Purpose: To compare 2 automated devices for measuring the horizontal corneal diameter [white-to-white (WTW) distance]. Methods: In this prospective comparative case series, the WTW distance was measured by independent examiners using the Pentacam HR and the Orbscan IIz in 101 eyes of 101 healthy refractive surgery candidates. Statistical evaluation was performed using the paired t test, Pearson correlation, and the Bland–Altman method for comparison of measurement techniques. Results: The mean WTW distance measurements were 11.76 ± 0.38 mm as obtained with the Pentacam HR and 11.66 ± 0.37 mm as obtained with the Orbscan IIz (P < 0.001). The measurements were highly correlated (Pearson correlation coefficient = 0.948; P < 0.001). The 95% limits of agreement for the Pentacam HR versus the Orbscan IIz were −0.14 to 0.33 mm. Conclusions: The observed differences in WTW distance readings between the Pentacam HR and the Orbscan IIz are not clinically relevant, and the 2 devices could be used interchangeably in clinical practice.

To compare the anterior and posterior elevation measurements above the best-fit sphere (BFS) between the Galilei (dual-Scheimpflug) and Pentacam (single-Scheimpflug) systems in candidates for refractive surgery. Poostchi Ophthalmology Research Center, Shiraz, Iran. In this prospective study, both eyes of consecutive patients were examined with the 2 imaging systems. The anterior and posterior BFS and the central and maximum elevation measurements in each of 4 quadrants were compared between the dual-Scheimpflug system and the single-Scheimpflug system. Bland-Altman plots were used to evaluate the agreement in the measurements between the imaging systems. The study comprised 31 patients (62 eyes). The mean radius of the anterior BFS measurement was 7.72 mm +/- 0.21 (SD) with the dual-Scheimpflug system and 7.83 +/- 0.21 mm with the single-Scheimpflug system. The mean radius of the posterior BFS was 6.37 +/- 0.18 mm and 6.47 +/- 0.19 mm, respectively. On the anterior and posterior elevation maps, the single-Scheimpflug system led to statistically significantly higher measurements than the dual-Scheimpflug system in the central, inferior, and temporal elevations (P<.001). Bland-Altman plots showed more agreement between the systems in anterior elevation measurements than in posterior elevation measurements. In refractive surgery candidates with healthy eyes, the elevation map measurements with the single-Scheimpflug system were significantly different from those with the dual-Scheimpflug system in most aspects and therefore may lead to misinterpretation of clinical data that could alter clinical decisions if the 2 imaging systems are considered interchangeable.

To report a case of fungal keratitis caused by Paecilomyces lilacinus (P. lilacinus) associated with a retained intracorneal hair. A 61-year-old man developed pain, decreased vision, hyperemia, and corneal infiltrates in his right eye without any predisposing factor. An intracorneal hair had migrated superiorly in the corneal stroma, giving rise to 3 separate stromal infiltrates. The patient demonstrated a waxing and waning course over several months despite antimicrobial and steroid therapy. Histopathologic examination of a corneal biopsy specimen disclosed the presence of fungal elements, and intensive antifungal therapy was initiated. Verticillium sp. was initially identified as the causative organism, but after failure to improve on topical natamycin, subsequent investigations demonstrated the pathogen to be P. lilacinus that was resistant to routine antifungal agents. The patient was then initiated on systemic voriconazole and terbinafine. He responded well to treatment and ultimately recovered a best-corrected visual acuity of 6/15 in the affected eye. This is the first case of P. lilacinus keratitis associated with a retained intracorneal hair. Hair in the cornea could be a predisposing factor for this infection. Early corneal biopsy should be considered to properly diagnose and manage atypical keratitis and to prevent further complications.

Purpose: To evaluate the clinical and epidemiological characteristics of children with ocular trauma. Materials and Methods: We retrospectively reviewed the medical records of 278 children (aged 15 years or less) hospitalized with ocular injuries and treated as inpatients at a tertiary referral center in Shiraz, Iran, from 2005 to 2008. Nominal variables were evaluated with a Chi-square test. A P -value less than 0.05 indicated statistical significance. Results: The cohort was comprised of 205 (74%) males, outnumbering females by a ratio of 2.81/1. The mean age was 7.6 ± 3.96 years. Rural residents comprised 125 (45%) of the cohort. Sharp objects caused ocular injury in 211 (76%) cases, and 207 (74%) cases had open-globe injuries. The lens was injured in 62 (30%) cases at initial examination and 89 (43%) patients according to ultrasound examination ( P = 0.006). Twenty-eight cases (10%) developed post-traumatic endophthalmitis. Endophthalmitis was associated with needle injury [odd ratio (OR) = 19.25] and presence of intraocular foreign body (OR = 3.48). Visual acuity of patients with closed-globe injuries was 20/200 or better on both initial and final examinations. Visual acuity of patients with open-globe injuries were in the range of light perception to 20/200. Conclusions: Trauma is an important cause of childhood ocular morbidity in southern Iran. Playing with sharp objects is an important cause of ocular trauma in children, and most injuries can be prevented by careful supervision.