Migration of intraocular silicone oil, used in the treatment of complicated retinal detachment, has been rarely described, but when it happens it can arise with a differential diagnosis with scleral buckling extrusion, tumor, dermoid, ocular cysticercosis, and abscess. The presence of silicone oil in the eye gives very ugly echographic pictures, but these kinds of pictures can be very useful in making a differential diagnosis in the above-mentioned cases. A 39-year-old white female complained of the presence of conjunctival hyperemia and tearing in the right eye (RE); her visual acuity was hand motion, and the intraocular pressure was 14 mmHg. In the upper nasal quadrant a dome shaped lesion was detected. Due to the lens opacities, the patient underwent an echographic examination, which revealed the presence of silicon oil both in the vitreous chamber and in a large subconjunctival space, corresponding to the lesion. This article in addition provides a possible explanation of such cystic formation and discusses the risk factors and the role of the echographic examination in such cases.
Achados oftalmológicos na distrofia miotonicaDear Editor, We read with great interest the article by Ikeda et al. concerning ophthalmological findings in myotonic dystrophy (MD) 1 .We would like to thank the authors, because they cited a study we published in 2009, where we tried to understand the reasons for low intraocular pressure (IOP) in these patients. Our first goal was to check if this was a real hypotony or if it was related to an incorrect measurement of the IOP, as it is well known that Goldmann applanation tonometry can give incorrect measurements in cases of abnormal corneas 2 . In that paper, we excluded the possibility that corneal biomechanical properties could alter the IOP measurements in MD patients. We found these patients had slightly thicker corneas compared to a normal population, so this could not explain the finding of the lower IOP, but should have given a higher measurement if the thickening was not related to a corneal edema. To exclude a corneal edema, we studied the endothelial cell characteristics, and we found them to be normal 3 .For these reasons, as Ikeda et al. stated, we hypothesized that a low IOP could be related either to increased aqueous humor outflow or decreased aqueous secretion, but a complete pathophysiologic model to explain reduced IOP was not yet available.Later, performing an echographic evaluation of the anterior segment of these patients, we found a detachment of the ciliary body, which may explain the low IOP values in MD 4 .Based on these results, we tried to determine if a low IOP was also present in other kinds of muscular dystrophies, and we found that patients with facio-scapulo-humeral muscular dystrophy also have low IOP, but, contrary to patients with MD, they have thinner corneas. This could explain a different reason for the lower IOP measurement in this other group of muscular dystrophies 5 .
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