The histopathological changes were observed to evaluate the effect of single intraopferative application of mitomycin C soaked Cottonoid on wound healing process after strabismus surgery. A 3mm recession of the superior rectus muscle was performed after application of 0.5mg/ml mitomycin C soaked Cottonoid for 5 minutes in one eye of 15 rabbits(30 eyes) and was copiously irrigated with normal saline. The same procedure was done in the contralateral eye as a control using normal saline. The less amount of inflammatory cellular infiltration and the less granulomatous reaction to suture material were observed in mitomycin C treated eyes. The proliferation of fibroblast was considerably inhibited in mitomycin C-treated group. The postoperative adhesion, the fibrosis of extrocular muscle and the depositon of collagen fibers were also decreased in mitomycin C-treated group. Gross complications was not present in rabbit during 3 months of experiment. No pathologic sign of undesirable side effects was noted. In conclusion, the single intraoperative application of mitomycin C soaked Cottonoid could decrease the postoperative adhesion and extraocular muscle fibrosis through its inhibitory effects on the inflammatory reaction and fibroblast proliferation in strabismus surgery without any complications which were reported in subconjunctival injection of mitomycin C. Further studies investigating the optimal concentration, application method and time of mitomycin C soaked Cottonoid and its promising potential for use in humans are needed.
Collagen ; Fibroblasts ; Fibrosis ; Humans ; Mitomycin* ; Strabismus ; Sutures ; Wound Healing* ; Wounds and Injuries*

Long-term surgical results for 3 or 4 horizontal muscles surgery were evaluated in 58 infantile esotropes with large angle of 55 PD or more. They were followed up for 2 years or more(mean 5.6+/-2.16 years). The mean preoperative deviation was 63.2(+/-5.30)PD, ranging from 55 to 75 PD. Monocular preference was shown in fifty seven percent(34 patients)at the first visit. Thirty eight patients(65.5%)were aligned within+/-8 PD of orthotropia after primary procedure and forty nine patients(84.5%)after the second operation. The immediate postoperative deviation averaged 4.8+/8.99 PD of exotropia in 38 patients all of whom were aligned within+/-8 PD of orthotropia at the last visit. Prospectively, the patients with immediate overcorrection of 4 to 9 PD of orthotropia after surgery were found to be mostly aligned within 8 PD of orthotropia at the last visit. Among the 49 patients with stereopsis testing, 29 patients(58%)had measurable stereopsis and 70%of these patients had favorable stereopsis of 800 seconds or less. In conclusion, 3 or 4 horizontal muscles surgery was effective as initial procedure in large angle infantile esotropia with 55 PD or more deviation. Small amount of exotropia less than 10 PD in the immediate postoperative period was desirable for the best long-term alignment.
Depth Perception ; Esotropia* ; Exotropia ; Humans ; Muscles* ; Postoperative Period ; Prospective Studies

The commonly used tests for stereopsis are Titmus-fly, Randot, and TNO tests. In this study, 50 normal subjects were tested with these tests in order to set a criterion for normal stereopsis. The value of mean, mode and 75% point of these three tests were derived and compared.These three tests were also performed in 23 intermittent exotropes and 32 accommodative esotropes who showed gross stereopsis in the range of 60 to 400 seconds of arc by Titmus-fly testing. The aim was to obtain standards for clinical applicability and accuracy of these tests.This study cincludes that the appropriate criteria for normal stereopsis are less than 60 seconds of arc for Titmus-fly or Randot test, and 120 seconds of arc fot TNO test. Accurate testing for stereopsis in patients with gross stereopsis requires both Titmus-fly and Randot tests together. TNO test was inferior to the other two tests in terms of the accuracy and clinical applicability.
Depth Perception ; Humans

PURPOSE: This study was performed in order to discover the influence of the different types of computer and VDT work on the dryness of eyes. METHODS: Forty people without eye disease were included in this study. The frequency of blinking, BUT and width of palpebral fissure were measured after working on documents with desktop computers and laptop (notebook) computers and playing computer games at PC-room for 30 minutes each. RESULTS: The BUT value was 7.0+/-2.52 seconds after working on document with laptop computers and 5.7+/-1.86 seconds with desktop computers. Whereas the frequency of blinking was almost the same, the width of palpebral fissure was 6.6+/-0.95 mm in the former and 7.7+/-1.07 mm in the latter. After playing computer games at PC-room for 30 minutes, the BUT was as low as 4.6+/-1.61 seconds. The frequency of blinking was as low as 7.7+/-2.52 times/minute, and width of palpebral fissure as high as 9.2+/-1.24 mm. CONCLUSIONS: The highest value of palpebral fissure and the lowest value of BUT were obtained after playing computer games at PC room. These results indicate that the most severe dryness of eyes results from playing computer games at PC room and leads to eye fatigue easily. This was followed in the order of severe dryness by working on documents with desktop computers and laptop (notebook) computers. Therefore, proper rest during computer work, use of artificial tears and improved environment of the VDT working room are required.
Asthenopia ; Blinking ; Eye Diseases ; Ophthalmic Solutions ; Video Games

The ocular symptoms of visual display terminal (VDT) syndrome are caused by asthenopia, electromagnetic waves, and eye fatigue. To find out what cause make the fatigue of eye during VDT work, we measured frequency of blinking and height of palpebral fissure at near, reading a book, and during VDT work. Tear film break-up time(BUT) was measured immediately after the VDT work and during reading a book. The frequency of blinking during VDT work and book reading decreased significantly comparing with the one at rest (p<0.01). The average frequency of blinking is 20.52 +/- 5.89/min at rest, 8.29 +/- 4.15/min at VDT work, and 10.31 +/- 5.48/min at reading. The BUT measured immediately after VDT work decreased much more than in the resting state (p<0.01). The average BUT was 11.52 +/- 3.41sec at rest and 6.18 +/- 2.65sec immediately after VDT work. The height of palpebral fissure during VDT work increased significantly comparing with the value at rest (p<0.01). The average height of palpebral fissure was 7.39 +/- 0.78mm at rest and 8.83 +/- 0.75mm during VDT work. This study reveals the fatigue of eye during VDT work was induced by the dryness of eye resulted from the increased evaporation due to the decrement in the frequency of blinking and the widening of palpebral fissure. To prevent the fatigue of eye caused by dryness during VDT work, it is important for VDT workers to intend to blink frequently, place VDT lower than eye level to reduce the height of palpebral fissure, humidify the room adequately, put artificial eye tear in eye frequently, and take a rest after 20 mimutes work at least.
Asthenopia ; Blinking ; Electromagnetic Radiation ; Eye, Artificial ; Fatigue ; Tears

We studied the relationship of deviated eye with dominant eye, dominant hand and visual acuity in 109 horizontal strabismic patients. Control group of 109 normal subjects without strabismus or specific ocular diseases were also examined. Right ocular dominance in normal subjects was noted in 66.1%. Strabismic patients showed ocular dominance of nondeviated eye in 78.5%. The dominance of right hand in normal subjects were noted in 89.0% and those were 82.6% in strabismic patients. Better visual acuity of right eye were noted in 40.4% of normal subjects, and 28.4% in left eye. Equal visual acuity between two eyes were 31.2% of the subjects. Strabismic patients showed better visual acuity in 70.9% of nondevia ted eye. Based on these results, the correlation of nondeviated eye with dominant eye, and better visual acuity were statistically significant(p<0.01, respectively), but not with dominant hand(p>0.05).
Dominance, Ocular ; Hand* ; Humans ; Strabismus* ; Visual Acuity

Cyclic esotropia is a rare condition, first mentioned by Burian in 1958, in which orthophoria is regularly followed by constant deviation on rhythmic pattern. The periodicity would suggest a biologial clock mechanism. Consecutive cyclic esotropia following strabismus surgery is extremely rare. Only three cases of consecutive cyclic esotropia following surgery for intermittent exotropia have been reported We report one case of consecutive cyclic esotropia in an 8-year-old girl who underwent surgery for intermittent exotropia. The periodic esodeviation was treated with bimedial rectus recession. We suggest the overcorrection after surgery for intermittent exotropia would cause the periodicity by biological clock mechanism when the biorhythm of the patient is in an unstable and dangerous state.
Biological Clocks ; Child ; Esotropia* ; Exotropia* ; Female ; Humans ; Periodicity ; Strabismus

Management of infantile and early childhood onset strabismus should be completed during early childhood to gain better binocular function and vision. The author experienced 38 adult patients who had horizontal strabismus without any adequate treatment lasting over 14 years with onset before 6 years of age. They showed large angle of deviation and deep amblyopia. After surgery, stereopsis was never developed in all of the 14 congenital strabismic patients, whereas 30% of the 24 patients with acquired onset showed gross stereopsis. There was abnormal muscular contracture requiring adjustable stutre. All of the patients showed abnormal character psychologically. This study revealed that the lunger the duration of misalignment, the greater the chance of deep amblyopia large angle of deviation, abnormal sensory and motor adaptation, psychological influence, and ahnormal muscular contracture. Therefore early initiation of therapy during early childhood should be emphasized.
Adaptation, Psychological ; Adult* ; Amblyopia ; Contracture ; Depth Perception ; Humans ; Strabismus* ; Telescopes

The patients with accommodative esotropia due to high AC/A(accommodative convergence/accommodation) ratio show prominent esodeviation and can not fuse without bifocals at near. The purpose of this study is to eliminate prominent near esotropia in those patients and let them fuse at near without bifocals. We performed unilateral or bilateral medial recti recti recessions according to the angle of near esotropia in 14 patients. Twelve patients showed orthophcria or small esophoria less than 12 delta. Eleven of these patients obtained solid fusion after surgery except 3-year-old patient who could not understand the stereopsis test. One patient had esophoria of 20 delta after surgery and showed gross stereopsis. The other patient recurred 27 delta of intermittent esotropia. Twelve of 13 patients(92.3%) could fuse without bifocals at near. The recession of medial rectus or recti was effective on the removal of prominent near esotropia and obtaining fusion without bifocals. Furthermore it did not disturb angle of deviation and fusion at distant. We recommend this procedure as a secure and effective treatment for near esotropia caused by high AC/A ratio.
Child, Preschool ; Depth Perception ; Esotropia* ; Humans ; Linear Energy Transfer

PURPOSE: To report a male infant with bilateral Duane's retraction syndrome treated with bilateral horizontal transpositions of vertical recti to the lateral rectus muscle. METHODS: An 8-month-old boy showed bilateral Duane's retraction syndrome with esotropia of 45PD, severe limitation of abduction (-4 and -3.5 in each eye) and mild globe retraction in both eyes. It was assumed that he inherited the condition from his father through an autosomal dominant pattern. His father showed esotropia of 25PD with -4 limitation of abduction in the left eye and a left head-turn of 10 degrees. He also had +2 globe retraction, +1 upshoot and +2 downshoot in adduction of the left eye. Transposition of two vertical recti to the lateral rectus muscle was performed in both eyes of the boy. RESULTS: Nine months after surgery, the boy had achieved a microesotropia of 6PD in primary gaze with stereopsis of 3000 seconds of arc and considerable improvement in abduction (-2, -1.5 in each eye). The amount of correction of esodeviation was 39PD. This favorable state was maintained at follow-up 3.5 years after surgery. CONCLUSIONS: An 8-month-old boy who had esotropia of 45PD caused by bilateral Duane's retraction syndrome, underwent bilateral horizontal transpositions of vertical recti to the lateral rectus muscle. He achieved a microesotropia of 6PD in primary gaze and considerable improvement of abduction with only mild eyeball retraction.
Depth Perception ; Duane Retraction Syndrome* ; Esotropia ; Fathers ; Follow-Up Studies ; Humans ; Infant ; Male