We discovered statistically significant astigmatic changes; however, these were clinically insignificant visual acuity changes in compatibility with prior studies. Patients undergoing blepharoplasty surgery should be advised that this procedure may potentially alter vision. It is also very important to advise the patients to undergo cataract and/or refractive surgery after having upper eyelid surgery that this procedure may induce vision changes.

Implant infection is a serious problem that requires additional patient visits, intensive antibiotic therapy, surgery, or some combination of these. Existence of a peg system appears to play a role in implant infection. Infection may develop as late as 6 to 7 years after pegging, and the patient should be cautioned about potential late-onset problems. It is possible to control the infection with appropriate antibiotic therapy; removal should be reserved for refractory cases.

The aim of this study was to determine whether retinal nerve fibre layer (RNFL) thickness is correlated with cerebral white matter lesions (WML) in migraine patients. Forty migraine and 40 healthy subjects were included in this study. The difference in RNFL thickness between the control and a migraine group with WML and a migraine group without WML were investigated using analysis of variance (ANOVA). A Tukey post hoc test was conducted to determine from which group the difference originated. Lower RNFL thicknesses were observed in the migraine patient group where WML was detected using magnetic resonance imaging (MRI), compared with the control group and with the migraine group with no WML. Statistically significant difference was found between the three groups in terms of RNFL thickness. Although there was a statistically significant difference between the control and the migraine group with WML detected with MRI, no statistically significant difference was found in terms of RNFL thickness between the control and the migraine group with no WML related to Tukey post hoc test. Moreover, there was a statistically significant difference between migraine patients with WML and patients without WML in terms of retinal nerve fibre layer thickness. The results indicate that reduction in RNFL detected via optical coherence tomography may be related to cerebral WML in migraine patients. Further studies by neurologists and ophthalmologists are necessary to determine the clinical relevance of the relation between RNFL and cerebral WML. ARTICLE HISTORY

The objective of this study was to evaluate the retinal nerve fibre layer (RNFL) thickness using spectral-domain optical coherence tomography (Optos SD-OCT, UK) in migraine patients with or without aura and to search for possible structural effects of migraine on the retina. Eighty eyes of 40 migraine patients and 80 eyes of 40 healthy subjects were included in this study. All four quadrants (temporal, superior, nasal, and inferior) and average peripapillary RNFL measurements were taken with SD-OCT in both groups. The average age of the patients and the control group were 35.7 ± 9.5 and 40.9 ± 12.7 years, respectively. In the migraine group, 45% of patients were with aura, and 55% were without aura. The average frequency of attacks per month and the migraine diagnosis time was 4.6 ± 4.4 and 6.2 ± 5.6, respectively. Parameters related to RNFL thickness of right and left eyes' average, superior, inferior, nasal, and temporal quadrant values were found to be similar in migraine and control subjects (p40.05). Focusing on the RNFL thickness of right and left eyes and the migraine parameters, there were no statistically significant differences between migraineurs with aura and without aura (p40.05). The correlations between the RNFL thickness parameters and the migraine patient's MIDAS (Migraine Disability Assessment Score) score, frequency of attacks, and diagnosis time of migraine were studied and no correlation was noted (p40.05). These findings demonstrated that migraine disease with or without aura does not have any effect on the thickness of the RNFL.

be a functional indication for ptosis repair and blepharoplasty. OBJECTIVE To evaluate the changes in headache-related quality of life in patients who underwent upper eyelid ptosis repair or blepharoplasty. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study was conducted among 108 patients who underwent standard upper eyelid blepharoplasty and 44 patients who underwent ptosis repair (levator resection, Müller muscle resection, or frontalis suspension) for obscuration of the superior visual field at an ophthalmology clinic's oculoplastic department from September 1, 2014, to September 1, 2015. A validated headache-related quality-of-life survey, the Headache Impact Test-6 (HIT), was administered preoperatively and postoperatively to patients who had tension-type headache. The minimum time interval after the operation was 3 months (mean, 13.5 weeks; range, 12-17 weeks). MAIN OUTCOMES AND MEASURES Postoperative HIT scores, decline in HIT scores, and marginal reflex distance test 1 scores. RESULTS Of the 108 patients (66 women and 42 men; mean [SD] age, 49.8 [10.7] years) who underwent blepharoplasty and the 44 patients (26 women and 18 men; mean [SD] age, 45.6 [17.8] years) who underwent ptosis repair, 38 (35.2%) and 28 (63.6%), respectively, had symptoms of tension-type headaches. In both groups, the mean (SD) postoperative HIT scores were statistically significantly better than the preoperative HIT scores (blepharoplasty group: preoperative score, 55.9 [6.6] vs postoperative score, 46.4 [9.0]; ptosis repair group: preoperative score, 60.0 [7.2] vs postoperative score, 42.3 [9.3]; P = .001). In the patients who underwent ptosis repair, the mean (SD) preoperative HIT score was significantly higher than in those who underwent blepharoplasty (60.0 [7.2] vs 55.9 [6.6]; P = .007) and the postoperative HIT score was significantly lower than those who underwent blepharoplasty (42.3 [9.3] vs 46.4 [9.0]; P = .03). The mean (SD) decline in the HIT score was significantly higher in patients who underwent ptosis repair than in those who underwent blepharoplasty (17.8 [9.9] vs 9.5 [8.6]; P = .002). For patients who underwent ptosis repair, there was a statistically significant negative correlation between the results on the marginal reflex distance test 1 (median, 1.82; minimum, 1.0; maximum, 3.5) and change in the HIT score (median, 18; minimum, 0; maximum, 30) (P = .005; r =-0.645). In patients who underwent ptosis repair, the mean (SD) difference between the preoperative and postoperative HIT scores was significantly higher for the patients who underwent levator resection (3.1 [0.3]) than for those who underwent Müller muscle resection (1.5 [0.7]) and frontalis suspension procedures (1.9 [0.7]) (P = .001). CONCLUSIONS AND RELEVANCE The operations for ptosis and blepharoptosis provide significant relief for tension-type headache and result in improved headache-related quality of life. As a result, tension-type headache can be a functional indication for upper eyelid blepharoplasty and ptosis repair, especially for p...

In nephrotic syndrome cases especially with accompaniment of high blood pressure, fluid accumulation in the retina layer may occur. Serous macular detachment must be kept in mind when treating these patients.

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Objectives:To determine the outcome and long-term efficacy of external dacryocystorhinostomy (ext-DCR) with or without bicanalicular silicon intubation in patients with functional nasolacrimal drainage obstruction (FNLDO).Materials and Methods:Patients with epiphora and patent lacrimal systems on nasolacrimal irrigation were prospectively enrolled in the study. Each patient was assessed with lacrimal scintigraphy to differentiate drainage abnormalities as presac (proximal) or postsac (distal) delays. All patients underwent ext-DCR; bicanalicular silicone intubation was performed only in presac delay cases. On follow-up examinations patients were asked to report their symptoms as none, mild, moderate or unchanged. Success was defined as lacrimal patency to irrigation and no or mild epiphora at the end of the follow-up period.Results:Twenty-six lacrimal systems of 23 patients were eligible for inclusion. There were 9 presac delay and 17 postsac delay cases. Average follow-up time was 72.85 weeks (47-88 weeks). A successful outcome was achieved in 76.9% of the operated lacrimal systems. Success rate was 55.5% among presac obstructions and 88.2% among postsac obstructions.Conclusion:The long-term efficacy of ext-DCR in FNLDO patients is confirmed with our overall successful outcome of 76.9%. In preoperative assessment, lacrimal scintigraphy is helpful to determine the surgical approach and to predict the surgical outcome.