Nazmi Zengin

Do daily wear opaquely tinted hydrogel soft contact lenses affect contrast sensitivity function at one meter

Purpose. To investigate the effects of daily wear opaquely tinted hydrogel soft contact lenses on contrast sensitivity functions, as measured using the Pelli-Robson chart viewed at 1 meter. Methods. Contrast sensitivity was measured in 48 healthy individuals before and 6 hours after soft contact lens wear. Twenty-four subjects used clear soft contact lenses and 24 used tinted soft contact lenses. Results. The contrast sensitivity scores were significantly decreased monocularly and binocularly (P = 0.000 and P = 0.002, respectively) in the colored contact lens group whereas there were no significant changes in the clear contact lens group (P = 0.317 and P = 0.317, respectively). Conclusions. Color-tinted contact lenses were associated with a reduction of contrast sensitivity function. Therefore, those who wear colored contact lenses should be informed about the possible consequences of tinted contact lens wearing.

Evaluation of Retinal Nerve Fiber Layer Thickness in Patients With Anisometropic and Strabismic Amblyopia Using Optical Coherence Tomography

PURPOSE To evaluate the retinal nerve fiber layer (RNFL) thickness of eyes with amblyopia using optical coherence tomography (OCT). METHODS RNFL thickness measurements obtained by time-domain OCT of amblyopic eyes of patients with strabismus (35 patients) and patients with anisometropia (30 patients) were compared with their fellow eyes and age- and gender-matched healthy eyes (40 participants). RNFL thickness values of the groups were also compared and the correlation between RNFL thickness and refraction was evaluated. RESULTS In the strabismic and anisometropic groups, there were no statistically significant differences in average RNFL thickness between amblyopic eyes and their fellow eyes (P > .05). Temporal RNFL quadrant in the hypermetropic anisometropic group, and superior RNFL quadrant in the myopic anisometropic group were significantly thinner in amblyopic eyes compared to their fellow eyes (P < .05). RNFL thickness did not differ between strabismic amblyopic, anisometropic amblyopic, and control eyes (P > .05). In the anisometropic group, a significant correlation was found between mean RNFL thickness and refraction (P < .05). CONCLUSION Amblyopia is not associated with a decrease in RNFL thickness in strabismic or anisometropic amblyopia. In the anisometropic group, the inter-eye differences in RNFL thickness parameters seemed to be related to the refraction differences between the amblyopic eyes and their fellow eyes.[J Pediatr Ophthalmol Strabismus 2013;50:113-117.].

TRAUMATIC GLOBE LUXATION

Abstract A case of globe luxation which followed a relatively slight trauma is presented. The luxation was accompanied by laceration of the conjunctiva in this case. After achieving reposition in the emergency room, the patient underwent a surgical exploration of extraocular muscles and conjunctival fornices where many eyelashes were removed. The clinical features and management of globe luxation is discussed, importance of surgical exploration is emphasized.

Unilateral chemosis, acute onset myopia and choroidal detachment following the use of tamsulosin

Editor, T amsulosin is a subtype-selective a1A and a1D adrenoceptor antagonist which improves maximal urine flow by relaxing the prostate and bladder smooth muscles (Dunn et al. 2002). Its well-known ocular side-effect is intraoperative floppy iris syndrome (Keklikci et al. 2008). We present a case report of unilateral chemosis, acute onset myopia and choroidal detachment following tamsulosin treatment in a patient who had undergone a vesical diverticulectomy procedure 1 month previously. A 44-year-old man was referred to our clinic with painless conjunctival swelling and blurred vision in his right eye of 5 days’ duration. The patient had undergone an uncomplicated vesical diverticulectomy 1 month earlier and had been put on oral ciprofloxacin and tamsulosin (Flomax; Boehringer Ingelheim, Istanbul, Turkey) treatment the day after the operation. He had stopped taking antibiotic pills 10 days after the operation and had not used any medications other than Flomax since then. He had no systemic diseases, history of drug allergy or ocular trauma. The subject’s best corrected visual acuity (BCVA) was 20 ⁄ 25 with ) 3.75 to 0.50 · 70 in the right eye. Uncorrected visual acuity was 20 ⁄ 20 in the left eye. Ocular examination revealed conjunctival hyperaemia and severe chemosis protruding over the lower lid margin in the right eye (Fig. 1A). No purulent discharge was observed. The anterior chamber was shallow without any cellular reaction and intraocular pressure was 19 mmHg in the right eye. Fundus examination revealed a ring-shaped anterior choroidal detachment preserving the posterior pole. The optic disc, macula and vascular structures were normal. No pathology was noted in the left eye. Orbital magnetic resonance imaging confirmed cilio–choroidal detachment and there were no orbital pathologies to explain severe chemosis in the right eye (Fig. 1B). Anterior segment examination with Scheimpflug imaging revealed a shallow anterior chamber in the right eye (Fig. 2A). Anterior chamber depths were 2.03 mm OD and 2.68 mm OS. Anterior chamber volumes were 92 mm OD and 159 mm OS. Anterior chamber angles were 26.2 degrees OD and 36.5 degrees OS. After consultation with his urologist, the patient’s systemic treatment (Flomax) was stopped and topical prednisolone and cyclopentolate was started. Chemosis and choroidal detachment was entirely resolved at the end of 1 month. The anterior chamber depth and iridocorneal angle in the right eye were normalized (Fig. 2B) and BCVA was 20 ⁄ 20 with ) 0.75 to 0.75 · 70 (equal to the former spectacle correction).

The effect of dacryocystorhinostomy on tear film flow and stability in patients with chronic dacryocystitis

Abstract. In 30 patients suffering from chronic dacryocystitis, tear film flow and stability were assessed by means of Schirmer I and break‐up time tests before and after dacryocystorhinostomy. When compared with those of healthy individuals, mean values of Schirmer I tests were found to be decreased before dacryocystorhinostomy, but reached normal levels after a successful operation. Break‐up time levels were found to be within normal limits before and after surgery and no statistically significant difference was observed between patients and control group. These findings not only confirm the previous findings, that tear secretion in patients with chronic dacryocystitis was reduced and break‐up time was not affected, but also indicate that the reduction of tear secretion can be eliminated by a successful dacryocystorhinostomy.

Ophthalmic Manifestations in Recently Diagnosed Childhood Leukemia

Purpose To determine the prevalence and the pattern of ocular involvement in children with leukemia at the time of diagnosis. Methods The data of patients with leukemia who underwent complete ophthalmic examination at the time of diagnosis between January 2005 and December 2014 were retrospectively reviewed. Demographic data, type of leukemia, ocular findings, blood parameters, and duration of follow-up were analyzed. Results A total of 185 patients (111 male and 74 female) were included in the study, with a median age of 6.0 years (range 0.5-18.0 years) and a median follow-up time of 36.0 months (range 0.5-108.0 months). Ocular signs were present in 24.3% of the patients at the time of diagnosis and 37.8% of them were symptomatic. The prevalence of ocular involvement was 20.4% in patients with acute lymphocytic leukemia (ALL) and 36.4% in patients with acute myelocytic leukemia (AML) (p = 0.051). Fatality rate was significantly higher in subjects with AML compared with ALL (p = 0.019), but was not significantly different between patients with and without ocular involvement (p = 0.166). There were no significant differences in hemoglobin levels, white blood cell counts, or platelet counts between patients with ALL and AML. Platelet counts were significantly lower in patients with ocular signs compared with subjects without ocular involvement (p = 0.012), while hemoglobin levels and white blood cell counts did not differ significantly. Conclusions Various ocular signs may be present at the time of diagnosis in childhood leukemia, even in patients without any symptoms. Routine ophthalmic examination should be performed in recently diagnosed children with leukemia.

Cavernous hemangioma with cone dysfunction.

We report a 13-year-old male who complained of strabismus and low visual acuity in the right eye. Saccular aneurysms filled with dark-colored blood were noted in the upper nasal quadrant of the right fundus. Ishihara color plates and Lanthonys new color test revealed a red-green color defect. Cone response and 30-Hz flicker responses were nearly absent. Cavernous hemangioma of the retina is a rare vascular hamartoma; the associated findings show cone dysfunction concomitant with this peripheral lesion.

Pattern-reversal electroretinograms and visual evoked potentials in branch retinal vein occlusion

We recorded pattern electroretinograms and visual evoked potentials in a group of selected patients with unilateral uncomplicated branch retinal vein occlusion. To document the effects of preexisting risk factors, patients were divided into three groups: diabetes mellitus, hypertension with hyperlipidemia and no systemic disease. The transient and steady-state pattern electroretinogram and visual evoked potential amplitudes were significantly reduced and visual evoked potential peak times were delayed relative to the fellow eyes and agematched normal subjects. There was a second amplitude reduction relative to the other patient groups in both the affected and fellow eyes of the diabetes mellitus group, which was indicative of an additive effect of diabetes mellitus.

The Effect of Dehydration and Fasting on Corneal Biomechanical Properties and Intraocular Pressure.

Purpose: To evaluate the changes in corneal biomechanical properties and intraocular pressure (IOP) during fasting period in healthy subjects. Methods: Seventy-two eyes of 72 fasting subjects (study group), and 62 eyes of 62 nonfasting subjects (control group) were enrolled in this prospective study undertaken at a single university hospital. All subjects underwent complete ophthalmologic examination including ocular biomechanical evaluation with ocular response analyzer. Ocular response analyzer measurement was performed on the right eyes of the subjects between 5.00 and 6.00 PM after approximately 14 hr of fasting for the study group and after a nonfasting period for the control group. The corneal hysteresis, corneal resistance factor, mean corneal compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) values were measured with a patented dynamic bidirectional applanation process. Results: Goldmann-correlated IOP and IOPcc measurements in the study group and the control group were found as 13.8±2.8 mm Hg, 14.6±2.6 mm Hg and 16.3±2.2 mm Hg, 15.7±2.4 mm Hg, respectively. There was statistically significant difference within the two groups in IOPg and IOPcc (P<0.001). In addition, corneal hysteresis and corneal resistance factor significantly decreased in study group compared with control group (P<0.001, P=0.012, respectively). Conclusion: Prolonged fasting causes a significant decrease in IOPg, IOPcc, corneal hysteresis, and corneal resistance factor in healthy subjects, altering the biomechanical properties of the cornea.

Influence of cyclopentolate hydrochloride on corneal biomechanical properties in healthy individuals.

Objective: This observational study aims to investigate the effects of cyclopentolate hydrochloride (1%) on corneal biomechanical properties, with the ocular response analyzer (ORA), in healthy individuals. Methods: Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) measurements of 36 (15 female and 21 male) healthy individuals, before and after 45 min of 1% cyclopentolate hydrochloride instillation, were performed by the ORA. Results: The mean CH and IOPcc measurements of the eyes were 10.63±1.17 mm Hg and 15.15±2.69 mm Hg, precycloplegia, and 11.09±1.32 mm Hg and 14.16±2.77 mm Hg, postcycloplegia, respectively. The differences between the precycloplegia and postcycloplegia in both measurements were statistically significant (P=0.031, P=0.016, respectively; paired t test). The mean CRF and mean IOPg measurements of the eyes were 10.40±1.16 mm Hg and 14.83±2.56 mm Hg, precycloplegia, and 10.61±1.33 mm Hg and 14.25±2.65 mm Hg, postcycloplegia, respectively. The differences between the precycloplegia and postcycloplegia measurements of the eyes were insignificant (P=0.264 and P=0.100, respectively; paired t test). Conclusions: A 1% cyclopentolate hydrochloride instillation leads to significant changes in the CH values and IOPcc measurements. This should be taken into account during the evaluation of refractive surgery candidates and in clinical conditions where ORA measurements are considered in the diagnosis and follow-up.