AIM:To report a rare case of medullary thyroid carcinoma (MTC) with iridocorneal angle metastasis.METHODS:A 28-year-old woman,a known case of sporadic MTC was referred to our hospital due to left eye mass involving iridiocorneal angle.Several months' later retinal evaluation revealed retinal involvement with some patches.RESULTS:After palliative laser photocoagulation ablation of the choroidal and angle lesions no signs of recurrence or any new lesion was detected.CONCLUSION:As we know this is the first report of MTC with iridocorneal angle metastasis in the literature.

AIM: To determine the frequency of HIV-related ocular involvement and to describe the characteristics of involvement in a special clinic in Tehran.METHODS: In this cross sectional study, 141 patients (125 male and 16 female, 282 eyes) of HIV-infected patients with various stages of HIV infection that were referred to Center of behavioral diseases were evaluated during a period of 7 months. Every patient had a complete profile including demographic data, method of HIV transmission, recent CD4 T cell lymphocyte count, serological studies for common sexual or blood-born viruses and toxoplasmosis, history of antiretroviral therapy, and associated systemic disease. RESULTS: A total of 141 patients were evaluated. HIV-related ocular involvement was detected in 15 patients (10.6%), including 3 mycobacterium tuberculosis-related choroiditis, 2 cytomegalovirus retinitis, 2 retinal toxoplasmosis, 2 herpes simplex virus-related lesions, 1 HIV-associated retinopathy, 1 herpes zoster ophthalmicus, 1 undetermined vitritis, and 3 cases of cranial nerve involvement including 2 cases of gaze palsy and 1 case of papilitis. In our study, mean CD4 T cell lymphocyte count was fewer in patients with ocular involvement than in patients without ocular involvement (204.7±123.8 vs 403.7±339.7, P=0.029), but there was no difference in other possible associated factors between two groups.lesions are the most common HIV-related ocular involvements in Tehran that is different from those of recent publications in developed countries.

AIM: To study the frequency of amblyogenic factors in patients with congenital ptosis.congenital ptosis more than 1 year old were included. Amblyopia was defined as best-corrected visual acuity (BCVA) less than 10/10 or a difference between the two eyes of at least 2/10. In patients too young to be measured by the linear Snellen E test, fixation behavior was observed. Different types of amblyopia were assessed for each patient as: 1) anisometropic amblyopia: astigmatic anisometropia≥ 1dpt, hyperopic spherical anisometropia≥ 1dpt, myopic spherical anisometropia≥ -3dpt (with cycloplegia);2) strabismic amblyopia, and 3) stimulus deprivation amblyopia (SDA). Then the total incidence of amblyopia and each type of it were obtained. Patients with uni-and bi-lateral ptosis were also compared. Each specific cause was refractive amblyopia in 29.8%, SDA in 10.5%, strabismic amblyopia in 4.3%. Amblyopia was more frequent in severe ptosis, 76% in patients with covered optical axes (OA), compared to non-covered OA (22.5%). In unilateral ptosis with covered OA, astigmatic anisometropic amblyopia was more frequent, and in bilateral ptosis with at least one eye covered OA, spherical anisometropic amblyopia was more frequent. In both unilateral and bilateral ptosis, SDA was more common if the OA was covered. Paying attention to all causes of amblyopia may be important in preventing amblyopia in a child with a ptotic eye.

Here we describe shifting bubble sign in manual dissection of deep anterior lamellar keratoplasty (DALK). This sign can be noticed in more than 99% of patients. It is very useful in phakic keratoconic eyes, the leading indication for DALK. We believe that our small modification can help surgeons early in learning curve to avoid inadvertent anterior chamber penetration during the final stages of DALK.

·Color blindness is a common disorder in human. Congenital color blindness is a trait of X-linked recessive inheritance. In our study, one thousand and six hundred female students were selected by randomized group sampling and tested by "Ishihara pseudoisochromatic plates".Among this(0.63%) showed color vision deficiency; among these cases six girls (0.38%) had deuteranomaly and 4 girls (0.25%) had protanomaly.

We reported an unusual case of choroidal melano-cytoma who was enucleated with diagnosis of retinoblastoma. A 14-month-old boy has been referred to the clinic with compliant of left eye exodeviation for about 10 months. Ocular examination and imaging work-up revealed retinal detachment with a calcified lesion. The patient underwent enucleation of the affected eye with diagnosis of retinoblastoma. Histopathological findings indicated large, polyhedral shape cells of the tumor with small nuclei and abundant cytoplasm filled with melanin granules, suggesting diagnosis of melanocytoma of the choroids and ciliary body. Many cases of the simulation of the malignant melanoma of the choroids and ciliary body with melanocytoma has been reported previously, but melanocytoma resembling as a calcified lesion and retinal detachment with diagnosis of retinoblastoma is a rare condition which has not been reported anywhere.

·We report clinical manifestations,angiographic,and optical coherence tomography (OCT) findings of four cases with bilateral idiopathic cystoid rnacular edema (CME).All were male with age between 30 and 52 years.All of them had compliant of bilateral visual loss during the last week.Fundus examination of their eyes showed macular edema in the posterior pole bilaterally. Fluorescein angiography revealed no specific finding in one of them and "typical petaloid pattern" in others.OCT showed subretinal fluid in all of them.All patients were managed with diagnosis of idiopathic CME,and after 6 weeks they had improved visual acuity.

AIM:TO evaluate chromosome 8 abnormalities in Duane's retraction syndrome(DRS)type 1.METHODS:We evaluated chromosome 8 abnormalities in 29 consecutive cases of DRS type Ⅰ.DNA was isolated from the peripheral leukocytes of patients using a genomic DNA extraction kit,then D8S553 and D8S1797 markers used for polymerase chain reaction(PCR).RESULTS:None of the cases were positive for the two markers D8S553 and D8S1797 on chromosome 8 which were tested in our study.CONCLUSION:The possible cause of this finding is that DRS in our patients is more commonly sporadic rather than familial.We recommend study with more cases,other markers,and different chromosomes.

AIM: To review the characteristics, complications, and epidemiology of perforating eye injury treated at a referral eye centre in Tehran, over one year, ·METHODS: The medical records of 959 patients hospitalized in Farabi Eye Hospital, Tehran, Iran, due to ocular trauma in 2002 were studied. Information recorded included demographic information (age, sex, and occupation), offending agent, type of trauma, initial visual acuity, location where trauma occurred, accompanying signs and symptoms, and types of treatment provided. ·RESULTS: Mean age of patients was (22.6±16.4) years with a peak age of 21-25 years in males and under 5 years in females. The ratio of male to female was 4.2:1.62.4% of patients had penetrating trauma, 33.9% had blunt trauma, and 3.7% had mixed or chemical trauma. Metallic agents were the most common cause of penetrating ocular trauma, while stone was the most common blunt counterpart. Foreign bodies were observed in 23.4% of cases. Cornea was the most com-mon site of rupture (46.7%). ·CONCLUSION: Based on this study, penetrating trauma is more common than blunt trauma. Younger individuals are more prone to ocular trauma. Cornea is the most common site of injury.

· We report successful treatment of a case of fungal keratitis caused by Pseudallescheria boydii with minimal corneal scar. A 71-year-old woman with history of pain, redness and foreign body sensation presented to our tertiary eye center. Initial corneal scraping revealed fungal elements. After two days fungal culture became positive, and after five days it was shown to be growth of Pseudallescheria boydii. The patient achieved clinical cures with medical therapy alone with minimal corneal scar and good visual outcome of 3/10.