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To evaluate the effects of horizontal strabismus surgery on the refractive and astigmatic status of eyes following horizontal muscle surgery using double-angle vector analysis.This was a retrospective analysis of 137 patients (250 eyes) conducted between February 1997 and October 2010 in patients who had unilateral or bilateral recession or monocular recession and/or underwent resection of horizontal muscles by a single surgeon. Refraction data were obtained at 1-2 weeks preoperative and at 4-6 weeks and 4-6 months postoperative. Surgically induced refractive changes were calculated using double-angle vector analysis.The mean change in the spherical equivalent (SE) of the refraction was 0.23 ± 0.78 D for surgically induced refractive changes at 4-6 weeks postoperative (SIRC1; p0.0001) and 0.14 ± 0.85 D (p = 0.018) for surgically induced refractive changes at 4-6 months postoperative (SIRC2), indicating a small shift in the myopic direction with regression at 4-6 months. The mean amplitudes of the induced cylinders were 0.072 ± 1.22 D (p = 0.262) in SIRC1 and 0.20 ± 1.14 D (p = 0.012) in SIRC2, and the mean axis of the induced plus cylinder was 21.74° in SIRC1, indicating a small shift in the with-the-rule direction, but no statistically significant difference from zero (p = 0.331). The changes in the surgically induced refraction over time (SIRC d), ie, 0.05 ± 0.64 in SE (p = 0.255) and 0.09 ± 0.65 in the cylinder (p = 0.049), were stable. There was no significant correlation between the amounts of horizontal rectus muscle recession and/or resection and the cylinder power of individual induced astigmatism at 4-6 weeks after surgery (p = 0.266) and the myopic shift (p = 0.345). Moreover, there were no significant correlations between the ages of the patients and the spherical equivalent for SIRC1 (p = 0.858) and the induced cylinder for SIRC1 (p = 0.750).Horizontal rectus muscle surgery tended to induce a transient, statistically significant change in the spherical equivalent of refraction, with a myopic shift that was clinically not important. Our findings did not strongly support that the astigmatism induced changes. There was no correlation between the amount of recession and/or resection and the amount of induced refractive error.

Purpose To describe demographic criteria of primary congenital glaucoma (PCG) subjects and to evaluate the surgical outcomes of children who underwent angle surgery over a 20-year period. Methods This is a retrospective study of patients diagnosed with PCG who underwent trabeculotomy, trabeculectomy, or combined trabeculotomy-trabeculectomy (CTT). The surgery was considered to be successful if intraocular pressure (IOP) was 21 mm Hg or less with or without treatment. Results A total of 148 eyes (85 patients) were included in the study. The majority of the patients were younger than 6 months of age (78.9%), with a median age of 2 months. Sex distribution was relatively even between girls and boys (45:40) (53%/47%). Bilateral disease was seen in 63 patients (74%). The overall success rate was achieved in 80.4%. The majority of the eyes needed only one surgery (105 [70.9%]), 34 eyes (23.0%) needed 2 surgeries, and 7 eyes (4.7%) had 3 surgeries. There was no statistically significant difference in success rate between types of surgery and number of performed procedures. A progressive decline in success rate over time was evident, as success rate dropped from 96.6% at 5 months to less than 50% after 11 years of follow-up. Conclusions Excellent IOP control can be achieved in a majority of patients with equally effective results from all 3 surgical procedures. The surgical outcome of PCG was more favorable in infants presenting before the age of 6 months. Adjuvant topical antiglaucoma medications can augment the surgical success rate.

We report a family of three siblings followed between 2005 and 2011 with bilateral combined hamartoma of the retina and retinal pigment epithelium, with the age of diagnosis ranging from 7 to 13years. The main reason for consultation was reduction of vision and squint. The diagnosis was determined based on the clinical findings on fundus examination: increased pigmentation at the macula with slightly elevated, gray–white macular lesion, tortuosity of perimacular blood vessels and glial epiretinal membrane. The elder brother was found to have left posterior subcapsular cataract. He was also confirmed to have neurofibromatosis type 1, the youngest sister fit in the diagnostic criteria for neurofibromatosis type 1, while the middle sister was presumed to have neurofibromatosis type 1. Follow-up showed stability of the retinal lesion in the three cases, with the progression to develop right posterior subcapsular cataract in the elder sister.This report is aimed to demonstrate that the occurrence of bilateral combined hamartoma of the retina and retinal pigment epithelium could raise the possibility of associated neurofibromatosis.

The aim of this study was to investigate the presence of increased macular or retinal nerve fiber layer thickness (RNFLT) in amblyopic eyes, find if the increased macular or RNFLT is related to the lack of response in amblyopic eyes, and to explore whether the increased central macular thickness (CMT) in amblyopic eyes is purely related to the hyperopia. This is a prospective descriptive study. CMT and peripapillary RNFLT were measured by spectral-domain optical coherence tomography to evaluate 60 patients with unilateral-treated amblyopia (median age 11.00 year). Patients were divided into two groups: 33 patients in recovered amblyopia group and 27 patients in persistent amblyopia group. The mean CMT in the recovered group was 247.31 (±23.4) versus 246.8 (±32.7) µm (p = 0.95) for the persistent group. The mean peripapillary RNFLT was 99.13 (±12.1) versus 99.9 (±14.9) µm (p = 0.85) for the persistent group. In anisometropic amblyopia, there was no significant difference in CMT and RNFLT in either group. Also there was no relation between the type of refractive error and CMT or RNFLT. There was no significant difference in CMT and RNFLT in amblyopic eyes for both the recovered amblyopia group and the persistent amblyopia group to explain the lack of response in persistent amblyopic eyes. Additionally there was no relation between the type of refractive error and CMT or peripapillary RNFLT.

This is a descriptive case report of a seven-year-old boy presented in January 2007 with decreased vision in the right eye, for 2months after sustaining a trauma while he was playing with fireworks during the Eid holiday. He was treated in a suburban hospital for corneal laceration and was prescribed a topical antibiotic and a topical steroid. When the child presented to us, a slit lamp examination revealed a thread in the anterior chamber, his un-aided visual acuity was 6/60 on a Snellen chart. Surgery to remove the foreign body was scheduled, but the patient never attended. The patient was lost to follow-up and returned in January 2011 with an un-aided visual acuity of 6/12, although the foreign body was retained in the anterior chamber (AC) with a quiet eye and good vision. At that time, we decided to follow the patient without any surgical intervention. Again, the patient was lost to follow-up and returned with almost full vision in September 2012, with a visual acuity of 6/6 without correction. Thus, we concluded that thread like IOFBs in the AC can be considered inert materials that may not need any surgical intervention in a quiet eye that does not show any signs of inflammation and where the IOFB is non-mobile and located away from the endothelium.

Purpose To determine the distribution of intraocular pressure (IOP) and its association with age, gender and refractive error in non-glaucomatous Saudi participants. Design Hospital-based cross-sectional observational study during Vision Day Screening Program. Participants: 458 participants living in the Al-Khobar, Saudi Arabia. Methods Recruited participants (aged 20years or over) underwent a comprehensive questionnaire and ocular examination, including measurement of IOP with Perkins hand-held applanation tonometry and autorefraction. Main outcome measures The distribution of IOP of either of the eyes (right or left eye by randomization) and associations with age, gender and refractive error. Results Median IOP was 15.0 (range: 6–28) mmHg in the total population. There is no significant difference between the overall IOP of male participants, median 15 (range: 6–28) mmHg and female participants, median 16 (range: 6–28) mmHg ( p =0.180). No statistically significant difference in IOP in relation to age comparing 20–45years group to 46–69years group was documented ( p =0.751). There was no statistically significant relationship between refractive error category and IOP ( p =0.405). Ocular hypertension with IOP>21mmHg was found in 8.7% of the participants. Conclusion Variation in IOP by gender, age group and type of refractive error was not statistically significant. The observations need confirmation by study with larger sample representing Saudi population.