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INTRODUCTION: Chronic progressive external ophthalmoplegia is characterised by limitation of ocular motility in all directions of gaze and ptosis. Innervational or myogenic factors were claimed to be responsible for this motility disorder. The aim of this study was to investigate the extraocular muscles in CPEO with computerized tomography in an attempt to distinguish extraocular muscle morphology caused by this disorder from that occurring in normal individuals. METHODS: Eighteen orbits from 9 patients diagnosed with CPEO were included in the study. Axial and coronal scans were obtained for CT evaluation of extraocular muscles and the dimensions of extraocular muscles were measured. The control group consisted of 40 orbits belonging to 20 individuals and, the results were compared with a student's t test. RESULTS: The thickness (the vertical dimension of vertical recti and the horizontal dimension of horizontal recti) of all rectus muscles was significantly decreased in comparison with the control group, whereas the width (the horizontal dimension of vertical recti and the vertical dimension of horizontal recti) was similar in both the diseased and normal orbits. In all the rectus muscles of the diseased orbits, the normal fusiform shape was lost and the muscles appeared as thin bands. DISCUSSION: The differentiation of CPEO from other myogenic and neurogenic disorders may present difficulty, and a cluster of criteria are required for a final diagnosis. CT has proven to be a valuable tool in assessing extraocular muscles [1, 2]. In this study, an extreme atrophy of all rectus muscles was demonstrated by means of CT. This diagnostic method may consequently contribute to a proper diagnosis of CPEO.

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AIMS: Intractable glaucoma is glaucoma resistant to medical therapy and conventional surgical procedures. In this study, a planned surgical technique is discussed for controlling the increased intraocular pressure in selected cases with intractable glaucoma. METHODS: Total pars plana vitrectomy with pars plana tube implantation was performed in 17 eyes of 17 cases with intractable glaucoma. Patients with neovascular glaucoma were not included in this study. The mean age of these patients (seven men, 10 women) was 44.6 (SD 22.1) years and mean follow up period was 30.3 (15.5) months (range 4-71). Drainage implants with a disc were used in 16 cases, whereas, a tube with scleral buckle (Schocket surgery) was preferred in one case. An intraocular pressure below or equal to 20 mm Hg without any adjunctive medication or with only one type of antiglaucomatous drop was considered as an adequate operative outcome. RESULTS: 16 out of 17 eyes maintained adequate pressure control. Only three out of these 16 eyes required prophylactic antiglaucomatous medications. One patient underwent reoperation for pressure control. The most severe complications observed postoperatively were intravitreal haemorrhage (one case), choroidal detachment (one case), implant failure (one case), total retinal detachment (two cases), and corneal endothelial decompensation (five cases). CONCLUSION: Pars plana placement of drainage tube following pars plana vitrectomy should be considered as an alternative method for controlling increased intraocular pressures in selected patients with intractable glaucoma.

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Three years after the initial diagnosis, a 21-year-old healthy man with Bietti's crystalline retinopathy developed unilateral stage 4 macular hole with surrounding macular detachment. The mechanism of macular hole formation, which may or may not be a feature of Bietti's crystalline dystrophy, is not clear.

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An 8-year-old girl with a history of mild amblyopia who had occlusion therapy, but her anisocoria went unnoticed, was studied. Old photographs of the patient were reviewed and a 0.1% pilocarpine test was performed. Review of her old photographs suggested that she had anisocoria at least since she was 3 years old. The 0.1% pilocarpine test confirmed a diagnosis of Adie's syndrome. In light of this case, it must be kept in mind that though rare, Adie's syndrome can be encountered in early childhood.

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Thirty-one patients with the diagnosis of thyroid associated eye disease were included in the study. Samples were obtained from upper and temporal bulbar conjunctiva of both eyes by cellulose acetate filter paper. Control group included 20 healthy individuals. In patients with thyroid associated eye disease, grade 2 or 3 squamous metaplasia was observed in 32.26% of the samples obtained from upper bulbar conjunctiva, whereas this ratio increased to 82.26% in temporal bulbar area. None of the control cases showed changes of grade 2 or more. The evaluation of cytological changes with respect to clinical findings revealed that the main factor responsible for the cytological findings was inflammatory changes of the conjunctiva, whereas interpalpebral distance and proptosis had only a partial effect.

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Upper-eyelid retraction is a common sign of thyroid-associated eye disease (TAED), and these patients are highly bothered by the appearance of their eyes. In this study, botulinum toxin A (BTA) was injected into the levator palpebrae superioris muscle in 8 eyes of 4 patients in an attempt to control the abnormal elevation of the upper eyelid. BTA provided control of the upper-eyelid retraction, and the cosmetically acceptable effect lasted for 3-4 months. It was concluded that BTA is an effective method of treatment in this condition. Since it has a temporary effect, it can safely be used to provide relief of symptoms related to upper-eyelid retraction during unstabilized periods of TAED, which may last as long as several years in some patients.

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We report a case of transient ectropion associated with corneal ulcer. The corneal ulcer responded well to treatment with fortified gentamicin and cefazolin. As the corneal ulcer healed, the eyelid simultaneously returned to its original position. We suggest that in the presence of involutional eyelid changes, even a minimal additional factor, such as conjunctival edema and blepharospasm, may cause transient ectropion.

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BACKGROUND AND OBJECTIVE: To evaluate the sensitivity of magnetic resonance imaging (MRI) in detecting retinal detachment (RD) in eyes filled with silicone oil, and to determine the MRI characteristics of silicone oil in vivo. PATIENTS AND METHODS: Seven eyes of seven patients with RD and eight eyes of eight patients without RD after silicone oil surgery were included in the study. All of the patients had clear media. MRI was performed in these patients. The results of ophthalmic examinations were compared with MRI findings. RESULTS: MRI detected six of the seven detached retinas. The multiplanar imaging capability of MRI helped in showing the RDs in various locations. The chemical shift artifact exaggerated the retinal thickness and made the detached retina visible. Fat suppressed images showed the silicone oil-corneal contact clearly. CONCLUSION: MRI is an effective technique for demonstrating RD in eyes filled with silicone oil and can be used successfully in eyes with opaque media.

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We report a case with progressive visual loss whose ophthalmic examination revealed bilateral optic atrophy and choroidal folds in the left eye. Neuroimaging demonstrated a sellar mass compressing the optic chiasm and the left optic nerve was to be stretched. We assume the traction created on the optic nerve by the mass stretched the optic nerve and caused the choroidal folds.

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PURPOSE: We treated a case of transient myopia in a patient being treated with hydrochlorothiazide and triamterene for tinnitus. METHODS: The patient underwent gonioscopic, ophthalmoscopic, and echographic examinations. RESULTS: Examination showed anterior chamber flattening and echography disclosed bilateral 360-degree shallow choroidal detachments. CONCLUSION: All of the patient's symptoms and signs resolved after the cessation of drug therapy.

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