Thyroid ophthalmopathy is an autoimmune disease that affect the orbital and periorbital soft tissue, characterized by bulging eye (exophthalmos) and compressed orbital structures, such as the optic nerves. The indications for surgical treatment for thyroid ophthalmopathy include decreased visual acuity caused by optic neuropathy, conjunctivitis and progressive facial deformity caused by exophthalmos. Orbital wall decompression by nasal endoscopy resulte in good cosmetic effects and visual recovery. Balanced orbital decompression is considered to be a safe and effective surgery that can help avoid postoperative diplopia. We introduce three successful cases of orbital wall decompression for the treatment of thyroid ophthalmopathy.
Autoimmune Diseases ; Congenital Abnormalities ; Conjunctivitis ; Decompression ; Diplopia ; Endoscopy ; Exophthalmos ; Optic Nerve ; Optic Nerve Diseases ; Orbit ; Thyroid Gland ; Visual Acuity

Posttraumatic facial deformities (PTFDs) are very difficult to correct, and if they do occur, their impact can be devastating. It may sometimes be impossible for patients to return to normal life. The aim of surgical treatment is to restore the deformed bone structure and soft tissue to create symmetry between the affected side and the opposite side. In the process of managing PTFD, correcting enophthalmos is one of the most challenging aspects for surgeons because of difficulties in overcoming the scar tissue and danger of injuring to the optic nerve. In this article, surgical options for reconstruction of the medial wall, floor, lateral wall, and roof of the orbit are described. To optimize aesthetic improvement, additional cosmetic procedures such as facial contouring surgery, blepharoplasty and rhinoplasty can be used. Plastic surgeons should join emergency trauma teams to implement an overall treatment plan containing rational strategies to avoid or minimize PTFD.
Blepharoplasty ; Cicatrix ; Congenital Abnormalities ; Emergencies ; Enophthalmos ; Facial Bones ; Humans ; Optic Nerve ; Orbit ; Orbital Fractures ; Plastics ; Rhinoplasty ; Surgeons

PURPOSE: We report a case of visual loss after the injection of poly-L-lactic acid filler into the right forehead area for cosmetic purposes. CASE SUMMARY: A 46-year-old female patient visited our clinic due to sudden visual disturbance and dysesthesia on the right forehead and cheek. Her best corrected visual acuity was no light perception in the right eye and 20/20 in the left eye. Visual acuity in her right eye was not corrected. An afferent papillary defect in the right eye and paralysis of oculomotor muscles were observed. Fundus exam revealed a pale optic nerve and turbid retina on the posterior pole. The retinal vessels were narrowed. A papule 1 cm to the lateral margin of the right eyebrow due to the needle injection was found and no other visible skin abnormalities were observed. She had a cosmetic poly-L-lactic acid filler injection into the right forehead area immediately before the visual disturbance occurred. Fluorescent angiography showed occlusion of the right retinal artery and blood flow defects on the retina and choroid were present. The patient was followed up for 6 months and visual acuity and dysesthesia in her right forehead and cheek did not improve. CONCLUSIONS: Several cases of visual loss have occurred after injection of filler on the glabella and forehead for cosmetic purposes. However, most of the complications were observed after the use of hyaluronic fillers and not due to poly-L-lactic acid filler. This is the first case report of visual loss caused by poly-L-lactic acid filler in South Korea in a normal patient. Hence, consideration of complications when using this type of fillers is important.
Angiography ; Cheek ; Choroid ; Eyebrows ; Female ; Forehead* ; Humans ; Korea ; Middle Aged ; Needles ; Oculomotor Muscles ; Optic Nerve ; Paralysis ; Paresthesia ; Retina ; Retinal Artery ; Retinal Vessels ; Skin Abnormalities ; Visual Acuity

A 59-year-old woman was referred to our clinic for a glaucoma evaluation. The visual acuity and intraocular pressure were normal in both eyes. However, red-free fundus photography in the left eye showed a superotemporal wedge-shaped retinal nerve fiber layer defect, and visual field testing showed a corresponding partial arcuate scotoma. In an optical coherence tomography examination, the macula was flat, but an arcuate-shaped peripapillary retinoschisis was found. Further, the retinoschisis seemed to be connected with a superotemporal optic pit shown in a disc photograph. After 3 months of a topical prostaglandin analogue medication, the intraocular pressure in the retinoschisis eye was lowered from 14 to 10 mmHg and the peripapillary retinoschisis was almost resolved. We report a rare case of an optic disc pit with peripapillary retinoschisis presenting as a localized retinal nerve fiber layer defect.
Female ; Humans ; Middle Aged ; Nerve Fibers/*pathology ; Optic Disk/*abnormalities/*pathology ; Optic Nerve Diseases/*diagnosis ; Retinal Ganglion Cells/*pathology ; Retinoschisis/*diagnosis/drug therapy ; Tomography, Optical Coherence

An 18-year-old man presented with poor vision in both eyes that had been present since birth. Central corneal opacity and inferior peripheral sclerocornea with iridocorneal adhesion were observed upon anterior segment examination of the left eye. A coloboma of the iris was observed in the patient's right eye, which manifested as a small notch in the inferior pupillary margin and cataract. Fundus examination of the right eye showed a large inferior chorioretinal coloboma involving the optic disc and macula. It is essential to examine the fundus in detail, if possible, in cases of Peters' anomaly, because these patients may have congenital anomalies such as chorioretinal coloboma.
*Abnormalities, Multiple ; Adolescent ; Anterior Eye Segment/abnormalities ; Choroid/*abnormalities ; Coloboma/*diagnosis ; Corneal Opacity/*diagnosis ; Diagnosis, Differential ; Eye Abnormalities/*diagnosis ; Humans ; Male ; Microscopy, Acoustic ; Optic Nerve/abnormalities ; Retina/*abnormalities

An 18-year-old man presented with poor vision in both eyes that had been present since birth. Central corneal opacity and inferior peripheral sclerocornea with iridocorneal adhesion were observed upon anterior segment examination of the left eye. A coloboma of the iris was observed in the patient's right eye, which manifested as a small notch in the inferior pupillary margin and cataract. Fundus examination of the right eye showed a large inferior chorioretinal coloboma involving the optic disc and macula. It is essential to examine the fundus in detail, if possible, in cases of Peters' anomaly, because these patients may have congenital anomalies such as chorioretinal coloboma.
*Abnormalities, Multiple ; Adolescent ; Anterior Eye Segment/abnormalities ; Choroid/*abnormalities ; Coloboma/*diagnosis ; Corneal Opacity/*diagnosis ; Diagnosis, Differential ; Eye Abnormalities/*diagnosis ; Humans ; Male ; Microscopy, Acoustic ; Optic Nerve/abnormalities ; Retina/*abnormalities

Coloboma ; Humans ; Infant, Newborn ; Male ; Optic Nerve ; abnormalities

Axenfeld-Rieger syndrome (ARS) is associated with ocular and systemic anomalies. PITX2 is known to be a major controlling gene in the pathogenesis of ARS and is associated with differentiation in both the neural crest and mesoderm during eye development. A 4-year-old girl with bilateral ARS had 20 prism diopters (PD) of exotropia with 30PD of A- pattern deviation, more than 20PD of dissociated vertical deviation (DVD), and severe superior oblique overaction (SOOA). During surgery we observed that the SO inserted more posteriorly than normal. We believe this finding is one of the abnormal manifestations of the development of the extraocular muscles in ARS.
*Abnormalities, Multiple ; Anterior Eye Segment/*abnormalities ; Child, Preschool ; Eye Abnormalities/*diagnosis/surgery ; Eye Movements ; Female ; Follow-Up Studies ; Humans ; Oculomotor Muscles/*abnormalities/surgery ; Ophthalmologic Surgical Procedures/*adverse effects ; Optic Nerve/abnormalities ; Postoperative Complications ; Sclera/*pathology/surgery ; Syndrome ; Tooth Abnormalities/*genetics

Peters' anomaly is a rare form of anterior segment dysgenesis in which abnormal cleavage of the anterior chamber occurs. It is defined as a congenital central corneal opacity with corresponding defects in the posterior corneal stroma, Descemet's membrane, and endothelium. Peters' anomaly may be associated with other ocular or systemic abnormalities like microphthalmos, colobomata, retinal and optic nerve dysplasia, developmental delay, central nervous system defects, craniofacial abnormalities, seizure disorders, genitourinary malformations, and cardiopulmonary defects. Peters' anomaly may also have an inherited pattern, mostly autosomal recessive and dominant inheritance. Mutations involve the PAX6 gene, RIEG1 gene, and other genes. Management of infants with congenital corneal opacity is quite difficult, but penetrating keratoplasty is known as the effective treatment for visual outcome if it is performed within the first 3 months of life. We recently experienced a case of Peters' anomaly in association with atrial septal defect & chromosomal abnormality, therefore herein present it with a brief review of relevant literature.
Anterior Chamber ; Central Nervous System ; Chromosome Aberrations ; Corneal Opacity ; Corneal Stroma ; Craniofacial Abnormalities ; Descemet Membrane ; Endothelium ; Epilepsy ; Heart Septal Defects, Atrial ; Humans ; Infant ; Keratoplasty, Penetrating ; Microphthalmos ; Optic Nerve ; Retinaldehyde ; Wills

Peters' anomaly is a rare form of anterior segment dysgenesis in which abnormal cleavage of the anterior chamber occurs. It is defined as a congenital central corneal opacity with corresponding defects in the posterior corneal stroma, Descemet's membrane, and endothelium. Peters' anomaly may be associated with other ocular or systemic abnormalities like microphthalmos, colobomata, retinal and optic nerve dysplasia, developmental delay, central nervous system defects, craniofacial abnormalities, seizure disorders, genitourinary malformations, and cardiopulmonary defects. Peters' anomaly may also have an inherited pattern, mostly autosomal recessive and dominant inheritance. Mutations involve the PAX6 gene, RIEG1 gene, and other genes. Management of infants with congenital corneal opacity is quite difficult, but penetrating keratoplasty is known as the effective treatment for visual outcome if it is performed within the first 3 months of life. We recently experienced a case of Peters' anomaly in association with atrial septal defect & chromosomal abnormality, therefore herein present it with a brief review of relevant literature.
Anterior Chamber ; Central Nervous System ; Chromosome Aberrations ; Corneal Opacity ; Corneal Stroma ; Craniofacial Abnormalities ; Descemet Membrane ; Endothelium ; Epilepsy ; Heart Septal Defects, Atrial ; Humans ; Infant ; Keratoplasty, Penetrating ; Microphthalmos ; Optic Nerve ; Retinaldehyde ; Wills