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Poster 42 - Ocular and Physical Manifestations of Juvenile Xanthogranuloma
symptom frequency scales revealed a greater reduction in mean frequency of dryness (1.00 vs. 0.54), scratchiness (1.47us. 0.13),grittiness (0.73 vs. 0.07), and foreign body sensation (0.80 vs. 0.34) for subjects using Drop 1 compared to those using Drop 2. Also, subjects using Drop 1 more strongly agreed with comfort statements than subjects using Drop 2 (e.g., "drops provide long-lasting comfort"; Drop 1 = 80%, Drop 2 = 40%). Conclusion: The novel lubricating eye drop was more effective at reducing both signs and symptoms associated with moderate dry eye compared to a comparator artificial tear. (Investigator was reimbursed for study-related costs by Alcon Laboratories, Inc., Fort Worth, Texas.)
POSTER 42 Ocular and Physical Manifestations of Juvenile Xanthogranuloma Wn C. Tea, O.D. and Nimali Patel, O.D. Nova Southeastern University, College of Optometry, 3200 South University Drive, Ft. Lauderdale, Florida 33328
Background: Juvenile xanthogranuloma UXG) is a relatively rare pediatric skin disorder that manifests as asymptomatic smooth, round, yellowish papules that can occur anywhere on the skin, eyes, and viscera. Although rare, cases of ocular JXG have been reported without skin lesions. The eye is the most frequent site of extracutaneous involvement. Ocular manifestations may include eyelid and conjunctival lesions, iris heterochromia, iris and ciliary body masses, spontaneous hyphema, uveitis, cataract, unilateral glaucoma, and retinal detachments. Case Report: S.G., an &year-old boy, was seen at the Nova Southeastern University College of Optometry Eye Institute on February 3, 2004. His mother reported a history of cutaneous juvenile xanthogranuloma during infancy and wanted to rule out any ocular findings suggesting recurrence of the disease. Best-corrected visual acuity was 20120 O.D. with + 2.50 -0.75 x 010 and 20140 O.S. with -3.25 -2.00 x 160. Anterior-segment evaluation with assessment of the conjunctiva and iris revealed no pathology. Accommodation and binocular vision skills were adequate. Color vision and pupil testing was unremarkable and a careful dilated fundus evaluation revealed no pathology. Of concern was VOLUME 75lNUMBER 61JUNE 2004
the reduced best-corrected acuity in the left eye. Although the boy had an anisometropic refractive condition with high enough astigmatism to suggest refractive amblyopia in the left eye, ocular JXG is a unilateral disease that could have manifested visual complications obscured by the presence of the amblyogenic refractive error. He was treated for refractive amblyopia and will be carefully monitored for any worsening of visual acuity or development of new xanthogranulomas Conclusion: Juvenile xanthogranuloma is a pediatric skin disorder that can have ocular manifestations, but has seldom, if ever, been mentioned in optometric literature. This poster discusses the management of a unique child with both amblyopia and a history of JXG. Additionally, a review of JXG and its differential diagnoses is provided. Photographs of skin and ocular lesions will serve to introduce optometry to this rare disorder mostly managed by dermatologists and ophthalmologists.
POSTER 43 Atypical Use of an Ahmed Valve to Treat Silicone Oil-induced Secondary Glaucoma Nicole Monroe, 0 .D.aand Kristopher A. May, 0 .D.b aColdwater Vision Center, 412 Central Avenue, Coldwater, Mississippi 38618 and bSouthern College of Optometry, 1245 Madison Avenue, Memphis, Tennessee 38104
Background: Silicone oil is used in surgical repair of complicated retinal tears and detachments that require longer-acting tamponade than perfluorohexane or perfluoropropane gases can provide. Silicone oil has the advantage of long duration of action and does not require prone-head position, as required by gas bubbles. To prevent pupillary block by anterior migration of the oil, an inferior peripheral iridectomy is performed during surgery. However, secondary glaucoma has been reported in as many as 18.5% of cases. Silicone oilinduced secondary glaucoma is primarily due to oil emulsification, a closed inferior iridectomy, or oil bubbles in the anterior chamber and trabecular structures. Secondary glaucoma treatment modality and success vary by case and causation. Case Report: J.M., a 65-year-oldman underwent multiple retinal detachment repairs due to proliferative vitreoretinopathy (PVR). After OPTOMETRY
POSTER 42 Ocular and Physical Manifestations of Juvenile Xanthogranuloma Wn C. Tea, O.D. and Nimali Patel, O.D. Nova Southeastern University, College of Optometry, 3200 South University Drive, Ft. Lauderdale, Florida 33328
Background: Juvenile xanthogranuloma UXG) is a relatively rare pediatric skin disorder that manifests as asymptomatic smooth, round, yellowish papules that can occur anywhere on the skin, eyes, and viscera. Although rare, cases of ocular JXG have been reported without skin lesions. The eye is the most frequent site of extracutaneous involvement. Ocular manifestations may include eyelid and conjunctival lesions, iris heterochromia, iris and ciliary body masses, spontaneous hyphema, uveitis, cataract, unilateral glaucoma, and retinal detachments. Case Report: S.G., an &year-old boy, was seen at the Nova Southeastern University College of Optometry Eye Institute on February 3, 2004. His mother reported a history of cutaneous juvenile xanthogranuloma during infancy and wanted to rule out any ocular findings suggesting recurrence of the disease. Best-corrected visual acuity was 20120 O.D. with + 2.50 -0.75 x 010 and 20140 O.S. with -3.25 -2.00 x 160. Anterior-segment evaluation with assessment of the conjunctiva and iris revealed no pathology. Accommodation and binocular vision skills were adequate. Color vision and pupil testing was unremarkable and a careful dilated fundus evaluation revealed no pathology. Of concern was VOLUME 75lNUMBER 61JUNE 2004
the reduced best-corrected acuity in the left eye. Although the boy had an anisometropic refractive condition with high enough astigmatism to suggest refractive amblyopia in the left eye, ocular JXG is a unilateral disease that could have manifested visual complications obscured by the presence of the amblyogenic refractive error. He was treated for refractive amblyopia and will be carefully monitored for any worsening of visual acuity or development of new xanthogranulomas Conclusion: Juvenile xanthogranuloma is a pediatric skin disorder that can have ocular manifestations, but has seldom, if ever, been mentioned in optometric literature. This poster discusses the management of a unique child with both amblyopia and a history of JXG. Additionally, a review of JXG and its differential diagnoses is provided. Photographs of skin and ocular lesions will serve to introduce optometry to this rare disorder mostly managed by dermatologists and ophthalmologists.
POSTER 43 Atypical Use of an Ahmed Valve to Treat Silicone Oil-induced Secondary Glaucoma Nicole Monroe, 0 .D.aand Kristopher A. May, 0 .D.b aColdwater Vision Center, 412 Central Avenue, Coldwater, Mississippi 38618 and bSouthern College of Optometry, 1245 Madison Avenue, Memphis, Tennessee 38104
Background: Silicone oil is used in surgical repair of complicated retinal tears and detachments that require longer-acting tamponade than perfluorohexane or perfluoropropane gases can provide. Silicone oil has the advantage of long duration of action and does not require prone-head position, as required by gas bubbles. To prevent pupillary block by anterior migration of the oil, an inferior peripheral iridectomy is performed during surgery. However, secondary glaucoma has been reported in as many as 18.5% of cases. Silicone oilinduced secondary glaucoma is primarily due to oil emulsification, a closed inferior iridectomy, or oil bubbles in the anterior chamber and trabecular structures. Secondary glaucoma treatment modality and success vary by case and causation. Case Report: J.M., a 65-year-oldman underwent multiple retinal detachment repairs due to proliferative vitreoretinopathy (PVR). After OPTOMETRY