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Purpose: To compare Behçet uveitis patients who presented in the 1990s and 2000s.Methods: Records of 170 patients seen in 1990-1994 and 258 patients seen in 2000-2004 were reviewed. Presenting features were analyzed in the whole cohort. Uveitis attacks, vision, complications, and immunomodulatory treatment (IMT) were compared in patients with 3-year follow-up.Results: Posterior segment involvement was less common, visual acuity was better, and more patients received IMT before referral in the 2000s. Follow-up revealed no significant difference in number of uveitis attacks in the first 3 years. Less eyes lost useful vision, no patient became legally blind, and fewer severe ocular complications occurred in the 2000s. IMT was started within 3 months in more patients and interferon alfa-2a was used only in the latter study period.Conclusions: The findings suggest a milder disease at referral, lower rate of severe complications, and a better 3-year visual outcome in patients who presented in the early 2000s. [ABSTRACT FROM AUTHOR]

Purpose: To investigate serum levels of interleukin (IL)-12 (Th1 cytokine), IL-27 (an immunomodulatory cytokine), IL-4 (suppressor of Th1-cell growth), IL-13 (a stimulatory signal for Th2 cytokines), and IL-33 (an epithelial cell-derived cytokine) and their relations with the disease activity in Behcet's Disease (BD)., Methods: Four groups, each composed of 20 participants were enrolled in the study; active ocular BD (Group-A), ocular BD in remission (Group-B), nonocular BD in remission (Group-C) and healthy controls (Group-D). IL levels were compared between the study groups and their correlation with the disease activity parameters were analyzed., Results: IL-13 and IL-33 were higher in Group-A. IL-27 was lower in all BD groups. Additionally, IL-13 and IL-33 levels were positively correlated with disease activity parameters., Conclusion: These findings show Th2 dominance in the active phase of BD. Besides, decreased levels of IL-27, and presumably, its protective anti-inflammatory effect in all study groups may exert a new pathologic finding in BD.

Objective: To evaluate the changes in psychological distress level and quality of life (QoL) scores of keratoconus (KC) patients 1 year after corneal collagen cross-linking (CXL)., Methods: Observational cross-sectional study. Thirty-three, consecutive progressive KC patients who received CXL treatment were enrolled in the study. All patients were evaluated before and 1 year after CXL ophthalmologically and psychologically. Main outcome measures were the visual, refractive, and topographic changes and the Beck Depression Inventory, State-Trait Anxiety Inventory (STAI), Short Form-36 (SF-36), and The National Eye Institute Visual Function Questionnaire (NEI-VFQ-25)., Results: There were significant improvements in the keratometric readings at flat axis, steep axis, the mean keratometric reading, the corneal astigmatism (Kast), and the maximum keratometric reading. State-Trait Anxiety Inventory-II scores, QoL dimensions, such as physical role difficulty, general health, mental health, ocular pain, near activities, distance activities, peripheral vision, and mental health scores, and the composite score of NEI-VFQ-25, were higher after surgery. There was a positive correlation between the changes observed in Kast and mental health; a negative correlation between the changes in Kast and STAI-II, and a negative correlation between the changes in mental health and STAI-II. Change in STAI-II has significantly predicted the improvement observed in general health., Conclusions: Our results suggested lower trait anxiety and better vision-related and health-related QoL in KC patients 1 year after successful CXL treatment. Better QoL in these patients seems to be related not only with the visual and refractive results but also improvement observed in trait anxiety.

Objective: To compare central corneal thickness (CCT) measurements with a rotating Scheimpflug camera (RSC), noncontact specular microscopy (SM), optical low-coherence reflectometry (OLCR), and ultrasonic pachymetry (UP) in keratoconus (KC) patients., Method: In this prospective study, four CCT measurements taken with an RSC, SM, OLCR, and UP were compared in 81 eyes of 44 consecutive KC patients. The KC patients were divided into four subgroups according to Amsler-Krumeich's KC classification., Results: The RSC and UP measurements of the CCT were not statistically significant in all the groups. Comparison of the SM vs. the OLCR measurements yielded statistically significant differences in all the KC patients and in all KC stages. In all the KC patients, RSC and OLCR showed a high correlation coefficient factor (r = 0.87, p = 0.000)., Conclusion: CCT measurements with RSC are comparable to those achieved with UP. Compared with the other devices, according to SM measurements, the central cornea is thicker in all keratoconic eyes and in all KC grades, and it is thinner according to OLCR. RSC, UP, SM, and OLCR should not be used interchangeably in keratoconic eyes.

Purpose: The aim of this study was to evaluate the retinal nerve fiber layer (RNFL) thickness in vernal keratoconjunctivitis (VKC) patients who were under long-term topical corticosteroid therapy., Methods: Thirty-six eyes of 36 VKC patients with clear cornea and normal videokeratography and 40 eyes of 40 age- and gender-matched normal children were included in the study. Clinical and demographic characteristics of the patients were noted and detailed ophthalmological examination was performed. Visual acuity (VA), spherical equivalent (SE), axial length (AL) and RNFL thickness measurements were compared between the groups. To correct ocular magnification effect on RNFL, we used Littmann's formula., Results: All VKC patients had history of topical corticosteroid use and the mean duration of the topical corticosteroid use was 23.8 ± 9.09 months. There was no significant difference between the groups in terms of intraocular pressure (IOP). VKC group had significantly worse VA, greater SE and AL and thinner mean global, superior and inferior RNFL thickness. There were significant negative correlations between the duration of topical corticosteroid use and the mean global, superior and temporal RNFL thickness in VKC group. After correction of magnification effect, VKC group still had thinner mean global, superior and inferior RNFL thickness, and significant difference between the groups in inferior RNFL thickness did not disappear., Conclusion: Significant RNFL thickness difference between the groups suggests a possible effect of long-term corticosteroid use in VKC patients. Because visual field (VF) analysis in pediatric patients is difficult to perform and IOP may be illusive, RNFL thickness measurements in addition to routine examinations in VKC patients may help clinicians in their practice.

We present an 8-month-old female patient with bilateral spontaneous corneal perforation and lamellar ichthyosis. On examination, the skin of the body and face of the patient was completely dry and scaly. Cicatricial ectropion and descemetocele with small perforations were seen. Double-layered amniotic membrane transplantation on the cornea with eyelid construction was performed on both eyes. At the 6-month follow-up, lower eyelid minimal ectropion formation and inferior corneal leukoma were seen bilaterally. In ichthyosis patients, the cornea should be monitored closely due to the risk of severe visual loss and corneal perforation.

Background: Vernal keratoconjunctivitis (VKC) is a chronic, bilateral inflammation of the conjunctiva that mostly affects children and young adult males. Management of VKC is primarily aimed at reducing symptoms and preventing serious vision threatening sequelae., Objectives: To assess the efficacy of topical cyclosporine A (CsA) 0.05% on the signs and symtomps in the management of VKC., Material and Methods: This is a placebo-controlled, randomized prospective study. Sixty-two patients with VKC were included in this study. Patients were randomly assigned (1 : 1) to treatment with topical 0.05% CsA eyedrops or a placebo (artificial tears) for a period of 4 weeks, 4 times daily. Ocular signs and symptoms were in all patients scored at entry and at the end of 4 weeks., Results: When pre-treatment mean signs and symptoms scores were compared in both groups, there was no significant difference (p > 0.05). However, mean post-treatment scores as regards signs and symptoms were found to be lower in cyclosporine group than those in placebo group (p < 0.001). No side effects of the treatment with CsA 0.05% eyedrops were observed., Conclusions: It was found that topical CsA 0.05% eyedrops were safe and effective in the treatment of patients with VKC.

We present a case of a 40-year-old female with severe keratouveitis secondary to Euphorbia trigona plant sap. The patient dropped sap into both eyes to relieve itching and developed Euphorbia keratouveitis. Visual acuity was finger counting at 1 m in both eyes on presentation. On examination, eyelid edema, ciliary injection, corneal edema with Descemet membrane folds and exudate in the anterior chamber were seen bilaterally. With supportive treatment all signs and symptoms were relieved. Exposure to Euphorbia sap should be treated immediately to prevent sequelae like corneal scarring.

Aim: To demonstrate the effects of two different types of allergic conjunctivitis on severity of keratoconus (KC)., Methods: We retrospectively reviewed the medical records of 171 KC patients referred between June 2010 and June 2011. The KC patients were divided into 3 groups as KC (group A), KC with vernal keratoconjunctivitis (VKC) (group B) and KC with allergic conjunctivitis (AC) (group C). Main outcome measures were demographic and ocular clinical features including age at presentation, gender, spherical equivalent (SE), best spectacle corrected visual acuity (BCVA), mean keratometric measurement (Km), central corneal thickness (CCT), and intraocular pressure (IOP). Groups were compared in term of study variables., Results: The median age at presentation was significantly lower in group B (P<0.001). According to the median SE (P=0.003), BCVA (P=0.022), Km (P<0.001), CCT (P=0.015) and Amsler-Krumeich classification (P<0.001), KC was more severe in group B. There was no significant difference in terms of IOP and corrected IOP among the groups (P=0.44), however there were 4 patients who had increased corrected IOP developed after topical corticosteroid use in group B. The differences among the groups persisted even after controlling for age and gender., Conclusion: Our findings demonstrated a more severe KC in VKC patients despite their younger age which suggests evaluation of VKC patients as a separate group in keratoconus disease.

Purpose: To investigate the prevalence of refractive errors and other eye diseases, incidence and types of amblyopia in school-aged children, and their relation to gender, age, parental education, and socioeconomic factors., Methods: A total of 21,062 children 6 to 14 years old were screened. The examination included visual acuity measurements and ocular motility evaluation. Autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus were performed., Results: There were 11,118 females and 9,944 males. The average age was 10.56 ± 3.59 years. When all of the children were evaluated, 3.2% had myopia and 5.9% had hyperopia. Astigmatism 0.50 D or greater was present in 14.3% of children. Myopia was associated with older age, female gender, and higher parental education. Hyperopia was inversely proportional with older age. Spectacles were needed in 4,476 (22.7%) children with refractive errors, and 10.6% of children were unaware of their spectacle needs. Amblyopia was detected in 2.6% of all children. The most common causes of amblyopia were anisometropia (1.2%) and strabismus (0.9%)., Conclusion: Visual impairment is a common disorder in school-aged children. Eye health screening programs are beneficial in early detection and proper treatment of refractive errors., (Copyright 2013, SLACK Incorporated.)

Purpose. To investigate if there is a prognostic implication of the presence of cellular debris in the anterior vitreous in patients with Behçet's disease (BD) without any ocular symptoms. Methods. One hundred and twenty eyes of 60 patients with BD were included in the study. The eyes were divided into two groups according to the presence of cellular debris in the anterior vitreous. The first group included 54 eyes which were cellular debris (+) (group A), and the second group included 66 eyes which were cellular debris (-) (group B). Fluorescein angiography (FA) was performed to all patients following routine ocular examination. Patients were called for the six monthly control visits to investigate possible new ocular involvement during followup. The Kaplan-Meier method was used to estimate survival curves. Results. Seven eyes (13%) in group A and four eyes (6.1%) in group B showed optic disc hyperfluorescence on FA (P = 0.2). None of the eyes with disc hyperflourescence on initial examination developed uveitis attacks in their followup. In Kaplan-Meier survival analysis there was a significant difference between the groups (group A 20.6% and group B 4.2%) by means of ocular involvement during their followup (log-rank = 6.85, P = 0.009). Conclusions. Presence of cellular debris in the anterior vitreous may have prognostic implications in patients with BD screened for ocular involvement.

Purpose: To determine the social phobia rate, social anxiety level, severity of depressive symptoms, and disease-related disability in adult strabismus patients., Methods: Forty-nine strabismus patients and 46 control subjects from 15 to 65 years of age were evaluated. A psychiatric interview focusing on social phobia and the Liebowitz Social Anxiety Scale (LSAS) were administered to each participant. All participants completed the Hospital Anxiety and Depression Scale (HADS), a psychiatric symptom checklist (Symptom Checklist 90-Revised; SCL-90R), and the Sheehan Disability Scale., Results: Social phobia was diagnosed in 26 of the 49 strabismus patients and in 8 of the 46 control subjects (p < 0.001). Strabismus patients demonstrated significantly greater scores in all of the subscores and the total scores of LSAS. They were more disabled in social life, family life, and at work. They also showed greater interpersonal sensitivity scores compared with the control group. Compared with strabismus patients without social phobia, the strabismus patients with social phobia demonstrated significantly greater depression scores in HADS and also scored in all dimensions of LSAS. Their social life and family life scores in disability scale and all scores in SCL-90-R except somatization were better than strabismus patients without social phobia., Conclusions: In adult strabismus patients, social phobia is a frequent psychiatric comorbidity. Adult patients with strabismus need to be carefully evaluated for social phobia for an appropriate referral and treatment.