: This study was performed to evaluate the level of I-TAC in tears of patients with dry eye syndrome and its correlation with the tear surface parameters. METHODS: I-TAC levels were measured by enzyme-linked immunosorbent assay (ELISA) in tear samples collected from 33 dry eye patients (16 patients with Sjogren syndrome and 17 patients with non-Sjogren syndrome) and 15 control subjects. The correlations between I-TAC levels and tear surface parameters including tear film break-up time (BUT), basal tear secretion, tear clearance rate (TCR), corneal sensation, keratoepitheliopathy and conjunctival goblet cell density were analyzed. RESULTS: The mean levels of I-TAC were 717+/-377 pg/ml in patients with dry eye and 444+/-119 pg/ml in control subjects (P=0.003). The mean levels in Sjogren syndrome patients (1261+/-324 pg/ml) were significantly higher than those of non-Sjogren syndrome patients (614+/-131 pg/ml, P=0.003). I-TAC levels correlated significantly with basal tear secretion (P=0.006), TCR (P=0.007), keratoepitheliopathy (P=0.022) and goblet cell density (P<0.001), but did not correlate with BUT (P=0.110) and corneal sensation (P=0.090). CONCLUSIONS: The level of I-TAC is elevated in tears of patients with dry eye syndrome including Sjogren syndrome. The level correlates with disease severity and tear surface parameters.
Dry Eye Syndromes ; Enzyme-Linked Immunosorbent Assay ; Eye ; Goblet Cells ; Humans ; Sensation ; Sjogren's Syndrome ; Tears

BACKGROUND: With the increase of interest in health promotion, doctor's role in health promotion has been progressively emphasized. Although there were many findings which showed that interventions by doctors can result in important changes in the health behaviors of patients, little was known about patients perception of doctor's intervention. Therefore, we attempted to find out about the factors related to patients interests in health behaviors (smoking, alcohol drinking, body weight, and exercise) and patient's perception of the need for doctor's intervention in changing these health behaviors. METHODS: The study subjects were patients who visited either two private clinics (265 patients) or the department of family medicine in a tertiary hospital(410 patients) located in Seoul. Questionnaires concerning demographic characteristics, patients interests, health behaviors, and their perception of the need for doctors intervention in changing health behaviors were administered to the study subjects between March 1997 and June 1997. We examined the factors which had significant relatianship with patient's interest and the perceptions of the need for doctor's intervention in health behaviors with multiple linear logistic regression analysis. The relationship between patients interests in health behavior and the perception of the need for doctor's intervention was evaluated with Spearman's correlation coefficients. RESULTS: Patient's interest and the perception of the need for doctors intervention in smoking was significantly higher in males, smokers, and private clinic patients. Patients interest in alcohol drinking was significantly higher in males, exsmokers, and drinkers. Patient's perception of the need for doctor's intervention in drinking was significantly higher in males, smokers, drinker's, and those who had chronic disease. Patient's interest in body weight control was significantly higher in females, exsmokers, tertiary hospital patients, and those who viewed themselves as obese. Patients perception of the need for doctor's intervention in body weight control was significantly higher in private clinic patients and those who viewed themselves as obese, and was significantly lower in those who recognized their body frame as normal. Patients interest in exercise was significantly higher in those who were older and who was exercising more than once a week. Patient's perception of the need for doctor's intervention in exercise was significantly higher among tertiary hospital patients. Significant relationship between patient's interest and the perception of the need for doctor's intervention in health behaviors, especially in smoking and drinking habit, was observed in private clinic patients as well as those in tertiary hospital. CONCLUSIONS: The degree of patients interest in health behaviors and their perception of the need for doctor's intervention in health promotion was significantly different according to the type of health behavior, the individual health habits, the demographic characteristics, and the type of medical center used by the patient. Therefore, doctors should pay more attention to providing interventions that affect the health behaviors of patients in consideration of these factors.
Alcohol Drinking ; Body Weight ; Chronic Disease ; Drinking ; Female ; Health Behavior ; Health Promotion ; Humans ; Logistic Models ; Male ; Seoul ; Smoke ; Smoking ; Tertiary Care Centers ; Surveys and Questionnaires

PURPOSE: To report a case of high-pressure paint gun injury to the eyeball and ocular adnexa. CASE SUMMARY: A 50-year-old woman was admitted after accidental high-pressure paint injection to her right eye while working. She complained of pain and severe swelling of the eyelids covered with paint. Slit lamp biomicroscopy showed multiple conjunctival lacerations, deposition of paint material on her conjunctiva, corneal edema and crystalline lens dislocation. Orbital computed tomography revealed infiltration of paint material into the retrobulbar space and rupture of medial rectus muscle. The paint was removed from the conjunctiva, Tenon's tissue, and medial orbit after the medial rectus muscle was disinserted. On the second postoperative day, the wound was irrigated and pus was drained from the conjunctiva wound. Two months after the operation, the patient underwent cataract removal due to high intraocular pressure associated with lens dislocation. Six months after the operation, eyeball movement was improved except medial gaze, and the cornea was stable with moderate corneal haziness. CONCLUSIONS: In high-pressure paint gun injury to the eye, detail evaluation, prompt removal of the foreign body and proper management of complications are necessary.
Cataract ; Conjunctiva ; Cornea ; Corneal Edema ; Dislocations ; Eye ; Eyelids ; Female ; Foreign Bodies ; Humans ; Intraocular Pressure ; Lacerations ; Lens Subluxation ; Lens, Crystalline ; Middle Aged ; Muscles ; Orbit ; Paint ; Rupture ; Suppuration

PURPOSE: To report the clinical effect of an eyelid stretching exercise in 8 cases of overcorrected congenital ptosis after levator resection and present a literature review. CASE SUMMARY: Eyelid stretching exercise was performed by pushing the margin of the upper eyelid down. If margin reflex distance 1 (MRD1) asymmetry was larger than 1.5 mm compared with the other eyelid after the stretching exercise for 2 weeks, the exercise was extended for 1 more week. This study included 8 eyes of 8 patients who performed eyelid stretching exercise for 2 weeks when overcorrected 1 week after undergoing levator resection. We compared preoperative MRD1 and postoperative MRD1s for 1 month. Overcorrection was corrected satisfactorily in all patients with bilateral symmetry with eyelid stretching exercise for 2 weeks. Additional exercise did not affect MRD1. CONCLUSIONS: In congenital ptosis overcorrected after levator resection, medical treatment including eyelid stretching exercise could be considered before undergoing a secondary operation. Eyelid stretching exercise can be effective when performed early before fibrous tissue bonds are too firm.
Eyelids* ; Humans ; Reflex