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Öğe Anthrax in upper eyelid [Üst göz kapa?inda şarbon](2013) Köktekir B.E.; Sümer Ş.; Gedik Ş.; Okudan S.Anthrax is an acute infection caused by Bacillus anthracis. Although it is a zoonotic disease that mainly affects herbivorous animals, it might also be contagious to humans by infected animals. The most common type is skin anthrax. When eyelid is involved; echymosis, bulla formation and necrosis can be observed. We report a 75 years old woman presenting with bilateral extensive lid echymosis and edema and diagnosed as anthrax. The clinical findings resolved with appropriate systemic and topical antibiotic treatment, and the lesions on the eyelid resulted with scatrizating ectropion. In failure of early diagnosis and treatment, there is a high risk of mortality and sequela with this particular disease which rarely involves eyelids.Öğe The effects of smoking on anterior segment parameters, retinal nerve fiber layer, and pupillary functions [Sigarani{dotless}n ön segment parametreleri, retinal sinir lifi tabakasi{dotless} ve pupil fonksiyonlari{dotless} üzerine etkileri](Turkish Ophthalmology Society, 2014) Köktekir B.E.; Gönül S.; Bakbak B.; Gedik S.; Marako?lu K.Objectives: To evaluate the alterations in the anterior segment parameters, retinal nerve fber layer, and pupillary functions in smokers. Materials and Methods: In this case-control study, 45 eyes of 45 smokers and 45 eyes of 45 non-smoker control subjects were evaluated. All patients underwent measurement of anterior segment parameters with optical low coherence refectometry (OLCR), mesopic and photopic pupillary diameter with an aberrometer device, retinal nerve fber layer thickness with optical coherence tomography, and dry-eye assessment with Schirmer's test. The results were compared with independent t-test by SPSS 16.0 Inc., and a p-value lower than 0.05 was determined as signifcant. Results: There was a signifcant difference between both groups in terms of mesopic pupil diameters that were measured with both OLCR and aberrometer device (p=0.03 and 0.02, respectively). Schirmer scores were also signifcantly decreased in smokers (p=0.001). The other measured parameters demonstrated no difference between smokers and non-smokers (p>0.05 for all). Conclusion: Smoking may affect pupillary functions, especially the mesopic pupillary diameter, and may cause a defciency in pupil response under dark circumstances.Öğe Is it possible to replace automated keratometry with current devices: Comparison with lenstar and OPD II [Yeni cihazlar otomatize keratometre yerine kullanılabilir mi? Lenstar ve OPD ile karşılaştırılması](Turkish Ophthalmology Society, 2013) Köktekir B.E.; Gedik S.; Bakbak B.; Gönül S.; Do?an O.K.Purpose: To compare the keratometry results obtained with optical low-oherence reflectometer, corneal topography, and automated keratometry readings and to assess the interexaminer reproducibility of each device. Ma te ri al and Met hod: This comparative study examined 65 eyes of 65 healthy subjects. Detailed ophthalmic examination was performed in all cases following keratometry measurements with a KR 8100A (Topcon, Japan), an OPD Scan II (Nidek, Japan), and a LenStar LS900 (Haag-Streit, Switzerland). Patients with spheric values over ±3.0D or cylindric values over ±1.0D and with history of chronic ocular/systemic disease or contact lens usage were excluded from the study. The keratometry readings were compared by using ANOVA test (SPSS 16.0). A p-value lower than 0.05 was taken as statistically significant. Bland-Altmann analysis was used to demonstrate agreement between methods, and Spearman rank correlation coefficient (r) was calculated for the correlation. To assess the interexaminer reproducibility, intraclass correlation coefficient was calculated in 30 eyes for each device. Re sults: The mean age of the 65 patients enrolled in the study was 21.9±3.25 years. The mean keratometric values obtained with the autorefractokeratometer, OPD Scan II, and LenStar LS 900 were 43.30±1.47, 43.42±1.44, and 43.29±1.42 respectively. No statistically significant difference was observed among the three groups (p=0.840). Interexaminer intraclass correlation was found as 78.9%, 99.9%, and 99.7% for ARK, OPD, and LenStar, respectively. Dis cus si on: LenStar has provided comparable and well-correlated keratometry measurements in comparison with automated keratometer and corneal topography.Öğe Optical coherence tomography findings in patients with Wolfram syndrome [Wolfram sendromlu hastalarda optik koherans tomografi bulgulari{dotless}](Turkish Ophthalmology Society, 2014) Köktekir B.E.; Bakbak B.; Gönül Ş.; Gedik Ş.Objectives: To report the optical coherence tomography (OCT) fndings in patients with Wolfram syndrome. Materials and Methods: Four patients who fulfilled the criteria for Wolfram syndrome were recruited to the study. In all patients, OCT was performed with Stratus OCT (OCT-3, Carl Zeiss Meditec, Inc. Germany). The fast retinal nerve fiber layer (RNFL) and fast macular thickness protocols were used to measure the RNFL and macular thickness, respectively. The fast optic disc protocol was used to determine the cup-to-disc ratios of the optic disc. All patients were examined with VEP (Retimax, CSO Strumenti Oftalmici, Florence, Italy). Results: In eight eyes of four patients (3 male and 1 female) with a mean age of 18.5±2.08 years (range 16-21 years), RNFL, macular thickness, and cup-to-disc ratios were determined. The mean RNFL was 42.2±5.6 ?m (range 34.1-49.5 ?m), while the mean macular thickness and cup-to-disc ratios were 145±15 ?m (range 125-160 ?m) and 0.79±0.07 (range 0.7-0.92), respectively. There was a moderate negative correlation between VEP latencies and macular and RNFL thicknesses (Spearman correlation coefficient was -0.23 and -0.34, respectively). Conclusions: RNFL loss and secondary optical atrophy are severe complications that may affect the visual acuity in patients with Wolfram syndrome. Retinal changes in these patients may be quantified and can be observed using OCT.Öğe Painful ophthalmoplegia manifesting with third nerve palsy in childhood [Çocukluk ça?ında üçüncü sinir felci i?le seyreden a?rılı oftalmopleji](Turkish Ophthalmology Society, 2012) Köktekir B.E.; Gedik S.; Bakbak B.The causes of painful ophthalmoplegia that manifests with third nerve palsy in childhood include postinfectious third nerve palsy, compressive lesions, vascular anomalies and ophthalmoplegic migraine. Ophthalmoplegic migraine is a rare pathology in the literature and is characterized by recurrent attacks of headache and ophthalmoplegia that usually begins during childhood. Ophtalmoplegia occurs due to paresis or paralysis of cranial nerves 3, 4 or 6. Attacks may last a few hours to weeks and usually are recovered with appropriate therapy, but some cases may demonstrate permanent defects. In this paper, we discuss the case of an 11-year-old patient, who was admitted to our outpatient clinic with the complaints of right ptosis, mydriasis and severe headache. Ophthalmologic examination revealed oculomotor nerve palsy, the patient was diagnosed as having ophthalmoplegic migraine and medical treatment was started. Her complaints have regressed with medication for migraine and recovered completely in 8 weeks. In this case report, painful ophthalmoplegia during childhood and its possible causes are discussed.Öğe Tonic pupil following traumatic hyphema: Case report [Travmatik hifema sonrası gelişen tonik pupilla: Olgu sunumu](Turkish Ophthalmology Society, 2013) Gönül S.; Köktekir B.E.; Bakbak B.; Gedik S.; Beyo?lu A.A 7-year-old girl was admitted to our clinic after crash injury with air gun pellet in her right eye. There was an intense anterior chamber reaction and hyphema on the biomicroscopic examination. During the control examination after treatment of hyphema including cyclopentolate 1%, prednisolone acetate 1% and lomefloxacin 0.3%, anisocoria and mydriasis in the right eye were observed and the difference between both pupils was less in darkness. The case was diagnosed as tonic pupil following trauma, and diluted pilocarpine 0.125% test was performed. On diluted pilocarpine test, right pupil responded excessively to pilocarpine compared with the other pupil. As in our case, in cases with anisocoria following blunt trauma to orbit, tonic pupil should be keep in mind.
