Purpose To determine whether altered eating habits and periods, especially the pre-dawn meal, during Ramadan fasting have any significant effect on intraocular pressure (IOP), tear secretion, corneal and anterior chamber parameters. Methods IOP, basal tear secretion (BTS), reflex tear secretion (RTS), and Pentacam measurements of 31 healthy volunteers were performed at 0800 and 1600 hours during Ramadan fasting and 1 month later during non-fasting period. Results Comparison of measurements between fasting and non-fasting periods at 0800 hours revealed significantly higher values for IOP (P ¼ 0.005), RTS (P ¼ 0.006), and BTS (P ¼ 0.014) during fasting. Conversely at 1600 hours, IOP was significantly lower during fasting (P ¼ 0.013) and no statistically significant difference was noted for RTS and BTS. IOP showed a diurnal variation of 2.45 mmHg (Po0.001) and BTS showed a 3.06 mm decrease (P ¼ 0.04) during the fasting period. No significant differences could be found in the corneal and anterior chamber parameters during fasting and non-fasting periods. Conclusions Our results revealed that fluid loading at the pre-dawn meal during Ramadan fasting might increase the IOP and tear secretion in the early morning period and these values decrease remarkably at the end of 12 h of fasting due to dehydration.

This study was designed to determine whether a new form of treatment of diabetic retinopathy (DR) was acceptable to patients and whether reduction in the maximal activity of rods in diabetes could affect the progress of DR. Methods In 12 patients, trans-lid retinal illumination of one eye was employed during sleep to prevent the depolarisation of rods and thus reduce their metabolic activity. Techniques A headband was used to place a source of chemical light over one eye, with its fellow as a control. Measurements Colour contrast thresholds were measured before and after a period of treatment in treated eyes, and the changes were compared to those in untreated fellow eyes, and areas of 'dark retinal anomalies' (microaneurysms, dot haemorrhages) were measured at the same time points. Results Patients found this intervention to be acceptable, and no adverse effects were noted. In the majority of cases, and for each outcome measure, the treated eyes improved relative to their fellows. The intervention significantly reduced the tritan thresholds in treated eyes relative to their fellows (P ¼ 0.03), and the area of dark retinal anomalies decreased in treated eyes and increased in untreated eyes, with a similar probability.

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Objectives:To evaluate the anterior segment biometric features and corneal endothelial changes in eyes with pseudoexfoliation (PEX) syndrome and senile cataract.Materials and Methods:The central corneal thickness, anterior chamber depth (ACD), pupil diameter, lens thickness, endothelial cell density (ECD), and percentages of polymegathism and pleomorphism of 52 subjects with PEX and cataract were compared with 51 age- and gender-matched control subjects with cataract using optical low-coherence reflectometry (OLCR, Lenstar LS 900; Haag Streit AG, Switzerland) and in-vivo confocal microscopy (Confo Scan 4, Nidek Co. Ltd, Osaka, Japan). Nineteen subjects with PEX syndrome had glaucoma and were using anti-glaucoma medications. Only one eye of the subjects was used in statistical analysis and a p value less than 0.05 was considered statistically significant.Results:None of the OLCR parameters reached statistically significant differences among the 3 groups (ANOVA p>0.05). The percentage of eyes with ACD <2.5 mm was 13.7% in the control group, 24.2% in PEX eyes without glaucoma and 21.1% in PEX eyes with glaucoma, with no statistically significant differences (p=0.45). There was a significant difference in mean ECD among the 3 groups (ANOVA p=0.02), whereas no differences could be found in respect to polymegathism and pleomorphism (p>0.05). Mean ECD was significantly lower in the PEX glaucoma group (2,199.5±176.8 cells/mm2) than the control group (2,363±229.3 cells/mm2) (p=0.02), whereas no difference was found in mean ECD of PEX eyes without glaucoma and the control group (p=0.42). ECD was less than 2,000 cells/mm2 in 15.8% of PEX subjects with glaucoma, 9.8% of control subjects and 6.1% of PEX eyes without glaucoma, with no statistically significant difference (p=0.52).Conclusion:As eyes with both PEX glaucoma and cataract seem to be associated with decreased endothelial cell number, specular or confocal microscopy screening should be done for the patients scheduled for intraocular surgery.

In conventional and accelerated protocols, corneal stromal demarcation line is deeper compared with TE CXL; however, the DD has no correlation with topographic changes, which means that DD is not a direct measure for the efficacy of CXL.

Objectives:To examine changes in corneal endothelial cell density (ECD) in different stages of keratoconus and evaluate its correlation with corneal tomographic parameters.Materials and Methods:Two hundred six patients with keratoconus were enrolled in the study. Corneal topography was performed by Sirius (CSO, Italy), which has a rotating Scheimpflug camera and a Placido disc topographer. Automatic endothelial analysis was done with the non-contact endothelial microscope (20x probe) of Confoscan-4 (NIDEK, Japan). The eyes were classified into stages based on steepest keratometric value as follows: mild <45 D; moderate 45-52 D; severe >52 D and according to thinnest cornea thickness (TCT) as <400 μm, 400-450 μm, and >450 μm. Tomographic and endothelial cell parameters were compared among the groups using Kruskal-Wallis test and the correlations between them were analyzed using Spearman correlation.Results:The study included 391 eyes of 100 male (24.29±7.7 years, range 11-47 years) and 106 female (26.26±7.5 years, range 13-45 years) patients (p=0.07). Mean ECD values were 2628±262 cells/mm2, 2541.9±260.4 cells/mm2, and 2414.6±384.3 cells/mm2 in mild, moderate, and severe keratoconus, respectively (p<0.001) and 2592.3±277 cells/mm2, 2502±307 cells/mm2 and 2348±296 cells/mm2 in corneas with TCT values >450 µm, 400-450 µm, and <400 µm, respectively (p<0.001). ECD showed significant negative correlation with keratometric and elevation parameters and positive correlation with pachymetric parameters (p<0.05).Conclusion:As endothelial cell numbers seem to decrease with the progression of keratoconus, specular/confocal microscopy screening should be carried out, especially in eyes with advanced stages and corneas with TCT <400 µm.

Calcification does seem more marked in the area of folding and holding by the insertion forceps. This finding led us to consider that a potential irregularity or sulcus created during the insertion may have played a role, facilitating the deposits that might otherwise have been naturally washed out.Theoretically, the formation of calcium deposits is related to either the material of the IOL or the local chemical microenvironment of the aqueous humor. 5 In this regard, we recognize the potential significance of a metabolic disturbance such as diabetes, 6 which was present in 3 of our cases. However, it should be noted that hydrophilic acrylic IOLs from the same manufacturer, but not from the same batch, were implanted in the fellow eyes of these patients. We therefore conclude that calcium deposits can occur with this type of IOL from a combination of factors, most likely a combination of a modified manufacturing method that meets a favorable scenario, such as metabolic changes in the aqueous humor or anatomic alterations on the IOL surface. REFERENCES 1. Werner L. Calcification of hydrophilic acrylic intraocular lenses [editorial]. Am J Ophthalmol 2008; 146:341-343 2. Werner L. Causes of intraocular lens opacification or discoloration. J Cataract Refract Surg 2007; 33:713-726 3. Haymore J, Zaidman G, Werner L, Mamalis N, Hamilton S, Cook J, Gillette T. Misdiagnosis of hydrophilic acrylic intraocular lens optic opacification; report of 8 cases with the MemoryLens. Ophthalmology 2007; 114:1689-1695 4. Walker NJ, Saldanha MJ, Sharp JAH, Porooshani H, McDonald BM, Ferguson DJP, Patel CK. Calcification of hydrophilic acrylic intraocular lenses in combined phacovitrectomy surgery. J Cataract Refract Surg 2010; 36:1427-1431 5. Gartaganis SP, Kanellopoulou DG, Mela EK, Panteli VS, Koutsoukos PG. Opacification of hydrophilic acrylic intraocular lens attributable to calcification: investigation on mechanism. Am J Ophthalmol 2008; 146:395-403 6. Werner L, Apple DJ, Escobar-Gomez M, € Ohrstr€ om A, Crayford BB, Bianchi R, Pandey SK. Postoperative deposition of calcium on the surfaces of a hydrogel intraocular lens.Acinetobacter baumannii has emerged as one of the most troublesome pathogens for health-care institutions globally. We report a case of acute postoperative endophthalmitis caused by A baumannii following uneventful cataract surgery. CASE REPORTA nonimmunocompromised, previously healthy 76-year-old man was seen 2 days after the onset of blurred vision, eye redness, and pain. Symptoms had started 3 days after uneventful phacoemulsification with intraocular lens (IOL) implantation surgery for age-related cataract in the right eye.The examination revealed a visual acuity of counting fingers at 20 cm in the affected right eye. Slitlamp biomicroscopy showed conjunctival hyperemia, striate keratopathy, 1.0 mm hypopyon, pupillary membrane, and 4C cells in the anterior chamber. The intraocular pressure was 12 mm Hg measured by applanation tonometry. No fundus details were observed. On ocular ultrasonography, the retina appe...

ÖZETMethanol is a toxin with rare but serious effects on the central nervous system. It may cause severe visual dysfunction and mortality. This study presents the case of a 44-year-old man admitted to our clinic with bilateral amaurosis which developed after dental intervention for gingivitis. The patient was conscious and presented with stomach ache, nausea, vomiting, weakness, imbalance, and bilateral amaurosis; methanol poisoning was diagnosed. Upon examination, the absence of light perception in the eye and bilateral weakness in light reflexes were detected. Visually-evoked potentials (P100) could not be obtained. Hyper-intense lesions with bilateral putaminal localisation were observed on magnetic resonance imaging and bilateral pupil oedema was observed by fundus photography. The patient was treated with methyl prednisolone and intravenous vitamin B1. On the fifth day after admission, fluctuations in visual findings were observed, and light reflex loss and pupillary dilatation developed. Upon examination one and six months later, bilateral (total) amaurosis and bilateral optic atrophy were detected. This case demonstrates bilateral putaminal involvement after exposure to a very low dose of methanol.