• Archives of Plastic Surgery
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• v.37 no.4
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• pp.489-491
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• 2010

Purpose: Retrobulbar hemorrhage is a rare complication followed by blepharoplasty, trauma, orbital reconstruction, and so on. Most of the cases occur within 24 hours, half of them in the first 6 hours. Some authors have reported delayed retrobulbar hemorrhage after blepharoplasty and trauma within 1 day to 9 days. However, there have been few reports of delayed retrobulbar hemorrhage resulting from the complication of orbital reconstruction. Methods: A 22-year-old male underwent orbital floor reconstruction due to the orbital floor fracture. In 84 hours after the surgery, he complained sudden onset orbital pain and decreased visual acuity immediately after defecation. Intraocular pressure was unmeasurable due to the swelling at that time. Emergency computed tomography was performed. Results: Computed tomography revealed subperiosteal hematoma on inferior orbital wall extended to the apex. Emergency decompressive surgery was performed within 1 hour. After evacuation of hematoma, orbital symptom was improved and visual acuity was restored. Conclusion: Delayed retrobulbar hemorrhage is rare but vision-threatening. Therefore early diagnosis and treatment of delayed retrobulbar hemorrhage is thought to be crucial. The cause of delayed hemorrhage was not clear, however, valsalva maneuver might be the cause of hemorrhage.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.171-175
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• 2006

Objective : In the present study, we evaluate visual outcomes after surgical removal of craniopharyngiomas and analyze the factors that are considered to affect visual outcomes. Methods : This study includes 30 patients with craniopharyngioma, who underwent surgery in this clinic during the last 10 years. The changes of visual function [visual acuity and field] of the patients were assessed preoperatively and postoperatively, and paired data of this change were compared. Also, the factors that influence on this change were analysed. Results : Among the 21 patients complaining of decreased vision before the operation, 8 patients were improved [38.0%], and 7 patients were worse [33.3%]. However, Four out of 9 patients without any preoperative visual symptoms developed worse vision after the operation [44.4%]. The average duration of symptom was 17.2 months in the improved group and 23.6 months in the aggravated group. The tumors recurred in only 5 patients after the gross total resection : Four of them showed the aggravation of visual function after surgical removal and 1 had improvement. Conclusion : After removal of craniopharyngiomas, the overall rate of vision improvement, no change and aggravation are 26.6%, 36.7% and 36.7%, respectively. Aggravation of postoperative visual function is higher in males, children and patients with a longer duration of symptom and the tumor recurres more frequently in patients who complained of worsened vision after surgical removal.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.518-521
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• 2001

We present a rare case of a pituitary adenoma revealing a sedimentation level on MRI, which has not been previously documented. This 55-year-old woman was referred with the diagnosis of craniopharyngioma. She presented with four-month history of progressive headache and visual dimness. Neurological examination revealed a bitemporal hemianopsia and decreased visual acuity. Laboratory data including endocrine examination were unremarkable. An additional three-dimensional MRI was taken for further evaluation, and demonstrated a sedimentation level within the tumor. The patient underwent transcranial removal of the tumor. About 12cc of dark-red blood was aspirated from the tumor. Histological examination revealed a pituitary adenoma with hemorrhage. Postoperatively, the patient showed gradual improvement of visual function. Considering that the pituitary adenoma is one of more common tumors that cause tumoral bleeding, a cystic sellar tumor that has a sedimentation level should be sought first for a pituitary adenoma rather than a craniopharyngioma. This may have an important impact when deciding surgical approach.

• Journal of Korean Neurosurgical Society
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• v.48 no.1
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• pp.91-93
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• 2010

Neurocysticercosis (NCC) is the most common parasitic infestation of the central nervous system. Most cases of NCC are to related and/or associated with inflammation within the cerebral parenchyma. A 71-year-old woman presented with a 4-year history of visual disturbance. This symptom had become aggravated 4 weeks earlier. Her visual acuity gradually decreased and superior hemianopsia was noted. Magnetic resonance imaging (MRI) revealed an enhanced and thickened pituitary stalk accompanying a suspicious mass. The provisional diagnoses were lymphoma, glioma, or other inflammatory conditions. Laboratory studies, including blood and hormonal studies, showed normal findings. Surgical resection was performed. In the pathological examination, degenerated parasitic wall structure was seen and its contents were composed of completely degenerated focal globular structures suggesting the scolex of cysticercus. We report an unusual case of NCC involving the pituitary stalk which was presented with a juxtasellar tumor. The possible underlying mechanisms are discussed with a review of pertinent literature.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.921-924
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• 2001

The authors report a case of cholesterol granuloma in the sphoid sinus in 54-year old woman, which is probably the first report of cholesterol granuloma arising primarily in the sphenoid sinus apart from the petrous bone. The initial clinical presentations were unilateral decreased visual acuity and facial sensory change. The mass was removed totally via transsphenoidal route and the pathological examination revealed cholesterol clefts and chronic granulomatous changes. The differences between the present case and the previous reports are discussed.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.543-546
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• 2011

Purpose: LASIK, one of the currently popular ophthalmic procedures, can sometimes result in dry eye symptoms. In the patient who had underwent LASIK operation, the periorbital surgery may be more likely to lead to such a complication as dry eye symptom. We would like to report a case of corneal abrasion occurred after transconjunctival blepharoplasty in post-LASIK state and suggest the method about preventing the complication. Methods: A 30-year-old female patient underwent transconjunctival blepharoplasty and microfat graft into the face. She had history of LASIK operation 2 years ago. Corneal protector was applied to both eye during transconjunctival operation. After the surgery, she complained of visual blurring at left side. Ophthalmic examination revealed corneal abrasion of left eye. Results: Cornea protecting lens was applied to left eye for 2 weeks. Steroid and antibiotic eye drops were applied for relieving the symptoms and the prevention from progressing of complication. After 1 week, visual power and acuity was recovered to preoperative state. No other specific complications happened. Conclusion: Post-LASIK patient may have possibility of decreased corneal sensation and tear production. Preoperative ophthalmic examination is recommended for the prevention of complication. When corneal protector is applied, we suggest Optagel$^{(R)}$ as a useful lubricant.

• Journal of Korean Ophthalmic Optics Society
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• v.5 no.1
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• pp.73-81
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• 2000

This review on ocular toxicology concentrates on the effects on ocular health and contact lens wear induced by systemically used drugs, including alcohol. Many systemically administered drugs produce ocular adverse effects. Fortunately, relatively few are capable of causing significant, irreversible visual impairment. The visual symptoms of acute intoxication are as follows : Drop in vision/visual acuity, diplopia, poor dark adaptation, increase in time for glare recovery, early cataract, decreased depth perception, blue-yellow or red-green colour defect and visual hallucinations. Blinking pattern, tear production, and discoloration of contact lenses can be affected by some systemic or local ocular medications. The cornea, conjunctiva, or eyelids may react to some systemic medications and to some preservatives used in contact lens solutions. The hydrogel contact lens act as a drug reservoir that emits the drug over time. I discuss management of contact lens-induced infectious and inflammatory conditions.

• The Journal of Internal Korean Medicine
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• v.39 no.2
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• pp.130-138
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• 2018

Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder of the central nervous system characterized by optic neuritis and longitudinally extensive myelitis. Painful tonic spasm is a common complication of NMO, but there have been no reports about it in Korean medicine studies. In this case, we treated a 53-year-old woman diagnosed with NMO with paraplegia, painful tonic spasm, and decreased visual acuity using Korean medicine treatment, including acupuncture, herbal medicine, cupping, and moxibustion. We measured changes in clinical symptoms using the manual muscle testing (MMT), the numeric rating scale (NRS), the modified Barthel Index (MBI), and the Functional Independence Measure (FIM). After treatment, clinical symptoms were improved. The results indicate that Korean medicine treatment may be effective in the treatment of an NMO patient with paraplegia and painful tonic spasm.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.4
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• pp.551-555
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• 2014

Purpose: This study is to investigate if the improvement of visual sensory (VS) by amblyopia treatment affects the ocular functions in refractive errors, accommodative errors and phoria at distance and near. Methods: 10 subjects (17 eyes, mean age of $10.7{\pm}2.9$ years) who treated amblyopia completely, were participated for this study. Refractive errors, accommodative errors, and distance and near phoria were compared between before and after treatments of amblyopia. Refractive errors and accommodative errors at 40 cm were measured using openfield auto-refractor (NVision-5001, Shin Nippon, Japan) and using monocular estimated method (MEM) respectively. Phoria was determined at 3 m for distance and at 40 cm for near using Howell phoria card, cover test or Maddox rod. Results: Mean corrected visual acuity (CVA) significantly increased from $0.46{\pm}0.11$ (decimal notation) for before amblyopia treatment to a level of $1.03{\pm}0.13$ for after amblyopia treatment (p < 0.001). For spherical refractive error, hyperopia significantly decreased from $+2.29{\pm}0.86D$ to a level of $+1.1{\pm}2.38D$ (p < 0.05) but astigmatism did not significantly change; $-1.80{\pm}1.41D$ for before treatment and $-1.65{\pm}1.30D$D for after treatment (p > 0.05). Accommodative error significantly decreased from accommodative lag of $+1.1{\pm}0.75D$ to a level of $+0.5{\pm}0.59D$ (accommodative lag) (p < 0.05). Distance phoria significantly changed from eso $2.9{\pm}6.17PD$ (prism diopters) to a level of eso $0.2{\pm}3.49PD$ (p < 0.05), and near phoria also significantly changed from eso $0.4{\pm}2.32PD$ to level of exo $2{\pm}4.9PD$ (p < 0.05). There was a high correlation (r = 0.88, p < 0.001) between improvement of visual acuity and decrease of accommodative lag. Conclusions: Hyperopic refractive error decreased with improvement of CVA or VS by amblyopia treatment. And the improvement of VS by amblyopia treatment also improved accommodative error, and changed phoria coupled with accommodation.

• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.275-281
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• 2005

Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.