The Epidemiological study of glaucoma in Korean is essential because the prevalence and distribution of glaucoma can be different among race and country. We surveyed the prevalence and distribution of glaucoma in Korean careerrnen aged 20 years or older who visited Yongdong Severance Hospital to undergo a regular physical examination during the year of 1992 and the total number of subjects examined was 4959 adults. A mainstay of the screening consisted of applanation tonometry and direct ophthalmoscopy, followed by automatic perimetry as a recall examination. Patients with suspected abnormalities in either the IOP >or=22mmHg or the optic disc findings such as high cup/disc ratio (>or=0.7) were referred for recall examination as the second stage of the visual field test. Overall prevalence of glaucoma obtained was 2.04% (101 patients) and the most common type of glaucoma was low tension glaucoma, 1.71% (85 patients). The prevalence of glaucoma increase with aging especially in low tension glaucoma.
Adult ; Aging ; Continental Population Groups ; Epidemiologic Studies ; Glaucoma* ; Humans ; Low Tension Glaucoma ; Manometry ; Mass Screening ; Ophthalmoscopy ; Physical Examination ; Prevalence* ; Visual Field Tests

Although it is well known that ultraviolet and short wavelength visible rays are harmful to the human lens and the retina, consumers still tend to select sunglasses on the basis of fashion rather than protective quality. In order to provide guidelines for selecting appropriate sunglasses, we studied the mechanism of phototoxic damage and UV protective quality of commonly used sunglasses. Commonly used sunglasses were chosen by random sampling, and their UV transmittance was examined by spectrophotometer using neutral density filter method. UV transmittance was shown to be 3.0% to 40.8% and there was no significant relationship between UV transmittance and the tint or darkness of the sunglasses.
Darkness ; Humans ; Retina

BACKGROUND: Because of wide individual variations in response to sedative and the level of sedation desired by different patients, inadequate sedation is frequent during surgery. Patient-controlled sedation is a logical extension of patient-controlled analgesia to find and maintain their own steady-state of sedation by self-administration of sedatives during surgery. The purpose of this study was to evaluate the feasibility of patient-controlled sedation compared with anesthesiologist-controlled sedation during surgical spinal anesthesia. METHODS: Unpremedicated forty adult patients who received spinal anesthesia for lower extremity surgery were randomly allocated into two groups (n=20 for each group). After selection of target state of sedation according to sedation scale, patient-controlled sedation (PCS) group self-administered 0.5 mg (1 ml) intravenous midazolam in increments using a Walkmed PCA infusor and anesthesiologist- controlled sedation (ACS) group administered by the anesthesiologist as the same manner to achieve previously selected sedation state. Sedation score, vital signs, SpO2 were checked 5, 10, 20, 30, 40min after start of drug injection. RESULTS: The sedation scores patient desired were 4.4 +/- 0.8 in PCS group and 4.3 +/- 0.7 in ACS group. These scores were achieved 20min after start of injection in PCS group and 40 min in ACS grou p (p<0.05). Degree of satisfaction was higher in PCS group compared with ACS group (1.5 +/- 0.6 vs 2.1 +/- 0.8, p<0.05). No complications were detected in two groups. CONCLUSIONS: PCS using midazolam was better than ACS in terms of early achievement of sedation state patient desired and degree of satisfaction.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Humans ; Hypnotics and Sedatives ; Infusion Pumps ; Logic ; Lower Extremity ; Midazolam* ; Passive Cutaneous Anaphylaxis ; Vital Signs

The purpose of this study was to explore the effect of diabetic camp program on depression, self-efficacy and self-esteem of the juvenile diabetic patient who had participated with diabetic camp program at Seoul and Kyung In area from August 5 to August 9, 1995. Nursing staffs explained them how to respond to the questionnaire of depression. self-efficacy and self-esteem prior to beginning the program and following the program. The questionnaire of depression, self-efficacy and self-esteem was developed by both diabetes mellitus nurse specialist and pediatric nursing professors in reference with the previous research. Response items of the questions were structured as yes or no for the elementary school students and that of the questions were structured as 5 likert scale for the both middle and high school students. Paired t-test was used for the significance of the difference between values before and after the diabetic camp program. Depression decreased following the program, while self-esteem increased significantly following the program in elementary school students. There was no change in self-esteem, while self-efficacy increased significantly following the program in middle and high school students. Self-efficacy following the program was high as the frequency of exercise increased in the elementary school students. Self-efficacy prior to the program was high as the experience of diabetic education increased in the middle and high school students. Self-efficacy and self-esteem prior to the camp was highly correlated with that following the camp in middle and high school students. The result suggests that diabetic camp program could be on of ways to decrease depression and to increase self-efficacy of the diabetic children.
Adolescent* ; Child* ; Depression* ; Diabetes Mellitus ; Education ; Humans ; Nursing Staff ; Pediatric Nursing ; Seoul ; Specialization ; Child Health ; Surveys and Questionnaires

Mitomycin C has an inhibitory effect on the proliferation of fibroblasts and it is used as an adjunct to trabeculectomy. To clarify the effects of mitomycin C on trabeculectomy, we ana lysed 95 eyes that received trabeculectomy with mitomycin C and 90 eyes that received trabeculectomy without mitomycin C. There were no significant differences in sex, age, type of glaucoma and preoperative intraocular pressure (IOP) between two groups (p>0.05 respectively). The mean rops at 6 months after surgery and the success rate were not significantly different between two groups (p>0.05). But considering the mean IOP of successful cases, the mitomycin C used group showed the lower postoperative IOP(p<0.05). The rate of complete seccess which had no antiglaucoma medications and 5-fluorouracil administration during the postoperative period was higher in the mitomycin C used group (p<0.05). Postoperative complications, espicially hypotony, were more common in the mitomycin C used patients. Hypotony was more frequent in the patients who received brief exposure of mitomycin C. Most of the hypotony patients had primary open angle glaucoma and lower preoperative IOP. According to the results of our study, mitomycin C should be used in the high risk group patients who are young and have secondary glaucoma or history of failure of filtering procedures, and also in the patients with difficulty of postoperative medical treatment and requiring lower IOP.
Fibroblasts ; Fluorouracil ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Postoperative Period ; Trabeculectomy*

To find the factors that affect on the success rate of the trabeculectomy, we investigated 208 eyes of 158 patients with various types of glaucoma which had undergone trabeculectomy. The patients were followed up at least 3 month postoperatively. The criteria of success was maintenance of postoperative IOP below 21 mmHg. The total success rate was 89.4%. In young patients, the success rate was lower than that of older ones. The success rate of open angle glaucoma, acute angle closure glaucoma and chronic angle closure glaucoma were higher than that of congenital glaucoma and secondary glaucoma. Recently performed operation demonstrated higher success rate. The type of conjunctival flap, scleral flap and use of 5-fluorouracil were independent factors that affect on the success rate.
Fluorouracil ; Glaucoma ; Glaucoma, Angle-Closure ; Glaucoma, Open-Angle ; Humans ; Trabeculectomy*

The anterior chamber depth is important in diagnosis and treatment of glaucoma, thus the research of the anterior chamber depth would help the understanding of angle closure glaucoma. Then the estimation of anterior chamber depth might help the diagnosis of certain cases of glaucoma. It has been reported by other authors in Korea, but there were not enough subjects to see the correlation between age and the anterior chamber depth. The purpose of this study was to measure the variation of the anterior chamber depth in relation to the normal aging process. The anterior chamber depth was measured in 2,524 eyes of normal subjects aged 20 years or older who visited our hospital to receive a health examination. Measurements of the anterior chamber depth were carried out conviniently with the Haag-Streit pachometer. Intraocular pressures were measured with the Pulsair non-contact tonometer, and the refractive errors of each subject were divided into hyperopia, emmetropia, and myopia. These data were analyzed statistically by Student's t-test. Female subjects had a smaller measurement for anterior chamber depth than male. The average anterior chamber depth of the emmetropes was smaller than that of the my opes and larger than that of the hyperopes. It was found that the anterior chamber depth decreased with age(0.015mm/year). The anterior chamber depth seemed not to be correlated with the intraocular pressure.
Adult* ; Aging ; Anterior Chamber* ; Diagnosis ; Emmetropia ; Female ; Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Hyperopia ; Intraocular Pressure ; Korea ; Male ; Myopia ; Refractive Errors

Measurement of the depth and angle of the anterior chamber can provide valuable information for the diagnosis, treatment and prognosis of angle closure glaucoma. We measured the depth and angle of the peripheral anterior chamber in the normal and the angle closure glaucoma eyes by utilizing ultrasonographic biomicroscopy. We also measured the 4 directions of the depth and angle of the peripheral anterior chamber and iris thickness before and after dilation in the normal eyes. The mean depth and angle of the peripheral anterior chamber were 421 +/- 73 micro meter, 30.46 +/- 6.49 degree in the normal eyes and 294 +/- 25 micro meter, 29.12 +/- 3.75 degree in the angle closure glaucoma eyes respectively. The differences of the depth and angle of the peripheral anterior chamber between the two groups were statistically significant(P<0.05, respectively). The depth and angle of the peripheral anterior chamber significantly increased after dilation in the normal eyes(P<0.05, respectively). The thickness of the iris was 421 +/- 54 micro meter at the iris root site, 509 +/- 57 micro meter in at the middle site and 582 +/- 74 micro meter at the pupillary margin site.
Anterior Chamber* ; Diagnosis ; Glaucoma, Angle-Closure ; Iris* ; Microscopy, Acoustic* ; Prognosis

It was previously reported that sudden loss of central vision and small residual fields in advanced glaucomatous eyes after filtering surgery. This study was undertaken to assess the risk of sudden wipe-out phenomenon on 57 eyes of advanced glaucomatous patients who could be followed up at least 8 weeks after filterlng surgery. The eyes were classified into three categones according to the seventy of visual field loss, evaluated with Humphrey computerized visual field analyzer and Goldmann perimetry using target with I-4-e. Sudden wipe-out phenomenon was divided into absolute and relative. The former was sudden complete loss of central vision immediately after filtering surgery. The latter was visual acuity decreasing 2 or more lines in Snellen visual acuity chart compared with before surgery or obvious progress1on of visual field defect at the t1me of 8 to 1O weeks after surgery However there were no absolute and relative sudden wipe-out phenomenon in our study. In the light of our experiences, it is concluded that filtering surgery can be performed with caution in advanced glaucomatous eye whenever it is indicated.
Filtering Surgery ; Glaucoma* ; Humans ; Visual Acuity ; Visual Field Tests ; Visual Fields

Visual field measurements are useful tool for diagnosis and management of glaucoma, and for evaluation of prognosis. But it has intratest and intertest variability, which interfere the precise interpretation of visual field changes. To examine the long term fluctuation, we conducted visual field measurements on three separate sessions in 44 glaucomatous eyes using Humphrey visual field analyzer. Each visual field results were compared with that of the following results. The long term fluctuation of visual field measurem-ent was between 1.85 and 8.81dB and in average 4.36 +/- 1.56dB. If one retinal location shows variaton greater than 8.81dB, automated visual fields must be interpreted cautiously and require confirmation and assessment of other clinical factors.
Diagnosis ; Glaucoma* ; Humans ; Prognosis ; Retinaldehyde ; Visual Fields*