Purpose: To evaluate the clinical characteristics of patients with intermittent exotropia who exhibited a dramatic decrease in ocular deviation 1 day before surgery. Methods: This study retrospectively enrolled patients with intermittent exotropia who underwent surgery between Decem-ber 2013 and December 2019. Those who exhibited a decrease in ocular alignment ≥10 prism diopters (PD) at the last exam-ination (1 day before surgery) compared with the largest previous angle of deviation were included. A monocular occlusion test was performed to re-confirm the largest angle of ocular deviation. Results: Among 547 patients with intermittent exotropia, 10 (six females; mean age, 8.6 years) exhibited a dramatic de-crease in ocular deviation before impending surgery. The mean largest angle of deviation was 31.0 PD (range, 20 to 50 PD) at distance and 34.5 PD (range, 20 to 55 PD) at near. The mean control scores using the LACTOSE (Look and Cover then Ten Seconds of Observation Scale for Exotropia) scoring system were 2.5 at distance, 1.8 at near, and 4.3 when combined. Mean ocular deviation prior to the impending surgery decreased to 7.4 PD (range, 0 to 10 PD) at distance and 6.2 PD (range, -10 to 10 PD) at near. The largest angle of ocular deviation was re-confirmed using the monocular occlusion test in all patients. All patients underwent surgery as planned, and none exhibited postoperative overcorrection. Conclusions A relatively small number of patients with intermittent exotropia exhibited a dramatic decrease in ocular align-ment 1 day before surgery but demonstrated a relatively better level of control. The monocular occlusion test was helpful in re-confirming the largest angle of ocular deviation.

Purpose: To compare clinical characteristics between the poor visual outcome (PVO) and good visual outcome (GVO) groups in culture-proven bacterial keratitis. Methods: A total of 230 cases (44 and 186 eyes in the PVO and GVO groups, respectively) of culture-proven bacterial keratitis, treated between January 2007 and December 2020, were reviewed retrospectively. The PVO group included cases with the final best-corrected visual acuity (BCVA) of less than 0.1 and no improvement compared to the initial BCVA. The remaining cases were included in the GVO group. The microbiological profiles, epidemiology, predisposing factors, and clinical characteristics were compared between the PVO and GVO groups, and the risk factors for PVO were analyzed. Results: Staphylococcus spp. and Pseudomonas spp. were common isolates in both the PVO and GVO groups, with no significant differences in the distribution of isolates. There were no significant differences between the groups in terms of sex, seasonal distribution, corneal trauma, and prior topical steroid use, but contact lens wear was significantly less in the PVO group. Significant risk factors for PVO were age ≥60 years (Z = 4.22, two-proportion Z-test), central corneal lesions (Z = 3.80), epithelial defect size ≥5 mm2 (Z = 3.74), prior ocular surgery (Z = 3.63), hypopyon (Z = 3.42), previous ocular surface disease (Z = 3.32), and diabetes (Z = 3.12). Conclusions In patients with bacterial keratitis, PVO was associated with older age, severe initial corneal findings, previous ocular disease history, and diabetes, but not with the causative pathogen itself.