Aniridia or irideremia is characterized by reduction of iris or absence of total iris, but a rudimentary iris is always present in most cases. This congenital anomaly is familial and the transmission is strongly dominant by an autosomal gene. It demonstrates high penetrance and variable expression. Aniridia is mainly due to a primary defect in development of the neural ectoderm and an aberrant development of the mesoderm. Glaucoma and cataract in the eye is frequently complicated with other deformities of the body and the treatment is not satisfactory. The author have experienced a case of aniridic family which is composed of 7 persons. Of these, the father, one son and 3 daughters are affected with aniridia, cataract, nystagmus and amblyopia and the mother and one son are healthy. The author reports this cases with the review of literature.
Amblyopia ; Aniridia* ; Cataract ; Congenital Abnormalities ; Ectoderm ; Fathers ; Glaucoma ; Humans ; Iris ; Mesoderm ; Mothers ; Nuclear Family ; Penetrance

PURPOSE: To obtain guideline of diagnosis and treatment when hyperdeviation associated with intermittent exotropia shows symptoms similar to superior oblique palsy (SOP). METHODS: We reviewed the charts retrospectively in 27 patients showing simulated SOP in intermittent exotropia, in which hyperdeviation in primary gaze and 10PD or more by Bielschowsky head tilt test were present. Overaction of Inferior oblique, (IOOA) dysfunction of superior oblique, and forveal extorsion more than +2 were excluded including reoperation and head tilt history. All patients were undergone horizontal muscle surgery only. The postoperative changes of deviation were analyzed at postoperative one day, one month, six month, and one year. RESULTS: Average amount of distant horizontal deviation in primary gaze was 32.3+/-9.58PD. Hyperdeviation was 3.8+/-2.52PD. Degree of IOOA averaged +1.18 in hypertropic eye, and +1.06 in hypotropic eye. Only 10 patients (37%) had foveal extorsion less than +2 in degree. Average vertical deviation of hypertropic eye side was 12.7+/-2.93PD on head tilt test. After horizontal surgery only, the amount of hyperdeviation decreased to 1.3PD at 1st day. On head tilt test, hyperdeviation was almost eliminated showing 0.6PD on the hypertropic side and 0.1PD on the contralateral eye at one month. All patients were aligned up to the follow-up of one year. CONCLUSIONS: To differentiate simulated SOP from intermittent exotropia with hyperdeviation, none of head tilt history, mild foveal extorsion, mild oblique dysfunction less than +3, double Maddox rod test, and forced duction test are important guidelines. Horizontal muscle surgery is only needed to remove exodeviation and hyperdeviation.
Diagnosis ; Exotropia* ; Follow-Up Studies ; Head ; Humans ; Paralysis* ; Reoperation ; Retrospective Studies

The procedures available to weaken inferior oblique muscle overaction(IOOA) are disinsertion, tenotomy, myectomy, and recession. But those procedures are ineffective in the cases of 4+ overacting inferior oblique and postoperative return of overaction following those surgeries. The author performed denervation and extirpation in 8 cases with 4+ or marked IOOA and 1 case of return of IOOA following 14mm recession of inferior oblique. None of those has shown a return of IOOA, undercorrection, overcorrection and any other complications such as adherence syndrome at follow-up of at least 10 months.
Denervation* ; Follow-Up Studies ; Tenotomy

It is important to detect binocular suppression of pediatric strabismic patients, especially in accommodative esotropes and intermittent exotropes. However, it may take a long time and false results may be obtained in young children. In order to examine binocular suppression, we selected 103 accommodative esotropes with binocular suppression. Vectograph test, Worth 4 dot test, and 4 prism base-out test were performed at distance, and Worth 4 dot test, TNO test, and Bagolini test at near. Titmus fly test and Randot stereotest were administerd to know the relationship between stereoacuity and suppression. In detecting binocular suppression, the true rate of vectogram was 95%, which was the highest result of all tests and 4 prism base-out test was the next with 88% of the true rate. The stereoacuity was increased in proportional to the absence of suppression. The vectographic porject test was the easiest and the most accurate test to identify normal fusion or binocular suppression at distance in young strabismic children. The accuracy will be increased in the combination with 4 prism base-out test. Therefore the vectograph also can be used in the screening of small amount of deviation, monocular amblyopia and low vision in kindergarten and elementary school.
Amblyopia ; Child ; Diptera ; Humans ; Mass Screening ; Telescopes* ; Vision, Low

Accommodative esodeviation is the result of either the need to clear the blurred vision caused by hypermetropia or a high accommodative convergence to accommodation(AC/A) ratio. In 1958, Parks showed that there were three origins of accommodative convergence to accommodation(AC/A), and a combination of the two. The authors experienced 71 cases of accommodative esotropia which were treated with hyperopic glasses, executive bifocals, and surgery on nonaccommodative component. Accommodative esotropia was subdivided into 3 types as refractive, nonrefractive and combined type. The refractive type was 59.1%, nonrtfractive type 8.5%, and combined type 32.4%. Among all 71cases, partially accommodative esotropia was 32.4%. The onset was at the age between 2 and 4 years in 50.8%. In most cases the sphero-equivalent of refractive error was +4.00 to less than +6.00 D in the refractive type with a normal AC/A ratio, less than +2.00 D in the nonrefractive type with a high AC/A ratio, and +2.00 to less than +4.00 D in the combined type with a high AC/A ratio. The cases with a normal AC/A ratio showed more hypermetropia. The amount of esodeviation controlled by hyperopic glasses was 24.4 to 25.0 delta at distance; by executive bifocals 26.2 delta in the nonrefractive type and 18.6 delta in the combined type at near. Stereoacuity was tested in 34 cases who understood the test, was better in the refractive type with normal AC/A ratio than in nonrefractive and combined type with a high AC/A ratio, and was absent in 26.4%. In many cases without stereopsis, the interval between onset and institution of therapy was too long and the age at treatment was too old. The longer the eyes are not aligned the greater chance for the development of amblyopia and sensory motor misalignant. Therefore early recognition and early initiation of treatment should be emphasized.
Amblyopia ; Depth Perception ; Esotropia* ; Eyeglasses ; Glass ; Hyperopia ; Refractive Errors

Superior oblique palsy is the most common isolated palsy of an extraocular muscle and the most frequent cause of vertical strabismus. Patients with superior oblique palsy are frequently symptomatic from diplopia, anomalous head postures and loss of binocular vision, and showed hyperdeviation in primary position on the prism cover test, positive three step test and unilateral oblique muscle dysfunction on version. The surgical treatment of superior oblique palsy is very important because it not only prevents musculoskeletal changes from occurring in the face and neck by the elimination of abnormal head postures, but also corrects hypertropia and excydotropia in the primary position and preserves and improves stereopsis. The author had 52 patients of unilateral superior oblique palsy treated with superior oblique tucking, weakening of inferior oblique (recession, and denervation and extirpation of inferior oblique), recession of contralateral inferior rectus and ipsilateral superior oblique recession. The results were as follows. Children under 10 years of age were 71.2% of the patients. The average amount of hyperdeviaiton in primary position was 24.0 delta with range of 4 to 70 delta. Maddox double rod test was performed in 22 patients who understood it and all of them showed excyclodeviation of either eye. The range was 2 to 10 degrees with average of 5.2 degrees. Stereopsis was present in 77.1% of all the patients, in 91.3% of superior oblique palsy alone combined with horizontal strabismus before surgery. Following inferior oblique weakening procedure, the mean correction of hyperdeviation in primary position was 15.7 delta by 10 mm recession, 20.4 delta by 14 mm recession and 38.3 delta by denervation and extirpation of inferior oblique muscle.
Child ; Denervation ; Depth Perception ; Diplopia ; Exercise Test ; Head ; Humans ; Neck ; Paralysis* ; Posture ; Strabismus ; Vision, Binocular

Brown's syndrome is a clinical entity which shows restriction of elevation in the adducted position of the affected eye and in which the forced duction test for elevation in adduction is positive. The syndrome has been found to be bilateral in 10% of the cases. The authors experienced Brown's syndrome of both eyes associated with exophoria-tropia and both superior oblique overaction(SOOA OU) in an 18-year-old girl. We performed tenotomy of the superior oblique muscles in both eyes and 8mm recession of left lateral rectus muscle. After operation, orthophoria was achieved in primary, up and downgaze and SOOA of both eyes disappeared and there is only mild restriction of elevation in adduction in each eyes. The same findings were shown in follow up of 6 month after operation.
Adolescent ; Female ; Follow-Up Studies ; Humans ; Muscles ; Tenotomy

PURPOSE: We performed this study to evaluate the occurrence of consecutive esotropia after early surgery in the patients with intermittent exotropia less than 4 years of age. METHODS: We analyzed the surgical results of 37 patients who underwent surgery before 4 years of age retrospectively. They were followed up at least more than 1 year after surgery. The orthophoria was defined as an exophoria of 0 to 12PD or an esophoria of 0 to 5PD after surgery. The consecutive esotropia was defined as an esodeviation lasting more than 3 months that needed surgical correction due to sensorial deterioration. RESULTS: Preoperative angle of exodeviation at distance ranged from 20PD to 60PD (mean 35.1 +/- 9.2PD). Twenty-seven of 37 patients (75.7%) showed orthophoria after surgery in 1 year follow-up and 20 of 31 patients (64.5%) in 2 years follow-up. Five patients (13.5%) showed recurrence and 4 patients (10.8%) consecutive esotropia. Immediate postoperative overcorrection was 14.1 +/- 8.7PD(0-30) in patients who were orthophoric after postoperative follow-up more than 2 years. The rate of consecutive esotropia was high in patients with an exo-angle of 30PD or more and a large amount of recession of lateral recti more than 7mm. CONCLUSIONS: This study revealed that consecutive esotropia after early surgery for intermittent exotropia less than 4 years of age was noted to the 10.8%.
Esotropia ; Exotropia* ; Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies

No abstract available.
Adenocarcinoma, Mucinous* ; Child* ; Colon* ; Humans ; Mucins*

Water's view was used to establish the presence of a foreign body and its approximate position and then the accurate localization of the foreign body was assessed in postero-anterior and lateral views of skull with reference to a thin and long indicator attached to the sclera, At the site nearest the foreign body, a lamellar scleral undermining (about 5 mm) was performed on both sides of a single scleral incision which was parallel to the limbus, (about 15 mm). Surface diathermies were applied in the area undermined. The choroid was exposed by means of double scleral trap door incision. The foreign body was attached to the magnet tip when the hand magnet was brought up to the choroid. After extraction of the foreign body, mattress suture was then inserted in the undermining sclera. Scleral buckling was done using a preserved scleral implant. In contrast to the 41.7 percent sucess in removal of the foreign body by Comberg's technique and pars plana approach, we removed all of the foreign bodies by the above mentioned method in 11 cases. In my opinion, this localization of the foreign body is very accurate and the magnetic foreign body, although it is engaged by fibrous tissue, can be removed by this method in all patients. This method is very effective for prophylaxis and treatment of retinal detachment occuring in the course of removal of the intraocular foreign body.
Choroid ; Diathermy ; Foreign Bodies* ; Hand ; Humans ; Retinal Detachment ; Sclera ; Scleral Buckling ; Skull ; Sutures