Purpose: To investigate the prevalence of low vision and legal blindness based on the Korea National Health and NutritionalExamination Survey (2017). Methods: Based on the results of the National Health and Nutritional Examination Survey conducted in 2017, we analyzed 3,160patients, 40-80 years of age, and measured the visual acuity among the total of 8,127 patients. The visual acuity was measuredusing Jin’s vision chart (for 4 m). When the uncorrected visual acuity was less than 0.8 in the first visual acuity test, vision wasre-evaluated with correction using autorefractor. The analyses of the prevalence of low vision and legal blindness were based onthe criteria of the World Health Organization: moderate visual impairment, 0.32-0.125; severe visual impairment, 0.1-0.025; andlegal blindness, <0.025 in the better eye. We analyzed the occupational reclassification and unemploymentoneconomic activitypopulation status codes of the questionnaire surveys. Results: The prevalence of low vision included 46 (1.46%) patients among a total of 3,160 patients (mean age, 59.4 ± 11.8 years;male:female, 1,328:1,832) and visual impairment including low vision and legal blindness involved 74 (2.34%) patients.Seventy-six percent of the low vision patients were not designated with legal disabilities. In addition, 61.5% of the patients withlow vision and 75.0% of the legally blind patients were unemployed. Conclusions Based on these results, it is necessary to study the precise condition of the low vision and legally blind patients,and to conduct comprehensive treatments for patients who cannot be covered by the Welfare Act for the Disabled.

Purpose: To investigate physical ophthalmological parameters relevant to job choice. Methods: I analyzed the ophthalmological demands imposed on those engaged in military service and on applicants for army officer, air force officer, naval officer, railroad officer, firefighting officer, police officer, state public officer, and pilot positions; the visual requirements for a driver’s license were also examined. Visual dysfunction was classified into loss of visual acuity, visual field defects, refractive errors, color vision disorders, strabismus, and other disorders. Additional restrictions imposed by each occupation were investigated. Results: Various standards were imposed on the occupational groups. Applicants to the Air Force Academy required 1.0 visual acuity; the visual acuity for applicants to the military and naval academies were ≥0.6, and those for fire and police personnel ≥0.8. The general public official regulations do not mention visual acuity. In terms of visual field defects, such defects must be <33% for firefighters and railroad drivers; no clear standard was set for other occupations. The importance of color vision differed by job type; pilots and railroad drivers must have full color vision. In terms of refractive error and strabismus, the standards differed among occupations. Conclusions As the ophthalmological standards vary extensively by occupation, both ophthalmologists and clients must be aware of this information. The scientific basis of the various standards requires attention.

Purpose: To investigate the prevalence of amblyopia in children between the ages of 5-8 years based on the Korean National Health and Nutrition Examination Survey (2016). Methods: Based on the results of the Korean National Health and Nutrition Examination Survey conducted in 2016, among a total of 443 children, we measured and analyzed the visual acuities of 420 children. The visual acuity was measured using a conventional visual acuity chart. When the uncorrected visual acuity was < 0.8 in the first visual acuity test, a refraction test was performed using the automatic refraction test (KR-8800, Topcon, Tokyo, Japan) and the corrected visual acuity was measured. Unilateral amblyopia and bilateral amblyopia were defined as a ≥ 2 line difference between two eyes and visual acuity in the better eye < 0.8 or < 0.63. The significant refractive errors were defined as follows: the spherical lens was 1.5 diopters (D) or more, astigmatism was 1.0 D or more, or astigmatism of 2.5 D was 4.0 D or more. Results: The prevalence of amblyopia was 5.0% (21 patients, < 0.8 in the better eye) and 3.8% (16 patients, < 0.63 in the better eye) in a total of 420 patients (male:female = 219:201). The prevalence of amblyopia in different age groups was: 10 (10%) at 5 years of age, 6 (5.6%) at 6 years of age, 3.8% at 7 years of age, and 0.9% at 8 years of age. Nine out of 21 patients (42.9%) had significant refractive errors. The regional distribution was highest in Gangwon-do and Chungcheongnam-do provinces and parental income did not affect the prevalence of amblyopia (p = 0.189). Conclusions The prevalence of amblyopia decreased with age suggesting that early detection and treatment of amblyopia are important. Therefore, systematic eye examinations that can detect amblyopia in the early stage may be important in the National Health Care results.

PURPOSE: To compare the characteristics of the pattern visual evoked potential (PVEP) in patients with severe visual loss and normal controls, and to demonstrate the range of PVEP parameters in normal Koreans. METHODS: The patients were divided into three groups according to visual acuity: group 1, ranging from no light perception to less than 0.02; group 2, ranging from 0.02 to 0.1; and group 3, ranging from 0.125 to 0.25. Group 4 was established as a healthy control group. The 95% confidence intervals (CIs) of the PVEP parameters were calculated for group 4. The PVEP parameters were compared among these four groups, and the amplitudes were evaluated with respect to the 95% CIs. We used the area under the curve to integrate the sensitivity and the specificity of the PVEP parameter quantitative values (7.01 to 9.57 microV and 6.75 to 10.11 microV). RESULTS: A total of 101 eyes were investigated. The 95% CIs of the P100 and N135 amplitudes of group 4 were 7.01 to 9.57 microV and 6.75 to 10.11 microV, respectively. The amplitudes of P100 and N135 were significantly higher in group 4 (p < 0.001). The P100 and N135 amplitude were below the 95% CI in all group 1 patients. The area under the curve of the P100 amplitude was the highest (0.789). CONCLUSIONS: No legally blind patient in the present study exhibited a value within the 95% CI of the controls. The P100 amplitude may be the best parameter for defining blindness in patients.
Adult ; Blindness/*physiopathology ; *Evoked Potentials, Visual ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vision, Low/*physiopathology ; *Visual Acuity ; Young Adult

PURPOSE: To compare the characteristics of the pattern visual evoked potential (PVEP) in patients with severe visual loss and normal controls, and to demonstrate the range of PVEP parameters in normal Koreans. METHODS: The patients were divided into three groups according to visual acuity: group 1, ranging from no light perception to less than 0.02; group 2, ranging from 0.02 to 0.1; and group 3, ranging from 0.125 to 0.25. Group 4 was established as a healthy control group. The 95% confidence intervals (CIs) of the PVEP parameters were calculated for group 4. The PVEP parameters were compared among these four groups, and the amplitudes were evaluated with respect to the 95% CIs. We used the area under the curve to integrate the sensitivity and the specificity of the PVEP parameter quantitative values (7.01 to 9.57 microV and 6.75 to 10.11 microV). RESULTS: A total of 101 eyes were investigated. The 95% CIs of the P100 and N135 amplitudes of group 4 were 7.01 to 9.57 microV and 6.75 to 10.11 microV, respectively. The amplitudes of P100 and N135 were significantly higher in group 4 (p < 0.001). The P100 and N135 amplitude were below the 95% CI in all group 1 patients. The area under the curve of the P100 amplitude was the highest (0.789). CONCLUSIONS: No legally blind patient in the present study exhibited a value within the 95% CI of the controls. The P100 amplitude may be the best parameter for defining blindness in patients.
Adult ; Blindness/*physiopathology ; *Evoked Potentials, Visual ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vision, Low/*physiopathology ; *Visual Acuity ; Young Adult

PURPOSE: The aim of this study was to investigate the quantitative effect of inferior oblique (IO) 10- and 14-mm recession on postoperative horizontal deviation. METHODS: Patients (22 men and 18 women) who underwent IO recession were divided into two groups for comparison studies: group 1 (10-mm IO recession, 15 patients) and group 2 (14-mm IO recession, 25 patients). Preoperative and postoperative horizontal deviations were measured, and the resulting horizontal deviations from the 10- and 14-mm IO recession surgeries were compared. The effects of superior oblique underaction, IO overaction, and combined exodeviation on postoperative horizontal deviation were analyzed. RESULTS: Although group 1 did not show a significant horizontal deviation change after surgery (1.9 ± 4.5 prism diopters [PD], p = 0.452), group 2 had a meaningful horizontal change after 14-mm recession (2.2 ± 3.8 PD, p = 0.022). Both groups showed a significant esodrift in horizontal deviation (group 1, p = 0.017; group 2, p = 0.030) in patients with exodeviation over 8 PD. The mean change in horizontal deviation was 6.0 ± 5.4 PD for group 1 and 9.0 ± 5.0 PD for group 2. Although the amount of superior oblique underaction did not affect the extent of change in horizontal deviation, patients with severe IO overaction showed a significant change in horizontal deviation after 14-mm IO recession. CONCLUSIONS: Fourteen-millimeter IO recession could make a statistically significant change in horizontal deviation after surgery. In addition, esodrift should be considered after IO recession in patients with a preoperative exodeviation greater than 8 PD or severe IO overaction.
Exotropia ; Humans ; Jupiter ; Male ; Strabismus

A 65-year-old man who had been experiencing diplopia in front and down gaze for 15 days visited our hospital. Hypertropia was noted in the patient's left eye, and limitation of depression was found in the adduction, primary gaze, and abduction. Brain magnetic resonance imaging showed no remarkable findings. Two weeks after the first visit, the patient complained of ptosis in the left eye. An ice test was performed and the ptosis was resolved after the test. Then, anti-acetylcholine receptor binding antibody levels were checked and found to be slightly elevated. We prescribed methylprednisolone per os 24 mg for 2 weeks, and his symptoms improved after the 2-week treatment. Five weeks after his first visit, the patient showed an ortho result in the alternate prism cover test and normal ocular movements. This may be the first case in which ocular myasthenia gravis presented as double depressor palsy, and in such cases, the possibility of ocular myasthenia gravis should be considered to rule out double depressor palsy.
Aged ; Diagnosis, Differential ; Diplopia/*diagnosis/*etiology ; Humans ; Male ; Myasthenia Gravis/*complications/*diagnosis ; Ocular Motility Disorders/diagnosis/etiology ; Strabismus/diagnosis/etiology

A 44-year-old woman with Castleman disease presented with acute visual loss in the left eye. A full ophthalmologic examination and imaging were performed. Visual acuity was 20/20 in the right eye and 20/100 in the left eye. Total dyschromatopsia, a relative afferent pupillary defect, and a cecocentral scotoma were observed in the left eye. Mild disc edema, without leaking during fluorescein angiography, was also observed. Magnetic resonance imaging revealed a small cystic epidermoid-like lesion in the right prepontine and suprasellar cistern. Her visual acuity did not improve and deteriorated to 20/200 in the left eye at 22 months after the initial visual loss. Optic neuropathy may rarely be associated with Castleman disease and suggests a poor prognosis.
Adult ; Diagnosis, Differential ; Disease Progression ; Female ; Fluorescein Angiography ; Fundus Oculi ; Giant Lymph Node Hyperplasia/*complications/diagnosis ; Humans ; Magnetic Resonance Imaging ; Optic Nerve Diseases/diagnosis/*etiology/physiopathology ; Tomography, Optical Coherence ; Visual Acuity ; Visual Field Tests ; Visual Fields

PURPOSE: We investigated chief complaints and ocular disorders in infants under one year of age and analyzed the association between complaints and disorders. METHODS: The medical records of 815 infants were reviewed. Chief complaints were grouped into the following 11 categories: eyelid drooping, epiphora (tearing), ocular discharge, lid swelling, eyelashes touching the eyeball, abnormalities of the anterior segment, abnormal eyeball movement (e.g., squint or nystagmus), red eye, trauma, poor eye contact, and miscellaneous. We performed ophthalmologic examinations at the doctors' discretion and analyzed the relationship between chief complaint and final diagnosis. RESULTS: Mean age of visiting the outpatient clinic was 6.09 +/- 3.07 months. The most common complaint was ocular discharge, followed by abnormal eyeball movement, epiphora, and eye redness. Among infants with ocular discharge, most were attributed to congenital nasolacrimal duct obstruction (155 infants) and conjunctivitis (75 infants). A total of 160 guardians complained of abnormal eyeball movement and 86 of 160 infants (51.9%) suffered from pseudoesotropia. Additionally, exodeviation and esodeviation was found in 17.9% and 16.4% of infants, respectively. Eight guardian complained of poor eye contact in their infants and these infants were diagnosed with retinal disorders (3), congenital optic nerve disorders (2), cataract (1), glaucoma (1), and high hyperopia (1). CONCLUSIONS: The most common ocular symptoms in infants under one year of age included ocular discharge, epiphora, and eye redness. However, infants with poor eye contact or suspected abnormal eye movement should undergo a full ophthalmologic examination.
*Ambulatory Care Facilities ; Eye Diseases/*diagnosis ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; *Patient Compliance ; Retrospective Studies

PURPOSE: To evaluate optic disc pallor using ImageJ in traumatic optic neuropathy (TON). METHODS: This study examined unilateral TON patients. The optic disc was divided into 4 quadrants (temporal, superior, nasal, and inferior), consistent with the quadrants on optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness maps. Optic disc photography was performed and disc pallor was quantified using gray scale photographic images imported into ImageJ software. The correlation between optic disc pallor and RNFL thickness was examined in each quadrant. RESULTS: A total of 35 patients (31 male, 4 female) were enrolled in the study. The mean participant age was 34.8 +/- 15.0 years (range, 5 to 63 years). Overall RNFL thickness decreased in 6 patients, with thinning most often occurring in the inferior quadrant (28 of 35 eyes). There was a significant correlation between optic disc pallor and RNFL thickness (superior, rho = -0.358, p = 0.04; inferior, rho = -0.345, p = 0.04; nasal, rho = -0.417, p = 0.01; temporal, rho = -0.390, p = 0.02). The highest level of correspondence between disc pallor and RNFL thickness values outside of the normative 95th percentiles was 39.3% and occurred in the inferior quadrant. CONCLUSIONS: Optic disc pallor in TON was quantified with ImageJ and was significantly correlated with RNFL thickness abnormalities. Thus, ImageJ evaluations of disc pallor may be useful for evaluating RNFL thinning, as verified by OCT RNFL analyses.
Adolescent ; Adult ; Child ; Child, Preschool ; Colorimetry/methods/standards ; Diagnosis, Computer-Assisted/*methods/standards ; Female ; Humans ; Male ; Middle Aged ; Optic Atrophy/etiology/*pathology ; Optic Nerve Diseases/etiology/*pathology ; Optic Nerve Injuries/*pathology ; Photography/*methods/standards ; Reproducibility of Results ; Software ; Tomography, Optical Coherence/*methods/standards ; Trauma Severity Indices ; Young Adult