Thyroid Orbitopathy (TO) is characterized by exophthalmos, palpebral retraction and compressive optic neuropathy (CON) in the more severe cases. Orbital decompression surgery is carried out in these cases to preserve vision. The study presents a 56 year old masculine patient, who is a smoker with hypertension. In 2009, he was diagnosed with Graves' disease with a slight TO that progressed to severe TO with CON, after he was treated with radioactive Iodine to control hyperthyroidism. An orbital compression surgery by nasal endoscopy was carried out with excellent visual and aesthetic results. Objectives: To show the results of the orbital decompression by endonasal endoscopy, besides the analysis of the complications and factors associated with TO progression in this patient. Results: The results of the surgery were satisfactory, as regard to the exophthalmos and the intraocular pressure decrease plus the visual acuity, colour vision and visual field improvement. He suffers strabismus after surgery. Conclusion: We concluded that the surgery results were satisfactory in this patient and strabismus was a complication after surgery. Smoking and iatrogenic hypothyroidism were the factors worsening the thyroid orbitopathy.

Introduction The present study intended to analyze the presence of refractive errors and strabismus at 3 years of age in a Portuguese population of ex-preterm infants with gestational age (GA) less than or equal to 32 weeks, as well as research potential risk factors for its occurrence. Material and methods Retrospective analysis of clinical charts from ex-preterm infants with GA less than or equal to 32 weeks, who were born in Centro Hospitalar de Entre Douro e Vouga – Unidade de São Sebastião (CHEDV-USS), Santa Maria da Feira, Portugal, between 2001 and 2007, and who were observed by the Ophthalmology Department. Data on neonatal history (GA, birth weight, duration of hospitalisation, duration of oxygen supplementation and a history of retinopathy of prematurity - ROP) as well as on the presence of refractive errors and strabismus at 3 years of age was collected. Results The study included 58 ex-preterm infants with a mean GA of 29 weeks. At 3 years of age, the prevalence of refractive errors was 5,17% for significant myopia, 10,34% for significant astigmatism and 5,17% for anisometropia. Strabismus was found in 18,97% of children. Almost one quarter (24.14%) of these ex-preterm infants were known to have significant ametropia and/ or strabismus. The duration of oxygen supplementation was found to be statistically significant in the development of myopia (p=0.0033) and anisometropia (p=0.0033) at 3 years of age. Discussion The results showed a high prevalence of ambliogenic risk factors in former premature infants at 3 years of age. Ophthalmic surveillance protocols of this group of children should assess the presence of ambliogenic risk factors in a systematic and periodic fashion, in order to address these changes as early as possible and prevent/ treat a potential amblyopia. Resumo Introdução Pretende-se estudar a presença de ametropias e estrabismo aos 3 anos de idade numa população portuguesa de ex-prematuros com idade gestacional (IG) igual ou inferior a 32 semanas, assim como pesquisar possíveis factores de risco para a sua ocorrência. Material e Métodos Estudo retrospectivo dos processos clínicos de ex-prematuros com IG igual ou inferior a 32 semanas nascidos no Centro Hospitalar de Entre Douro e Vouga – Unidade de São Sebastião (CHEDV-USS), Santa Maria da Feira, Portugal, entre 2001 e 2007, e que foram observados pelo Serviço de Oftalmologia. Foram recolhidos dados relativos aos antecedentes neo-natais (IG, peso ao nascer, número de dias de internamento, número de dias de oxigénio suplementar e antecedentes de retinopatia da prematuridade - ROP) e presença de ametropias e estrabismo aos 3 anos de idade.

We performed a prospective study in 137 patients between the ages of 1 and 19 first seen in our department of ophthalmology, which were referred to as carriers or be in the study of rheumatic disease. All patients underwent complete eye examination, 78 were female and 59 were men. 106 patients had active lesions, 101 of them anterior uveitis, 67 of them uveitis was bilateral in 34 was unilateral; cataract was found in 2 patients (1 unilateral and 1 bilateral), adhesions in 3 patients (1 unilateral and 2 bilateral ), 31 active patients showed alterations. The youngest patient who presented active lesions was a girl one year, which was found anterior uveitis.

Objective: To determine the effectiveness of treatment of myopic anisometropia with the Artisan^TM or Artiflex^TM phakic intraocular lens and refractive surgery in the Ophthalmological Cuban Institute Ramón Pando Ferrer between June 2008 and June 2010. Methods: The cohort consisted of 50 patients with myopic anisometropia in whom an Artisan^TM or Artiflex^TM phakic intraocular lens was implanted in the more myopic eye with and in whom the other eye was treated with LASEK. The sphere and refractive cylinder, uncorrected visual acuity and best corrected visual acuity, endothelial cell density, contrast sensitivity testing, and the binocular vision testing were analyzed as variables prior to surgery and 12 months later. Results: Sphere and refractive cylinder were corrected significantly. Uncorrected visual acuity was increased to 0.7 in the eye with phakic intraocular lens and to 0.9 in the eye treated with LASEK. Best corrected visual acuity increased to 0.9 and 1.0 respectively. Contrast sensitivity was recorded at 3 months of postoperative. 70% of cases before the surgery were had stereopsis, and of the 30% remaining, 16% achieved stereopsis in the post-operative period. Conclusions: The combined use of Artisan^TM or Artiflex^TM phakic intraocular lens and treatment with excimer laser were effective in the treatment of myopic anisometropia. Both sphere and refractive cylinder were reduced, and the majority of patients achieved stereopsis. Resumen Objetivo: Determinar la efectividad del tratamiento de la anisometropía miópica con el implante del lente fáquico Artisan^TM o Artiflex^TM y la cirugía refractiva láser en el Instituto Cubano de Oftalmología “Ramón Pando Ferrer” en el período de junio del 2008 a junio del 2010. Método: El universo estuvo constituido por un total de pacientes (50) con anisometropía miópica a los cuales se les implantó el lente fáquico de soporte iridiano en el ojo de mayor miopía y se corrigió el ojo contralateral utilizando la técnica de LASEK. Se analizaron como variables la esfera y cilindro refractivo, la mejor agudeza visual sin corrección y corregida, la densidad celular tomada por microscopía endotelial, la sensibilidad al contraste y estudios de visión binocular en el preoperatorio y a los 12 meses de las cirugías. Resultados: En el postoperatorio se obtuvo una corrección significativa de la esfera y el cilindro refractivo, la agudeza visual sin corrección se elevó en el ojo del lente fáquico y el ojo con LASEK a 0.7 y 0.9 respectivamente y la corregida a 0.9 y a 1.0. La sensibilidad al contraste se recuperó a partir de los tres meses del postoperatorio. El 70% de los casos en el preoperatorio tenían estereopsia. Del 30% restante, un 16% logró estereopsia en el postoperatorio. Conclusiones: La combinación del lente fáquico Artisan^TM o Artiflex^TM y el tratamiento con Excimer Láser para tratar la anisometropía miópica, resultó efectiva al reducir la esfera y el cilindro refractivo en ambos ojos y lograr estereopsia en la mayoría de los pacientes.

Purpose: To review the epidemiology, clinical features, diagnosis, and management of patients with fungal keratitis. Methods: Review of the literature and summary of personal experience. Results: Fungi may be part of the normal external ocular flora but are found with greater frequency in diseased eyes. Trauma is the most frequent risk factor and often occurs outdoors and involves plant matter. The Gram and Giemsa stains are the most common stains used for the rapid identification of fungi. The only commercially available topical antifungal in the United States is natamycin 5% and it is therefore the first line treatment in most cases. The length of time required for topical treatment is on average 4 to 6 weeks but must be titrated based on clinical response. The most common surgical approach to fungal keratitis is daily debridement with a spatula or blade. Approximately one-third of fungal infections need additional surgical intervention, most commonly in the form of a therapeutic penetrating keratoplasty. The prognosis of fungal keratitis depends on the depth and size of the lesion; small superficial infections respond well to topical therapy. Deep stromal infections and infections with concomitant scleral or intraocular involvement are much more difficult to eradicate. Conclusions: The diagnosis of fungal keratitis can be quite challenging, and treatment requires prolonged antifungal therapy often combined with surgical intervention in the form of penetrating keratoplasty, conjunctival flap, or cryotherapy.