Hüseyin Bayramlar

Comparison of ocular-surface disease index questionnaire, tearfilm break-up time, and Schirmer tests for the evaluation of the tearfilm in computer users with and without dry-eye symptomatology

Objective To compare the diagnostic values of the Schirmer’s and tearfilm breakup time (TBUT) tests and the Ocular Surface Disease Index (OSDI) in dry-eye syndrome. Subjects and methods Thirty-five employees of Ümraniye Training and Research Hospital who used computers in their daily work participated in this prospective study. All participants completed the OSDI. Following routine ophthalmologic examination, the TBUT and Schirmer’s test were undertaken and outcomes were compared. Results The mean age was 29.09 ± 6.73 (range 20–46) years. Mean OSDI questionnaire, TBUT, and Schirmer’s test scores were detected as 37.12 ± 19.05 (range 4–75), 11.37 ± 3.69 seconds (range 4–18 seconds), and 25.80 ± 8.43 mm (range 6–35 mm), respectively. There was a significant inverse correlation between the OSDI and TBUT scores (r = −0.385, P = 0.022). No significant correlation existed between the OSDI and Schirmer’s test scores. Conclusion Dry eye is a common problem among computer users. The OSDI questionnaire, used together with the TBUT, is easily performed and may be of benefit in supporting the diagnosis of dry-eye syndrome.

Inferior flap anastomosis in external dacryocystorhinostomy.

Purpose: To describe the inferior flap design as a modification in external dacryocystorhinostomy (DCR) and to evaluate the effectiveness on surgical outcome. Methods: This prospective study enrolled 33 consecutive patients with acquired nasolacrimal duct obstruction who underwent external DCR with this modified flap design from February 2007 to April 2008. Success was defined as amelioration of epiphora and anatomic patency. Operative outcomes and success of the procedure were evaluated. Results: The mean age was 45 years (range, 12–65 years). The mean follow-up time was 15.6 months (range, 10–23 months). None of the patients had signs or symptoms of epiphora at the end of the follow-up period. Conclusions: The inferior flap design simplifies the surgical procedure and produces success rates comparable with those found in conventional DCR. Further studies with larger numbers of patients are necessary.

Vitiligo in a Patient Treated with Interferon Alpha-2a for Behçet’s Disease

Behçets disease (BD) and vitiligo are diseases of unknown etiology. Interferon (IFN) alpha therapy is commonly used in Behçet uveitis. Interferon treatment in various diseases have also been observed causing certain autoimmune diseases such as vitiligo because of its immunomodulatory activity. The association between IFN therapy and vitiligo has been reported in the literature. We report a 21-year-old man with BD in whom vitiligo occurred during IFN treatment. To the best of our knowledge, this is the first reported case of such an association.

Ipsilateral Rotational Autokeratoplasty for the Management of Traumatic Corneal Scar

A 40-years-old male patient with a corneal scar secondary to perforating eye injury had undergone ipsilateral rotational autokeratoplasty in our clinics. The corneal scar involved the pupillary area. The patient had a preoperative visual acuity of counting fingers. The patients cornea was trephined with a 0.5 mm temporal decentration. The 8.0 mm autograft was rotated approximately 180° to relocate the scar to the temporal aspect of the cornea. The final position of the corneal scar was temporal of the visual axis and central area was clear. The visual acuity at 1-, 3-, and 6-months followups was better than the first visual acuity in the patient. Ipsilateral rotational autokeratoplasty has many advantages over conventional keratoplasty. There is no risk of immunological rejection of the graft, postoperative corticosteroids are not needed as frequently, and donor cornea is not required. A rotational autograft can be a powerful alternative to conventional keratoplasty for some patients with traumatic corneal scars.

Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation.

Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE). The patients best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared. Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

The etiological features of anterior uveitis in a Turkish population

Purpose To identify any patterns in the cause of anterior uveitis in a Turkish population and compare them with results from previous studies. Methods The clinical records of 75 patients between January 2009 and January 2010 were retrospectively analyzed and classified as anterior uveitis according to Standardization of Uveitis Nomenclature criteria. Complete blood count, sedimentation rate, chest radiography, purified protein derivative skin test, and venereal disease research laboratory test were done on all patients. Additional serologic and radiographic tests were performed when indicated. Results Forty-one (54.6%) were male and 34 (45.3%) were female patients. The mean age at presentation was 39.1 ± 12.6 years. Fifty-six (74.6%) had unilateral and 19 (25.3%) had bilateral disease at presentation. A specific diagnosis was able to be established in 54 (72%) patients. The most common diagnoses were anterior uveitis associated with human leukocyte antigen B27 (14.6%) and Fuchs uveitis syndrome (14.6%). The second most common diagnosis was uveitis associated with herpes simplex virus (13.3%), followed by Behcet’s uveitis (6.6%). Systemic disease associations were noted in 15 (20%) patients, and the most commonly associated systemic disease was Behcet’s disease (6.6%). Conclusion Fuchs uveitis syndrome and anterior uveitis associated with human leukocyte antigen B27 were the most common form of anterior uveitis in this study. Using a systematic approach, a diagnosis was able to be established in 72% of the anterior uveitis cases.