• Journal of Korean Ophthalmic Optics Society
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• v.9 no.2
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• pp.333-343
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• 2004

Impression cytology refers to application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. The technique is non-invasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squmaous metaplasia assessed. This study was performed to evaluate the conjunctival surface by impression cytology in dry eye patients. A total of 70 students with no contact lens wearing history were recruited. Subjects were required to fill in a McMonnies dry eye symptom questionnaire. The non-invasive tear thinning time(TIT) test of each subject was measured, followed by Schirmer tear test(STI), tear film break-up time(TBUT) tests and Rose-bengal staining were performed as a baseline. Conjunctival epithelial cells from the inferior bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS(Periodic Acid Schift)-haematoxylin. The goblet cells and conjunctival epithelial cells were observed under a light microscope of 400x magnification. The specimens were classified according to the Nelson Grading scale which was based on the degree of squamous metaplasia such as changes of goblet cells density, size/form, N:C(nucleus : cytoplasm) ratio. Dry eye patients were observed morphological changes of the epithelial cells, different nuclear alterations, decrease of the goblet cells density. The degree of cytological changes was related to severity of dry eye conditions. When the epithelial cell morphology was graded according to the system described by Nelson, specimens from the control group revealed 91.43% of the eyes to be grade 0 and 8.57% to be grade 1, whereas of the dry eye patients, 20% were grade 0, 42.86% grade 1, 34.29% grade 2 and 2,86% grade 3. Impression cytology represents a non- or minimally invasive biopsy of the ocular surface epithelium with no side effects or contraindications. It has demonstrated to be a useful diagnostic aid for a wide variety of processes involving the ocular surface. This technique is a safe, simple method and may help increase understanding of various ocular surface alterations in dry eye patients.

• Journal of The Korean Ophthalmological Society
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• v.58 no.11
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• pp.1313-1316
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• 2017

Purpose: To report fundus photography using a smartphone in an infant with abusive head trauma. Case summary: An 8-month-old male infant presented to the emergency room with decreased consciousness and epileptic seizures that the parents attributed to a fall from a chair. He had no external wounds or fractures to the skull or elsewhere. However, computerized tomography of the brain revealed an acute subdural hematoma in the right cranial convexity and diffuse cerebral edema, leading to a midline shift to the left and effacement of the right lateral ventricle and basal cistern. The attending neurosurgeon promptly administered a decompressive craniectomy. Immediately after the emergency surgery, a fundus examination revealed numerous multi-layered retinal hemorrhages in the posterior pole extending to the periphery in each eye. He also had white retinal ridges with cherry hemorrhages in both eyes. We acquired retinal photographs using the native camera of a smartphone in video mode. The photographer held the smartphone with one hand, facing the patient's eye at 15-20 cm, and held a 20 diopter condensing lens at 5 cm from the eye in the other hand. Our documentation using a smartphone led to a diagnosis of abusive head trauma and to obtain the criminal's confession, because the findings were specific for repetitive acceleration-deceleration forces to an infant's eye with a strong vitreoretinal attachment. Conclusions: This ophthalmic finding had a key role in the diagnosis of abusive head trauma. This case presented the diagnostic use of a smartphone for fundus photography in this important medicolegal case.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.3
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• pp.331-337
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• 2014

Purpose: This is a comparative experimental study on the amount of phoria by the removal time of binocular fusion. In this study, three tests were used for phoria test like Howell test, Thorington test and developed 3D polarizing test. Methods: In this study, it was considered the removal time of binocular fusion for measuring phoria. The three methods were used for measuring quantity of phoria: Howell test, Thorington test and developed 3D Polarizing test. The measurements progressed quickly to avoid eye-strain. So we designed the test charts for marking 3D display modules and the apparatus inserted lenses, like Maddox lens and prism, which are compatible with three phoria tests. The phoria at the moment separation was measured when the binocular fusion was broken through the apparatus and the that at the stable separation was measured when activity of the separated two images like indicated box and figure on horizontal axis stopped. Results: There were statistically significant difference between quantity of phoria at moment separation and that at stable separation. Amount of phoria at moment separation was relatively larger than amount of that at stable separation. In result in exophoria, the quantity of phoria at moment separation was higher than that at stable separation, and in phoria measured by developed 3D polarizing test, it shows the similar results at two condition. Conclusions: For exophoria, the amount of phoria at moment separation of binocular fusion was relatively larger than that at stable separation. The amount of difference between phoria values at moment separation and that at stable separation was alike among three phoria tests. Usually in working, there is no distinction between moment separation and stable separation. But there were definitely the difference between two ways to separate binocular fusion. Therefore, it is need for writing on prescription test name for measuring phoria and condition of separation of binocular fusion.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.3
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• pp.191-201
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• 2016

Purpose: In the present study, the effect of artificial tears with different ingredients on tear film stability and subjective symptoms of dry eyes in the early stage of soft contact lenses wear was investigated. Methods: The three kinds of artificial tears and saline solution were respectively applied onto 50 dry eyes which wore soft contact lenses made of etafilcon A. Then, non-invasive tear film break-up time (NIBUT) was measured at every five minutes for 30 minutes right after the instillation of artificial tears, and the changes in blink rate and subjective symptoms were estimated after 30 minutes from the instillations. Results: All three kinds of artificial tears increased NIBUT larger than saline. The effect of increasing NIBUT immediately after the instillation of artificial tears was the largest when the artificial tear containing viscosity enhancer was used. The duration time of the effect was the longest when the artificial tear having both surfactant and viscosity enhancer was applied. The blink rate was not significantly changed when both artificial tears and saline solution were instilled. Subjective symptoms were significantly improved by the instillation of both artificial tears and saline solution and dryness, irritation, tiredness, stiffness, dazzling were improved by the use of most solutions. However, the subjective symptoms were rebounded to the level before the instillation of artificial tears after 30 minute-instillation. Conclusions: It was revealed that both artificial tears and saline solution could improve the subjective symptoms of dry eye in the early stage of soft contac lenses however, the effect of these solutions on the tear film stability was different according to the components. From the results, it is suggested that the proper selection of artificial tears is necessary for the improvement of dry eye symptoms at the early stage of soft contact lenses wear in dry eye.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.4
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• pp.463-469
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• 2015

Purpose: A hydrogel including alginate and $CaCl_2$ extracted from seaweed was manufactured, and their physical properties were investigated. Also, its applicability as contact lenses was examined. Methods: A film-type sample used in this experiment was manufactured using 2-hydroxyethyl methacrylate (HEMA), which is the raw material of hydrogel contact lenses; azobisiobutyonitile (AIBN), which is an initiator and ethylenglycoldimethacrylate (EGDMA), which is a cross-linking agent. It was hydrated in a PBS solution for 24 hours, and an interpenetrating polymer network (IPN) was formed in 1% and 2% alginate and 1%, 3%, and 5% $CaCl_2$ solutions for 24 hours, respectively. Results: The measurement of the physical properties of the film after the IPN showed that the moisture content was 30.89~36.89%, the refractive index was 1.431~1.441, the contact angle was $62.98{\sim}80.45^{\circ}$, and the tensile strength was 2.378~4.215 ($gf/mm^2$). Also, the physical properties hardly changed as the content of alginate increased, and the moisture content decreased as the content of $CaCl_2$ increased. As a result of the IPN, the moisture content and contact angle decreased compared to those of basic HEMA, but the tensile strength increased. The tensile strength of the second IPN was higher than that of the first IPN. In the case of $CaCl_2$, for the sample polymerized for 24 hours and the second IPN sample with 2% alginate, the contact angle decreased as the content of $CaCl_2$ increased. Conclusions: In this study, the tensile strength increased as the content of $CaCl_2$ increased, and the wettability increased as a result of IPN of alginate and $CaCl_2$. The hydrogel containing the alginate and $CaCl_2$ was confirmed possible utilization as contact lens material.

• Journal of Korean Ophthalmic Optics Society
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• v.20 no.2
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• pp.247-253
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• 2015

Purpose: The purpose of this study was to compare and analyze the ocular surface and the palpebral conjunctiva of categorized subjects, which were divided into normal eye group and dry eye group, by using a thermal camera. Methods: Subjects were 144 eyes of 72 normal university students, who didn't have any corneal disease, abnormal lacrimal ducts, medical records regarding ocular surgeries, or experience of using contact lens. Subjects were divided into two groups, which were normal eye group and dry eye group, based on the results of TBUT, Schirmer I test, and McMonnies test. After categorizing the subjects, the temperature of the subjects' ocular surface and the palpebral conjunctiva were measured and analyzed by using a thermal camera (Cox CX series, Answer co., Korea). Results: In the normal eye group's Central Ar.1, Nasal Ar.2, Temporal Ar.3, Superior Ar.4, Inferior Ar.5, the measured amount of temperature change on each area was $-0.13{\pm}0.08$, $-0.14{\pm}0.08$, $-0.12{\pm}0.08$, $-0.14{\pm}0.08$, $-0.10{\pm}0.09(^{\circ}C/sec)$. The dry eye group's results were $-0.17{\pm}0.08$, $-0.16{\pm}0.07$, $-0.16{\pm}0.08$, $-0.17{\pm}0.09$, $-0.15{\pm}0.08(^{\circ}C/sec)$. When compared with the normal eye group, the values of Ar.1, Ar.3, Ar.5 were significantly different in the dry eye group(p<0.05). The amount of temperature change, which was observed on the palpebral conjunctiva(Ar.1:central, Ar.2: nasal, Ar.3: temporal) of the normal eyes, measured by thermography, was $34.36{\pm}1.12$, $34.17{\pm}1.10$, $34.07{\pm}1.12^{\circ}C$ on each area. Same values taken from the dry eye group was $33.55{\pm}0.94$, $33.43{\pm}0.97$, $33.51{\pm}1.06^{\circ}C$ on each area. The values of Ar.1, taken from the dry eye group, had a significant difference, compared to the values of the normal eye group(p=0.05). Conclusion: The temperature of the ocular surface decreased faster on the dry eyes, compared to the normal eyes. The temperature measured on the palpebral conjunctiva of the dry eyes were also lower than the normal eyes. The temperature changes on the ocular surface, observed with a thermal camera, were objective values to assess the stability of tear films, and might provide useful data for studies related to dry eye syndrome.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.4
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• pp.527-532
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• 2014

Purpose: The matching of the optical center and the pupil center was measured by photographs in wearing glasses. In this study, the influences of the induced prism by the mismatching are studied. Methods: 74 subjects (148 eyes) who were spectacles wearer were participated in this study. The mean age was $29.19{\pm}12.22$ years (range 19-55 years). The facial photographs of subjects were taken while wearing spectacles. The matching of the corneal reflected image and optical center of the spectacle lens in the horizontal deviations, and the vertical deviations were measured by the observation of the photo image. The prisms induced in accordance with various frame type were calculated from the mismatching deviations. Results: The binocular horizontal deviations were $1.55{\pm}1.70mm$ for the metal frame, $1.71{\pm}2.21mm$ for the clings type plastic frame, and $1.15{\pm}1.38mm$ for the plastic frame. In the horizontal direction induced prism, the ratio over the tolerance was 23%. The ratio were the 17.6% at the BI prism, and 5.4% at the BO prism. The binocular vertical deviation comparisons were $3.93{\pm}1.91mm$ for the metal frame, $5.79{\pm}1.93mm$ for the clings type plastic frame, and 1$6.01{\pm}2.94mm$ for the plastic frame. In the vertical direction induced prism, the ratio over the tolerance was 44.6%. Based on the refraction power, the ratio were 12.2% at -0.25${\leq}-3.00$, and 32.4% at -3.00${\leq}-12.00D$. Conclusions: The induced prisms in the horizontal direction were much in the BI prism. The binocular vertical deviations of the glasses.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.3
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• pp.273-281
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• 2011

Purpose: In order to provide the fundamental information for the design development of RGP lenses and its clinical prescription, the corneal types of Korean twenties were analyzed according to corneal shapes, astigmatic degree, and the certain distance from the corneal apex. Methods: Corneal types of total 252 eyes in 20s were firstly classified, then their corneal radii from the certain distance from the corneal apex were measured by corneal topography and further analyzed based on the astigmatic degree. Results: Korean 20s' corneal types were classified as 14.3%(36 eyes) of round, 31.3%(79 eyes) of oval, 28.6%(72 eyes) of symmetric bow tie, 17.5%(44 eyes) of asymmetric bow tie, 8.3%(21 eyes) of irregular shapes. The round and oval typed corneas had mild astigmatic degree whereas the higher astigmatic degree in symmetric and asymmetric bow tie typed corneas were shown. The relative corneal radii of round and oval typed corneas at each distance from corneal apex were shown to consistently increase regardless of astigmatic degrees when they measured at certain distances from the corneal apex. However, the relative corneal radii of symmetric and asymmetric bow tie typed corneas within 1.0-1.5mm from the corneal apex were decreased, which showed steeper slope than it within 1.0 mm and somewhat different based on astigmatic degrees. Bigger change of corneal radii outer 3.5 mm from the corneal apex in symmetric bow tie typed corneas with astigmatism of 1.50-2.00 D and 2.25-2.75 D appeared. Conclusions: The consideration of radial change from the central cornea to peripheral cornea is necessary for manufacturing RGP lens and its prescription since they showed different change in corneal radii by corneal patterns and astigmatic degrees.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.2
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• pp.89-98
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• 2010

Sex and its tropic hormones influence the lacrimal system, corneal anatomy and disease, aqueous humor dynamics and glaucoma, crystalline lens and cataract, and retinal disease. Dry eye occurs especially frequently during pregnancy, oral contraceptive use, and after menopause, during which androgen levels decrease. Androgen control development, differentiation, and lipid production of sebaceous glands throughout the body, and androgen deficiency also leads to meibomian gland dysfunction and evaporative dry eye. On the other hand, estrogen causes a reduction in size, activity, and lipid production of sebaceous glands. Sex and its tropic hormones also influence the corneal anatomy and disease, and corneal thickening occurred on the second day of the menstrual cycle and around the time of ovulation and appeared to be related to estrogen levels. Fuchs' dystrophy is more commonly seen in postmenopausal women than men and may be linked to hormonal changes that occur with aging. In addition, overexpression of estrogen and progesterone receptors in the conjunctiva of vernal keratoconjunctivitis patients. Serum progesterone levels also may be associated with intraocular pressure especially in pregnant women, and for the women. For women with cataracts, hormone levels were typical of menopause, and there was a significant negative correlation between estradiol and follicular stimulating hormone levels. In addition, serum testosterone levels are associated with the development of diabetic retinopathy. Although the role of sex hormones on the eye is largely unknown, and the results should be interpreted with caution until replicated, the functions of sex hormones in ocular disease remains to be investigated, because they may be involved in structure and function of the ocular components, which are important in the pathogenesis of ocular disease.