PRESENTATION: A 23-year-old healthy male presented to our outpatient department with complaint of foreign body sensation and a painless, red mass on the nasal side of his right eye, which he had noticed approximately six months before. It had gradually increased to attain its present size. . .

Purpose: To evaluate and compare the results of different surgical methods for post-trabeculectomy bleb revision at Labbafinejad Medical Center, Tehran-Iran, from 1999 to 2003.Methods: This study was conducted on all patients who underwent post-trabeculectomy bleb revision due to hypotony [intraocular pressure (IOP) less than 6 mmHg] or bleb leakage. Surgical methods were: Conjunctiva advancement. rotational Conjunctiva flap and free Conjunctiva graft. Bleb revision was performed in the cases of bleb leakageif the bleb hole was greater than 1mm or leakage could not be controlled within 1 to 2 weeks of conservative treatment. Bleb revision was performed in eyes with hypotony in cases with cataract development or progression or hypotony maculopathy or iridocomeal adhesion. Surgical success was defined as IOP between 6-21mmHg with a maximum of 2 topical antiglaucoma medications and discontinuation of leakage.Results: Twenty-seven eyes of 27 patients (17male, 10 female) with meanage of 37.8±15.2 years (9-37 years) were studied. Indication for surgery was bleb leakage in 22 cases (81.5%) and hypotonous maculopathy in 5 cases (18.5%). Mean IOP was 4.4±1.04mmHg preoperatively and 13.00±1.29mm Hg postoperatively. (P<0.001) Mean visual acuity was 0.9 LogMAR (20/160) before surgery and reached 0.6 LogMAR (20/80) after bleb revision. (P<0.002) Mean cup/disc ratio was 0.7 preoperatively which remained unchanged postoperatively. Conjunctival advancement was performed in 18 cases (success rate=72.2%). rotational Conjunctival flap in 6 cases (success rate=66.7%) and free Conjunctiva graft in 3 cases (success rate=66.7%). (P=0.73) Bleb revision was repeated in 2 cases due to continuous leakage. Mitomycin-C (MMC) and 5-fluorouracilhad been used during primary trabeculectomy in 62% and 7.6% of cases. respectively. In 19.6% of cases surgery was done without using ant metabolites and usage of ant metabolites was unknown in 11%.The average time between primary trabeculectomy and bleb leakageor hypotonia was 17 monthsin cases with prior use of MMC and 52 months in the cases with no antimetabolite usage (P<0.05).Conclusion: Post-trabeculectomy bleb revision using Conjunctiva seems to be a successful method for control of leakage and prevention of complications of hypotony.

An asymptomatic fungal cyst of a Conjunctival infection was found and removed by biopsy in a young shepherdess. Histopathologic evaluations of the excised tissue specimen from the lesion of the Conjunctiva demonstrated an epithelium lined cavity containing a tangled mycelial mass that was surrounded by inflammatory cells and the fungus was identified as Bipolaris spicifera. It is concluded that asymptomatic Conjunctival infections by fungi may occur without a having previous history of trauma or having any signs of inflammation.

Purpose: To determine the prevalence of different eyelid and Conjunctival tumors in Farabi Eye Hospital during 1989 to 1998.Design: Descriptive - Retrospective.Material & Methods: Hospital records of 2316 patients who underwent biopsy for palpebral and Conjunctival tumors were reviewed.Results: Pathology documents showed 773 non-tumoral and 1543 tumoral diagnosis. Among 46 types of tumors, the diagnosis of SCC, BCC and melanoma was made in 67%, 20.2% and 9.6% of malignant tumoral specimens respectively. Nevi & benign Cystic Lesions (49.5% & 19.6% of benign tumors of Conjunctiva, respectively) were common. BCC was the most common malignant tumor of eyelids (78%). The most common benign lesion of the eyelids was "benign cystic lesion".Conclusion: Our results can be interpreted as a country-wised data because Farabi Eye Hospital is a large referral center. Special attention to the tumors of eyelids & Conjunctiva as a Priority is needed.

Purpose: To describe a case of bilateral squamous cell carcinoma in right nasal and left temporal Conjunctiva, simulating bilateral pterygiumCase report: A reddish fibrovascular pterygium-like lesion was observed in the nasal side of bulbar Conjunctiva on the right eye and temporal Conjunctiva of the left eye. Medical examination did not reveal any coexistent malignancy elsewhere. Excisional biopsy showed squamous cell carcinoma (SCC) insitu. Topical mitomycin C (0.02%) one drop 4 times daily was applied postoperatively. The outcome of the treatment was excellent.Conclusion: Bilateral pterygium-like lesion especially in the exposed area of Conjunctiva to sunlight may be a malignant lesion; so early excisional biopsy with supplement of mitomycin C results in long time relief without systemic involvement or recurrences.

Objective: Conjunctivitis is a common disease in neonates. Several bacterial and viral infectious agents may cause it. Tear circulation and blinking has protective effects from bacterial colonization in the conjuntival sac. Reduced blinking increases the possibility of bacterial conjunctivitis. We studied the effect of eye patches on bacterial colonization of the Conjunctival sac.Methods: In 100 icteric neonates who needed phototherapy and occlusive patches for their eyes during the procedure we did Conjunctival bacterial culture before and after 48 hrs after occlusive patches. The results of two cultures were analyzed with statistical tests, McNemar, chi- square and, binominal with SPSS V18 software.Results: In 100 neonates there were 51 (51%) males 49 (49%) females. The mean birth weight was 2578±736 g. Culture before ophthalmic patches showed 20 (20%) cases with positive Conjunctival cultures and 76 cases (76%) with positive culture 48 hrs after use of eye patches.Conclusion: Eye patches during phototherapy increase bacterial colonization in the Conjunctival sac. We must be aware of this complication during phototherapy.

Background & Objectives: The Conjunctiva is a mucus membrane that covers the internal surface of the eyelids and the external surface of the globe. Conjunctivitis comprises a variable group of infectious and non-infectious diseases. Bacterial conjunctivitis is a common type of ocular infections. The aim of this study was to determine the bacterial agents in conjunctivitis.Methods: This descriptive study was done on 148 patients with conjunctivitis who were hospitalized in pediatric hospital of Tabriz from March 2001 to February 2002 and had supportive discharge. Supportive discharge of the Conjunctiva was sampled and cultured on suitable media. Antibiogram of the isolated strains was done using the disk diffusion method. The data were analyzed by SPSS software using descriptive statistics. Results: The isolated organisms were in the following frequency: Pseudomonas aeroginosa (40), Staphylococcus aurous (26), Klebsiella pneumonia (20), coagulate negative Staphylococci spp (18), Enterobacter spp (12), E.coli (10), Seratia marcescens (6), Acintobacter spp (4), Beta-hemolytic streptococcus group A (4). These bacteria had varied degrees of resistance to ciprofloxacin (37%), Chloramphenicle (52%), Gentamycin (70%) and Cotrimoxazol (71%).Conclusion: In different studies the prevalence of conjunctivitis infection is reported to be 20-40% but we found 94.5%. Regarding the importance of bacterial conjunctivitis infection in hospital and the possibility of the transmission of resistant infection to the society, some measures should be taken to decrease these infections.