Objectives: This study aimed to examine whether infants with and without eye patches differ in terms of vital signs and clinical status after retinopathy of prematurity examination. Methods: Premature infants hospitalized in study center between June 2021-April 2022 were included. Group 1 is consisted of infants whose eyes were not closed after retinopathy of prematurity examination. Those infants whose eyes were closed eye-patches consisted of group 2. Vital signs were followed for 24 hours following the examination. Demographic, medical and follow-up data were all recorded prospectively. Vital signs were evaluated in accordance with birth week and weight. Pain score was evaluated by Neonatal Pain, Agitation, and Sedation Scale. Results: Pain scores were found to be lower in group 2 (p < 0.020). Although the systolic blood pressure, diastolic blood pressure, and mean blood pressure values of group 2 were found to be lower than group 1, they were within normal limits (all p < 0.05). Vomiting was not observed at all in Group 1 (p = 0.036). There was no significant difference between the groups in terms of fever, respiratory rate, heart rate, SpO2, and blood glucose values. Conclusions: This study showed that using an eye patch in infants after an eye examination reduces pain and increases comfort of infants. Although their pain scores are lower, taking necessary precautions are recommended for these patients in terms of vomiting. Thus, eye patches can be suggested as a non-pharmacological pain-reducing method after get advanced stagnation by the support of more studies with a larger number of participants.

Objectives: This study was carried out to determine the traditional practices that women who have just given birth apply to their babies. Methods: The research is descriptive. The participants were recruited from women who had just given birth to 198 women in a maternity hospital. The data was collected through the personal information form. The chi-square test was used to plan the categorical data in detail as the mean of the research data, as numbers, and as percentages. p < 0.05 was accepted as meaning. Results: It was determined that traditional practices frequently used by women; The use of the yellow blanket against jaundice, swaddling so that the waist does not sink in, staying warm, being hard as steel, and having straight legs and the use of salt. It was determined that these practices were applied more by mothers who graduated from primary school. Although the frequency of use of applications such as burying the belly in the garden and throwing it in the water was found to be significant by age, it was determined to be used more in the group aged 31 and over. It has been determined that wearing evil eye beads is more common among mothers under the age of 25. Conclusions: In our study, it was observed that traditional practices were widely applied in the neonatal period. Newborn health should be supported by providing continuous midwifery care to women, education, and health checks.

Pachychoroid neovasculopathy (PNV) is a pachychoroid spectrum disease characterized by macular neovascularization (MNV), dilated outer choroidal vessels (pachyvessels), and/or increased choroidal thickness. In PNV cases, optical coherence tomography angiography (OCTA) can reveal MNV with high resolution. A 65-year-old male patient was admitted to our clinic with the complaint of decreased vision in the right eye. On dilated fundus examination, retinal pigment epithelium changes were present in the foveal and extrafoveal areas in both eyes. There was subretinal fluid in the fovea and irregular pigment epithelial detachment in the right eye. Subfoveal MNV was detected in 3 × 3 mm sections of OCTA. A non-exudative MNV was also detected in a larger 6 × 6 mm area imaged with OCTA. Simultaneous non-exudative quiescent MNV in the extrafo- veal region of the same eye can be observed. To avoid missing those cases, it is critical to perform OCTA imaging sections, including the extrafoveal areas.

This case aims to report a patient who presented with reduced vision in her left eye and was diagnosed with giant cell ar- teritis (GCA) associated with isolated cotton wool spots (CWS). An 82-year-old woman presented with reduced visual acuity of 20/200 in her left eye for a day. Fundus examination revealed only multiple peripapillary CWS in the left eye. She had an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). A preliminary diagnosis of temporal arteritis, intravenous high-dose steroid therapy, was administered for 3 days. Then, the systemic symptoms resolved, and her ESR and CRP dropped. Temporal artery biopsy confirmed the diagnosis of GCA. The next 2 months, in the fundus examination, CWS resolved completely. The patient continued using systemic steroids and subcutaneous methotrexate with long-term gradual reduction. This extreme case should raise awareness for clinicians in the etiological investigation of CWS to identify sight-threatening GCA and promptly initiate appropriate treatment.

The aim of the study was to report the results of phototherapeutic keratectomy (PTK) and toric contact lens fitting for a young man with recurrent gelatinous droplet dystrophy (GDD) after penetrating keratoplasty (PK). A 21-year-old man was referred for pain, photophobia, and decreased vision. The patient who experienced decreasing vision for 15 years had under- gone PK 2 years ago due to GDD. He was having frequent recurrent epithelial erosions lately. Visual acuity (VA) was counting fingers at 3 m in the right eye and 0.8 in the left eye. Biomicroscopic examiantion revealed nodular dystrophic lesions on the nasal side of the graft in the right eye. Keratometric values were K1: 54.5, K2: 52.5 in the right eye and K1: 41.2, K2: 39.7 in the left eye. PTK was performed twice in the right eye and once in the left eye in 3 years. Final VA was 0.5 and 0.8 in the right and left eyes, respectively (with glasses and toric contact lenses) during 10 years of follow-up. A superficial corneal scar was noted on the right graft and the left cornea. No recurrence of dystrophy was observed. PTK decreases photophobia and provides visual improvement in patients with GDD and may help defer PK in case of recurrent GDD.

Orbital rhabdomyosarcoma is the most common malignant orbital tumor of child-hood originating from mesenchymal cells. The presenting symptom is usually acute onset unilateral proptosis. The rapidly progressive course of the findings may resemble infectious and inflammatory orbital diseases. Radiological imaging and histopathological examinations are crucial for differential diagnosis. The main goal of treatment with a multidisciplinary approach is to control both local and distant spread of the tumor and to prevent further damage. With the introduction of chemotherapy and radiotherapy in the treatment, the overall survival rate has in-creased. Thus, aggressive surgical approach for complete removal of the tumor has been abandoned.

Purpose: Study aims to assess the effect of pure blepharoplasty on the eyebrow position in patients with Grade 1 lateral dermatochalasis causing cosmetic complaints. Methods: This retrospective study includes patients undergoing upper eyelid blepharoplasty between December 2019 and November 2021. Patients with prior eyebrow or eyelid surgery and neurotoxins treatment were excluded from the study. Photographs were investigated using NIH ImageJ program to measure eyebrow position from medial canthus, mid pupillary level, and lateral canthus measured before and 6 months after the operation. Results: The mean pre-operative distance between the pupillary light reflex and the lowest eyebrow hair was 16.95 mm, and the mean post-operative height was 16.79 mm. This difference was not statistically significant (P=0.29). The mean pre-opera- tive lateral canthus to the lowest eyebrow hair (LBH) was 17.75 mm, and the mean post-operative height was 17.60 mm. This difference was not statistically significant (P=0.18). The mean pre-operative medial canthus to the LBH was 18.72 mm, and the mean post-operative height was 18.59 mm. This difference was not statistically significant (P=0.24). Conclusion: The present study represents that the position of the eyebrow may not be influenced significantly following a blepharoplasty procedure among female patients with Grade 1 lateral dermatochalasis and coexisting cosmetic complaints.

Purpose: This study’s aim is to evaluate the presence of dry eye in patients who had cataract surgery in the past 3 months and compare the results with the patients’ healthy eyes. Methods: Twenty patients were enrolled and both eyes were examined. Two groups were established, Group 1 was made up of eyes that had cataract surgery in the past 3 months and Group 2 of eyes that had not undergone the intervention. Dry eye presence was tested with tear film break-up time, Schirmer-1 test, Oxford scale, and Ocular Surface Disease Index (OSDI) score assessments. Results: Median tear film break up-time measurement was lower and the difference was statistically significant (p=0.037). Median OSDI and Oxford scale scores were higher in Group 1 and median Schirmer 1 value was lower in Group 1; however, no statistically significant difference was detected (p=0.063, p=0.545, and p=0.825, respectively). Conclusion: Between eyes with prior cataract surgery and those without, there were significant differences in the results of dry eye tests. We advise ophthalmologists to be aware that cataract surgery can trigger the development of dryness of the ocular surface and when any pathology detected on ocular surface after the surgery, it should not be neglected to prevent more serious consequences and to maintain ocular surface homeostasis.

Purpose: The purpose of this study was to determine if eyes with unilateral pterygium are more likely to suffer from dry eye symptoms and more prone to have abnormalities in dry eye parameters than healthy eyes. Methods: Forty eyes of 20 patients were enrolled. The eyes that were diagnosed as having pterygium were considered as Group 1 and other healthy eyes of the same patients were defined as Group 2. The existence of dry eye was tested with tear film break-up time, Schirmer-1 test, Oxford scale, and Ocular Surface Disease Index (OSDI) score assessments. Results: Median tear film break-up-time measurement and Schirmer 1 value were lower in Group 1; however, no statistically significant difference was detected (p=0.06 and p=0.308, respectively). Median OSDI score and median Oxford scale score were higher in Group 1; however, no statistically significant difference was detected (p=0.05 and p=0.250, respectively). Conclusion: Between eyes with pterygium and healthy ones, there was difference in dry eye test results. These results may show that there might be a relationship between pterygium and dry eye disease regardless of the genetic background and environmental factors.

Purpose: The purpose of the study was to evaluate Ocular Response Analyzer (ORA) measurements and endothelial cell density (ECD) in patients who received intravitreal dexamethasone implant (Ozurdex®) injection for diabetic macular edema. Methods: Twenty-three eyes of 13 patients who receive intravitreal dexamethasone implant injection (Group 1) for diabetic macular edema and 33 eyes of 33 healthy individuals (Group 2) were included in the study. All participants underwent a complete ophthalmologic examination including intraocular pressure measurement with Goldmann applanation tonome- ter (IOP-GAT), ORA measurements, and specular microscopy. Results: The mean age of the patients was 65.43±8.20 (49–75) in Group 1 and 61.94±4.52 (56–71) in Group 2 (p=0.114). The mean IOP-GAT was significantly higher in Group 1 (18.22±3.41; range 12–28 mmHg) than in Group 2 (15.41±3.07; range 8–21 mmHg) (p=0.02). The mean ECD was 2632.4±209.6 (2232–3067) cell/mm 2 in Group 1 and 2567±206.37 (2140–2854) cell/mm2 in Group 2 (p=0.60). The mean corneal resistance factor (CRF) was 12.16±2.35 (7.4–15.3) mmHg in Group 1 and 10.18±1.83 (6.7–14.2) mmHg in Group 2 (p=0.02). Mean corneal hysteresis (CH) in Groups 1 and 2 was 8.87±2.45 (4.1–13.4) mmHg and 10.47±1.43 (6.9–13.2) mmHg, respectively (p=0.001). Mean corneal compensated IOP and Goldman correlated IOP (IOPg) were higher in Group 1 (24.72±7.12; range 12.1–36.4 mmHg and 23.21±7.01; range 14.2–36.2 mmHg) than in Group 2 (14.95±3.6; range 8.3–22.9 mmHg and 14.33±3.84; range 6.3–21.7 mmHg) (p<0.001). IOP-GAT was correlated with IOPg (p=0.01). Conclusion: Intravitreal Ozurdex® injection effects IOP, while it has no significant effect on ECD. Ozurdex® injections changed corneal biomechanical properties such as CH and CRF. Thus, ORA may be a useful to avoid underestimating the IOP and missing the alteration of elastic properties of the cornea.

Purpose: Incidence of diabetes mellitus (DM) increases rapidly in our country as well as around the world, posing a serious threat to public health. Diabetic retinopathy (DR) is the most common microvascular complication in patients with DM since microvascular damage secondary to chronic hyperglycemia starts affecting retina in the early stages of the disease. Our aim is to evaluate the real-life outcomes of intravitreal aflibercept monotherapy in treatment naive cases with diabetic macular edema (DME). Methods: This study was retrospective case–control study. Medical charts of 75 treatment naive cases with DME were re- viewed retrospectively. A total of 127 eyes that received intravitreal aflibercept monotherapy between January 2017 and December 2018 in our Retina Unit were enrolled. Demographics and the results of their initial and all follow-up ophthalmo- logic examinations as well as the number and frequency of intravitreal shots were noted for each participant. Chi-square, Mann–Whitney U, and Wilcoxon signed-rank tests were used for statistical analysis. Results: Of the total 75 patients with a mean age of 61.2±10.4 years, 38 (50.7%) were male. Mean follow-up period was 10.2±6.3 months. Mean baseline best-corrected visual acuity and central macular thickness scores were 56.8±19.9 ETDRS let- ters and 397.8±162.4 μm, whereas they were found as 67.9±16.9 ETDRS letters and 311.0±116.8 μm at the last visit (p<0.001 and p<0.001, respectively). Aflibercept monotherapy was found to provide better anatomic prognosis in eyes with serous macular detachment (p<0.001), and better anatomic as well as functional prognosis in eyes without any concomitant vitre- omacular interface disorders (p=0.037 and p=0.042, respectively). Conclusion: Intravitreal aflibercept monotherapy proves to be an effective and reliable treatment option in treatment-naive DME cases, even in those with marked optical coherence tomography biomarkers indicating poor outcomes.

Objectives: We aimed to evaluate the Magnetic Resonance Imaging (MRI) histogram texture analyzis of the optic nerve by comparing patients of isolated optic neuritis with a healthy control group and to provide objective information without using contrast in the diagnosis of the disease. Methods: A total of 40 patients, including 20 patients with isolated optic neuritis (13 females, 7 males) and 20 healthy controls (11 females, 9 males), were included in the study. Non-contrast brain MR images of the patient and control groups were analyzed retrospectively. In the coronal T2-weighted MRI sequence of both groups, the Region of Interest (ROI) was placed in the extraocular anterior 1/3 of the optic nerve of both eyes. Numerical data were obtained using histogram analysis and the data were evaluated in the MATLAB program. The data were compared statistically. In addition, sensitivity and specificity were determined by Receiver Operating Characteristic (ROC) curve analysis. Results: As a result of histogram analysis, a significant difference was found between the mean values in the healthy and affected eye of the patients with isolated optic neuritis and the mean values of the control group (p < 0.05). A significant difference was found in standard deviation, minimum, maximum, median, variance values between both groups. ROC analysis was performed for mean value, AUC = 0.943 and when threshold value was selected as 354.258 Haunsfield Unit, two groups could be differentiated with 84.2% of sensitivity and 92.1% of specificity. We can say that patients with isolated optic neuritis also have histological effects on the clinically asymptomatic eye. Conclusions: Histogram analysis can be used in the diagnosis of the patients with isolated optic neuritis without the need to use contrast in their MRI. In addition, histological effect can be detected in the eye that does not show clinical symptoms with histogram analysis.

Objectives: The aim of this study was to determine the efficacy of mineralocorticoids in the treatment of ocular inflammation, whose potential use has not been assessed. Methods: Thirty-five New Zealand albino rabbits were used in the study. Rabbits were divided into five groups. Only one eye was used for experimental purposes and the other eye was used as control. 11-deoxycortisol, deoxycorticosterone acetate, fludrocortisone acetate, aldosterone and 11-deoxycorticosterone were studied in a rabbit model of ocular inflammation. All animals in a group received the same corticosteroid. Paired t-tests and analysis of variance between subjects (ANOVA) were used to evaluate efficacy. Results: The eyes treated with 11-deoxycortisol, deoxycorticosterone acetate, and fludrocortisone acetate had statistically significant lower fluorescence compared to control eyes. 11-deoxycortisol and deoxycorticosterone acetate provided a greater reduction in fluorescence compared to other corticosteroids. Conclusions: Topical use of corticosteroids, especially those with mineralocorticoid activity can decrease ocular inflammation in a rabbit model. Clinical application of topical mineralocorticoids in human ocular inflammation needs to be performed.

Objectives: Age-related liquefaction of vitreous humor may result in posterior vitreous detachment, retinal tear, and detachment. The purpose of this study is to determine the normative values of age-related changes in the vitreous in the normal population using different MRI sequences. Methods: A total of 180 eyes of 90 healthy cases were enrolled in this retrospective study. Patients were divided into nine groups according to age, and each group was of equal size with 10 patients(5 male and 5 female). The T1, T2, standardized T1, standardized T2 signals and ADC values determined for each vitreous humor of each eye. MRI parameters of the vitreous were compared within and between age groups. Results: No difference was detected within the decadic age groups for mean T1W for the right and left (p = 0.912 and p = 0.903, respectively), T2W for the right and left (p = 0.966 and p = 0.983, respectively), standardized T2W for the right and left (p = 0.915 and p = 0.899, respectively), and ADC for right and left values (p = 0.622 and p = 0.524, respectively). A significant difference was found between decadic age groups in terms of the standardized T1W values for right and left (p < 0.001 and p < 0.001, respectively). Standardized T1W values of vitreous fluid show a moderate degree of correlation with age for the right (r=0.514, p < 0.001) and left eyes (r=0.534, p < 0.001). Conclusions: This study provides comprehensive normative data on the different MRI signal properties of the human vitreous and its change with age. Using MRI, especially with standardized T1 measurements, age-related changes in the vitreous humor can be revealed non-invasively.

Increasing numbers of the papers indicate that SARS-CoV-2 also causes neurological symptoms; the underlying mechanism has not been elucidated yet. Hypothetic mechanisms to explain the CNS involvement of SARS-CoV-2 include the neurotropic mechanisms and the cytokine storm developing during the disease process. A middle age female patient applied to the emergency department with complaints of eye pain, a double, foggy, and blurred vision and a severe throbbing headache. The outward gaze was found to be limited in her right eye. Nasopharyngeal swab for SARS-CoV-2 RNA was positive, radiological findings were supported the COVID pneumonia and diffuse sinonasal inflammation. Cranial imaging showed thickening and contrast involvement in the cavernous sinus in the postcontrast series. While shortness of breath improved, and the headache was completely resolved on the 10th day of treatment the right eye outward gaze restriction was continued. The control MRI reveals a significant reduction in cavernous thickening and contrast enhancement and complete resolution in dural thickening. In our case of COVID, cranial nerve involvement and pansinusitis developed without cytokine storm findings suggests that the virus has spread to the cavernous sinuses and dura by regional neighborhood. Neurological symptoms may appear as the first symptom of COVID.

Bilateral herpetic keratitis is a rare event and can occur in atopy, measles, and immunodeficiency. Long-term use of systemic steroids for any autoimmune condition also creates iatrogenic immunodeficiency. A 62-year-old female with Pemphigus Foliaceus who had been on long-term steroids presented with bilateral epithelial herpetic keratitis. She received topical ganciclovir 5 times daily for a total of 10 days and intravenous (iv) acyclovir 5–10 mg/kg for 2 weeks for diffuse periocular skin involvement. In 2 weeks, corneal lesions completely disappeared with intact epithelium and no stromal involvement. Treatment was discontinued as no further ocular signs were observed. Peroral antiviral prophylaxis was not initiated since systemic steroids were also discontinued. Three months after resolution, she underwent bilateral cataract surgeries with per- operative and post-operative systemic prophylaxis during topical steroid use. Long-term systemic steroid use seems to be a predisposing factor for bilateral herpetic ocular infections.

We report the diagnosis and treatment process of a patient who underwent CyberKnife radiotherapy with diagnosis of optic nerve sheath meningioma (ONSM) to emphasize visual field recovery with an early treatment. A 46-year-old woman pre- sented with puffiness, discomfort, and enlargement in right eye. Right sided proptosis and optic disc edema were detected as accompanying findings. Visual acuity was 20/20 in both eyes. Blind spot enlargement and mild peripheral constriction were found on the right side of visual field test. The diagnosis was made on the basis of clinical and radiological findings. Magnetic resonance imaging demonstrated an ONSM. The lesion was treated by three fraction stereotactic CyberKnife ra- diation therapy with dose of 19.5 Gy. Visual acuity was preserved and visual field was completely recovered after 6 weeks of follow-up. Due to its typical clinical and radiological findings, ONSM can be diagnosed without tissue biopsy. In progressive cases, optic nerve functions may recover by CyberKnife radiation therapy performed before development of significant visual loss. However, patients should be observed for radiation complications.

Fungi are among the most common agents of microbial keratitis, especially in developing countries and tropical regions. Early diagnosis and appropriate antifungal treatment are critical for clinical success in fungal keratitis (FK). A 35-year-old female patient was referred to our hospital because of the diagnosis of keratitis with resistant to topical antibacterial treat- ment. Her visual acuity was counting fingers at one meter for the right eye. Biomicroscopic examination revealed a large, white keratitis center with peripherally extension on cornea. Fungal hyphae were observed in microscopic examination and a filamentous fungus was isolated in culture of the corneal scrapings. It was identified as Scedosporium apiospermum by both phenotypic and molecular methods. She was treated with topical and oral voriconazole according to susceptibility testing result. It is important to early diagnosis, determine the causative agent and perform a susceptibility testing in FK.

Bacillary layer detachment (BALAD) is a relatively new optical coherence tomography (OCT) finding described by the utili- zation of OCT and characterized by the separation within the photoreceptor inner segment. The most common ocular dis- eases associated with BALAD include Vogt-Koyanagi-Harada’s disease, neovascular age-related macular degeneration, and central serous chorioretinopathy, and it is frequently observed in inflammatory, infectious, traumatic, and mass lesions of the choroid. It usually has a benign course and can resolve spontaneously or with treatment in a very short time, accompanied by an increase in visual acuity. However, its prognostic significance is still contradictory, as studies with long-term follow-up have shown that BALAD is related with subretinal fibrosis. In this review, the anatomical definition, multimodal imaging findings, course, and prognosis of BALAD in various ocular diseases are discussed.

Purpose: To predict the post-operative visual outcome considering the pre-operative factors and macular hole (MH) indices based on hole configuration in OCT. Methods: Twenty-six eyes of 26 patients with full thickness MH (Stage II, III, and IV) were enrolled in this retrospective ob- servational study between June 2017 and April 2019. Preoperative morphological parameters of MH such as base and min- imum diameter, vertical height, left arm, and right arm length were calculated manually using the software in the cirrus optical coherence tomography (OCT) machine. MH Index (MHI), hole form factor (HFF), traction hole index, and diameter hole index were calculated and correlated with post-operative best-corrected visual acuity (VA) at last follow-up. 23-gauge pars plana vitrectomy, internal limiting membrane peeling with 12% C3F8 tamponade was performed in all patients and was followed up to 6 months postoperatively. Results: The median value of patient’s age, duration of symptoms, pre- and post-operative best corrected VA were 60 years, 9 months, 1.15 logMAR, 0.80 logMAR, similarly axial length, minimum hole diameter, base diameter of the MH, and central subfoveal macular thickness (CMT) were 22.8 mm, 646.5 μm, 736.5 μm, and 291 μm, respectively. Post-operative visual out- come after MH surgery is better in patients with MHI ≥0.5, HFF ≥0.9, and CMT ≥300 μm. Conclusion: Pre-operative measurement of MH indices calculated from OCT images can be a prognostic factor in determin- ing the post-operative visual outcome of MH surgery.