Meral Yıldız

An Important Cause of Blindness in Children: Open Globe Injuries

Objective. Our aim was to present and evaluate the predictive factors of visual impairment and blindness according to WHO criteria in pediatric open globe injuries. Methods. The medical records of 94 patients younger than 18 years who underwent primary repair surgery were reviewed retrospectively. The initial and final visual acuity, anterior and posterior segment findings, and zone of injury were noted. The patients were classified as blindness in one eye or visual impairment in one eye. Results. Of 412 patients who presented with open globe injury, 94 (23%) were under 18 years old. Fifty-four (16 females, 38 males) children were included. The mean age of the children was 7.1 ± 4.1 years. According to WHO criteria, 19 of 54 patients (35%) had unilateral blindness and 8 had unilateral visual impairment (15%). There was no significant relationship between final visual acuity and gender and injured eye. In visually impaired and blind patients, presence of preoperative hyphema, retinal detachment, and zone 2 and zone 3 injuries was significantly higher. Conclusion. Presence of hyphema and zone 2 and zone 3 injuries and retinal detachment may end up with visual impairment and/or blindness in children.

Herpes zoster ophthalmicus and lateral rectus palsy in an elderly patient.

Acquired palsy of the lateral rectus presents with horizontal diplopia and has a broad differential. Herpes zoster ophthalmicus- (HZO) related cranial nerve palsy is a transient and self-limiting condition. Systemic antiviral treatment is administered in order to prevent sight-threatening complications. In suspected cases, zosteriform rash should be questioned. One should keep in mind that acquired esotropia in the elderly may sometimes present following HZO.

The role of serial measurements of serum insulin-like growth factor 1 levels in the development of retinopathy of prematurity

AIM To determine the role of serum insulin-like growth factor-1 levels in the development of retinopathy of prematurity, which is a major cause of childhood blindness worldwide. MATERIAL AND METHODS We prospectively studied newborn infants born at a postmenstrual age of <32 weeks and birth weights <1 500 gr, between January 1st, 2015, and December 31st, 2015. A total of 40 infants were enrolled in the study. The retinal examination time was determined in accordance with the American Academy of Pediatrics recommendations for retinopathy of prematurity screening and follow-up. Retinopathy of prematurity was classified according to the international classification of retinopathy of prematurity. Serum Insulin like growth factor 1 levels were measured serially in blood samples on the 1st, 3rd, 7th, 21st, and 28th day. RESULTS Among the 40 infants, 11 (27.5%) constituted the retinopathy of prematurity group and 29 comprised the non-retinopathy of prematurity group. In the retinopathy of prematurity group, the mean gestational age and birth weight was significantly lower. The demographic features of the study cohort were similar. The duration of mechanical ventilation was significantly greater in the retinopathy of prematurity group compared with the non-retinopathy of prematurity group (p=0.036). In terms of neonatal morbidities such as respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia, patent ductus arteriosus, and necrotizing enterocolitis, no differences were detected between the groups. The mean serum insulin-like growth factor-1 levels in retinopathy of prematurity group were significantly lower than those in the non-retinopathy of prematurity group at each time point (1st, 3rd, 7th, 21st, and 28th day of postnatal life) (p=0.001). CONCLUSIONS This study demonstrated the low serum insulin-like growth factor-1 levels was associated with retinopathy of prematurity development.

Comparison of Retinal Nerve Fiber Layer Thickness in Terms of Birth Weight in Prematurely Born Children.

Abstract Purpose: To study the potential effects of both prematurity and the sub-groups of low birth weight on thickness of RNFL. Methods: Prospective case series of 26 preterm school-aged children with low birth weight whose retinal nerve fiber layer analyses with RTVue-100 Fourier-domain optic coherence tomography were performed in 2013 at the Department of Ophthalmology, Erzurum Region Education and Training Hospital. Results: The mean retinal nerve fiber layer thicknesses were 100.6 ± 13.3 microns in extremely low birth weight, 103.9 ± 8.4 microns in very low birth weight, and 104.1 ± 10.8 microns in low birth weight groups. There was no significant difference in RNFL among the groups. Conclusions: No significant relationship was found between birth weights and retinal nerve fiber layer thickness of preterm children who were appropriate for gestational age.

Demographics of the Open-Globe Injuries in Pediatric Age Group in Northwest Turkey

Introduction: Our aim was to investigate the pattern of open globe injury and assess the effect of age on different parameters of open globe injury in pediatric patients. Materials and Methods: The medical records of the patients under 18 years old who had open-globe injury were retrospectively reviewed. Age, gender, the cause of the trauma, presence of intraocular foreign body and the extent of the ocular damage were recorded. Results: The study was comprised of 79 patients (23 female, 56 male) with a mean age of 7.7±4.4 (range: 2-18 years). Thirty-nine patients were injured with a blunt tip object, 27 with a sharp object and one has rupture with trauma. Thirty-five injuries occurred outside and 45 at home. The season in which most of the injuries took place was summer (32%). Seventy-five percent of the injuries were noted in 11 years and under. The mean age subject to blunt tip object injury, organic body injury and outdoor injury was significantly higher compared to that of with sharp object, inorganic body injury and indoor injury. Conclusions: The open globe-injury rates in Northwest Turkey is found to be higher in smaller age groups. Making the parents aware of the danger and consequences of the trauma and avoiding the easily accessible sharp objects may decrease the trauma rates.

Induction of bilateral ligneous conjunctivitis with the use of a prosthetic eye

The purpose of this article to report a case of ligneous conjunctivitis in an anophthalmic socket, in respect of a 20-year-old woman. The subject woman had a history of left enucleation surgery presented with bilateral palpebral ligneous conjunctivitis and ligneous gingivitis. The hematologic study revealed a severe plasma plasminogen deficiency. The eyelid lesions were successfully treated with surgical excision, topical heparin and corticosteroid eyedrops. However, the ligneous lesions recurred bilaterally after she was fitted with a prosthetic eye and were refractory to intensive topical treatment with heparin and cyclosporin A eye drops. This case shows that the use of a prosthetic eye may induce ligneous conjunctivitis in an anophthalmic socket and normal eye which is refractory to topical treatment.