Purpose: Several energy drinks containing a high content of caffeine are widely consumed among young adults. We examined the effects of caffeinated energy drinks on intraocular pressure (IOP) and blood pressure (BP) in healthy young subjects. Methods: In this prospective randomized, case-controlled cross over study conducted, from August to September of 2014, 40 healthy young volunteers (80 eyes) in their 20's and 30's drank 2 types of beverage each consumed after a 3-month washout period. The study participants were randomly given the caffeinated energy drink (group I, n = 20) or caffeine-free drink (group II, n = 20), IOP and BP were measured at 0, 30, 60, 90, and 120 minutes and 12 and 24 hours after beverage consumption. Results: In group I, the mean ± standard deviation (SD) of IOP at baseline was 13.2 ± 1.56 mm Hg and the IOP increased until 24 hours after drink consumption. IOPs at 30, 60, 90, and 120 minutes and 12 and 24 hours after drinking caffeinated energy drink were 14.45 ± 2.12, 14.93 ± 2.02, 14.85 ± 1.55, 14.2 ± 1.34, 14.25 ± 1.74, and 13.35 ± 1.61, respectively and statistically significant at 30, 60, 90, 120 minutes and 12 hours (p < 0.05). A corresponding increase in BP after drinking the caffeinated energy drink was observed but without statistical significance. Drinking the caffeine-free beverage did not affect IOP or BP significantly. Conclusions: IOP increases after consuming the caffeinated energy drink were statistically significant at 30, 60, 90, and 120 minutes and 12 hours. Therefore, caffeinated energy drinks may not be recommended for glaucoma patients or glaucoma suspects.

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Purpose:To report a case of pediatric medial wall blowout fracture with entrapment of medial rectus muscle which can be easily misdiagnosed as a cerebral lesion. Case summary: A 16-year-old male visited our clinic with headache, severe restriction of his right eye movement, and diplopia after a head injury due to falling occurring 1 day before evaluation. The patient was inebriated at the time of the accident and could not recall the event but occipital hematoma was palpable. Periorbital ecchymosis or edema was not observed with minimal soft tissue injury except mild conjunctival injection on slit-lamp examination. The patient had an 18 prism diopter exodeviation at primary position and severe medial and mild lateral gaze limitation in his right eye. Brain magnetic resonance imaging (MRI) showed no specific cerebral findings although trapdoor orbital medial wall fracture with incarceration of soft tissue and medial rectus muscle at the medial wall fracture site of his right eye was observed. Within 48 hours from the first evaluation, the blowout fracture was repaired and 50 days postoperatively, right eye gaze limitation and diplopia were nearly recovered. Conclusions: A case of pediatric blowout fracture with uncertain injury location, periocular ecchymosis, or edema absent could be misdiagnosed as a cerebral lesion. If a pediatric patient is experiencing gaze limitation, diplopia, nausea, or vomiting after trauma, neurological examination as well as evaluation for blowout fracture should be performed. J Korean Ophthalmol Soc 2015;56(6):961-966Key Words: Entrapment of medial rectus muscle, Pediatric medial wall blowout fracture, White-eyed blowout fracture ￭

Purpose To determine the different clinical findings between good and poor prognosis group which is diagnosed with branch retinal artery obstruction(BRAO) and treated with conservative care. We evaluate the average macular thickness, foveal thickness, outer nuclear layer(ONL) on optical coherence tomography(OCT) and retinal artery diameter in both groups. Methods 9 eyes(9 patients) in patients with non‐complicated BRAO with good prognosis and a poor prognosis control group with non‐complicated BRAO of 11 eyes(11 patients) were used in this study. The average macular thickness, foveal thickness and ONL thickness at the center of fovea on OCT were measured. And branch retinal artery widths were measured by a semi‐automated retinal vessel width measurement system retrospectively. Results The average age of the patients was 67.3 ± 11.5 years. The average ONL thickness at the central fovea of the good prognosis group was significantly thicker than that of the control group (p = 0.016). There were no statistically significant result at average macular thickness and foveal thickness. In good prognosis group, Ischemic retinal artery diameter and Central retinal artery equivalent(CRAE) were wider than those of poor prognosis group and they were statistically significant (p = 0.028, p = 0.01). Conclusion In the patients diagnosed with BRAO and treated with conservative care, foveal thickness, ischemic retinal artery diameter and CRAE were statistically significant between good and poor prognosis groups. In the patients diagnosed with BRAO, foveal thickness and retinal artery diameter could be prognostic factors that predict visual prognosis.

Purpose: To evaluate the degree of eyelid deformation and satisfaction after direct closure in patients with 40-70% eyelid defects after resection of an eyelid malignant tumor. Methods: We retrospectively reviewed the clinical records of patients diagnosed with eyelid malignant tumors between January 2009 and June 2016, who were treated with resection of 40-70% of the eyelid, followed by reconstructed direct closure only or by direct closure with lateral canthotomy and cantholysis. Age, sex, diagnosis, tumor location, satisfaction, and complications were analyzed, and the ratio of horizontal width ratio and vertical height ratio were compared before and after surgery. Results: The results of satisfaction were: 12 patients (60%), very good; five patients (25%), good; and three patients (15%), fair. The average preoperative horizontal width ratio and vertical height ratio were 1.03 ± 0.01 and 1.08 ± 0.30, respectively. The average postoperative horizontal width ratio and vertical height ratio were 1.04 ± 0.08 and 1.01 ± 0.17, respectively There was no significant difference in horizontal width ratio or vertical height ratio before and after surgery (p = 0.314 and p = 0.087, respectively). Conclusions: Eyelid reconstruction with a direct closure can be performed without a flap or graft for 40-70% of eyelid defects when resecting the eyelid of a malignant eyelid tumor.