This study was done to report the epidemiologic characteristics of medical retirement from the Republic of Korea (ROK) Army due to visual impairment and to suggest a practical screening system for the draft. The medical records of 423 eyes of 301 patients who retired from the ROK Army due to visual impairment were reviewed retrospectively between January 2010 and December 2014. The patients were grouped by the presence of trauma, and each group was subdivided by military rank. We analyzed demographic and ophthalmic data, including the etiology of ophthalmologic disease. The etiology was classified into 5 anatomical categories (ocular surface, lens, retina, optic nerve and extraocular visual pathway, and extraocular muscle and orbit), which were then subdivided into the type of disease. The mean age was 24.5 years, and non-traumatic mechanisms accounted for 81.1% (343/423 eyes) of medical retirements. Visual acuity was better in patients without trauma. In enlisted soldiers, disease in the optic nerve and extraocular visual pathway was the most common anatomical category (40.5%), and primary open angle glaucoma (30.8%), retinal dystrophy (18.3%), congenital cataract (14.5%), and retinal detachment (9.7%) were the four most common diseases. Most medical retirements due to visual impairment resulted from non-traumatic mechanisms, even though patients were young. The fundus examination and visual field test would be more useful tools than a conventional vision test for large-scale draft screening for the most common two disease types: primary open angle glaucoma and retinal dystrophy.
Adult ; Cataract/epidemiology ; Cohort Studies ; Glaucoma, Open-Angle/epidemiology ; Humans ; Male ; Middle Aged ; Military Personnel ; Republic of Korea/epidemiology ; Retinal Dystrophies/epidemiology ; *Retirement ; Retrospective Studies ; Vision Disorders/epidemiology/*pathology ; Visual Acuity ; Young Adult

The majority of dry eye symptoms are due to a chronic inflammation of the lacrimal functional unit resulting in a loss of tear film integrity and normal function. The tear secretion is controlled by the lacrimal functional unit consisting of the ocular surface (cornea, conjunctiva, and meibomian glands), the main lacrimal gland, and the interconnecting innervation. A lack of systemic androgen support to the lacrimal gland has been shown to be a facilitating factor in the initiation of ocular inflammation. If any portion of this functional unit is compromised, lacrimal gland support to the ocular surface is impeded. In this review, the classification and treatment of dry eye syndrome will be presented according to the A Delphi approach.
Classification ; Conjunctiva ; Cyclosporine ; Dry Eye Syndromes ; Inflammation ; Lacrimal Apparatus ; Tears

To evaluate the changes of the central corneal endothelial cell density and morphology after phacoemulsification and foldable silicone intraocular lens(IOL) implantation through a 3.2mm temporal clear corneal incision under topical anesthesia. On 43 patients(43 eyes) who had no systemic and ocular disease to influence the status of corneal endothelium , central corneal thickness, central corneal endothelial celldensity, pleomorphism index and polymegathism index, there was significant increase at 1 day postoperatively and recovery to preoperative state at 2 months poeroperatively. Central corneal endothelial cell losses were 8.92% at 1 day postoperatively and 15.95% at 2 months poeroperatively(p=0.00) and statistically significant increase of polymegathism index was noted at 1 day and 2 months poeroperatively. However no significant difference in central corneal endothelial cell loss and polymegathism index was noted at 6 months postoperatively. From the above results, we concluded that the phacoemulsification through a temporal clear corneal incision under topical anesthesia decreases the central corneal endothelial cell density and increase polymegathism index of the corneal endothelial cells, but these changes become stabilized after postoperative 2 months. Also proper control group must be set up to detect causes of corneal endothelial cell loss and it is neede to estalblish a new criteria for safe corneal endothelial cell density.
Anesthesia* ; Corneal Endothelial Cell Loss ; Endothelial Cells* ; Endothelium, Corneal ; Phacoemulsification* ; Silicones

PURPOSE: To report a rare case of localized orbital pseudotumor in the limbus. CASE SUMMARY: A 60-year-old man with a limbal mass in the left eye was referred to our clinic for further treatment. The patient's symptoms began 9-months earlier, and he was treated with oral prednisolone, but his symptoms relapsed. His left eye had a circumferentially protruded gelatinous limbal mass. The anterior segment fluorescein angiography was performed and the mass was then surgically removed. There was an interrupted fluorescence at the area of infiltrative mass at 8 seconds, and a relative hypofluorescence at 30 seconds on anterior segment fluorescein angiography. Histologic examination revealed a non-specific inflammatory reaction without the presence of tumor cells and these findings indicated a presumptive diagnosis of limbal pseudotumor. After the cessation of steroid treatment there was no evidence of tumor recurrence at the 6-month follow-up. CONCLUSIONS: The authors reported the first case of localized orbital pseudotumor in the limbus. Anterior segment fluorescein angiography was found useful in the evaluation and differential diagnosis of this type of limbal mass.
Diagnosis, Differential ; Eye ; Fluorescein Angiography ; Fluorescence ; Gelatin ; Humans ; Middle Aged ; Orbital Pseudotumor ; Prednisolone ; Recurrence

PURPOSE: To report a rare case of localized orbital pseudotumor in the limbus. CASE SUMMARY: A 60-year-old man with a limbal mass in the left eye was referred to our clinic for further treatment. The patient's symptoms began 9-months earlier, and he was treated with oral prednisolone, but his symptoms relapsed. His left eye had a circumferentially protruded gelatinous limbal mass. The anterior segment fluorescein angiography was performed and the mass was then surgically removed. There was an interrupted fluorescence at the area of infiltrative mass at 8 seconds, and a relative hypofluorescence at 30 seconds on anterior segment fluorescein angiography. Histologic examination revealed a non-specific inflammatory reaction without the presence of tumor cells and these findings indicated a presumptive diagnosis of limbal pseudotumor. After the cessation of steroid treatment there was no evidence of tumor recurrence at the 6-month follow-up. CONCLUSIONS: The authors reported the first case of localized orbital pseudotumor in the limbus. Anterior segment fluorescein angiography was found useful in the evaluation and differential diagnosis of this type of limbal mass.
Diagnosis, Differential ; Eye ; Fluorescein Angiography ; Fluorescence ; Gelatin ; Humans ; Middle Aged ; Orbital Pseudotumor ; Prednisolone ; Recurrence

PURPOSE: To evaluate the effects of ICL implantation on angle structures, intraocular pressure (IOP) and pupil diameter. METHODS: A Staar implantable contact lens (ICL) was implanted in 81 eyes of 43 patients with spherical equivalent over -6D. Gonioscopy was done 1 day after laser iridotomy and 6 months after ICL implantation and postoperative changes in gonioscopic findings were evaluated. Also IOP and pupil diameter were examined. RESULTS: There were occlusion or narrowing of the LI opening site in 10 eyes (12.3%). Width of angle was wide over 30 degrees in all cases but that was narrowed under 20 degrees in 16 eyes (19.8%) at postoperative 6 months. The mean pigmentation was 2.11 in inferior, 0.47 in nasal, 0.22 in temporal and 0.18 in superior angle at 6 months postoperatively by semiquantitative method (Grade 0~4). There was decrease of pigmentation in nasal and temporal angle but no change in inferior and superior angle after ICL implantation. There was temporary increase of IOP at 1 week and 1 month postoperatively due to steroid eye drops but returned to preoperative level and maintained until the 6 months postoperatively. There was significant decrease of pupil diameter at postoperative 1 and 3 months but returned to the preoperative level at postoperative 6 months. There was no evidence of pigment dispersion syndrome and pigmentary glaucoma. CONCLUSIONS: ICL implantation caused the narrowing of width of angle but did not increase trabecular pigmentation. We expect that ICL implantation is safe about pigment dispersion syndrome and pigmentary glaucoma.
Glaucoma, Open-Angle ; Gonioscopy ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Ophthalmic Solutions ; Pigmentation ; Pupil

We report a case of recurrent occlusion of laser iridotomy (LI) sites after a Visian ICL (Implantable contact lens version 4, Staar Surgical AG, Nidau, Switzerland) implantation. A 45-year-old woman had bilateral ICL implantation after placement of two peripheral LI sites in each eye to prevent pupillary block. At one month after the operation, severe narrowing or occlusion of four LI sites occurred. After this, although she received four additional LIs at postoperative months 1, 6, 9 and 10 in both eyes, the narrowing or occlusion recurred. Mild chronic anterior chamber inflammation was observed intermittently throughout the follow-up period. We performed clear lens extraction in both eyes (at postoperative month 11 in the left eye and month 26 in the right eye) due to recurrent occlusion of the LI sites and excess trabecular meshwork pigment deposition presumably caused by the four repeated LIs. Recurrent obstruction of LI sites can occur after ICL implantation. These problems were unresolvable despite four repeated laser iridotomies. The risks associated with anterior uveitis must be considered when planning an ICL implantation.
Female ; Humans ; Iridectomy/*methods ; Iris/*surgery ; *Laser Therapy ; Lasers, Solid-State ; Lens Implantation, Intraocular/*adverse effects ; Middle Aged ; *Phakic Intraocular Lenses ; Pigment Epithelium of Eye/pathology ; *Postoperative Complications ; Recurrence ; Reoperation ; Trabecular Meshwork/pathology ; Uveitis, Anterior/etiology

We report the first case of ocular benign lymphoid hyperplasia (BLH) treated with subconjunctival injection of bevacizumab (Avastin). A 27-year-old man presented to our clinic with conjunctival masses and limbal neovascularization. An incisional biopsy yielded the diagnosis of BLH. The patient was subsequently given a subconjunctival injection of bevacizumab (1.25 mg / 0.1 mL). The patient did not experience recurrence or malignant metaplasia during the one-year follow-up period. In patients with conjunctival BLH, subconjunctival injection of bevacizumab can be a useful treatment option in patients unable to undergo a surgical procedure due to limbal neovascularization.
Adult ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Conjunctiva ; Conjunctival Diseases/*drug therapy/*pathology ; Humans ; Hyperplasia ; Injections, Intraocular ; Limbus Corneae/blood supply ; Lymphoid Tissue/*pathology ; Lymphoproliferative Di ; Male ; Neovascularization, Pathologic/drug therapy

A 69-year old man presented to us with decreased vision in his right eye and a relative afferent pupillary defect. Under the presumption that he was suffering from retrobulbar optic neuritis or ischemic optic neuropathy, visual field tests were performed, revealing the presence of a junctional scotoma. Imaging studies revealed tumorous lesions extending from the sphenoid sinus at the right superior orbital fissure, with erosion of the right medial orbital wall and optic canal. Right optic nerve decompression was performed via an endoscopic sphenoidectomy, and histopathologic examination confirmed the presence of aspergillosis. The patient did not receive any postoperative antifungal treatment; however, his vision improved to 20 / 40, and his visual field developed a left congruous superior quadrantanopsia 18 months postoperatively. A junctional scotoma can be caused by aspergillosis, demonstrating the importance of examining the asymptomatic eye when a patient is experiencing a loss of vision in one eye. Furthermore, damage to the distal optic nerve adjacent to the proximal optic chiasm can induce unusual congruous superior quadrantanopsia.
Aged ; Antifungal Agents/therapeutic use ; Aspergillosis/*complications/diagnosis ; Decompression, Surgical/methods ; Diagnosis, Differential ; Endoscopy/methods ; Eye Infections, Fungal/*complications/diagnosis/therapy ; Follow-Up Studies ; Hemianopsia/*complications/diagnosis/therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Optic Nerve/pathology ; Scotoma/diagnosis/*etiology/therapy ; Sphenoid Bone/surgery ; Visual Acuity ; Visual Fields

PURPOSE: To report a case of drug-resistant Fusarium deep keratitis following sclera graft. CASE SUMMARY: A 48-year-old woman, who underwent excision of the pterygium nine years previous, received a scleral graft for scleromalacia and ocular pain. After surgery, due to melting of the scleral graft and the presence of Fusarium deep keratitis, she received surgical and intensive medical treatment including three intracameral injections of antifungal agent, administration of topical voriconazole 1%, scleral re-graft, autologous conjunctival graft, and amniotic membrane transplantation. Nevertheless, the patient's ocular condition deteriorated with increased hypopyon, corneal opacity, and perforation. Enucleation was ultimately performed.
Amnion ; Corneal Opacity ; Female ; Freezing ; Fusarium ; Humans ; Keratitis ; Middle Aged ; Pterygium ; Pyrimidines ; Sclera ; Transplants ; Triazoles