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Objectives: To investigate the results of different surgical techniques for treating cases of dissociated vertical deviation (DVD). Materials and Methods: A retrospective review of medical records was performed, including 94 eyes of 47 patients who had undergone bilateral superior rectus (SR) recessions (Group 1), bilateral SR recession with posterior fixation sutures (Group 2), or bilateral inferior oblique (IO) anterior transposition surgery (Group 3) for treatment of DVD. Nineteen patients underwent secondary procedures (SR weakening or IO anterior transposition) because of unsatisfactory results. The amount of the DVD in primary position before and after surgery, postoperative success ratios, and probable complications were evaluated. The Wilcoxon signed ranks test and chi-squared test were used for statistical evaluations. Results: In 69% of the 32 eyes in group 1, 65% of the 20 eyes in group 2, and 79% of the 42 eyes in group 3, satisfactory control of the DVD in primary position was achieved. All eyes undergoing both SR weakening and IO anterior transposition had a residual DVD of less than 5 prism diopters (pd). Of the total of 94 eyes, in 26 (89.6%) of 29 eyes that had a preoperative DVD angle of more than 15 pd [ten eyes from group 1, seven eyes from group 2, and nine eyes from group 3], the residual DVD angle after surgery was more than 5 pd. However, in the 65 eyes with preoperative DVD of 15 pd or less (21from Group 1, 12 from Group 2, and 32 from Group 3), the residual DVD angle after the operation was less than 5 pd. Two eyes of 2 patients had -1 limitation to elevation after surgery. Conclusion: Only IO anterior transposition or SR weakening surgery appear to be a successful surgical approaches in the management of patients with mild- and moderate-angle (≤15 pd) DVD. Weakening both the SR and IO muscles yield a greater success in the management of patients with large-angle (>15 pd) DVD. (Turk J Ophthalmol 2014; 44: 132-7)

Purpose: The purpose of this study was to evaluate the near point of convergence break in Turkish population with normal binocular vision and to obtain the normative data for the near point of convergence break in different age groups. Such database has not been previously reported. Material and Method: In this prospective study, 329 subjects with normal binocular vision (age range, 3-72 years) were evaluated. The near point of convergence break was measured 4 times repeatedly with an accommodative target. Mean values of near point of convergence break were provided for these age groups (≤10, 11-20, 21-30, 31-40, 41-50, 51-60, and >60 years old). A statistical comparison (one-way ANOVA and post-hoc test) of these values between age groups was performed. A correlation between the near point of convergence break and age was evaluated by Pearson’s correlation test. Results: The mean value for near point of convergence break was 2.46±1.88 (0.5-14) cm. Specifically, 95% of measurements in all subjects were 60 year-old age groups in the near point of convergence break values (p=0.0001, p=0.0001, p=0.006, p=0.001, p= 0.004). A mild positive correlation was observed between the increase in near point of convergence break and increase of age (r=0.355) (p

Spasm of the near reflex is a rare disorder that involves intermittent and variable episodes of esotropia, pseudomyopia, and pupillary myosis. It is usually functional in origin and is seen mainly in young patients. Treatment options for spasm of the near reflex have had variable success. In instances where the etiology of spasm of the near reflex was suspected to be hysteria, psychotherapy has proven beneficial. We report the case of an 11-year-old girl who had functional spasm of the near reflex. The symptoms persisted for two years. Symptomatic relief was achieved by cycloplegia and spectacle correction (added plus lenses at near). The patient also underwent psychological counseling. In our case, the functional spasm of the near reflex spontaneously resolved after 2 years. (Turk J Ophthalmol 2014; 44: 161-3

Molluscum contagiosum is a common viral skin infection in children with dome-shaped umbilicated nodules. Diagnosis is based on clinical appearance. An eight-year-old child presented to our clinic with multiple molluscum contagiosum nodules on the right lower and upper eyelid and one small papule on the left upper eyelid. Only a couple of lesions were squeezed with expression of cheesy material from the center of the lesions. In the follow-up period, beside resolution of the squeezed lesions, all other lesions disappeared spontaneously and no new lesion was observed in the following one year. This method is costless, neither needs a chemical agent nor results in scarring, so can be the first choice of treatment. (Turk J Ophthalmol 2014; 44:158-60)

Cyclic esotropia is a rare form of strabismus characterized by alternating periods of esotropia and orthophoric (or almost orthophoric) eye position. Herein, we discuss two children with cyclic esotropia and their surgical treatment results. A six-year-old boy was brought to our clinic with the typical complaint of a convergent squint which had been appearing and disappearing in a regular 24-hour cycle over a period of four years. He had a large deviation angle with associated suppression and no binocular function for a 24-hour cyclic pattern, but he had a small angle of esotropia with fusion and stereopsis for another 24 hours. He had undergone strabismus surgery on the left eye at another clinic 3 years ago. The other patient was a ten-year-old girl who was brought to our clinic with the reoccurring complaint of esotropia on alternating days over a period of four years. We determined that a large deviation angle with near-distance disparity and a 24-hour cyclic pattern were present. For both cases, we planned strabismus surgery according to the amount of deviation on the esotropic day. Following the surgery, the eyes have continued to remain permanently straight during the follow-up period. (Turk J Ophthalmol 2014; 44: 164-6)