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

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

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

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

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

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

PURPOSE: To develop a new decellularization technique of porcine cornea using freezing-thawing-centrifugation (FTC) and to examine the characteristics of acellular porcine cornea (APC) for xenograft material. METHODS: Two-hundred micrometer thickness porcine corneas were decellularized with DNase/RNase, followed by 3 freezing-thawing-centrifugations (FTC, group 1), lyophilized FTC-APC (group 2), and chemical enzyme treated APC (CE-APC, group 3). Histologic evaluation to examine cells and collagen matrix, comparison of transparency, and cultivation to determine the viability of stromal cells was performed in fresh porcine cornea and 3 experimental groups. RESULTS: Decellularization occurred successfully in all experimental groups. Decellularization was confirmed by H&E staining and cultivation. Transparency of group 1 was similar to the normal porcine cornea but transparency of group 2 and group 3 was decreased. Collagen fibers of CE-APC (group 3) were not as well arrayed as FTC-APC (group 2). CONCLUSIONS: Acellularity of porcine cornea was successfully achieved by the FTC method with preservation of the cornea stroma. Novel decellularized porcine cornea can be considered as xenogeneic material for corneal transplantation.
Collagen ; Cornea ; Corneal Transplantation ; Stromal Cells ; Transplantation, Heterologous

PURPOSE: The authors of the present study report a case of phthiriasis palpebrarum treated with petrolatum ointment and tea tree oil in a 12-month-old boy. CASE SUMMARY: A bluish-gray macule and blood clots were found on the central portion of the upper eyelid of a boy who had rubbed his eyelid vigorously 1 week prior. Several 0.5 mm sized brownish-gray nits and 1.6 mm sized lice on the eyelashes were visible and was diagnosed with phthiriasis palpebrarum after light microscopic examination. The nits and lice were gently removed mechanically with the help of a white petrolatum ointment (Vaseline) and the eyelashes were cleaned with 50% tea tree oil. Nits and lice were successfully eradicated without recurrence 10 days after daily treatment with petrolatum ointment and 10% tea tree oil eyelash cleansing.
Child ; Eyelashes ; Eyelids ; Humans ; Infant ; Light ; Pediculus ; Petrolatum ; Phthiraptera ; Recurrence ; Tea ; Tea Tree Oil

PURPOSE: To introduce autologous tragal perichondrium transplantation as a novel surgical modality for the management of intractable symptomatic bullous keratopathy. METHODS: In three eyes of three patients with painful bullous keratopathy, autologous tragal perichondria were transplanted on the corneal surface with the human amniotic membrane transplanted above. We included an additional three eyes of three patients with painful bullous keratopathy who received amniotic membrane transplantation only to serve as controls. Clinical symptom outcomes were assessed using a visual analogue scale at postsurgical months 1, 3, 5, 7, and 9. In addition, transplanted tragal perichondrium and amniotic membrane complex tissue button obtained from one patient who underwent penetrating keratoplasty was evaluated by immunohistochemical analysis of CD34, vimentin, and alcian blue staining. RESULTS: All three patients who underwent autologous tragal perichondrium and human amniotic membrane co-transplantation showed improvements in pain and tearing. However, all three patients in the control group experienced aggravation of tearing and no further improvement of pain 3 months after surgery. In addition, one patient in the control group developed premature degradation of the amniotic membrane. Histopathologic and immunohistochemical analysis showed intact surface epithelization and positive CD34, vimentin and alcian blue staining of transplanted tragal perichondria. CONCLUSIONS: The tragal perichondrium has a high mechanical structural force and high potency due to well-organized epithelization and the presence of mesenchymal stem cells. Autologous tragal perichondrium transplantation may be an effective modality for the management of painful bullous keratopathy.
Adult ; Aged ; Amnion/*transplantation ; Corneal Diseases/*pathology/*surgery ; Ear Cartilage/*transplantation ; Female ; Humans ; Keratoplasty, Penetrating/*methods ; Male ; Middle Aged ; Transplantation, Autologous ; Treatment Outcome