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Purpose: To investigate the clinical course of children younger than 5 years old who underwent rigid gas-permeable (RGP) contact lens (CL) wearing as visual rehabilitation of open globe injuries (OGIs) in Japan., Methods: This retrospective case series involved six eyes of six children (four boys and two girls) with OGIs. The mean patient age at injury was 4.0±0.83 SD (range: 2.5-5 years), and the mean follow-up period was 42.9 months (range: 31.6-52.8 months). In each child, data regarding injury type, ocular surgery performed, outcomes of amblyopia management (including best-corrected visual acuity [BCVA] with RGP CL or spectacles), the RGP CL-wear training period, and rate of continuous RGP CL-wear were analyzed., Results: Trauma type was penetrating injury (four eyes) and globe rupture (two eyes). All six cases showed lens penetration, and underwent corneal suture, lensectomy, and pars plana vitrectomy under general anesthesia. The mean RGP CL-wear training period was 3.5 months, and only one of the six cases discontinued RGP CL use. The mean BCVA with spectacles and with RGP CL was LogMAR: 1.52±0.41 (range 1.00-2.00) and 0.73±0.41 (range: 0.30-1.15), respectively. In all patients, except in one case in which strabismus developed, BCVA improved with RGP CL wear more than 0.2 logMAR compared with that with spectacles., Conclusion: Although the training period for RGP CL-wear is long in pediatric patients with OGIs, the treatment can be effective for refractive problems and for preventing the development of strabismus., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2020 Contact Lens Association of Ophthalmologists.)

Unlabelled: Purpose : To report 3 cases of severe ocular infection in elderly patients with dementia., Case Reports: Case 1 involved a 75-year-old man who presented after his wife noticed hyperemia and discharge in his right eye. Corneal infection with perforation was found. Wife-administered antibiotics healed the infection within 1 month. Case 2 involved a 97-year-old man who was referred to us after nursing-home staff members noticed redness and discharge in his right eye. Severe corneal infection with hypopyon was found. Following systemic and topical and antibiotics' administration by the nursing-home staff, the infectious keratitis healed within 2 weeks. Case 3 involved an 80-year-old woman referred to us from another clinic due to persistent epithelial defect in her left eye. Since the defect was accompanied by anterior uveitis and vitreous opacity, we suspected bacterial endophthalmitis. Following systemic and topical antibiotics' administration by family members, signs of infection diminished within 3 weeks. In all 3 cases, medical examination was difficult, topical eye-drop instillation by the patients themselves was impossible., Conclusions: In elderly dementia patients, cognizance of infection, medical examination, and treatment are difficult. Support by family members or nursing-home staff is necessary to obtain improved outcomes.

Purpose: To evaluate the clinical characteristics and management of short tear film breakup time (BUT) -type dry eye., Methods: Clinical background and post-treatment changes of symptoms in 77 patients with short BUT -type dry eye were investigated. Treatment consisted of artificial-tear eye-drop instillation and, if necessary, the addition of a low-density-level steroid, hyaluronic acid, a low-density-level cyclopentolate prepared by ourselves and punctal plugs inserted into the upper and lower lacrimal puncta., Results: There were three times more women than men among the patients, and the peak age of occurrence was in the twenties in the men and in the sixties in the women. Our findings show that visual display terminal (VDT) work, contact lens (CL) wear, and changes in the sex hormones may initiate subjective symptoms. Some patients had simultaneous conjunctivochalasis, allergic conjunctivitis, and meibomian gland dysfunction. Nineteen patients (24.7%) were effectively treated with eye-drop instillation alone. Thirty-seven patients (48.1%) required punctal-plug insertion, which was completely effective in only 8 of them (21.6%)., Conclusion: Mainly young men and menopausal women contract short BUT -type dry eye. Changes in sex hormones, VDT work and CL wear may be causal, and the disease cannot be controlled by eyedrop and punctal-plug treatment alone.

Purpose: To study the relationship between ocular surface colonization or infection and nasal carriage of methicillin-resistant Staphylococcus aureus(MRSA) among patients at high risk of infection and those who have already been infected., Subjects and Methods: We isolated MRSA from ocular surface and anterior nares in 35 patients at high risk of MRSA colonization and from 4 patients who had developed an active MRSA ocular infection in the conjunctiva., Results: Of the 7 patients who were carriers of conjunctival MRSA, 5 patients (78%) were found to be carriers of MRSA in the anterior nares. This ratio of nasal carriers is very high compared to the 11% in 28 patients without MRSA in the conjunctiva. All 4 cases who had active infections of MRSA in the cornea or conjunctiva showed MRSA from the nares. Even after MRSA was negative in their eye lesions, MRSA colonization in their nares continued for a long time., Conclusion: A significant relationship exists between MRSA in the ocular surface and MRSA found in the nares.