• Journal of Korean Ophthalmic Optics Society
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• v.20 no.3
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• pp.325-331
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• 2015

Purpose: This study was to find the correlation between exophthalmetry and visual functions. Methods: Exophthalmetry and visual functions of 200 adults without ophthalmophathy and general disease were examined. Exophthalmetry were measured with Hertel's exophthalmometer. Visual functions (myopia, distance exophoria, near exophoria, near point of convergence, near point of accommodation) were measured for three times. Results: The exophthalmetry was $13.59{\pm}1.10mm$. Myopia, distance exophoria, near exophoria, near point convergence, and near point accommodation were measured as $-2.48{\pm}1.91D$, $3.51{\pm}1.78{\Delta}$, $5.73{\pm}2.44{\Delta}$, $9.63{\pm}2.82cm$, and $21.73{\pm}10.28cm$. With increasing exophthalmetry, the unaided visual acuity, myopia and astigmatism were decreased. On the other hand, distance exophoria, distance esophoria, near exophoria, near point of convergence and near point of accommodation were significantly increased, while exophthalmetry was increased. Conclusions: The relationship between visual functions and exophthalmetry were found to be statistically significant. It could be used as the clinical criteria for prescription of binocular inspections.

• Journal of Korean Ophthalmic Optics Society
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• v.7 no.1
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• pp.9-13
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• 2002

It is well known that the maximum amplitude of accommodation decreases with increasing age.(Presbyopia). With single vision lenses presbyopia can be corrected only for one viewing distance. With progressive power lenses presbyopia can be corrected for all viewing distances. But there are some other changes in the visual system with age which can not be corrected by spectacle lenses. Pupillary diameter decreases and the light transmission of the ocular media decreases. Therefore old people need more light, they need better illumination. Cone density in the retina decreases, this is only one example for changes in the sensory system. These changes in the visual system cause changes in visual functions. At the age of 80 visual acuity has decreased to half. Contrast sensitivity for gratings decreases mainly for high spatial frequencies very important is the increase of stray light in the ocular media and therefore the increase of glare. Veiling luminance increases by a multiple of approximately 4, Dark adaptation gets slower and light sensitivity is approximately 2 log units (factor 100) less when the eye is completely dark adapted. Also colour vision gets worse, especially at low luminances. Elderly people have problems with visual tasks which require divided attention between foveal and peripheral vision. An example is the measurement of the useful field of view. This useful field of view be expanded (improved) by visual training.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.42.1-42.5
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• 2018

Background: Fractures of the orbital wall are mainly caused by traffic accidents, assaults, and falls and generally occur in men aged between 20 and 40 years. Complications that may occur after an orbital fracture include diplopia and decreased visual acuity due to changes in orbital volume, ocular depression due to changes in orbital floor height, and exophthalmos. If surgery is delayed too long, tissue adhesion will occur, making it difficult to improve ophthalmologic symptoms. Thus, early diagnosis and treatment are important. Fractures of the superior orbital wall are often accompanied by skull fractures. Most of these patients are unable to perform an early ocular evaluation due to neurosurgery and treatment. These patients are more likely to show tissue adhesion, making it difficult to properly dissect the tissue for wall reconstruction during surgery. Case presentation: This report details a case of superior orbital wall reconstruction using superior orbital rim osteotomy in a patient with a superior orbital wall fracture involving severe tissue adhesion. Three months after reconstruction, there were no significant complications. Conclusion: In a patient with a superior orbital wall fracture, our procedure is helpful in securing the visual field and in delamination of the surrounding tissue.

• Archives of Craniofacial Surgery
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• v.14 no.2
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• pp.133-136
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• 2013

Retrobulbar hemorrhage is a rare but serious complication after blepharoplasty, mid-face injury, and treatment of facial bone fractures. The incidence of postoperative retrobulbar hemorrhage is 0.055% with an incidence of associated permanent blindness of 0.005%. A 69-year-old male came to the emergency room with pain on both orbital areas and uncontrolled bleeding after cosmetic lower blepharoplasty performed at a private clinic. He had not been evaluated preoperatively by the private clinic, but we found that he had undergone percutaneous transluminal coronary angioplasty and taken anticoagulants for 10 years. We performed an emergency operation to evacuate the hematoma. However, after surgery, he persistently complained of orbital pain, pressure and diminished visual acuity. Intraocular pressure was increased, and computed tomography demonstrated a retrobulbar hemorrhage with globe displacement. Emergent lateral canthotomy and cantholysis were performed. Intraocular pressure was decreased to 48/30 mm Hg immediately after the operation, falling within the normal range the next day. We recommend three points to minimize loss of vision by retrobulbar hematoma. Firstly, careful preoperative evaluation must be conducted including current medications, underlying diseases and previous history of surgeries. Secondly, cautious postoperative observation is important for the early diagnosis of retrobulbar hematoma. Lastly, immediate treatment is crucial to prevent permanent blindness.

• Journal of Korean Neurosurgical Society
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• v.39 no.5
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• pp.329-334
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• 2006

Objective : In selected cases, the transsphenoidal approach[TSA] can be extended anteriorly to the tuberculum sellae, chiasmatic sulcus, and planum sphenoidale to obtain direct exposure of the suprasellar cisterns and its contents. We applied this modification of the TSA to various lesions of the presellar and suprasellar areas. We evaluate our clinical experience of this technique and review the related literature. Methods : From 1999 to 2004, we used the transsphenoidal supradiaphragmatic intradural approachs[TSIAs] in 9 patients who had various lesions at the pre- and suprasellar regions. Concomitant presellar extension of the bone window was performed with the sublabial or transnasal transseptal transphenoidal techniques. After removal of the lesions, sellar or anterior cranial floor was repaired with silicone plate substitute. Results : The TSIAs have been applied in the following cases : four tuberculum sellae meningiomas, two craniopharyngiomas, two Rathke's cleft cysts, and one non-functioning macroadenoma. The complications were one case of visual acuity decrease and one cerebrospinal fluid rhinorrhea. Conclusion : The TSIA is easily applicable through a minor modification of the standard TSA. It is suitable for removing lesions located in the presellar and suprasellar area adjacent to the pituitary stalk with minimal brain manipulation and decreased morbidity.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.3
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• pp.253-257
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• 2016

Purpose: To determine whether the distance between objects and the size of object are factors to be able to affect dynamic stereoacuity. Methods: Subjects were 37 adults (26 males and 11 females) with an average age of $23.89{\pm}1.76$. Refractive error was fully corrected for all subjects and each visual acuity of them was over 0.9. Three rods test was performed for measurement of stereoacuity. The viewing angles from left rod to right rod were set $5^{\circ}$, $10^{\circ}$, and $15^{\circ}$ and the rod thickness used 7 mm, 14 mm, and 21 mm, respectively. Stereoacuity was repeatedly measured three times in each test condition at 2.5 m distance, and reported the average value of them. Results: When rod thickness was 7 mm or 14 mm, dynamic stereoacuity decreased as the viewing angle increased, and they were significantly decreased (p<0.01) at viewing angles of $10^{\circ}$ and $15^{\circ}$ as compared with that of at $5^{\circ}$, respectively. When rod thickness was 21 mm, dynamic stereoacuity decreased as the viewing angle increased, especially, that of at $15^{\circ}$ decreased significantly (p<0.01) as compared with that of at $5^{\circ}$. The dynamic stereoacuity depending on the rod thickness have an increasing tendency as the rod thickness increased. Conclusions: The viewing angle between objects and the size of viewing object were factors that affect to dynamic stereoacuity.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.289-293
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• 2001

Objectives : The optimal treatment of craniopharyngioma is controversial. Despite recent advances in microsurgical management, complete surgical removal of craniopharyngioma remains very difficult. Radiation added to surgery is effective, but radiation therapy resulted in untoward side effect in young patient. Gamma knife radiosurgery offers the theoretical advantage of a reduced radiation dose to surrounding structures during the treatment of residual or recurrent craniopharyngioma compared with fractionated radiotheraphy. We described retrospective analysis of tumor size and clinical symptoms of patients after gamma knife radiosurgery in residual or recurrent craniopharyngioma were performed. Material and Methods : From September 1990 to January 2000, 18 patients of craniopharyngioma were treated by gamma knife radiosurgery. All patient had undergone surgery, but residual or recurrent tumor was found and all of them treated postoperative gamma knife radiosurgery. The mean age was 19(from 6 to 66) and male to female ratio was 10 to 8 and 8 patients were below 15 years old. In young age group(below age 15), the average volume of the tumor was $2904.8mm^3$ and mean maximal gamma knife dose was 34.9Gy. In old age group(older than 15), the average volume of the tumor was $2590.4mm^3$ and mean maximal gamma knife dose was 45.2Gy. The size of the tumor was average $2730.1mm^3$($88-12000mm^3$), mean average radiation dose was 40.7Gy and the mean prescription dose was 17.6 Gy(4-35Gy) delivered to a median prescription 50.7% isodose. Results : The follow up was from 1 year to 9 years(mean 59.1 months) after gamma knife radiosurgery. The tumor was controlled in 13(72.2%) patients. The tumor decreased in 9 patients and not changed in 4 patients. The tumor size increased in 4(22.2%) patients during follow up period. In two cases the tumor size increased because of its cystic portion was increased, but their solid portion of the tumor was not changed. In another two patients, the solid portion of the tumor was increased. So, one patient underwent reoperation and the other patient underwent operation and repeated gamma knife radiosurgery. The tumor recurred in one case(5.6%) that is a outside of irradiated site. The presenting symptoms were improved in 4 patients(improved visual acuity in 1, controlled increased intracranial presure sign in 3 patients). In one case, visual acuity decreased after gamma knife radiosurgery. The endocrine symptoms were not influenced by gamma knife radiosurgery. Conclusion : Craniopharyngioma can be treated successfully by gamma knife radiosurgery. Causes of the tumor regrowth are inadequate dose planning because of postoperatively poor margination of the tumor, close approximation of optic nerve and residual tumors outside the target lesion. Recurrence can develop 4 years after gamma knife radiosurgery. Volume is important, but the accurate targeting is more important to prevent tumor recurrence. If the tumor definition is not clear during planning gamma knife surgery, long-term image follow up is required.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.281-287
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• 2011

Objective : Pituitary apoplexy is life-threatening clinical syndrome caused by the rapid enlargement of a pituitary tumor due to hemorrhage and/or infarction. The pathogenesis of pituitary apoplexy is not completely understood. We analyzed the magnetic resonance imaging (MRI) of pituitary tumors and subsequently correlated the radiological findings with the clinical presentation. Additionally, immunohistochemistry was also performed to determine whether certain biomarkers are related to radiological apoplexy. Methods : Thirty-four cases of pituitary adenoma were enrolled for retrospective analysis. In this study, the radiological apoplexy was defined as cases where hemorrhage, infarction or cysts were identified on MRI. Acute clinical presentation was defined as the presence of any of the following symptoms: severe sudden onset headache, decreased visual acuity and/or visual field deficit, and acute mental status changes. Angiogenesis was quantified by immunohistochemical expression of fetal liver kinase 1 (Flk-1), neuropilin (NRP) and vascular endothelial growth factor (VEGF) expression, while microvascular density (MVD) was assessed using Endoglin and CD31. Results : Clinically, fourteen patients presented with acute symptoms and 20 for mild or none clinical symptoms. Radiologically, fifteen patients met the criteria for radiological apoplexy. Of the fifteen patients with radiologic apoplexy, 9 patients presented acute symptoms whereas of the 19 patient without radiologic apoplexy, 5 patients presented acute symptoms. Of the five biomarkers tracked, only VEGF was found to be positively correlated with both radiological and nonradiological apoplexy. Conclusion : While pituitary apoplexy is currently defined in cases where clinical symptoms can be histologically confirmed, we contend that cases of radiologically identified pituitary hemorrhages that present with mild or no symptoms should be designated subacute or subclinical apoplexy. VEGF is believed to have a positive correlation with pituitary hemorrhage. Considering the high rate of symptomatic or asymptomatic pituitary tumor hemorrhage, additional studies are needed to detect predictors of the pituitary hemorrhage.

• Journal of Korean Ophthalmic Optics Society
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• v.17 no.4
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• pp.395-401
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• 2012

Purpose: The purpose of this study was to research any effect on vision protecting or decreasing VDT syndrome of extracted anthocyanine from fermented purple sweet potato and blueberry. Methods: Subjects were aged 19-20 years old who do not have ophthalmic and systemic diseases and over -N4.00 D of refraction error. 40 mg of extracted anthocyanine from fermented purple sweet potato, from blueberry, and control group, placebo were dosed at separate try. After 2 hours later, subjects were directed perform visual display terminal (VDT) work for 2 hours. Objective refractive error was measured before dosing anthocyanine and after VDT work for 2 hours. Degree of head ache, eye pain and strain and subjective symptoms of neck, shoulder and waist was also examined through interviews by dividing its degree into severe, moderate, slight or none. Results: After 2 hours VDT work, vision protection effect in terms of refractive error for dominant eye was decreased by $0.031{\pm}0.21$ D in the group of extracted anthocyanine from fermented purple sweet potato, $0.006{\pm}0.32$ D in the group of extracted anthocyanine from blueberry. However, there was significantly myopic progression in the placebo group by $0.144{\pm}0.28$ D (t=2.27, p=0.03). Conclusions: It is considered that extracted anthocyanine from fermented purple sweet potato inhibits increase of refraction anomalies of dominant eye rather than non-dominant eye after VDT work.

• The Korean Journal of Vision Science
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• v.20 no.4
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• pp.431-442
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• 2018

Purpose : The purpose of this study was to investigate subjective symptoms according to the wearing, purchase and fitting status of soft contact lens wearers, and consumer perception of base curve. Methods : A survey was conducted for those who visited optical shops and lens shops in Seoul from June to August 2018. A total of 98 answer sheets they submitted were used for the analysis. The chi-square test and Fisher's exact test were used to compare subjective symptoms (dryness, glare, uncomfortable fitting, and decreased vision) according to whether fitting condition is screened (case history and push-up test, ect relevant to wearing sensation), and the odds ratio (OR) was obtained by the logistic regression analysis. Results : When the contact lenses were purchased, the rate of which the visual acuity test was performed was 86.6% at optical shop and 64.7% at lens shop. When purchasing contact lens and the contact lens was not tested for fitting, they more experienced dryness (OR 4.41, 95% CI 1.25-15.62) and uncomfortable fitting (OR 2.68, 95% CI 1.08-6.64) than testing for fitting. In addition, it was investigated that 87.8% of contact lens wearers did not know about the term base curve, 92.9% did not listen to an explanation related to the base curve when purchasing contact lenses, and 96.9% did not experience with base curve test. Conclusion : It would be thought that satisfaction of the contact lens fitting of existing consumers should be improved by changing a proper base curve by confirming the fitting condition when prescribing soft contact lens.