PURPOSE: We evaluated the structure, innervation of the extraocular pulley smooth muscle in the rabbit. METHODS: A rabbit was transcardially perfused with physiological saline followed by 4% formalin. The rabbit orbit was dissected en bloc, paraffin processed, and serially sectioned for Hematoxylin-Eosin and Masson's trichrome stain. The distribution of the extraocular pulley smooth muscle was confirmed by immunohistochemistry with human smooth muscle(SM) alpha-actin. RESULTS: We found that the pulley structure consisted of focal condensations of eleastin and collagenous connective tissue in relationship to the rectus muscle in the equatorial Tenon's fascia. The pulley smooth muscle in relation to medial rectus muscle was immunostained with TH and nNOS. CONCLUSIONS: The data support the presence of the extraocular pulley smooth muscle in the rabbit orbit having both parasympathetic and sympathetic innervation.
Actins ; Collagen ; Connective Tissue ; Fascia ; Formaldehyde ; Humans ; Immunohistochemistry ; Muscle, Smooth* ; Orbit ; Paraffin

The authors clinically analysed 317 industrial ocular injuries among 16,466 patients who visited department of ophthalmology of Masan Koryo General hospital during the 5 years from January 1, 1982 to December 31, 1986. The results were as follows: 1. The ambulation rate of industrial ocular injuries was 1.9% of all eye patients and 18.4% of all industrial injuries. 2. The incidence was higher in male(95.6%) and in the age of 3 rd decade(5.2%). 3. The incidence of affected side was 54.0% on the right, 37.5% on the left, and 8.5% on both sides. 4. There was no significant differences in seasonal distribution. 5. The most common cause of industrial ocular injuries was iron piece(32.8%) as a flying particle, followed by wire and nail(15.1%) and chemicals(8.2%). 6. Corneal foreign body(15.8%) was the most common disease of all industrial ocular injuries, followed by corneal laceration(12.7%) and thermal burn, conjunctiva and cornea(8.9%). 7. 29.3% of all industrial ocular injuries were hospitalized. Corneal laceration(21.0%) was the most common disease among in-patients and surgical procedures in in-patients included corneal suture(33.0%), lens extraction(17.5%), corneosclecral suture(13.6%). The average duration of hospitalization was 16.8 days. 8. The average duration of treatment required for all industrial ocular injuries was about 46.3 days. 9. The final visual acuity was improved to 0.9 or more in 45.3% and 34 eyes(9.9%) were below 0.1. 10. The most common complication of industrial ocular injuries after treatment was traumatic cataract(18.4%), followed by corneal opacity(16.8%) and irregular astigmatism(14.4%).
Burns ; Conjunctiva ; Diptera ; Hospitalization ; Hospitals, General ; Humans ; Incidence ; Iron ; Ophthalmology ; Seasons ; Visual Acuity ; Walking

PURPOSE: Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare disase, which causes chronic progressive inflammation and thickening of the basal dura mater. We report a case of IHCP associated with superior oblique paralysis and present a review of the literature. METHODS: An 8-year-old boy presented with binocular diplopia and left side head tilting. Suspecting right superior oblique muscle paralysis, an alternating prism test, head tilt test, fundus examinations, neurologic examination, and brain MRI were performed. RESULTS: The brain MRI revealed abnormal enhancement of the right tentorium in the course of the right fourth cranial nerve, leading to a diagnosis of IHCP with paralytic strabismus and the patient was treated with systemic steroid therapy. CONCLUSIONS: We report a case of IHCP with right superior oblique paralysis. Patients with recent onset paralytic strabismus require appropriate neurolgic and neuroimaging examinations.
Brain ; Child ; Diagnosis ; Diplopia ; Dura Mater ; Head ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Male ; Meningitis* ; Neuroimaging ; Neurologic Examination ; Paralysis* ; Strabismus ; Telescopes ; Trochlear Nerve

PURPOSE: To report a case of a Comamonas acidovarans corneal ulcer treated with antibiotics in Korea. Comamonas acidovarans corneal ulcer has not been previously reported to our knowledge. METHODS: A 70-year-old woman visited our clinic complaining of left ocular pain and decreased visual acuity for six days. We performed a smear and culture on the corneal lesion and treated it with topical and systemic antibiotics. RESULTS: Comamonas acidovorans was cultured from ulcer lesion. Corneal ulcer improved with the administration of ciprofloxacin and tobramycin.
Aged ; Anti-Bacterial Agents ; Ciprofloxacin ; Comamonas* ; Corneal Ulcer* ; Delftia acidovorans* ; Female ; Humans ; Korea ; Tobramycin ; Ulcer ; Visual Acuity

PURPOSE: To investigate the change of refractive error between the full-correction and under-correction treatment groups of myopic anisometropic patients. METHODS: This study included 36 patients who had no amblyopia with myopic anisometropia > 3.00 diopters (D) and less than 6.00 D using the cycloplegic refraction test. The patients were divided into two groups involving the full-correction of both eyes (group 1) or full-correction on the less myopic eye and under-correction with −0.50 D of the more myopic eye (group 2). We monitored refractive changes every 6 months for 24 months. RESULTS: At the first visit, the mean refractive error of the less myopic eye was −0.68 ± 0.54 D and that of the more myopic eye was −4.22 ± 0.77 D in group 1. The mean refractive error of the less myopic eye was −0.75 ± 0.58 D and that of the more myopic eye was −4.36 ± 0.73 D in group 2. There was no significant difference between the groups (p = 0.713 and p = 0.585, respectively). At 24 months, the mean refractive errors of group 1 were −1.27 ± 0.54 D and −4.88 ± 0.81 D, respectively, and that of group 2 were 1.38 ± 0.54 D and −5.59 ± 1.01 D, respectively. The mean refractive error of the less myopic eyes showed no significant difference between both groups (p = 0.555), but that of the more myopic eyes was significantly different (p = 0.027). Between both groups, the degree of anisometropia at 24 months was 3.61 ± 0.60 in group 1 and 4.20 ± 0.86 in group 2. Group 2 showed a significant difference and more severe anisometropic changes (p = 0.022). CONCLUSIONS: Full correction of myopic anisometropia without amblyopia is a better method for reducing the progression of anisometropia.
Amblyopia ; Anisometropia ; Humans ; Methods ; Myopia ; Refractive Errors

PURPOSE: To analyze peripapillary retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters with regard to age in children by using optical coherence tomography (OCT). METHODS: We analyzed RNFL thickness and ONH parameters by using Stratus OCT Model 3000 (Zeiss-Humphrey) in two-hundred eyes of 100 children ranging in age from 5 to 14 years, with 5 males and 5 females for each age. RESULTS: The RNFL thicknesses for 100 children (200 eyes) in total were as follows: Mean 104.67+/-9.07 micrometer, superior 131.84+/-18.71 micrometer, temporal 78.49+/-12.91 micrometer, nasal 73.85+/-14.26 micrometer, and Inferior 133.87+/-18.58 micrometer. The parameters of ONH for 100 children (200 eyes) in total were as follows: optic disc area 2.80+/-0.21 mm2, rim area 1.85+/-0.28 mm2, cup to disc area ratio 0.34+/-0.08, horizontal cup to disc diameter ratio 0.47+/-0.11, and vertical cup to disc diameter ratio 0.49+/-0.11. In analyzed RNFL thickness and ONH according to age, there was a significant negative correlation among mean RNFL, inferior RNFL, and age (r=-0.258, p=0.000, r=-0.464, p=0.000). There was a significant positive correlation between nasal RNFL and age (r=0.135, p=0.028). There was a significant positive correlation between disc area and age (r=0.528, p=0.000). There was a significant negative correlation among the cup to disc area ratio, the horizontal cup to disc diameter ratio, the vertical cup to disc diameter ratio, and age (r=-0.170, p=0.008, r=-0.266, p=0.000, r=-0.155, p=0.014). CONCLUSIONS: OCT can be used to measure RNFL thickness and ONH parameters in children. Age had an effect on RNFL thickness and ONH parameters in children.
Child* ; Female ; Humans ; Male ; Nerve Fibers ; Optic Disk* ; Optic Nerve* ; Retinaldehyde ; Tomography, Optical Coherence

PURPOSE: We report a case of acute visual loss with ophthalmoplegia after prone position spinal surgery who had blood supply dependence on collateral circulation due to occlusion of the Internal carotid artery. CASE SUMMARY: A 74-year-old man was referred to the department of ophthalmology for acute visual loss and ophthalmoplegia after lumbar spine surgery performed in prone position. On the initial visit, his right visual acuity was 0.8 and the left visual acuity was negative light perception. Intraocular pressure was normal. There was a relative afferent pupillary defect and ophthalmoplegia of all directions in the left eye. Because of the ptosis of the upper eyelid in the left eye, it was impossible to tune the eye voluntarily. The cherry red spot and pale retina were observed on the fundus examination. On brain magnetic resonance imaging angiography, we found complete obstruction of the left internal carotid artery. He had intravenous injection of 1 g methylprednisolone for 3 days, and discharged with per oral medicine. After 1 month of treatment, the ophthalmoplegia was slightly improved, but visual acuity was not recovered. CONCLUSIONS: In this case, unlike previous reports, acute visual loss and ophthalmoplegia occurred after spinal surgery the patient who had collateral circulation for ocular blood supply because of complete obstruction of the left internal carotid artery. This report highlights the importance of being aware of the anatomical variant in possible complications of external ocular compression after non-ocular surgery.
Aged ; Angiography ; Brain ; Carotid Artery, Internal ; Collateral Circulation ; Eyelids ; Humans ; Injections, Intravenous ; Intraocular Pressure ; Magnetic Resonance Imaging ; Methylprednisolone ; Ophthalmology ; Ophthalmoplegia ; Oral Medicine ; Prone Position ; Pupil Disorders ; Retina ; Retinal Artery Occlusion ; Spine ; Visual Acuity

A 21-year-old woman underwent bilateral augmentation mammoplasty by injection of an unknown volume of fat obtained via trochanteric and abdominal liposuction. The procedure was performed by a surgeon untrained in plastic surgery, at a clinic not affiliated with a hospital. Six months later, she presented to our clinic with a palpable left breast lump. Physical examination revealed a large firm mass occupying the entire upper outer quadrant of the left breast and a normal right breast. Breast ultrasound showed a large, well-defined isoechoic mass in the left upper outer breast. Considering her age, the patient underwent core needle biopsy, since the mass mimicked a phyllodes tumor on ultrasonography. The 14-gauge core needle biopsy demonstrated multiple lipid droplets with some white-yellowish tissue, caused by liquefaction of the injected fat. Histopathologic examination demonstrated the presence of a pseudocyst with fat necrosis, granulomatous reaction to lipid material, and cystic formations containing oily fluid. No signs of malignancy were detected. Surgical excision was performed, and histopathology revealed findings consistent with fat necrosis.
Biopsy, Large-Core Needle ; Breast* ; Fat Necrosis ; Female ; Femur ; Humans ; Lipectomy ; Mammaplasty ; Phyllodes Tumor ; Physical Examination ; Surgery, Plastic ; Ultrasonography ; Young Adult

Closed reduction is the treatment of choice for most nasal bone fractures. In this technique, the nasal bone cannot be directly visualized, proper reduction is confirmed by palpation of the bony contour. This confirmation-via-palpation is in most cases too uncomfortable or painful for patients, and this is the reason why most closed reductions of nasal bone fractures are performed under general anesthesia. Recently, ultrasonography has been adopted as a useful diagnostic method and operative adjunct. In this report, we report the use of ultrasonography as a means to provide palpation-less confirmation of proper reduction, which in turn allows for nasal bone reduction under local anesthesia.
Anesthesia, General ; Anesthesia, Local* ; Fractures, Bone ; Humans ; Nasal Bone ; Palpation ; Ultrasonography

Authers have experienced congenital punctal agenesis with syndactyly in sister and brother who complained purulent discharge and epiphora. Bilateral upper punctal agenesis, fistulas, and common canalicular obstruction in dacryocystogram were found in a 17 year-old brother. Bilateral upper and lower punctal agenesis was found in a 14 year-old sister. Syndactyly was found in both patients. In familial history, father of patients had syndactyly in upper and lower extremities and complained epiphora. Another sister of patients had experience of lacrimal system surgery. Conjunctivodacryocystorhinostomy using Jones tube was performed in both patients.
Adolescent ; Fathers ; Fistula ; Humans ; Lacrimal Apparatus Diseases ; Lower Extremity ; Siblings ; Syndactyly