Table of Contents - PAO Annual Meeting 2012

Free Paper Program 

Poster Presentation Program 

Oral Free Papers 

Poster Presentations 

Table of Contents 

1 - 4 

4 - 8 

9 - 27 

28 - 48 

from BA to CLINIC

PAO Free Paper Program 

DAY 3 • SUNDAY, DECEMBER 2, 2012 

Function Room 1 

SVC – 2 

CATARACT BREAKFAST SURGICAL VIDEO CONFERENCE 

9:00 – 9:07 am 

Lensectomy with Scleral Suturing of Cionni Ring with 

In-thebag Lens Implantation for Ectopia Lentis Secondary to 

Marfan Syndrome 

Reginald Robert Tan, Jay Marianito S. Vicencio 

DAY 1 • FRIDAY, NOVEMBER 30, 2012 


9:05 am – 11:30 am 

SY – 2 

NEURO-OPHTHALMOLOGY SYMPOSIUM 

Chair: Lourdes T. Ang, MD 

Co-chair: Rolan Mangahas, MD 

10:51am – 11:05 am 

FP-1 

Efficacy of Vitamin B in Preventing Color Vision Abnormalities 

Among Patients Undergoing DOTS for Tuberculosis 

Jan Michael R. Reyes, Ma. Melizza Theresa T. Ramirez, Anne 

Marfe L. Tan, Roland B. Bagnes, II, Evelyn S. Morabe, Emerson 

M. Cruz, Ma. Lourdes R. Nañagas 

Jose R. Reyes Memorial Medical Center, Philippines 

11:06 am – 11:14 am 

FP-2 

A Comparison of Visual Outcomes in Optic Neuritis Patients 

Treated with Intravenous Dexamethasone and 

Methylprednisolone at a Tertiary Hospital : A Retrospective Study 

Shalam Siao, Lee Allen D. Cloma, Leonides Karlo C. Melendres, III 

DOH Eye Center East Avenue Medical Center, Philippines 

DAY 2 • SATURDAY, DECEMBER 1, 2012 


SY – 10 

PUBLIC HEALTH OPHTHALMOLOGY SYMPOSIUM 

4:40 pm – 4:47 pm 

FP-3 

Barriers to the Utilization of Eye Care Services in a Rural Setting 

Mateo Andro R. Geronimo, Ma. Victoria A. Rondaris 

DOH Eye Center, East Avenue Medical Center, Philippines 

1 

4:47 pm – 4:54 pm 

FP-4 

Psychometric Analysis of the 25-Item National Eye Institute 

Visual Function Questionnaire (NEI VFQ-25) Filipino Version 

Lawrence Joseph S. Valdez , Ma. Victoria A. Rondaris 


4:54 pm – 5:01 pm 

FP-5 

Efficacy of Dry Heat Utilizing a Commercial Oven Toaster in 

the Sterilization of Stainless Steel Discs 

Maria Cielo R. Dizon, Robert Christian F. Reyes 

FREE PAPER SESSION 1 

Meeting Rooms 4-6 

8:30 - 10:30 am 

Chair: Jennifer Bernabe-Ko, MD 

Co-Chair: Marichele Aventura-Isidro, MD 

External Disease and Cornea 

8:30 am - 8:37 am 

FP-6 

Dry Eye After Clear Cornea Phacoemulsification 

Peter Mark G. Chao, Ruben Lim Bon Siong 

University of the Philippines-Philippine General Hospital, 

Philippines 

8:38 am - 8:45 am 

FP-7 

Petroleum Jelly Versus Tea Tree Oil and Tea Tree Facial 

Wash Lid Scrub in Patients with Blepharitis Associated with 

Above-normal Demodex Count 

Karen Angela L. Tiuseco, Johann Michael G. Reyes 

Ruben Lim Bon Siong, Eleonore B. Iguban 


Philippines 

8:46 am - 8:53 am 

FP-8 

Antifungal Activity of Voriconazole Against Local Isolates: 

An In Vitro Study 

Karina Q. De Sagun-Bella, Noel S. Cariño, Archimedes D. Agahan, 

Leo DP. Cubillan 


Philippines 

8:54 am - 9:01 am 

FP-9 

No Glue, No Suture Technique? Of Pterygium Surgery: A 

Local Experience 

Ma. Melizza Theresa T. Ramirez¹, Emerson M. Cruz², Evelyn S. 

Morabe¹, Roland B. Bagnes, II¹, Jan Michael R. Reyes¹ 

¹Jose R. Reyes Memorial Medical Center, Philippines, ²Asian Eye 

Institute, Philippines

9:11 am - 9:18 am 

FP-10 

A Randomized Controlled Trial of Tobramycin- 

Dexamethasone, Tobramycin, and Nepafenac Eye Drops in 

Patients with Acute Follicular Conjunctivitis 

Melquiades D. Figueroa 


9:19 am - 9:26 am 

FP-11 

Retrospective Study Comparing Femtosecond Lenticule 

Extraction (FLEX) with Femtosecond Laser In-Situ Keratomileusis 

For Myopia 

Tina Marie Saban-Roa, Irwin Y. Cua, Ruben Lim Bon Siong 

St. Luke’s Medical Center, International Eye Institute, Philippines 

9:27 am - 9:34 am 

FP-12 

In Vitro Efficacy of Imipenem Compared to Vancomycin 

against S. aureus in Intravitreal Concentration 

Ian Ethelbert Dy 

University of Sto. Tomas Hospital, Philippines 

9:35 am - 9:42 am 

FP-13 

Psoriatic Intraepithelial Keratitis After Laser In Situ 

Keratomileusis Treatment 

Jose L. Rodriguez-Prats², Hector Morbelli² 

Ma. Joanna M. Rodriguez-Chan¹, Jorge L. Alio² 

¹Makati Medical Center, Philippines, ²Vissum Corporation 

Instituto Oftalmologico de Alicante, Spain 

Optics, Refraction, and Contact Lens 

9:43 am - 9:50 am 

FP-14 

The Anti-microbial Efficacy of Multipurpose Contact Lens 

Solutions on Standard Strains of Common Ocular Pathogens 

Eleonore B. Iguban, Juan Pablo R. Nanagas 

Roslyn F. De Mesa- Rodriguez 


Philippines 

Chair: Raoul Paolo D. Henson, MD 

Co-Chair: Ma. Perla E. Duran, MD 

Orbit, Eyelids, Lacrimal, and Plastic 

10:01 - 10:08 am 

FP-15 

Superior Orbital Fissure Syndrome in Herpes Zoster 

Ophthalmicus 

Joanna Camille See Co, Ritsia A. Wastitiamurti 

Fatima University Medical Center, Philippines 


10:09 - 10:16 am 

FP-16 

Exophthalmometric Values of Adult Filipinos in a Rural Area: 

Barangay Bigaa, Cabuyao, Laguna 

Roland B. Bagnes, II, Evelyn S. Morabe, Anthony Christopher G. Ortiz, 

Ma. Melizza Theresa T. Ramirez, Jan Michael R. Reyes 


10:17 - 10:24 am 

FP-17 

Preseptal Cellulitis, Orbital Cellulitis and Cavernous Sinus 

Thrombosis in Jose R. Reyes Memorial Medical Center 

Anne Marfe L. Tan, Anthony Christopher G. Ortiz 

Evelyn S. Morabe, Roland B. Bagnes, II 


Pathology and Intraocular Tumors 

10:25 am - 10:32 am 

FP-18 

Your Common Sore Eyes or Something Endemic? 

Charl Marlo A. Jimenez 



Meeting Room 4-6 

9:05 - 11:30 am 

Chair: Danilo Constantino, MD 

Co-Chair: Roy Cagampan, MD 

Retina and Vitreous 

9:05 - 9:12 am 

FP-19 

Macular Measurements and Best Corrected Visual Acuity 

after Phacoemulsification in Diabetics with and without Partial 

Posterior Vitreous Detachment/ Focal Macular Traction 

Katrina Charisse T. Magno, Milagros H. Arroyo 

University of the Philippines-Philippine General Hospital 

Philippines 

9:13 - 9:20 am 

FP-20 

Full Field Electroretinography in Type 2 Diabetes Mellitus 

with No Diabetic Retinopathy and Mild Diabetic Retinopathy 

Institution: St. Luke’s Medical Center 

Rachelle G. Anzures, Leslie Gatchalian 


2


9:21 - 9:28 am 

FP-21 

Measurement of Retinal Nerve Fiber Thickness in Patients 

with Diabetic Retinopathy 

Maria Cecilia Arenal, Romulo Aguilar 


9:29 - 9:36 am 

FP-22 

Macular Pigment Optical Density of Healthy Eyes in University 

of Santo Tomas Hospital 

Ernesto D. Pablo, Jr. 


9:37 - 9:44 am 

FP-23 

Surgical benefits of Endo-Illumination Filters on the Stellaris 

PC Surgical System 

Alex U. Pisig, Emerson Molina, Margarita Justine O. Bondoc 

Narciso F. Atienza, Jr. 

Cardinal Santos Medical Center, Philippines 

9:45 am- 9:52 am 

FP-24 

Outcomes of Retinoblastoma Patients with High-risk 

Histopathological Features in a Tertiary Hospital 

Patricia E. Cabrera, Gary JV. Mercado 

Rolando Enrique D. Domingo 


Philippines 

9:53 am - 10:00 am 

FP-25 

Choroidal Melanoma in a Patient with Nevus of Ota 

Bryan Jason B. Atienza 

The Medical City, Philippines 

Chair: Vicente Victor D. Ocampo, Jr., MD 

Co-chair: Ellen Yu-Keh, MD 

Uveitis and Intraocular Inflammation 

10:12 am - 10:19 am 

FP-26 

Choroidal Tuberculosis: A Case Report 

Johanna T. Cervantes, Juan S. Lopez 


3 

10:20 am - 10:27 am 

FP-27 

Chronic Sympathetic Ophthalmia: A Case Report 

Margarita Justine O. Bondoc, Analyn Suntay-Guerrero, Emerson 

Jay B. Molina, Alex U. Pisig, Egidio Jose S. Fortuna, Kristine Corpus 




1:30 - 4:00 pm 

Chair: Rigo Daniel Reyes, MD 

Co-Chair: Ernesto Pangalangan, Jr., MD 

Glaucoma 

10:28 am - 10:35 am 

FP-28 

Ocular Toxoplasmosis among Filipino Patients seen at the 

East Avenue Medical Center: Clinical Manifestation and 

Effectiveness of Treatment 

Majourette Dy Varela, Jessica Marie R. Abaño 


10:36 am - 10:43 am 

FP-29 

Intermediate Uveitis as an Initial Presentation of Sarcoidosis 

in an Adolescent Male 

Jacqueline T. Mupas, Jessica Marie R. Abaño 

University of Santo Tomas Hospital, Philippines 

10:44 am - 10:51 am 

FP-30 

A Retrospective Study of the Incidence, Indications and 

Outcomes of Nd:YAG Capsulotomy in Eyes Implanted with 

and Accommodating IOL 

Angela Adelaida Samano¹, Rosalie Mae M. Reyes² 

¹Cardinal Santos Medical Center, ²Asian Eye Institute, Philippines 

10:52 am - 10:59 am 

FP-31 

Refractive and Visual Outcomes of Surgical Treatments for 

High Myopia Patients 

Ma. Rachelle Katrina C. Solis, Robert Edward T. Ang 


1:30 pm - 1:37 pm 

FP-32 

Preliminary Report on the Incidence of Steroid-induced Ocular 

Hypertension in Patients in a Tertiary Hospital: A 5-year 

Prospective Study 

Victoria Anne A. Yao, Ma. Margarita Lat-Luna, Juan S. Lopez 


Philippines

1:38 pm - 1:45 pm 

FP-33 

Comparison of Trabeculectomy with Mitomycin-C and 

Glaucoma Drainage Device Implantation in Glaucoma 

Management after Penetrating Keratoplasty 

Meliza Katrina B. Agulto, Rainier Victor A. Covar 


Philippines 

1:46 pm - 1:53 pm 

FP-34 

Factors that Affect the Iris Thickness Amongst Filipinos in 

View of Angle Closure Glaucoma 

Ritsia A. Wastitiamurti 


1:54 pm - 2:01 pm 

FP-35 

Malignant Glaucoma Post Pars Plana Vitrectomy with 

Intraocular Lens Retrieval 

Ian Ben M. Batcagan 

Quirino Memorial Medical Center, Philippines 

2:02 pm - 2:09 pm 

FP-36 

Correlation between the Average Retinal Nerve Fiber Layer 

Thickness and Rim Area Value of the Cirrus OCT with the 

Humphrey Visual Field Index Value 

Andrei P. Martin 


2:10 pm - 2:17 pm 

FP-37 

The Effect of Direct Cold Compress on Intraocular Pressure in 

Healthy Subjects 

Niccolo Zandro Valencia, Mario M. Yatco, Ian Ethelbert Dy 



2:18 pm - 2:25 pm 

FP-38 

Retinal Nerve Fiber Layer Measurements in Myopic Subjects 

Dennis L. Del Rosario, Mario M. Yatco 


Chair: Andrea Kristina M. Pajarillo, MD 

Co-Chair: Cheryl C. Tamayo, MD 

PAO Free Paper / Poster Presentation Program 

Pediatric Ophthalmology and Strabismus 

2:37 pm - 2:44 pm 

FP-39 

Epidemiology and Visual Outcomes of Pediatric Ocular 

Trauma Cases in a Tertiary Hospital 

Theresa Gladiola B. Merca, Marissa N. Valbuena 


Philippines 

2:45 pm - 2:52 pm 

FP-40 

Ophthalmologic Findings in Hunter Syndrome 

Frances Marie DC. Roa, Marissa N. Valbuena 

Mary Ann R. Abacan, Mary Anne D. Chiong 


Philippines 

2:53 pm - 3:00 pm 

FP-41 

A Preliminary Report on the Efficacy of Occlusion Therapy 

Versus Observation for Pediatric Intermittent Exotropia: A 

Single-Blind Randomized Controlled Trial 

Ma Patricia Therese R. Fellizar, Marissa N. Valbuena 

Melissa Anne M. Santos 


Philippines 

3:01 pm - 3:08 pm 

FP-42 

Eventual Outcomes of Retinopathy of Prematurity Screening 

at a Tertiary Government Hospital: A Five Year Study 

Emmeline M. Alvarez, Ricardo Ventura 


3:09 pm - 3:16 pm 

FP-43 

Effect of Pediatric Eye Screening Checklist and Training on 

Ophthalmology Referrals in QMMC, a 1-year Study 



3:17 pm - 3:24 pm 

FP-44 

Four Year Prevalence and Outcome of Initial Screening for 

Retinopathy of Prematurity (ROP) at the Clinical Division of a 

Tertiary Hospital 

James Rommet Luz, Marcelino D. Banzon, Almira A. Manzano 


4

PAO Free Paper / Poster Presentation Program 

3:25 pm - 3:32 pm 

FP-45 

Cycloplegic Effectiveness of Single-Dose Atropine 0.5% 

Compared with Three-Day Atropinization in Determining 

Error of Refraction in Children 

Anna Theresa G. Fernando, Fay Charmaine S. Cruz 

University of the East Ramon Magsaysay Memorial Medical 

Center Inc., Philippines 

POSTER PRESENTATIONS 


PP-1 

Bilateral Peripheral Ulcerative Keratitis in an Anti-nuclear 

Antibody (ANA) Positive 16 year-old Female: A Case Report 

Abigail O. Panganiban, Kate Concepcion-Torio 

Jennifer Aurea S. Sarmiento 


PP-2 

Sebaceous Gland Carcinoma Masquerading as a Large 

Molluscum Contagiosum Nodule 

Emerson Jay B. Molina, Jacinto U. Dy-Liacco, 



PP-3 

Effect of Topical Anesthetic in Pupillary Dilation 

in Filipino Eyes 

Joyce Ann L. Lo, Richard Raymund L. Nepomuceno 


PP-4 

A Case of Cogan’s Syndrome in the Philippines 

Ann Krystine C. Balmaceda, Jessica Marie R. Abaño 

Rene Louie C. Gutierrez 


PP-5 

A Case of Cogan Syndrome 

Jose Mari G. Sagmit, Jacinto S. Bautista, Jr., Noel Castillo 

Hospital of the Infant Jesus, Philippines 

PP-6 

Prevalence of Dry Eye Syndrome and Diabetic Retinopathy 

in Type 2 Diabetes in the Hospital of the Infant Jesus 

Ophthalmology Outpatient Department 

Jamil Laurence R. So-Reyes, Jacinto S. Bautista, Jr. 


5 

Glaucoma 

PP-7 

Axenfeld -Rieger Syndrome: Case Report 

Reggie R. Revilla, Ian Benjamin T. Hizon 


Hospital, Philippines 

PP-8 

Treatment Option for the Management of Neovascular 

Glaucoma 

Mark Gil J. Marasigan, Ronaldo Jarin 


Lens and Cataract Surgery 

PP-9 

Comparison of Axial Length Measurements Taken by 

Partial Optical Coherence Interferometry (IOL Master®) and 

Immersion Scan 

Jessica De Leon, Richard Raymund L. Nepomuceno 


PP-10 

Effect of Heat from Gaseous Sterilization on Antimicrobial 

Efficacy of Moxifloxacin 0.5% Eye Drops 

Mark Christian R. Rivera 


PP-11 

Comparison of the Sealing Ability Between the Wong Incision 

and Standard Stromal Hydration of Clear Cornea Incisions in 

Phacoemulsification Surgery: An Animal Eye Study 

Raymond Nelson C. Regalado, Ruben Lim Bon Siong 

Jay Marianito S. Vicencio, Lee Verzosa 


PP-12 

Evaluation of the Effectiveness of the Angled Sinskey Hook 

for Vertical Quick-Chop Nucleotomy in Phacoemulsification 

Lenard Paul Concepcion, Antonio Say, Alex Sua 


Neuro-ophthalmology 

PP-13 

Ocular Myasthenia Gravis with Probable Thymoma in a 

Prepubertal Male 

Jennifer Aurea S. Sarmiento, Karen B. Reyes 

Cardinal Santos Medical Center, Philippines

PP-14 

A Review of Prevalence of Neuro-Ophthalmic Disorders in a 

Government Tertiary Hospital in Quezon City, Philippines - 

A 4 years Study 

Ryan R. Bacani 


PP-15 

Ptosis and Ophthalmoplegia in a 56 Year Old Post Corneal 

Transplant Patient: A Case Report 

Kristine Belen Pascua, Leonides Karlo C. Melendres, III 

DOH Eye Center- East Avenue Medical Center, Philippines 

PP-16 

Unilateral Optic Nerve Atrophy in a Child with 

Schizencephaly: A Case Report 

Denver K. Ching, Leonides Karlo Melendres, III 


PP-17 

Third Nerve Palsy Probably Ischemic: A Non Resolving 

Palsy in a 58 Year Old Male 

Abegaile O. Bartolome, Erwin D. Palisoc, Emilio Macias, III, 

Evelyn S. Morabe 


PP-18 

Post Operative Abducens Nerve Palsy 

Caesar Percival F. Sunio, Karen B. Reyes 

Ospital ng Makati, Philippines 

PP-19 

Dengue Fever with Optic Neuropathy 

Pius Jonas F. Ocampo, Buenjim Mariano 


PP-20 

Giant Cell Arteritis: A Case Report of a 77 year old Female 

Almira A. Manzano, Roberto Uy 



PP-21 

Comparison of Visual and Refractive Outcomes Using a 

Microkeratome Versus Femtosecond Laser in Creating a 

Flap for Corneal Inlay Implantation 

Vincent Joseph Corpus, Robert Edward T. Ang 




PP-22 

Beveled Osteotomies in Lateral Orbitotomy Using a 

Customized Rotating Bone Saw for Orbital Neoplasms 

Ma. Donna D. Santiago 

Far Eastern University - Nicanor Reyes Memorial Foundation, 

Philippines 

PP-23 

Mixed Capillary and Cavernous Hemangioma: 

A Case Report 

Jesilyn Penny E. Lim, Ma. Donna D. Santiago 

Far Eastern University-Nicanor Reyes Medical Foundation 

Medical Center, Philippines 

PP-24 

Recurrent Orbital Inflammatory Disease in a 

Pediatric Patient 

Jerica Paula D. Berdon, Ma. Donna D. Santiago 



PP-25 

The Efficacy of Topical Mitomycin-C in the Prevention of 

Recurrence of Conjunctival Squamous Cell Carcinoma in a 

36-year Old Male 

Kate Concepcion-Torio, Ma. Rachelle Katrina C. Solis, 

Jo Anne P. Hernandez 


PP-26 

Wide Excision of a Large Upper Lid Sebaceous Gland 

Carcinoma with Reconstruction Using the Modified Cutler- 

Beard Technique 

Emerson Jay B. Molina, Alex U. Pisig, 

Margarita Justine O. Bondoc, Jo Anne P. Hernandez 


PP-27 

Pfeiffer Syndrome-A Case Report 

Christine S. Siguan, Marissa N. Valbuena, 

Prospero Ma. C. Tuaño 


Philippines 

PP-28 

Eyelid Neurilemmoma: A Vanishing Rarity 

Neal Vincent L. Torre, Fatima G. Regala 


6

PP-29 

A Case of Basosquamous Carcinoma of the Central and 

Midface Area in a 62 year old Filipino Male 

Rhyan Francis T. Monsanto, Charmaine Y. Ang 

Fatima G. Regala 


PP-30 

A Case Report on an Unusual Intraorbital Foreign Body 

Jessica Guzman, Fatima G. Regala, Charmaine Y. Ang 


PP-31 

Bilateral Proptosis with Visual Loss: A Case Report 

J. Rotsen Evaristo, Fatima G. Regala 


PP-32 

Carcinosarcoma in a Newborn 

Aimee C. Ng Tsai 


PP-33 

Comparative Study of Using Dermal Fat Graft Alone and 

Dermal Fat Graft with an Orbital Implant in Children 

Majourette Dy Varela, Fatima G. Regala, Charmaine Y. Ang 


PP-34 

Use of a Modified Metal Guide of a Bicanalicular Intubation 

Stent in Transected Canalicular Repair 

Marco A. Tumalad, Charmaine Y. Ang, Fatima G. Regala 


PP-35 

Cavernous Hemangioma of the Orbit: 

An Unusual Presentation 

Clarissa H. Tuliao, Anthony Christopher G. Ortiz, 

Evelyn S. Morabe, Ma. Lourdes R. Nañagas 


PP-36 

Sebaceous Gland Carcinoma of the Eyelid Presenting as a 

Chalazion: A Case Report 

Pearl Trisha M. Padilla, Leonardo R. Mangubat 

Makati Medical Center, Philippines 

7 


PP-37 

Orbital Metastasis Arising From Adenocarcinoma 

of the Lung 

Bernardo Joaquin Tuaño, Yvette Marie Santiago 


PP-38 

Spontaneous Resolution of Dilated Superior Ophthalmic 

Vein in a Patient with Indirect Carotid-cavernous 

Sinus Fistula 

Karen Joyce G. Castro, Prospero Ma. C. Tuaño 

St Luke’s Medical Center, Philippines 

PP-39 

Two-Stage Reconstruction of Upper and Lower Anterior 

Lamellar Eyelid Defect after Excision of Intradermal Nevus 

Pius Jonas F. Ocampo, Mary Rose Pe-Yan 

St. Luke’s Medical Center, Philippines 

PP-40 

Painful Ophthalmoplegia 

Honeylen Maryl Tiu Teo, Prospero Ma. C. Tuaño 

Buenjim Mariano 


PP-41 

Canalicular Reconstruction in Long Standing Healed 

Canalicular Laceration 

Simeon Arni A. Pagdanganan, Reynaldo M. Javate 


PP-42 

Microendoscopic Recanalization with Silicone Intubation 

for the Treatment of Canalicular and Primary Acquired 

Nasolacrimal Duct Obstruction 

Armida L. Suller, Reynaldo M. Javate, Raul T. Cruz, Jr. 



Adenoid Cystic Carcinoma of the Lacrimal Gland: 

A Case Report 

Mamerto G. Capero, Jr., Anthony Christopher G. Ortiz, Evelyn S. 

Morabe, Ma. Lourdes M. Nañagas 


PP-44 

Primitive Neuroectodermal Tumour of the Orbit in a 14 Year 

Old Male with Absolute 

Glaucoma Post Evisceration: A Case Report 

Manuel Benjamin B. Ibañez, IV, Leonardo R. Mangubat, 

Ramon Mario Ongsiako 

Makati Medical Center, Philippines


PP-45 

A Case of Bilateral Persistent Fetal Vasculature in a 

Premature Infant 

Arturo B. Capulong, Emilio Macias, III, Evelyn Morabe 


PP-46 

Moebius Syndrome Associated with Exposure 

to Misoprostol 

JC Martin S. Cabrera, Bibhuti R. Thapa, Emilio L. Macias, III, 

Evelyn S. Morabe, Ma. Lourdes Nañagas 


PP-47 

Strabismus Surgery in a Child with Moebius Syndrome 

Maureen M. Resonable, Michelle M. Hernandez 

Ospital ng Maynila Medical Center, Philippines 

PP-48 

Prevalence of Amblyopia in School Aged Children in 

Maybunga Elementary School 

Airene M. Oloroso 

Rizal Medical Center, Philippines 

PP-49 

Self-inflicted, Traumatic Disinsertion of the Lateral Rectus: 

A Case Report 

Patricia Isabel C. Manalastas, Fay Charmaine S. Cruz 




PP-50 

Neuritis and Neuro-retinitis as Initial Presentations of HIV 

Elenor Reina S. Aquino, Jessica Marie R. Abaño, Jocelyn Sy 


PP-51 

Bilateral Serous Retinal Detachment in Toxemia of 

Pregnancy: A Case Series 

Mayjane Joan G. Tumulak, Jocelyn Sy 


PP-52 

Choroidal Hemangioma: A Case Report 

Jan Carlo Y. Alegre, Jocelyn Sy 



PP-53 

Central Retinal Artery Occlusion in the Young 

Erica Blanca Daquil 


PP-54 

Best’s Vitelliform Macular Dystrophy with Normal EOG: 

A Case Report 

Nikki Doreen Angbue Te 


PP-55 

Neovascular Glaucoma and Exudative Retinal Detachment 

in a Young Male: A Case Report 

Mark Angelo B. Hosaka 


PP-56 

Treatment of Polypoidal Choroidal Vasculopathy 

Paul Samuel Del Mundo, Johanna T. Cervantes, 

Pearl Tamesis-Villalon 

St. Luke’s Medical Center International Eye Institute, Philippines 

PP-57 

Retinopathy of Prematurity Screening in a Tertiary Care 

Center: Incidence and Percentage of Referrals 

by Neonatologists 

Anna Karina D. Leopando 


PP-58 

Endogenous Endophthalmitis Secondary to Gram Negative 

Bacteremia (Klebsiella spp) with Secondary Urinary 

Tract Infection 

Jocelyn Therese M. Remo, Jose Luis G. De Grano, 

Ian Benjamin T. Hizon 


Center, Philippines 

PP-59 

Increased Intraocular Pressure after Anti-VEGF Injection – 

QMMC Experience 

Lyndon D. Edaño 


8

Poster Presentation Program / Oral Free Papers 


PP-60 

Vogt-Koyanagi-Harada Syndrome: A Case Report 

Anna Francesca B. Bayrante, Jessica Marie R. Abaño 


PP-61 

Ocular Involvement in Adamantiades-Beh’et Disease (ABD) 

Aileen Viguilla, Egidio Jose S. Fortuna 


DAY 3 • SUNDAY, DECEMBER 2, 2012 


SVC – 2 

CATARACT BREAKFAST SURGICAL VIDEO CONFERENCE 

9:00 – 9:07 am 

Lensectomy with Scleral Suturing of Cionni Ring with In-thebag 

Lens Implantation for Ectopia Lentis Secondary to 

Marfan Syndrome 

Reginald Robert Tan, Jay Marianito S. Vicencio 

Objective: To describe the surgical management and 

postoperative outcomes of a case of bilateral ectopia lentis 

secondary to Marfan syndrome. 

Methods: A 19 year-old female complained of progressive 

blurring of vision since early childhood. Patient was diagnosed 

with bilateral ectopia lentis secondary to Marfan syndrome. Best 

corrected visual acuity (BCVA) on the right and left eyes were 

counting fingers and 20/50, respectively. Slit lamp examination 

showed lens bissecting the pupil in both eyes. The patient 

underwent bilateral lensectomy with scleral fixation of Cionni 

modified capsular tension ring (MCTR) with in-the-bag intraocular 

lens implantation. 

Results: No major intraoperative and post-operative complications 

were met. On the first post-operative day, the vision was 20/400 

on the right eye and 20/32 on the left. The right eye showed mild 

corneal edema. One month post-operatively, visual acuity was 

still 20/400 and and 20/32, for the right and left eyes, respectively. 

In the two eyes, the corneas were clear. The lack of improvement 

in VA of the right eye was attributed to ambylopia acquired during 

childhood. 

Conclusions: Lensectomy with scleral fixation of capsular 

tension ring with in-the-bag intraocular lens implantation may 

be a safe procedure in ectopia lentis secondary to Marfan’s with 

good post-operative results. However, the procedure is not easy 

to perform and will need expertise on the part of the surgeon. 

Key Words: Capsular tension ring, Marfan syndrome, Scleral 

fixation, Lensectomy, Ectopia Lentis 

9 

DAY 1 • FRIDAY, NOVEMBER 30, 2012 


9:05 am – 11:30 am 

SY – 2 

NEURO-OPHTHALMOLOGY SYMPOSIUM 

Chair: Lourdes T. Ang, MD 

Co-chair: Rolan Mangahas , MD 

10:51am – 11:05 am 

FP-1 

Efficacy of Vitamin B in Preventing Color Vision Abnormalities 

Among Patients Undergoing DOTS for Tuberculosis 

Jan Michael R. Reyes, Ma. Melizza Theresa T. Ramirez, 

Anne Marfe L. Tan, Roland B. Bagnes, II, Evelyn S. Morabe, 

Emerson M. Cruz, Ma. Lourdes R. Nañagas 


Objective: To determine if Vitamin B supplementation can 

prevent the development of color vision abnormalities in patients 

taking Ethambutol as part of DOTS for tuberculosis. 

Methods: A randomized, placebo-controlled, double-blind 

clinical trial was conducted among newly diagnosed category-1 

tuberculosis patients enrolled in DOTS health centers in the third 

district of Manila from June 2011 to August 2012. Before starting 

therapy, the participants underwent complete eye evaluation. 

Baseline Color vision was tested using the Ishihara Color Vision 

Plates (Ishihara), Farnsworth Panel D-15 (FD 15), and Lanthony 

Desaturated D-15 tests. Only subjects who passed the three color 

vision tests were included in the study, and divided into 2 groups: 

Group A received vitamin B, and Group B received a placebo. 

Follow up color vision testing was done monthly for 3 months. 

Results: There were 105 patients included in the study, 77 males, 

and 28 females, age ranging from 16- to 68, with a mean of 37.43 

patients received VIT B (GRP A) and 62 received placebo, (GRP 

B) After one month of DOTS, 5 of 43 patients (11. 6 %) in GRP 

A developed color vision abnormalities, while 10 of 62 patients 

(16.1%) developed color vision abnormalities in the placebo 

group. The abnormalities were only detected using the Lanthony 

desaturated test. The absolute risk reduction (ARR) of color 

vision abnormalities by VIT B supplementation was 4.5%, with 

the number needed to treat (NNT) = 23. After the second month 

of therapy, ARR was 7.4%, and NNT = 14. ARR was highest in 

the third month at 8.3%, with a corresponding improved NNT of 

12. Among patients who developed color vision abnormalities, 

reversal of the abnormalities was observed in 80% of 5 subjects 

in Group A while only 40% of 10 patients improved in Group 

B. By the third month of treatment, all those in GRP A already 

had normal color vision. On the other hand, 40% of those in the 

placebo group still showed abnormal color vision. The difference 

of the two groups is statistically significant. 

Conclusions: This study shows that vitamin B complex is 

effective in reducing the risk of, and in reversing cases of color 

vision abnormalities among patients undergoing DOTS therapy for

tuberculosis. It is therefore recommended that all patients undergoing 

therapy be given Vit B supplementation. This is especially true in 

those receiving higher doses of the drug or prolonged treatment due 

to advanced or resistant disease. 

Key Words: Absolute risk reduction, Fansworth D15, 

Ishihara, Lanthony 

11:06 am – 11:14 am 

FP-2 

A Comparison of Visual Outcomes in Optic Neuritis Patients 

Treated with Intravenous Dexamethasone and 

Methylprednisolone at a Tertiary Hospital : A Retrospective 

Study 

Shalam Siao, Lee Allen D. Cloma, Leonides Karlo C. Melendres, III 


Objective: To compare rate and amount of visual recovery in 

Acute Optic Neuritis patients treated with IV Dexamethasone 

(8mg Loading Dose, 4mg every eight hours X11 doses) and 

IV Methylprednisolone 250mg every 6 hours for three days. To 

provide a clinical profile of patients treated at Neuro-Ophtha clinic 

as to age and sex, laterality of visual affectation, and to identify 

any associated systemic illness 

Methods: A Retrospective chart review of patients seen at the 

Neuro-ophthalmology Clinic at a tertiary hospital from year 2004- 

2012. Visual Acuity between treatment groups was recorded at 

the time of initial consult, after initiation of treatment and at one 

month follow-up. Gross color testing was also done together with 

an Ishihara Test. 

Results: Initial results showed that total of 24 patients were seen 

and diagnosed as acute optic neuritis cases. There was a 7:17 

Female to Male ratio noted with age range of 6-52 years of age 

among affected cases. 37.5% of cases had bilateral involvement. 

No cases have been reported to have comorbidities. Fifteen 

cases received IV dexamethasone treatment. 8 cases received 

IV methylprednisolone, a case received oral methylprednisolone 

and 3 cases did not receive any treatment. Visual acuity of the 

IV Dexamethasone group ranged from >+1.0 LogMar- +0.7 prior 

to treatment. Post treatment, visual acuity ranged from >+1.0 

Logmar-+0.6, by one month follow-up half of the group had 

vision ranging +0.2-0.1 Logmar. In the Methylprednisolone group, 

pretreatment visual acuity ranged from >+1.0-0.2 Logmar. By the 

end of IVtreatment 50% of cases had visual acuity of +0.2-0.1 

Log Mar. 

Conclusion: Improvement of visual acuity was noted in both 

treatment groups after initiation of treatment. It was observed that 

in the Methylprednisolone group that 50% achieved improved VA 

to Logmar +0.2-0.1 immediately post treatment as compared to 

only 33.3% of cases in the dexamethasone group. 

Key Words: methylprednisolone, visual recovery, Optic Neuritis 

DAY 2 • SATURDAY, DECEMBER 1, 2012 


SY – 10 

PUBLIC HEALTH OPHTHALMOLOGY SYMPOSIUM 

4:40 pm – 4:47 pm 

FP-3 


Barriers to the Utilization of Eye Care Services in a 

Rural Setting 

Mateo Andro R. Geronimo, Ma. Victoria A. Rondaris 

DOH Eye Center , East Avenue Medical Center , Philippines 

Objective: To determine the perceived barriers, attitudes and 

socio-cultural aspects of eye health and eye care services in a 

remote rural community in the Philippines. 

Methods: This is a qualitative study that deals with two focus 

groups (group I= 9 participants, group II= 7 participants) comprising 

of residents from a rural community in the Philippines. The 

population came from Sitio Mainit, Bgy. Pulang Bato, San Juan, 

Batangas, a relatively remote, land-locked community located 

around 4km from the highway via rough road. The focus group 

discussion follows a structured but open ended questionnaire. 

Discussions are videotaped and transcribed, and finally analyzed 

using a thematic framework approach. Questions deal mainly with 

experiences regarding eye symptoms, awareness of the need for 

consult, person or place of consult, reason for consult, and the 

different barriers encountered regarding eye care. 

Results: Sixteen Filipino residents from Bgy Pulang Bato, San 

Juan Batangas, aged 34 to 75 (mean: 52.9) were divided into two 

gender specific focus groups (Group I: female, group II: male). 

100% of the participants cited the major perceived barrier was 

cost, regardless if it was transportation related, opportunity cost, 

or health care costs. However, during probing, the main barrier 

noted by the investigators was not financial in nature, instead, it 

was the lack of awareness of their conditions. 14/16 participants 

(87.5%) had no initial perceived need for consult, until specific 

symptoms or conditions were elaborated to them. 

Conclusion: There are multiple barriers that may affect the 

healthcare behaviors and attitudes of patients. All of these 

features must be considered when planning to address the eye 

health care issues of a certain locale, where even the awareness 

of symptoms and disease entities may not be realized. The further 

development of awareness campaigns, coupled with a more 

intensive health education system may be necessary to increase 

the uptake of eye care services of our centers. 

Key Words: Barriers, eye health, focus groups, health seeking 

behavior 

10


4:47 pm – 4:54 pm 

FP-4 

Psychometric Analysis of the 25-Item National Eye Institute 

Visual Function Questionnaire (NEI VFQ-25) Filipino Version 

Lawrence Joseph S. Valdez , Ma. Victoria A. Rondaris 

DOH Eye Center , East Avenue Medical Center , Philippines 

Objective: To validate a Filipino version of the National Eye 

Institute Visual Function Questionnaire (NEI VFQ-25). 

Methods: A two-step process was used to validate the NEI VFQ- 

25. First, translation of the questionnaire to Filipino was performed 

by two ophthalmology residents, two ophthalmic nurses and four 

(two forward and two backward) linguists from the University 

of the Philippines, Sining ng Wikang Filipino, using forwardbackward-forward 

translation. Inconsistencies were noted and 

revised. The final Filipino NEI VFQ-25 was then pretested on ten 

patients in a tertiary government hospital. Second, psychometric 

analysis was performed on the response to the questionnaire of 

ninety six patients from the eye center of a tertiary government 

hospital. Internal consistency of the tool was then measured by 

Cronbach’s alpha for each subscale, and was used as an index 

of reliability. Evaluation of the questionnaire’s construct validity 

was performed using factor analysis. Subsequently, convergent 

and discriminant validities were calculated by means of multi-trait 

analysis. 

Results: Respondents mean age was 50.14 (SD 17.87), 55% 

were male and 32.29% had a college degree. Two patient groups 

were utilized, Group 1 included 71 participants with a single 

cause of visual impairment (22 cataract; 19 diabetic retinopathy; 

15 glaucoma; 3 uveitis; 4 microbial keratitis; 2 retinal detachment; 

4 corneal leukoma and 2 post penetrating keratoplasty patients). 

Group 2 included 25 healthy controls. The questionnaire’s internal 

consistency was high in most subscales, with a Cronbach’s alpha 

range from 0.62-0.91. All items passed the convergent and 

discriminant validity tests. Comparison between the subscale 

scores of patients and controls is statistically significant with a 

p-value < 0.001. 

Conclusion: The Filipino version of the NEI-VFQ 25 is a reliable 

and valid instrument to measure vision-related quality of life in 

patients with visual impairment hence can be applied to clinical 

research. 

Key Words: NEI VFQ-25, psychometric analysis, quality of life, 

questionnaire 

4:54 pm – 5:01 pm 

FP-5 

Efficacy of Dry Heat Utilizing a Commercial Oven Toaster in 

the Sterilization of Stainless Steel Discs 

Maria Cielo R. Dizon, Robert Christian F. Reyes 

Objective: To determine the efficacy of dry heat utilizing a 

commercial oven toaster in the sterilization of stainless steel discs 

in comparison to steam sterilization using the autoclave. 

11 

Methods: This was an experimental study utilizing a total of 198 

stainless steel discs, representative of stainless steel ophthalmic 

instruments, that were equally divided into 9 sets. They were 

sterilized by autoclave then inoculated with Staphylococcus 

aureus, Pseudomonas aeruginosa and Bacillus subtilis. The 

inoculated discs were wrapped again in sets and divided equally 

into 3 groups. The sets assigned to Group A underwent steam 

sterilization using an autoclave set at 121 C at 15 psi for 15 

minutes. The sets assigned to Groups B and C underwent dry heat 

sterilization using a commercial oven toaster at a temperature of 

190 C for 15 minutes and 200 C for 15 minutes, respectively. 

After the sterilization process, the stainless steel discs were 

submerged in tryptic soy broth (TSB). One loopful of the TSB was 

streaked unto blood agar plates. The plates were incubated at 

37 C and checked for bacterial growth (positive or negative) after 

24 hours and 48 hours. Fisher’s Exact Test and Chi Square Test 

were used to analyze the data obtained. 

Results: After 48 hours of incubation, there was no growth 

observed on all the plates in the autoclave group (Group A). In 

Group B (oven toaster 190 C for 15 minutes), there was no growth 

in all the plates of Pseudomonas aeruginosa and Bacillus subtilis. 

For Staphylococcus aureus, positive growth was seen in 1 out of 

20 plates. Statistical analysis using both the Chi Square Test and 

Fisher’s Exact Test showed that the growth of Staphylococcus 

aureus in the oven toaster group was not statistically significant. 

In Group C (oven toaster 200 C for 15 minutes), there was no 

growth observed in all the plates. 

Conclusion: The oven toaster set at 190 C for 15 minutes was 

100% effective in the sterilization of discs inoculated with P. 

aeruginosa and B. subtilis and the oven toaster set at 200 C for 15 

minutes was 100% effective in the sterilization of discs inoculated 

with S. aureus. In the sterilization of stainless steel discs, the 

oven toaster is non-inferior to the autoclave (all p > 0.05). The 

oven toaster may be considered in the sterilization of stainless 

steel ophthalmic instruments, especially when an autoclave is not 

available. 

Key Words: sterilization, oven toaster, dry heat 


Meeting Room 4-6 

8:30 - 10:30 am 

Chair: Jennifer Bernabe-Ko, MD 

Co-Chair: Marichele Aventura-Isidro , MD 


8:30 am - 8:37 am 

FP-6 

Dry Eye After Clear Cornea Phacoemulsification 

Peter Mark G. Chao, Ruben Lim Bon Siong 


Philippines 

Objective: To determine the incidence of dry eye in patients after 

undergoing clear cornea phacoemulsification; and to investigate

the changes in dry eye symptoms and tear physiology before and 

after clear cornea phacoemulsification. 

Methods: Study design was single-center, non-randomized, 

longitudinal, and prospective. The study involved forty four 

patients (49 eyes), diagnosed with age-related cataract, who 

underwent corneal phacoemulsification. Subjective grading 

of ocular discomfort, ocular surface disease index (OSDI), 

fluorescein tear break-up time (FTBUT), corneal staining, 

conjunctival and posterior lid margin staining with lissamine 

green, and Schirmer test without anesthesia and with anesthesia 

were assessed before surgery and 1 week, 1 month, and 3 

months after the surgery. 

Results: None of the patients enrolled qualified for the 

definition of dry eye disease before and after clear cornea 

phacoemulsification. Pre-operative FTBUT (14.01 seconds ± 

0.56) significantly decreased 1 week after surgery (3.97 seconds 

± 0.21; p

were determined using Sensititre Microtitre Colorimery method 

following guidelines of the Clinical and Laboratory Standards 

Institute for broth microdilution testing of yeasts and filamentous 

fungi. Two-way ANOVA, Duncan Test, and Pearson Chi Square 

test were used to analyze the data. 

Results: All isolates tested were sensitive to Voriconazole. Eighty 

percent of the isolates were sensitive to Amphotericin B. Twenty 

five percent showed resistance to Itraconazole. Yeast pathogens 

were all sensitive to Amphotericn B and Voriconazole. More than 

50% of the yeast pathogens were resistant to Ketoconazole. 

Molds or filamentous fungi showed higher susceptibility to 

Voriconazole than Amphotericin B and the other antifungals. All 

of the isolates were sensitive to Voriconazole followed by 66% of 

the isolates being sensitive to Amphotericin B. 

Conclusion: Voriconazole exhibited good in vitro activity 

against the isolates tested on. It has the same efficacy on Yeast 

pathogens as compared with the gold standard, Amphotericn B. 

It has superior efficacy on Filamentous fungi. There is a role for 

Voriconazole in the treatment of Ocular infections especially in 

the setting of poor antifungal drug availability. 

Key Words: Amphotericin B, Voriconazole, AntifungalVoriconazole 

8:54 am - 9:01 am 

FP-9 

No Glue, No Suture Technique? Of Pterygium Surgery: 

A Local Experience 

Ma. Melizza Theresa T. Ramirez¹, Emerson M. Cruz², Evelyn S. 

Morabe¹, Roland B. Bagnes, II¹, Jan Michael R. Reyes¹ 

¹Jose R. Reyes Memorial Medical Center, Philippines, ²Asian Eye 

Institute, Philippines 

This is to report our initial experience with the "No glue, No 

suture?" technique of pterygium surgery by Dr. Santanu Mitra of 

India. 

Objective: The objective is to determine if autologous blood 

is indeed effective in securing the conjunctival autograft to the 

scleral bed after excision of pterygium. 

Methods: This is a case series of 15 patients with primary 

pterygium seen at JRRMMC from April to July 2012. The surgery 

was done following the technique described by Mitra S. et al., 

which was presented at the AAO Annual Meeting in Florida last 

Oct. 2011. The technique involved the use of autologous blood 

to secure fixation of the conjunctival autograft to the scleral bed 

following pterygium excision. "Success" is defined as adherent 

conjunctival autograft at the end of 1 month observation period. 

Results: Eight males and 7 females, age ranging from 24 to 76 

years (mean of 49.9 + 13.4) were included. The most common 

indication for surgery was pterygium > 3mm and persistent foreign 

body sensation. All surgeries were completed uneventfully, with 

graft size ranging from 60 to 96 mm2. Conjunctival autologous 

grafting was successful in 12 of 15 cases (80%). Complications 

were graft loss in 3 patients (20%) and graft contraction in 2 other 

patients. (13%). 

13 


Conclusion: Autologous blood was effective in producing 

conjunctival autograft adherence, with successs rate of 80%. We 

recommend a randomized controlled trial with larger sample size 

to compare the results, including recurrence rates, with sutured 

and glued grafts. 

Key Words: no suture 

9:11 am - 9:18 am 

FP-10 

A Randomized Controlled Trial of 

Tobramycin-Dexamethasone, Tobramycin, and Nepafenac 

Eye Drops in Patients with Acute Follicular Conjunctivitis 

Melquiades D. Figueroa 


Objective: To compare the efficacy of topical Tobramycin- 

Dexamethasone, Tobramycin, and Nepafenac eyedrops, 

in relieving patient’s discomfort and conjunctival hyperemia 

associated with acute follicular conjunctivitis of presumed viral 

etiology. 

Methods: Patients presenting with acute follicular conjunctivitis, 

presumed viral in origin, were grouped using a simple random 

sampling. Conjunctival hyperemia was then assessed using 

Likert-type scales: 0-no hyperemia; 1-mild; 2-moderate; and 

3-severe. The first group was given Tobramycin-Dexamethasone 

eyedrops four times daily; Second group with Tobramycin alone 

four times daily; and the last group with Nepafenac eye drops 

thrice a day for 1 week. Patients were then requested to have 

a follow-up after 5-6 days of treatment. They were asked to 

complete a questionnaire on whether they thought the treatment 

had helped alleviate the discomfort. 

Results: A total of 42 patients were randomized into 3 groups 

equally: Fourteen (14) received Tobramycin-Dexamethasone; 

14 Tobramycin alone; and 14 received Nepafenac drops. Most 

patients (61%) sought consult within the first 3 days of manifesting 

symptoms. 28 patients (75%) presented without lymphadenopathy, 

and 57% had bilateral findings. Using Fischer’s method, it was 

found out that there was no significant difference among the 3 

groups in terms of mean conjunctival hyperemia (p=0.05). Most 

patients in all 3 groups reported symptomatic improvement 

with treatment. Patients on Tobramycin-Dexamethasone drops 

reported symptomatic relief such as reduced tearing (86%), and 

pain less than 3 days of instillation (93%). No patient on the said 

treatment experienced any serious complication. Two patients 

(14%) on Tobramycin drops alone developed pseudomembrane 

while 2 patients (14%) on Nepafenac drops developed punctate 

epithelial keratitis and subepithelial infiltrates. There was a 

significant difference between Tobramycin-Dexamethasone and 

Tobramycin in the improvement of tearing (p=0.01). However, 

there was no significant difference (p=0.01) on patient’s 

improvement particularly on conjunctival blurring and pain 

with Tobramyin-Dexamethasone, Tobramycin nor Nepafenac 

eyedrops. 

Conclusion: Based on physician’s grading of conjunctival 

hyperemia before and after follow-up no significant difference

was found among the three treatments. However, more 

patients favorably respond to Tobramycin - Dexamethasone in 

improvement of tearing, and no complication was recorded after 

the short-course of treatment. 

9:19 am - 9:26 am 

FP-11 

Retrospective Study Comparing Femtosecond Lenticule 

Extraction (FLEX) with Femtosecond Laser In-Situ 

Keratomileusis For Myopia 

Tina Marie Saban-Roa, Irwin Y. Cua, Ruben Lim Bon Siong 


Objective: To compare the efficacy, safety, predictability, stability, 

contrast sensitivity and higher-order aberration of patients who 

underwent Femtosecond lenticule extraction (FLEX) and patients 

who underwent Femtosecond Laser In-Situ Keratomeliuesis 

(Femto-LASIK). 

Methods: Retrospective review of FLEx and Femto-LASIK cases 

in the International Eye Institute, St. Luke’s Medical Center, 

Global City from November 2011 to May 2012 was done. 

Results: 26 eyes of 13 patients who underwent FLEx while 22 

eyes of 11 patients who underwent Femto-LASIK were included. 

The spherical equivalent of the FLEx group ranged from -2.50 to 

-6.75 and the Femto-LASIK group ranged from -2.63 to -6.875. 

Eyes which achieved uncorrected visual acuity (UCVA) of 20/32 

or better 1 day post-operatively was 15% and 100% for the FLEx 

and Femto-LASIK groups, respectively, but were similar after 3 

months. Spherical equivalent after 3 months was +0.06(±0.21) 

in the FLEx group and -0.44 (±0.35) in the Femto-LASIK group, 

which was statistically significant (p

is the first documented case of intraepithelial infiltrates within 

the flap of 1 eye after uneventful bilateral femtosecond LASIK 

concurrent with an acute dermatologic episode of psoriasis. 

There were no final adverse effects. 

Key Words: Psoriasis, keratitis, Laser in situ keratomileusis 


9:43 am - 9:50 am 

FP-14 

The Anti-microbial Efficacy of Multipurpose Contact Lens 

Solutions on Standard Strains of Common Ocular Pathogens 

Eleonore B. Iguban, Juan Pablo R. Nanagas, 

Roslyn F. De Mesa- Rodriguez 


Philippines 

Objective: This study aims to compare the anti-microbial 

efficacy of locally available multi-purpose contact lens solutions 

on standard strains of contact lens-related ocular pathogens. It 

also seeks to establish the recommended duration of exposure to 

multi-purpose contact lens solutions in order to achieve maximal 

anti-microbial effect. 

Methods: This study, a single-blind controlled experiment, 

evaluated five locally available multi-purpose solutions in terms 

of their anti-microbial efficacy towards common contact lensrelated 

ocular pathogens, namely Pseudomonas aeroginosa, 

Staphylococcus aureus, Eschericha coli, Fusarium solani and 

Candida albicans, using the stand alone criteria for determination 

of contact lens disinfection efficacy. Microbial viability counts were 

then obtained at serial durations namely after 1 hour, 3 hours, 6 

hours, and 12 hours of exposure. 

Results: Results of this study showed that the multi-purpose 

contact lens solutions containing Polyquaternium-1 and 

Myristamidopropyl dimethylamine (MPS C) and polyhexanide 

(MPS B and D) were able to reduce the bacterial concentrations 

by 3 log and fungal concentrations by 1 log, thus enabling them 

to fulfill the stand-alone criteria for disinfecting solutions as 

mandated by ISO/CD 14729. This anti-microbial efficacy was 

most evident at 6 hours of exposure of challenge organisms 

to the multi-purpose contact lens solutions. Moreover, the 

multipurpose contact lens solution containing Polyquaternium-1 

and Myristamidopropyl dimethylamine, was found to be have the 

broadest spectrum of effectivity against gram negative and gram 

positive bacteria, as well as Candida albicans. All multipurpose 

contact lens solutions tested in this study were found to have poor 

microbial activity against Fusarium solani, which is known for its 

high virulence and pathogenicity. 

Conclusions: Multi-purpose contact lens solutions truly show 

a wide range of variability in terms of their antimicrobial activity. 

A contact lens solution that has a better and broad spectrum 

antimicrobial efficacy compared to its counterparts in the local 

market could provide higher chance of attaining ocular safety 

among non-compliant contact lens users. Greater efforts to 

educate patients on proper lens care regimens are needed to 

15 


prevent contact lensrelated microbial keratitis from common 

ocular pathogens. 

Key Words: contact lens, infectious keratitis, microbial keratitis, 

multipurpose contact lens solution, silicon hydrogels 

Chair: Raoul Paolo D. Henson, MD 

Co-Chair: Ma. Perla E. Duran, MD 


10:01 - 10:08 am 

FP-15 

Superior Orbital Fissure Syndrome in Herpes 

Zoster Ophthalmicus 

Joanna Camille See Co, Ritsia A. Wastitiamurti 


Case Summary: A 55 y.o male was admitted for herpes 

zoster ophthalmicus (HZO) with complaints of periorbital pain, 

swelling of the left eye, and cutaneous vesicular lesions on 

the left forehead and eyelid. Initially, conjunctivalchemosis and 

epithelial keratitis were noted. Oral and ophthalmic antiviral 

and anti-inflammatory therapies were started. 1 week after, 

patient developed ptosis, diplopia, anisocoria, and partial 

ophthalmoplegia which became complete after 7 days. Superior 

orbital fissure syndrome (SOFS) was considered and CT-scan 

and MRI were requested. Methylprednisolone p.o. in tapering 

dosage for 2 weeks was given. 8 weeks after, Patient responded 

well with the treatment and improvement in the anterior segment 

symptoms, ophthalmoplegia, and ptosis, but not anisocoria were 

noted. SOFS is characterized by ophthalmoplegia, ptosis, fixed 

dilated pupils, and anesthesia of cranial nerve V1. It is associated 

with presence of traumatic injuries, tumours of the orbit, infection, 

inflammatory disorders, and vasculitic diseases. It is a relatively 

uncommon complication in patients who suffers from HZO. It 

can start as a simple reactivation of the virus to a more severe 

complication affecting structures located in the apex and fissures. 

A delay in identifying and management can lead to devastating 

sequelae such as chronic ocular inflammation, ophthalmoplegia, 

and visual loss. 

Key Words: Herpes zoster ophthalmicus, Superior Orbital 

Fissure Syndrome, ophthalmoplegia, anisocoria 

10:09 - 10:16 am 

FP-16 

Exophthalmometric Values of Adult Filipinos in a Rural Area: 

Barangay Bigaa, Cabuyao, Laguna 

Roland B. Bagnes, II, Evelyn S. Morabe, Anthony Christopher G. 

Ortiz, Ma. Melizza Theresa T. Ramirez, Jan Michael R. Reyes 


Objectives: Our aim is to determine the normal exophthalmometry 

values among Filipinos (18-60 years old) living in a rural Philippine 

village, and correlate results with demographic, physical and 

ocular factors.

Methods: In this cross-sectional study, randomly selected 

adult participants from Baraangay Bigaa, Cabuyao Laguna 

were examined by residents from the JRRMMC Department 

of Ophthalmology. Exophthalmometry was performed using 

a Hertel’s exophthalmometer (Oculus 35582 Germany). The 

exophthalmometry reading to the closest 0.5mm was taken 

simultaneously for both eyes and the base recorded to the 

nearest 1.0mm. Automated refraction was done using Huvitz 

(HRK7000), and axial length was measured using a soft-touch 

A-Scan (Accutome USA). Height (cm) and weight (kg) were 

measured and BMI computed as kg/m2. Results were analysed 

using Minitab Ver16 statistical software. 

Results: Total of 173 subjects participated and 3 patients 

were excluded, leaving 170 patients for analysis (104 

females & 66 males) with mean age of 46.4 years. The mean 

exophthalmometric value obtained was 13.8+/- 2.1mm. Females 

had significantly lower mean values at 13.5mm +/- 2.0 compared 

to 14.2mm+/- 2.2 for males. The relative ocular protrusion value 

in our subjects was 2 mm. Gender, BMI, axial length, weight and 

base were significantly associated with exophthalmometry values 

on bivariate analysis. However, on multivariate analysis, weight 

and base measurements were shown to be the only independent 

factors affecting the exophthalmometry values. 

Conclusion: Exophthalmometry values obtained among Filipino 

adults living in Brgy. Bigaa, Cabuyao, Laguna were lower than the 

reported values for other population. It is hoped that the values we 

obtained will henceforth be a helpful reference value in determing 

the presence or absence of absolute exophthalmos in Filipino 

patients being evaluated for the presence of orbital disease. 

Key Words: Exophthalmometer, Population, Axial Length, Mean 

Exophthalmometric Value, Relative Ocular Protrusion Value, 

Base, Exophthalmometry 

10:17 - 10:24 am 

FP-17 

Preseptal Cellulitis, Orbital Cellulitis and Cavernous Sinus 

Thrombosis in Jose R. Reyes Memorial Medical Center 

Anne Marfe L. Tan, Anthony Christopher G. Ortiz, 

Evelyn S. Morabe, Roland B. Bagnes, II 


Objectives: To determine the clinical patterns of Preseptal 

Cellulitis, Orbital Cellulitis and Cavernous Sinus Thrombosis in a 

tertiary government hospital in terms of patient profile, organisms 

involved, and antibiotic sensitivity patterns. 

Methods: Patients diagnosed with Preseptal Cellulitis, Orbital 

Cellulitis and Cavernous Sinus Thrombosis seen at Jose R. Reyes 

Memorial Medical Center from February 2011-August 2012, with 

available Culture and Sensitivity results were included in this case 

series. Gram stain, Culture and Sensitivity studies were done 

on eye discharge and/ or abscess drainage. All patients with 

impression of Orbital Cellulitis underwent Cranial CT Scan with 

Orbital cuts. Blood Culture and Sensitivity was also requested for 

patients suspected to have Cavernous Sinus Thrombosis. 

Results: A total of 112 patients participated in this study with 

an age range of 1-75. Mean age at presentation was 26.31. 

There were 68 females and 44 males, with female to male 

ratio of (1.5:1). 98 patients had Preseptal cellulitis, 14 patients 

had Orbital cellulitis. In 8 of these 14 patients, Cavernous Sinus 

Thrombosis was diagnosed by neuroimaging studies. Only 

22.32% of cultures yielded positive results but the most common 

isolate in all 3 conditions was Staphyloccocus Aureus. Sensitivity 

tests of Staphyloccocus Aureus isolates showed 100% sensitivity 

to Chloramphenicol, Cotrimoxazole, Gentamicin, Tetracycline 

and 100% resistant to Oxacillin and Penicillin. All patients with 

Preseptal Cellulitis and Orbital Cellulitis resolved with no serious 

complication. Three patients diagnosed with Cavernous Sinus 

Thrombosis expired while 5 other patients recovered with no 

serious complication. Conclusion: Preseptal cellulitis should be 

distinguished early from Orbital cellulitis, an extremely serious 

infection that can spread posteriorly to the cavernous sinus. CT 

scan and Microbial studies aid in the diagnosis and treatment. 

Pending availability of laboratory results, the sensitivity patterns 

noted in this study can be used as a guide. 

Key Words: Cellulitis, Preseptal, Orbital, Cavernous Sinus 

Thrombosis 


10:25 am - 10:32 am 

FP-18 

Your Common Sore Eyes or Something Endemic? 

Charl Marlo A. Jimenez 


Objective: To document and report a rare case of an 18 year old 

female presenting throughout the course of illness sore eyes and 

eventually transforming into a conjunctival mass. 

Methods: Case Report Method 


Results: A case of an 18 year old female who initially came in 

complaining of intermittent eye redness, itchiness and tearing 

for the past 3-6 months. She would claim of usage of brazen 

of antibiotics and combinations recommended by both general 

physicians and ophthalmologists in their locale which would 

provide partial relief of symptoms. In lieu the aforementioned 

history, loss of vision, diplopia and dizziness would not be 

encountered by the patient. Although the persistence of the 

aformentioned symptoms and an increasingly obvious growth of 

a conjunctival mass led to consult the DOH Eye Center. Patient 

was initially treated as ocular tuberculosis, work-up was done, 

in order to rule out other diagnoses such as ocular cicatricial 

pemphigoid and squamous cell carcinoma. When the patient was 

finally cleared for operation, excision biopsy of conjunctival mass 

was done with cryotherapy and amnion graft placement on the left 

conjunctiva under general anesthesia which she tolerated well. 

Conclusion: The specimens were sent of histopathology and 

Immunofluorescence studies - which recorded negative for 

fibrinogen, C1g, C3c, IgM and IgA. It showed chronic inflammation 

whereas lymphoproliferative diseases cannot be ruled out. The 

bulbar mass, measuring 2 x 2 x 2 mm and marginal sections 

16

also sent for histopathology, revealed chronic granulomatous 

inflammation highly suggestive of conjunctival tuberculosis. 

Patient was then referred for TB treatment and subsequent 

follow-up was done. 

Key Words: conjunctival TB, ocular cicatricial pemphigoid, 

papilloma, ocular TB, squamous cell, carcinoma 



9:05 - 11:30 am 


9:05 - 9:12 am 

FP-19 

Macular Measurements and Best Corrected Visual Acuity 

after Phacoemulsification in Diabetics with and without Partial 

Posterior Vitreous Detachment/ Focal Macular Traction 

Katrina Charisse T. Magno, Milagros H. Arroyo 

University of the Philippines-Philippine General Hospital 

Philippines 

Objective: To document the presence or absence of 

pre-phacoemulsifcation Partial Posterior Vitreous Detachment 

(PPVD)/ Focal Macular Traction (FMT) and to compare the 

post-phaco changes in macular thickness using Optical 

Coherence Tomography (OCT)-derived macular measurements 

of Central Macular Thickness (CMT) and Total Macular Volume 

(TMV), and post-phaco Best-Corrected Visual Acuity (BCVA) in 

patients with Non-Proliferative Diabetic Retinopathy (NPDR) at 

the Department of Ophthalmology and Visual Sciences, Philippine 

General Hospital, from the period of January-June 2012. 

Methods: 10 adult diabetics with Non-Proliferative Diabetic 

Retinopathy and who were scheduled for Phacoemulsification 

were included in the study. All pre-phaco eyes underwent OCT 

examination using OCT Stratus Zeiss with software version 4.0 

to document presence / absence of Partial Posterior Vitreous 

Detachment (PPVD)/Focal Macular Traction (FMT). Two 

quantitative OCT measurements: Central Macular Thickness 

(CMT) and Total Macular Volume (TMV) were measured 

automatically using OCT retinal mapping software. OCT was 

repeated at 6 weeks post-surgery. Main outcome measures are as 

follows: OCT assessment of the pre-phacoemulsification presence 

or absence of Partial Posterior Vitreous Detachment (PPVD)/Focal 

Macular Traction (FMT) OCT-derived macular measurements, 

Central Macular thickness (CMT) and Total Macular Volume 

(TMV) obtained at one week pre-Phacoemulsification and at 6 

weeks post-Phaco\n? Best Corrected Visual Acuity (BCVA) with 

the EDTRS chart in logmar units obtained 1 week pre-phaco, and 

at Day 1, Week 1, 2 and 6 post-phaco. 

Results: 10 eyes with NPDR were included in the study. 

6/10 eyes had PPVD/FMT pre-phacoemulsification. After 

Phacoemulsification, CMT in eyes without PPVD/FMT was 

statistically insignificant at p=0.20. CMT in eyes with PPVD/FMT 

17 


was statistically insignificant at p=0.65. Mean post-phaco CMT 

between groups was not statistically significant at p=0.33. TMV in 

eyes without PPVD/FMT was statistically insignificant at p=0.56. 

TMV in eyes with PPVD/FMT was statistically insignificant at 

p=0.28. Mean post-phaco TMV between groups was statistically 

insignificant at p=0.26. BCVA improved at day 1 post-phaco in 

both groups and showed no deterioration till the 6th week postphaco 

despite the increasing macular measurements. Differences 

between groups however were not statistically significant at day 1 

post-op (p=0.26), week 1 (p=0.32), week 2 (p=0.88) and at week 

6 (p=0.83). 

Conclusion: In this study, eyes with or without PPVD/FMT were 

observed to have an insignificant increase in macular thickness 

and volume after phacoemulsification. Insignificant improvement 

in BCVA continued till the 6 weeks post-phacoemulsification 

despite an increased CMT and TMV in both groups. A larger 

subject pool, a longer follow-up period as well as use of an 

upgraded OCT are recommended for future studies. 

Key Words: Optical Coherence Tomography, Diabetic 

Retinopathy 


9:13 - 9:20 am 

FP-20 

Full Field Electroretinography in Type 2 Diabetes Mellitus 

with No Diabetic Retinopathy and Mild Diabetic Retinopathy 

Institution: St. Luke’s Medical Center 

Rachelle G. Anzures, Leslie Gatchalian 


Objective: To describe and compare the full field 

electroretinograph of type 2 diabetes mellitus patients with no 

diabetic retinopathy and mild diabetic retinopathy. To correlate 

the electroretinographic changes noted with HbA1c, duration of 

diabetes, age, gender, BMI, type of medication and smoking. 

Methods: The subject population was composed of 18 eyes of 10 

patients with type 2 diabetes mellitus. They were recruited from 

St. Luke’s Medical Center out patient department and private 

clinics from October 2011 to June 2012. Medical history taking 

and comprehensive ophthalmic examination was done on each 

patient. The patients who met the inclusion criteria proceeded with 

HbA1c, fluorescein angiography and full field electroretinography. 

Independent masked retina specialist and neurophysiologist 

interpreted the respective results. 

Results/Conclusion: Prolonged oscillatory potential 1 implicit 

time is the most common ERG abnormality seen in patients with 

Type 2 DM patients with no diabetic retinopathy and mild diabetic 

retinopathy regardless of HbA1c level and disease duration. 

Higher percentage of patients with delayed OP1 implicit time 

is seen in patients with mild diabetic retinopathy compared to 

patients with no diabetic retinopathy. Disturbances of the ERG

components is more consistent in patients with disease duration 

of 5 years and more, male gender, smoking and age 51 years 

and above. 

Key Words: Full Field Electroretinography, Mild Diabetic 

Retinopathy, Type 2 Diabetes Mellitus, No Diabetic Retinopathy 

9:21 - 9:28 am 

FP-21 

Measurement of Retinal Nerve Fiber Thickness in Patients 

with Diabetic Retinopathy 

Maria Cecilia Arenal, Romulo Aguilar 


Objective: The study was carried out to detect whether there 

is early neuronal degeneration or atrophy among patients with 

diabetes using the Cirrus SD-OCT. 

Methods: 26 diabetic subjects (52 eyes) with varying degrees 

of diabetic retinopathy and 24 age-matched controls (48 eyes) 

without optic nerve and retinal disease were analyzed. RNFL 

thickness around the disc was measured using Cirrus, SD-OCT. 

Results: The average RNFL thickness was found to be 

significantly thinner among diabetics (95 +/-10um) compared 

to control (99.2+/-9.8um; p=0.04). Comparing all quadrants, 

only the temporal RNFL thickness was noted be significantly 

different between the 2 groups (66.5+/-9.6 um versus 73.6+/- 

13.6 um; p=0.003). RNFL thickness did not seem exhibit a linear 

relationship with either Hba1c or duration of diabetes. 

Conclusion: Measurement of RNFL thickness offers another 

non-invasive and affordable and screening tool for diabetic 

retinopathy. Evidence of neuronal degeneration or atrophy found 

in this study may pave the way for the development of a new 

therapeutic strategies for Dr. like neuroprotection. 

Key Words: diabetic retinopathy, retinal nerve fiber layer 

thickness, Cirrus SD-OCT, HBALC 

9:29 - 9:36 am 

FP-22 

Macular Pigment Optical Density of Healthy Eyes in 

University of Santo Tomas Hospital 

Ernesto D. Pablo, Jr. 


Objective: To determine the Macular Pigment Optical Density 

(MPOD) of healthy eyes in the University of Santo Tomas 

Hospital using a macular pigment densitometer (Macuscope). To 

determine significant difference between Age and Sex with the 

MPOD values. 

Methods: Cross sectional, prospective study of 60 healthy eyes 

in the University of Santo Tomas Hospital from June 2012-August 

2012. The subjects underwent complete ophthalmologic exam to 

satisfy the requirements for the inclusion and exclusion criteria. 

The subjects had MPOD measurement with a macular pigment 

densitometer. 

Results: The mean MPOD in the sample population was 

0.275±0.025 log units (0.25-0.30) using the MAD t test. There 

were no significant difference between MPOD values with age 

(p>0.15) and sex (p>0.99). 

Conclusion: The study establishes MPOD levels in the given 

population. Age and sex do not affect the MPOD levels. 

Key Words: Macular pigment optical density, Macular pigments, 

heterochromatic flicker, photometry, Lutein, mesozeaxanthin, 

zeaxanthin 

FP-23 

9:37 - 9:44 am 


Surgical benefits of Endo-Illumination Filters on the Stellaris 

PC Surgical System 

Alex U. Pisig, Emerson Molina, Margarita Justine O. Bondoc, 

Narciso F. Atienza, Jr. 


Endo-illumination is an indispensable tool for visualization 

of ocular tissues during vitreoretinal surgery. It is, however, 

important to balance between the need for bright illumination 

and protection from light hazard brought about by the illumination 

itself. The Stellaris PCä is integrated with different light sources 

offering adjustments for different vitreoretinal surgery modalities 

without sacrificing optimal illumination and safety measures. 

Objective: To elucidate the surgical benefits of each of the color 

filters integrated in the Stellaris PC’s surgical system. 

Methods: Review of personal surgeon’s experience. 

Results: We describe our experiences with 78 eyes using the 

different illumination filters of Stellaris PCä surgical system, which 

is equipped with a dual bright light source (xenon and mercury 

vapor) and 3 color filters. The parameters used were 5000 cuts 

per minute (cpm) with vacuum of 300 mm Hg and the light source 

at 40% illumination. The xenon light source with the yellow or 

green filter was used for general core vitrectomy; the xenon 

light source with the green filter was used for macular work. The 

yellow filter provides good visualization and blocks blue light 

delivery to reduce phototoxicity and improve overall comfort. 

The green filter enhances contrast to help visualize structures 

and reduce dependency on indocyanine green angiography 

(ICG). The amber filter was used for diabetic cases with vitreous 

hemorrhage, tractional retinal detachment, and proliferative 

diabetic retinopathy. This filter passes the longest wavelengths 

and is potentially the safest for the unstained eye. The amber 

filter is excellent for peripheral vitreous procedures and minimizes 

glare from instruments during air/fluid exchange. 

Conclusion: The color filters available with the Stellaris PCä 

improve the surgeon’s ability to visualize ocular tissues under 

various surgical conditions, minimize phototoxicity, and optimize 

clinical outcomes. The Stellaris PCä system allows the surgeon 

to choose the light source and a color filter based on his or her 

needs. 

18


Key Words: Endo-illumination, Vitrectomy, Color Filters, Stellaris 

PC, Xenon light source, Mercury Vapor, Phototoxicity. 

9:45 am- 9:52 am 

FP-24 

Outcomes of Retinoblastoma Patients with High-risk 

Histopathological Features in a Tertiary Hospital 

Patricia E. Cabrera, Gary JV. Mercado, 

Rolando Enrique D. Domingo 


Philippines 

Objective: To desribe the outcome of patients with bilateral or 

unilateral retinoblastoma with high-risk histopathological features 

managed at a tertiary hospital in the Philippines. 

Methods: This was a descriptive, retrospective review 

of retinoblastoma cases with high-risk histopathological 

characteristics seen at a tertiary hospital from January 1999 to 

July 2012. Out of 239 patients, those with at least one of the 

following features were included in the study: positive cut optic 

nerve margin, post-laminar optic nerve involvement (PLONI), 

intra- or extrascleral involvement, choroidal invasion, and anterior 

segment involvement. We determined the number of patients who 

developed orbital recurrence and metastasis, otherwise known 

as events, within 1 year after enucleation or exenteration and 

compared the outcomes between those who received and did not 

receive adjuvant therapy. 

Results: Of the 82 eyes of 79 patients with high-risk 

histopathologic features, 25.6% had orbital recurrence and 

18.3% developed CNS, lymph node, or distant metastasis. 

None with isolated choroidal involvement (n=24) or combined 

choroidal and anterior segment involvement (n=4) developed 

recurrence or metastasis. Both patients with isolated anterior 

segment (n=1) and PLONI with negative margin involvement 

(n=1) remained event-free with chemotherapy. The following 

developed orbital recurrences: 2 of 9 patients with combined 

choroid and scleral involvement, and 1 of 8 patients with PLONI 

negative margin with choroidal involvement. These patients did 

not receive immediate post-operative chemotherapy. Two out of 

4 patients with isolated PLONI with positive margin of resection 

developed metastasis despite adjuvant therapy. Of 12 patients 

with combined choroid, scleral, or anterior segment and PLONI 

with positive margin involvement, only 3 of the 7 patients who 

received full chemotherapy remained event-free, while the rest 

developed orbital recurrence or metastasis (9 of 12). Of 17 

patients with extrascleral involvement and varying degrees of 

intraocular involvement and optic nerve margin involvement, only 

3 of the 9 who received full chemotherapy remained event-free, 

including two who received an intensive chemotherapy course. 

Conclusion: Our small sample size is attributable to limited 

patient follow-ups and chemotherapy drop-outs. Isolated choroidal 

and combined choroid and anterior segment involvement had no 

recurrences or metastasis either with or without adjuvant therapy. 

Patients with combined choroid and scleral involvement and 

those wih PLONI, negative margin with choroidal involvement 

had better outcomes with adjuvant therapy than without. Patients 

19 

with the following features developed events despite adjuvant 

therapy: positive optic nerve margin combined with any ocular 

tissue involvement, and extrascleral involvement combined with 

any other feature. We recommend giving a timely and complete 

chemotherapy regimen to prevent recurrence or metastasis in 

combined choroid and scleral involvement, and PLONI negative 

margin with choroidal involvement. We suggest intensive 

chemotherapy for patients with positive margin involvement or 

extrascleral involvement. Further studies are recommended 

to establish the need for chemotherapy in isolated PLONI and 

isolated anterior segment involvement. 

Key Words: Retinoblastoma, High-risk, Histopathology, 

Outcomes 

9:53 am - 10:00 am 

FP-25 

Choroidal Melanoma in a Patient with Nevus of Ota 

Bryan Jason B. Atienza 


Objective: To describe what we believe to be the first reported 

case of choroidal melanoma in a patient with Nevus of Ota in the 

Philippines. 

Methods: Case Report 

Results: This is a case of a 33 year-old Filipino male, presenting 

with unnoticed blurring of vision in right eye, detected on 

routine pre-employment physical exam. He was known to have 

congenital oculomucodermal melanocytosis, and was apparently 

well until present consult. Best corrected visual acuity was 20/30- 

2 in the right eye, and 20/20-1 in the left eye. Amsler grid showed 

metamorphopsia in superomedial quadrant of the right eye. Dilated 

eye exam showed an elevated choroidal mass approximately 10 

mm in diameter, immediately below the optic nerve, extending 

temporally involving the inferior aspect of the macula. B-scan 

revealed the peripapillary choroidal mass approximately 7.5 mm 

in thickness. MRI of the orbits were consistent with a melanincontaining 

tumor. Enucleation with scleral-wrapped orbital 

implant was done. Histopathology showed malignant melanoma, 

epithelioid type. 

Conclusion: Choroidal melanoma is the most common primary 

intraocular malignant tumor in adults. It is common in Caucasians, 

extremely rare in Blacks, with Hispanics and Asians having small 

to intermediate risk. Nevus of Ota, a hamartoma of dermal 

melanocytes, presents as a blue or gray patch on the face, and 

may involve ocular and oral mucosal surfaces. Less than 20 

cases worldwide since 1980 have been reported; we believe that 

this is the first reported case of choroidal melanoma presenting in 

a patient with oculomucodermal melanocytosis in the Philippines. 

It is important to recognize that choroidal melanoma may arise in 

patients diagnosed to have Nevus of Ota. Hence we recommend 

that fundus screening of these patients be performed. 

Key Words: choroidal, melanoma, nevus, ota, oculomucodermal, 

melanocytosis, malignant, tumor

Chair: Vicente Victor D. Ocampo, Jr., MD 

Co-chair: Ellen Yu-Keh, MD 


10:12 am - 10:19 am 

FP-26 

Choroidal Tuberculosis: A Case Report 

Johanna T. Cervantes, Juan S. Lopez 


Objective: To describe a case report of choroidal tuberculosis in a 

44 year old male patient with no signs of pulmonary tuberculosis. 

Method: Case report 

Results: The patient presented with unilateral eye redness 

and blurring of vision. Fundoscopy revealed multiple yellow 

elevated nodules with ill-defined borders at the posterior pole and 

peripapillary area. T spot test was positive. Patient was started 

on anti-koch’s therapy with initial worsening of vision. Continued 

treatment provided gradual and steady improvement of signs and 

symptoms. 

Conclusion: Intraocular tuberculosis can occur without concurrent 

systemic tuberculosis. Patients may observe paradoxical initial 

worsening of lesions after initiation of treatment, but symptoms 

improve with continued medication. 

Key Words: Choroidal tuberculosis, T spot test, Intraocular TB, 

Tuberculoma, Jarisch-herxheimer reaction 

10:20 am - 10:27 am 

FP-27 

Chronic Sympathetic Ophthalmia: A Case Report 

Margarita Justine O. Bondoc, Analyn Suntay-Guerrero, Emerson 

Jay B. Molina, Alex U. Pisig, Egidio Jose S. Fortuna, 

Kristine Corpus 


Objective: To report a case of chronic sympathetic ophthalmia in 

a 44 year old female and its management. 

Methods: This is a case report. 

Results: A 44 year old female first seen 4 years prior after blunt 

trauma to the right eye resulted in blurring of vision on both eyes. 

Reduced visual acuity to counting fingers and finding of panuveitis 

on both eyes through flourescein angiography led to the diagnosis 

of sympathetic ophthalmia. She was treated with oral and topical 

steroids then 2 cycles of IV cyclophosphamide which resolved her 

symptoms. After 2 years of no follow up, she returned with good 

vision but with +1 cells on the left eye. Mild topical steroid was 

started. Flourescein angiography revealed no active inflammation 

or choroiditis. The steroid was then tapered and discontinued. 

Conclusion: Sympathetic ophthalmia is a bilateral, nonnecrotizing, 

granulomatous uveitis that can occur following 

ocular trauma or surgery. It is has an acute and chronic phase 

and can have exacerbations. Prompt assessment and treatment 

with corticosteroids and immunomodulating therapy should 

be instituted to increase the chances of regaining good visual 

function. 

Key Words: chronic sympathetic ophthalmia, recurrence, 

relapse, eye trauma 



1:30 - 4:00 pm 

Chair: Rigo Daniel Reyes, MD 

Co-Chair: Ernesto Pangalangan, Jr., MD 

Glaucoma 

10:28 am - 10:35 am 

FP-28 

Ocular Toxoplasmosis among Filipino Patients seen at the 

East Avenue Medical Center: Clinical Manifestation and 

Effectiveness of Treatment 

Majourette Dy Varela, Jessica Marie R. Abaño 


Objective: To determine the profile of Ocular Toxoplasmosis 

among Filipino patients seen at the Department of Ophthalmology 

East Avenue Medical Center in terms of its clinical manifestation 

and the effectiveness of treatment from January 2007 to August 

2012. 

Methods: A retrospective descriptive study was conducted 

among patients with uveitis seen at a tertiary government hospital 

from January 2007 to August 2012. All patients who were positive 

with toxoplasmosis titer were included in the study. Excluded 

were cases wherein toxoplasmosis was considered but titers 

were not available and cases with positive titers but treatment 

was not instituted due to default follow-up. The presenting ocular 

symptoms, treatment received and latest ocular findings were 

collected. Descriptive statistics was used to analyze the data. 

Results: Fourteen patients were identified with 4:3 male to female 

ratio and mean age of 41.07. The most common presentation 

was blurring of vision. Presenting visual acuity ranged from 

20/32 to counting fingers. Most common ocular findings were 

iritis and vitritis. All patients received the standard treatment for 

toxoplasmosis. Three cases were lost to follow-up in the course 

of the treatment. There was absence of iritis and vitritis as well 

as improved visual acuity among patients who had completed 

treatment. Two patients developed increased intraocular pressure 

that had been controlled by topical anti-glaucoma medication. 

Conclusions: Toxoplasmosis is a disease known to be the 

most common cause of retinochoirditis and in immunocompetent 

patient, is usually self-limiting. Treatment shortens the duration of 

the disease and showed results of better visual prognosis at the 

end of treatment regimen. Patients should be well advised on the 

course of the disease and the benefits of a completed treatment. 

Key Words: Treatment, Filipino 


20


10:36 am - 10:43 am 

FP-29 

Intermediate Uveitis as an Initial Presentation of Sarcoidosis 

in an Adolescent Male 

Jacqueline T. Mupas, Jessica Marie R. Abaño 


Objective: To report a case of sarcoidosis, initially presenting as 

intermediate uveitis in an adolescent Filipino male. 

Methods: Case report. 

Results: This is a case of a 19-year-old male, who presented 

with bilateral uveitis when he was 13 years of age. On initial 

examination, he had minimal anterior segment inflammation with 

++ vitreous cells, macular edema and optic disc hyperaemia on 

both eyes. Chest x-ray was read as possible koch’s infection and 

PPD was positive at 22mm. Impression then was intermediate 

uveitis, possibly ocular tuberculosis. He was then referred to a 

pulmonologist who gave him quadruple anti-koch’s treatment. His 

ocular inflammation initially responded to topical and systemic 

medication but later became recurrent in nature. At this time, a 

pediatric rheumatologist cleared him of any systemic disease 

that might contribute to ocular inflammation. A year later, patient 

developed subcutaneous on both lower extremities for which he 

was treated with topical medications. His ocular inflammation 

would recur intermittently and he was treated with both topical 

and oral steroids whenever necessary. 2 years later, chest x-ray 

showed extensive PTB but sputum AFB were negative. He was 

again treated with anti-tuberculosis medication for 6 months. A 

year later he has swelling of the cheek and ulcerations on the 

legs. Biopsy showed granulomatous inflammation w/ some 

necrosis, AFB (-) PAS (-). Lung findings revealed hilar infiltrates. 

He was again referred to rheumatologist who then diagnosed him 

to have Sarcoidosis. 

Conclusion: Although relatively uncommon, sarcoidosis 

should be a differential diagnosis of tuberculosis in patients with 

recalcitrant uveitis associated with other systemic granulomatous 

inflammation. This is particularly important in regions where 

tuberculosis is epidemic and sometimes overdiagnosed. 

Key Words: tuberculosis, sarcoidosis, intermediate uveitis 

10:44 am - 10:51 am 

FP-30 

A Retrospective Study of the Incidence, Indications and 

Outcomes of Nd:YAG Capsulotomy in Eyes Implanted with 

and Accommodating IOL 

Angela Adelaida Samano¹, Rosalie Mae M. Reyes² 

¹Cardinal Santos Medical Center, ²Asian Eye Institute, Philippines 

Objective: To report the incidence of capsular changes in 

Crystalens-implanted eyes and analyze the indications and 

outcomes of yag capsulotomy. 

21 

Methods: We reviewed the records of 411 eyes of 258 patients 

implanted with the Crystalens IOL. Capsular change indications 

for yag capsulotomy were posterior capsular opacity (PCO), 

lens tilt and capsular striae. Eyes in each indication were further 

subdivided into therapeutic yag (TY) and prophylactic yag (PY) 

groups. Outcomes before and after yag capsulotomy were 

analyzed. 

Results: 90 of 411 crystalens-implanted eyes (21%) had 

undergone yag capsulotomy. 61 eyes had PCO, 12 had lens tilt 

and 17 had striae. 27 eyes belonged to the therapeutic (TY) and 

63 eyes to the prophylactic (PY) yag group. The mean interval 

between phacoemulsification and yag capsulotomy was 10 

months. In the TY PCO subgroup, UDVA changed from 20/40 preyag 

to 20/25 post-yag, UNVA from J3 to J2, MRSE from -0.43D 

to -0.2D. In the TY tilt subgroup, UDVA changed from 20/50 to 

20/30, UNVA was unchanged at J2 and MRSE from -1.21D to 

-0.89D. In the TY striae group, UDVA changed from 20/50 to 

20/30, UNVA from J3 to J2 and MRSE from 0.62D to -0.4D. In 

the PY PCO subgroup, UDVA was unchanged at 20/25, UNVA 

unchanged at J2 and MRSE changed from -0.52D to -0.47D. In 

the PY tilt subgroup, UDVA changed from 20/25 to 20/20, UNVA 

was unchanged at J2 and MRSE changed from -0.87D to -0.45D. 

In the PY striae subgroup, UDVA was unchanged at 20/30, UNVA 

changed from J3 to J2 and MRSE changed from -0.62D to -0.7D. 

Conclusion: Capsular changes occur after Crystalens 

implantation which necessitate yag capsulotomy. Once vision 

has deteriorated, a therapeutic yag treatment can help improve 

vision. If capsular changes have occurred but vision has not 

deteriorated, a prophylactic yag capsulotomy can stabilize visual 

and refractive outcomes. 

Key Words: Crystalens, Nd:YAG laser posterior capsuolotomy, 

Accommodating IOL, Posterior capsular opacity 

10:52 am - 10:59 am 

FP-31 

Refractive and Visual Outcomes of Surgical Treatments for 

High Myopia Patients 

Ma. Rachelle Katrina C. Solis, Robert Edward T. Ang 


Objective: To present the refractive and visual outcomes of 

refractive surgical treatment options used in high myopia patients. 

Methods: This is a retrospective review of patients diagnosed 

with high myopia (MRSE >/= -6.00D) who underwent one of 

the following procedures: Laser In Situ Keratomileuis (LASIK), 

Photorefractive Keratectomy (PRK), phakic IOL implantation 

with the Staar Implantable Collamer Lens (ICL) or Alcon Cachet 

Phakic IOL. Eyes with BDVA of less than 20/30 due to amblyopia 

or eye pathologies were excluded from the study. 

Results: This study evaluated 145 eyes of 77 patients. 86 

eyes underwent LASIK; 37 eyes underwent PRK; 16 eyes 

were implanted with the STAAR ICL and 6 eyes with Acrysof 

Cachet lens. Preoperatively, the mean MSRE of the LASIK

group was -7.44D, the PRK group was -7.71D, the STAAR ICL 

group was -9.82D and the Cachet group was -12.08D. At 1 year 

postoperatively, the mean MRSE was -0.22D for the LASIK group, 

+0.23D for the PRK group, -0.40D for the STAAR ICL group and 

-0.28D for the Cachet group. The mean UDVA at 1 year follow-up 

was 20/20 in the LASIK and PRK groups, 20/25 in the STAAR 

ICL group and 20/30 in the Cachet group, while the BDVA was 

20/20 in all groups. An increase in spherical aberration (SA) and 

total higher order aberration (HOA) was observed in LASIK (SA 

p=0.00; HOA p=0.00) and PRK (SA p=0.00; HOA p=0.00) but 

not in the STAAR ICL (SA p=0.11; HOA p=0.69) and Cachet (SA 

p=0.95; HOA p=0.25) groups. 

Conclusion: The four refractive treatment options were effective 

at reducing the myopic refractive error and achieving good 

uncorrected distance vision. Laser refractive treatments cause an 

increase in spherical and higher order aberrations not seen in the 

phakic IOL treatments. 

Key Words: Laser In Situ Keratomileusis (LASIK), Photorefractive 

Keratectomy (PRK), Cachet, Phakic IOL 

1:30 pm - 1:37 pm 

FP-32 

Preliminary Report on the Incidence of Steroid-induced 

Ocular Hypertension in Patients in a Tertiary Hospital: A 

5-year Prospective Study 

Victoria Anne A. Yao, Ma. Margarita Lat-Luna, Juan S. Lopez 


Philippines 

Objective: To determine the incidence of steroid induced ocular 

hypertension among patients in the Department of Ophthalmology 

and Visual Sciences, Sentro Oftalmologico, Philippine General 

Hospital from January 2012 to January 2017 

Methods: A prospective, observational, non-randomized 

study among patients who are and will be administered topical, 

periocular, intravitreal and systemic steroids, aged 10 years old 

and above, is being used in this study. The incidence of steroidinduced 

ocular hypertension was measured and compared 

according to the different routes of administration. 

Results: Twenty patients were recruited into the study. Among 

the 27 eyes 6 had an increase in intraocular pressure 24mmHg 

with a total incidence of 22%. A higher proportion of male eyes 

were noted (29%) compared to female eyes (10%). The mean 

age of eyes with steroid-induced ocular hypertension is 27±7 

years which is lower compared to eyes without steroid-induced 

ocular hypertension (39±15 years). The mean baseline IOP is 

slightly higher (14.7±1.5) compared to those without steroidinduced 

ocular hypertension (12.4±2.5) (p=0.0567). Mean vertical 

cup-to-disc ratio among eyes with steroid ocular hypertension 

is 0.5 while the mean vertical cup-to-disc ratio of eyes without 

steroid induced ocular hypertension is 0.4±0.08 (p=0.0253). The 

incidence seems to be higher among those with combination 

(33%) as compared to those on topical steroids (22%). Upon 

administration of the steroids 2 of the patients had increase in 

intraocular pressure after 1 week, one patient after 2 weeks, one 

patient after one month and one patient after 2 months. 

Conclusion: A 22% incidence of steroid-induced ocular 

hypertension was demonstrated. Higher incidence of steroidinduced 

ocular hypertension were seen among males, of younger 

age and with greater baseline vertical cup-to-disc ratio. Use of 

a combination of steroids was noted to cause an increase in 

intraocular pressure more than the topical or periocular routes. 

Key Words: steroid-induced, ocular hypertension 

1:38 pm - 1:45 pm 

FP-33 


Comparison of Trabeculectomy with Mitomycin-C and 

Glaucoma Drainage Device Implantation in Glaucoma 

Management after Penetrating Keratoplasty 

Meliza Katrina B. Agulto, Rainier Victor A. Covar 


Philippines 

Objective: The management of glaucoma post penetrating 

keratoplasty is difficult particularly when medical treatment 

has failed. Surgery is the next step particularly in intractable 

glaucoma. Surgical treatment options for patients post 

penetrating keratoplasty include trabeculectomy with or without 

anti-metabolites, drainage devices, and cycloablation. Secondary 

glaucomas have poorer visual outcomes, and limited treatment 

options. Thus treatment is a challenge. This study was done 

to compare surgical outcomes in terms of intraocular pressure 

control of trabeculectomy with mitomycin-C and glaucoma 

drainage device implantation and determine appropriate surgical 

management in glaucoma control in post-penetrating keratoplasty 

patients. 

Methods: This is a retrospective study where a review of 

medical records of patients who developed glaucoma after 

penetrating keratoplasty and underwent either trabeculectomy 

with mitomycin-C or glaucoma drainage device implantation to 

control the glaucoma between October 2006 to June 2012 at 

the Department of Ophthalmology, University of the Philippines- 

Philippine General Hospital was done. The following information 

was documented for each patient: age, gender, corneal diagnosis 

before keratoplasty, details of keratoplasty in terms of graft versus 

donor size, other simultaneous operations, visual acuity (VA), 

intraocular pressure (IOP), number of glaucoma medications 

before and after PKP, graft status before glaucoma treatment 

and at the final visit, type of glaucoma before treatment, and the 

glaucoma procedure performed and its complications if any. Three 

primary outcomes were evaluated: graft status, postoperative IOP, 

and VA. Controlled IOP with or without medications was defined 

as IOP greater than 6 but less than 20. Summary of quantitative 

data were expressed in mean, standard deviation and range. 

Paired t-test was used to determine significant decrease in the 

mean IOP control and number of medications before and after 

keratoplasty. Single-factor analysis of variance (ANOVA) was 

used to determine if there are significant differences in the mean 

between the two surgeries. Mc Nemar’s Test and generalized 

Fisher’s exact test were also used to compare percentages. 

Kaplan-Meier survival analysis was used to compare the 

22


surgeries in its effect to graft clearance. All the statistical tests 

were performed using SAS 9.0. P-values less than 0.05 indicate 

significant difference. 

Results: Out of the 222, 25 charts met the study’s criteria. 

Sixteen (55.1%) had clear graft after the surgery; 12 (48%) corneal 

graft status was the same pre- and post- glaucoma surgery. 

Eleven (78.6%), and 11 (100%) underwent trabeculectomy 

with mitomycin-C, and GDD had controlled IOP. No significant 

difference (p = 0.069) in percentage of patients with IOP control 

between the two groups. Mean IOP of patients under the Trab 

MMC [32.6 ± 14.4 to 15.1 ± 13.2, p = 0.002] and GDD group 

[22.8 ± 15.7 to 12.7 ± 2.5, p = 0.035] significantly decreased. The 

decrease in mean IOP of the two groups did not differ [p=0.553] 

significantly. Using Mc Nemar’s, patients in the Trab MMC group 

(p=0.004) with IOP of 6 to 20 mmHg significantly increased 

(14.3% to 78.6%). In the GDD group, the number of patients 

with IOP of 6 to 20 mmHg (72.7% to 100%) and the number of 

patients with IOP of more than 20 mm Hg (27.3% to 0%) did not 

change significantly (p=0.250). Before [p = 0.724] surgery, there 

is no significant difference in number of medications taken by 

both groups. After surgery both groups significantly reduced the 

mean number of medications. The mean number of months that 

a patient treated with Trab MMC and GDD will have a controlled 

IOP are 12.5 ± 1.9 and 14.5 ± 6.4 respectively. Log Rank test [p 

= 0.847] indicated that the surgeries do not differ in the number of 

months to have controlled IOP. 

Conclusions: The two surgical procedures of trabeculectomy 

with mitomycin-C and glaucoma drainage device implantation 

are effective methods of controlling IOP post keratoplasty. There 

was no significant difference between the two groups with respect 

to controlling IOP. These two methods were able to supplement 

aqueous outflow in patients post keratoplasty. Although IOP 

increased months after keratoplasty these surgeries were able 

to lower IOP and lower the amount of medications needed by 

the patient to achieve IOP control as compared to pre- glaucoma 

surgery. It was notable that visual acuity and graft status did not 

significantly alter or deteriorate post- glaucoma surgery. 

Key Words : glaucoma, glaucoma drainage device, penetrating 

keratoplasty, trabeculectomy with mitomycin-C 

1:54 pm - 2:01 pm 

FP-35 

Malignant Glaucoma Post Pars Plana Vitrectomy with 

Intraocular Lens Retrieval 



Objective: To present a d discuss a case of a 60 year old female 

who developed malignant glaucoma post pars plana vitrectomy 

and intraocular lens retrieval. To emphasize the importance of a 

thorough ophthalmic evaluation, diagnosis and management of 

this case 

Methods: Case Report Setting: Tertiary Government Hospital 

Patient: One 

23 

Results: This is a case of a 64 year old female who underwent 

extracapsular cataract extraction with posterior chamber 

intraocular lens implantation (IOL). The surgery was uneventful, 

however, on follow up it was noted that the patient’s lens implant 

was not in place and was in the vitreous cavity. A small retinal 

tear was also noted. The patient underwent pars plana vitrectomy 

with IOL retrieval, cryoretinopexy and perfluoropropane infusion. 

Five days post operatively the patient developed severe eye pain. 

Consult was done. It was noted that anterior chamber was shallow 

and that the intraocular pressure was 35 mmHg. The retina was 

unremarkable. The patient was given brimonidine eye drops. On 

follow up, 12 days post IOL retrieval, the chamber still shallow 

and intraocular pressure was 42 mmHg. Dorzolamide and timolol 

maleate was added to the patient medications. Laser Iridotomy 

(LI) was done. Intraocular pressure was monitored post LI. The 

pressure was still ranging from 12-42mmHg. An Ultrasound 

biomicroscopy was done and revealed supraciliary effusion, a 

posterior capsule-iris diaphragm and malrotation of the ciliary 

body. A diagnosis of malignant glaucoma was made. At this point 

the plan was to drain the supraciliary fluid, remove the perfluoron 

infused, and goniosynechiolysis to create a communication 

between the vitreous and the anterior chamber. The patient then 

underwent the proposed procedure. Postoperatively the patient’s 

IOP was noted to be 12 mmHg and the anterior chamber was 

deep. 

Conclusion: Malignant glaucoma treatment still remains a 

challenge because of the limited understanding of its etiology. 

Whatever pathogenesis for the development of malignant 

glaucoma is important to establish a communication between the 

anterior chamber and vitreous and that it involves the interplay of 

the ciliary process, lens and anterior vitreous. 

Key Words: Malignant glaucoma, aqueous misdirection, pars 

plana vitrectomy, ultrasound biomicroscopy 

2:02 pm - 2:09 pm 

FP-36 

Correlation between the Average Retinal Nerve Fiber Layer 

Thickness and Rim Area Value of the Cirrus OCT with the 

Humphrey Visual Field Index Value 

Andrei P. Martin 


Objective: To examine the correlation between the average 

retinal nerve fiber layer (RNFL) thickness and visual field index 

(VFI), as well as the correlation of rim area (RA) and VFI. 

Methods: This retrospective study was performed on 121 eyes 

of 87 patients who are diagnosed cases of glaucoma. All eyes 

underwent examination by the Cirrus OCT and the Humphrey 

visual field analyzer. The correlation of VFI and RNFL thickness, 

and VFI and RA were analyzed in all eyes. The Spearman’s rank 

correlation coefficient was used for analysis. 

Results: A positive correlation (0.9987) between RNFL thickness 

and VFI was seen in all eyes. RA and VFI also showed a positive 

correlation (0.9992) in all eyes.

Conclusion: Both the average retinal nerve fiber layer thickness 

and the rim area value of the Cirrus OCT have a positive 

correlation with the Humphrey visual field index value. 

Key Words: RNFL thickness, rim area, visual field index, 

Glaucoma, Cirrus OCT 

2:10 pm - 2:17 pm 

FP-37 

The Effect of Direct Cold Compress on Intraocular Pressure 

in Healthy Subjects 

Niccolo Zandro Valencia, Mario M. Yatco, Ian Ethelbert Dy 


Objective: To investigate the effect of direct cold compress on 

intraocular pressure (IOP) in normal subjects. 

Methods: A randomized Controlled Trial; Thirty eyes from fifteen 

healthy volunteers; One eye of each of the fifteen subjects was 

randomly chosen as the experimental eye. The other eye, which 

also remained closed was not subjected to the cold compress 

and served as the control eye: IOP were measured in thirty 

eyes of fifteen healthy volunteer subjects before and after the 

application of direct cold compress using an ice-filled zip lock 

with a temperature of 20-25 degrees Celsius. IOP was measured 

using the Goldmann Applanation tonometer after 5 minutes 

of compress and then after 15 minutes of compress, while the 

temperature of the cold compress was taken using an ordinary 

laboratory alcohol thermometer during the 1st minute of each 

compress. Data was then analyzed using t-test for dependent 

and independent variable. 

Results: After application of cold compress for 5 minutes, the 

mean IOP on the experimental eyes decreased from a baseline 

of 17.17 mmHg to 14.51 (P< 0.014) and after 15 minutes, to 13.15 

mmHg (P


and severity of Pediatric Ocular Trauma Cases seen in a tertiary 

hospital for four months, to establish the visual outcomes of 

the cases and to determine prognostic factors that affected the 

outcomes of pediatric ocular injuries. 

Methods: This was a prospective, observational study done at 

the Department of Ophthalmology and Visual Sciences of the 

Philippine General Hospital from January to April 2012. Pediatric 

patients aged 0-18 who came in to the Emergency Clinic for 

ocular trauma were referred to the study. Eighty six (86) patients 

were included in the study. Patients were examined on initial 

consult and computed for the Ocular Trauma Score by converting 

the OTS variables into OTS categories as performed in the OTS 

study. Patients were followed up after 1-, 2- and 3 months after 

initial consult. The distribution of percentage of final visual acuity 

was compared between the OTS study and our result. Descriptive 

and correlation statistics were performed to determine prognostic 

factors affecting visual outcomes. 

Results: In our setting, there was male predominance 

(76%), mostly occurring in 2-6 age group (37%). Injuries were 

predominantly accidental (91%) occurring at home (72%). Majority 

were caused by blunt trauma (55%) followed by penetrating 

injuries (21%). Majority of the patients (76.2%) had no impairment 

while 14% had severe visual impairment after three months. 

There was 88.39% agreement (p=0.05) of the OTS predicted 

visual acuity with the final visual acuity in the study. Factors that 

affected the outcomes included initial visual acuity, penetrating 

injuries, endophthalmitis and retinal detachment. 

Conclusion: Ocular trauma is a common cause of visual 

impairment in children and can be prevented. There should be 

preventive measures, better supervision, public education and 

aggressive and prompt management to improve visual outcomes. 

Key Words: ocular trauma, pediatric ocular trauma, ocular trauma 

score, visual prognosis.. 

FP-40 

2:45 pm - 2:52 pm 

Ophthalmologic Findings in Hunter Syndrome 

Frances Marie DC. Roa, Marissa N. Valbuena, 

Mary Ann R. Abacan, Mary Anne D. Chiong 


Philippines 

Objective: To identify the eye findings of patients diagnosed with 

Hunter Syndrome and to correlate the severity of ocular findings 

with that of the disorder. 

Methods: A Descriptive Analysis was done on 15 patients, 

with a mean age of 11 years. All patients were diagnosed with 

Mucopolysaccharidoses Type II or Hunter Syndrome using 

specific enzyme assays from plasma and leukocytes. All patients 

underwent ophthalmologic examination including visual acuity 

(VA), eye motility, refraction, slit-lamp examination, tonometry 

and indirect ophthalmoscopy. 

Results: All patients manifested with refractive error, the most 

common being hyperopia (13/15 or 86.7%). Two patients 

25 

presented with strabismus. Tessellated retinas were observed 

in 5 (33.3%) patients, while pigmentary retinopathy was found 

in 2 (13.3%). Bilateral large cup-to-disc ratios were seen in 3 

(20%) individuals. Nonetheless, there was functional vision 

in all of the subjects that could be examined, as evidenced by 

their independence in day-to-day activities. Patients with errors 

of refraction corrected with spectacles reported improvement in 

their schooling. 

Conclusion: The results showed that all individuals with Hunter 

syndrome have ophthalmological abnormalities. Eye pathologies 

may go undetected or unmanaged in the presence of other more 

life-threatening problems. In individuals with a more gradual 

course, however, early detection and management of eye 

problems can have a profound impact on quality of life. Given the 

progressive nature of the disorder, regular follow up in the setting 

of integrated care is warranted. The goal of the ophthalmologist is 

not only to maximize vision but also to curtail to the patient’s age, 

mental capability and physical state. 

Key Words: Eye pathology, Hunter Syndrome, 

Mucopolysaccharidoses II 

2:53 pm - 3:00 pm 

FP-41 

A Preliminary Report on the Efficacy of Occlusion Therapy 

Versus Observation for Pediatric Intermittent Exotropia: 

A Single-Blind Randomized Controlled Trial 

Ma Patricia Therese R. Fellizar, Marissa N. Valbuena, 

Melissa Anne M. Santos 


Philippines 

Objective: To determine the efficacy of occlusion therapy for 

intermittent exotropia among patients aged 5-18 years. 

Methods: This is a single-center, single blind prospective 

interventional randomized study. Twenty eight pediatric patients 

diagnosed with small angle, good to fair control intermittent 

exotropia with best corrected visual acuity of 20/50 or better were 

included in the study and randomized into 2 groups: Observation 

Group where no treatment was prescribed; and Occlusion Group 

where patching of the non-deviating eye with a flannel cloth for 3 

hours a day for 6 weeks was prescribed. Follow-up was done at 

the first, third, sixth, and twelfth week on treatment and at 1 month 

post-treatment. Outcome measures were the best corrected 

visual acuity (BCVA), angle of deviation, stereoacuity using the 

Titmus Fly Test, and degree of control of exotropia using the 

Newcastle Control Score (NCS). 

Results: There was significant improvement of all outcome 

measures in both groups over time. There was significantly 

better stereoacuity and degree of control in the Occlusion Group 

compared to the Observation Group in all follow-up periods. 

There was no significant difference in BCVA for OD (p=0.5253), 

BCVA for OS (p=0.8075), angle of deviation at near (p=0.4679), 

angle of deviation at distance (p=0.1347), NCS clinic control for 

near (p=0.8939), and NCS total (p=0.3388) between groups.

Conclusions: Although this study is still currently on going, the 

preliminary data shows that there was improvement in all outcome 

measures for both occlusion and observation alone over time. It 

was observed that there was more improvement in stereoacuity 

and in degree of control with the Occlusion Group compared with 

the Observation Group. Therefore, both occlusion and observation 

are effective managements for intermittent exotropia. However, 

occlusion therapy is more effective in improving stereoacuity and 

degree of control of pediatric patients with intermittent exotropia 

compared to observation alone. 

Key Words: intermittent exotropia, occlusion therapy, patching, 

occlusion, efficacy 

3:01 pm - 3:08 pm 

FP-42 

Eventual Outcomes of Retinopathy of Prematurity Screening 

at a Tertiary Government Hospital: A Five Year Study 

Emmeline M. Alvarez, Ricardo Ventura 


Objective: To determine the eventual outcomes of retinopathy 

(ROP) screening at a tertiary government hospital in Quezon City, 

Manila, Philippines 

Methods: A retrospective chart review of retinopathy of 

prematurity patients at a tertiary government hospital from 

January 2008 to July 2012 was done. Eventual outcomes of our 

center’s ROP screening were analyzed. 

Results: A total of 388 eyes of 194 premature infants were 

included in the study. Two hundred ninety-six (76.28%) eyes 

had no ROP and 92 (23.71%) eyes were diagnosed with ROP. 

Thirty-two (10.81%) eyes without Rop were able to have a followup 

exmination at our center. Thirty-fiv (38.08%) with ROP were 

classified as stage 2, followed by 23 cases (25.00%) with stage 

1 and 13 cases (14.13%) with stae 3 as based on ICROP. Fiftythree 

eyes with rOP were able to have follow-up examinations 

and of which 26 eyes with rop were able to receive treatment and 

27 eyes wih cycloplegic refraction. Thirteen eyes (48.15%) were 

hyperope, 12 eyes (44.44%) were myope and two eyes (7.40%) 

were emmetrope. 

Conclusion: There is a low follow-up rate for premature infants 

who underwent ROP screening at our center. The importance of 

a regular and timely follow-up examination should be stressed 

to parents and referring physicians in order to monitor visual 

development of these patients. Appropriate treatment can be 

advised and administered as well. Errors of refraction can also 

be addressed for proper visual maturation and prevention of 

amblyopia. 

Key Words: retinopathy of prematurity, eventual outcomes, 

follow-up rate, refractive outcomes 

3:09 pm - 3:16 pm 

FP-43 

Effect of Pediatric Eye Screening Checklist and Training on 

Ophthalmology Referrals in QMMC, a 1-year Study 



Objective: To assess whether an eye screening checklist and a 

short training course result in an increase in appropriate referrals 

of suspicious ophthalmologic abnormalities in the pediatric age 

group. 

Methods: Pediatric residents were given a 3-part lecture in 

conducting ophthalmologic pediatric evaluation. A pediatric eye 

screening checklist, based on the 2002 American Academy of 

Ophthalmology Pediatric Eye Evaluations Preferred Practice 

Patterns and 2002 American Academy of Pediatrics Eye Vision 

Screening Recommendations for Primary Care Providers, was 

made available to the pediatric residents. All patients from the outpatient, 

nursery and ward were screened. All high risk patients, 

premature, family history of ophthalmologic problems and neurodevelopmental 

delay are excluded from the study. The patients 

referred are then assessed by the ophthalmology residents 

whether these patients are appropriate referrals. Appropriateness 

of referral was determined before and after the interventions and 

later compared. 

Results: Results showed a 13.8% increase the number of 

appropriate referrals the post intervention group. There was 

a marked increase of appropriate referrals in the following 

age groups new born to 2 years old and 6 - 12 years, and the 

differences from the intervention group in these age groups are 

21.57% and 22.03% respectively. 

Conclusion: Pediatric screening is important in the early 

detection of ophthalmologic problems so that an early treatment 

or intervention may be initiated to avoid devastating outcomes. By 

providing an eye screening checklist and a short course training 

of pediatric residents can help in the detection of ophthalmologic 

conditions and familiarize pediatric residents to the ophthalmologic 

screening test. 

Key Words: pediatric eye screening 


26

3:17 pm - 3:24 pm 

FP-44 

Four Year Prevalence and Outcome of Initial Screening for 

Retinopathy of Prematurity (ROP) at the Clinical Division of 

a Tertiary Hospital 

James Rommet Luz, Marcelino D. Banzon, Almira A. Manzano 


Objective: To determine the 4 year prevalence and outcome 

of initial screening for ROP among newborn infants referred to 

the Department of Ophthalmology Clinical Division of a Tertiary 

Hospital. 

Methods: This is a retrospective study involving review of 

medical records of infants screened for ROP from August 1, 2008 

to July 31, 2012 at a tertiary hospital. The study focused on the 

findings on initial examination and outcomes on follow up post 

discharge at the Out-Patient Department (OPD). Prevalence 

was determined using frequencies and percentages. Statistical 

analysis to correlate ROP to age of gestation and birth weight 

were done using Chi Square Test. 

Results: Fifty eyes of 25 infants were included in the study 

comprised of 9 boys and 16 girls with mean birth weight (BW) 

of 1318 grams and mean age of gestation (AOG) of 31 weeks. 

Nine eyes were positive for ROP. One eye had stage 4 zone 2 

ROP with plus disease. Three eyes had stage 3 ROP with plus 

disease. Five eyes had Stage 1 zone 3 ROP. Regression was 

noted on follow-up. Statistical analysis revealed no significant 

correlation of BW and ROP staging (2= 6.49711, = 9.48773) but 

noted significant correlation between AOG and ROP staging (2= 

13.69014, = 9.48773). 

Conclusion: Despite the increasing prevalence of retinopathy of 

prematurity worldwide, only a relatively minimal number of infants 

were identified on initial screening done in the institution over 

the years 2008 to 2012. Although only a few of these patients 

came back for follow up, those who were seen showed significant 

improvement from baseline. There is significant correlation 

between age of gestation and retinopathy of prematurity staging, 

congruent to previous studies. However, this study showed no 

correlation between birth weight and ROP staging. 

Key Words: Initial screening, Retinopathy of Prematurity, 

Prevalence, outcome of initial screening 

27 


3:25 pm - 3:32 pm 

FP-45 

Cycloplegic Effectiveness of Single-Dose Atropine 0.5% 

Compared with Three-Day Atropinization in Determining 

Error of Refraction in Children 

Anna Theresa G. Fernando, Fay Charmaine S. Cruz 


Center Inc., Philippines 

Objective: The aim of the study is to compare the efficacy of 

single-dose Atropine 0.5% (half percent of Isopto® Atropine 1%) 

with 3-day atropinization (Atropine 1.0%, Isopto® Atropine 1%) as 

a cycloplegic agent in determining error of refraction in children. 

Methods: The study is a randomized, prospective clinical trial. A 

total of twenty-two (22) children (44 eyes) ages 4 to 12 years old, 

with a mean age of 7.82 + 2.68 years seen at University of the 

East Ramon Magsaysay Memorial Medical Center (UERMMMC) 

Outpatient Department from June to September 2012, were 

included in the study. Children were randomized to two (2) groups 

using a computer-generated method. Group 1 was given a single 

dose of Atropine 0.5% and group 2 was given 3-day atropinization 

(Atropine 1%) prior to refraction. All subjects had refraction done 

using the Grand Seiko Refractometer GR-3100K before and 

after instillation of the cycloplegic agent. The subjects? visual 

acuity and pupil diameter were also recorded every 2 days. The 

differences between the two groups were then analyzed using the 

SPSS Independent Samples T-Test. 

Results: The mean excess refraction uncovered by Atropine 

0.5% was 0.3864 D, whereas the mean hyperopia uncovered by 

Atropine 1% was 0.4205 D. The difference between the means 

is -0.03409, which is not statistically significant (P < 0.05). The 

cycloplegic effect of Atropine 1% was noted to last between 7 

to14 days, while that of Atropine 0.5% lasted 2 to 3 days. 

Conclusion: We conclude that Atropine 0.5% is of comparable 

efficacy to 3-day application of Atropine 1% in performing 

cycloplegic refraction in children. 

Key Words: cycloplegic refraction, Atropine 0.5%, 3-day 

atropinisation, error of refraction


PP-1 

Bilateral Peripheral Ulcerative Keratitis in an Anti-nuclear 

Antibody (ANA) Positive 16 year-old Female: A Case Report 

Abigail O. Panganiban, Kate Concepcion-Torio, 



Objective: This is the case of a 16 year-old female, who noticed 

occasional eye redness, blurring of vision and whitish opacities 

around the cornea on both eyes 2 years prior to initial consult. 

Methods: Baseline uncorrected visual acuity (UCVA) was 20/25 

OD and 20/20 OS, best corrected to 20/20 OU with the following 

manifest refraction spherical equivalent (MRSE) of -0.50 OD. 

Slitlamp examination showed perilimbal corneal thinning OU 

with minimal neovascularisation and conjunctival hyperemia OU. 

Other external eye exam findings, anterior segment findings and 

posterior segment were normal. Patient was referred to External 

Diseases and Cornea Service with the assessment of Peripheral 

Ulcerative Keratitis OU and was started on fluorometholone eye 

drops TID, OU. 

Results: Subsequent follow-ups revealed gradual progressive 

blurring of vision 20/50 OD and 20/30 OS, with concomitant 

myopic shift in manifest refraction spherical equivalent (MRSE) 

to -0.63 OD, and -0.38 OS. An inferior descemetocele was noted 

OD. Congested perilimbal neovascularization was noted to be 

greater on OD. Patient was started with Ofloxacin + Prednisolone 

(Exopred) eyedrops TID for 1 week and underwent 0.3 cc 

subconjunctival triamcinolone acetonide injection OD inferiorly 

and 0.2 cc superiorly. Patient was advised autoimmune disease 

work-up. Purified Protein Derivative (PPD), Chest Xray and Antinuclear 

antibody (ANA) testing were requested. PPD and chest 

Xray were negative while ANA was noted to be positive. 

Conclusion: She was referred to Pediatric service for further 

systemic evaluation and management. She was maintained on 

the pure topical antibiotic eye drops and was advised to follow up 

every 3 months. 

Key Words: Peripheral Ulcerative Keratitis, Systemic Lupus 

Erythematosus, Rheumatoid Arthritis, Autoimmune Disease, 

Keratolysis, Anti-nuclear Antibody 

PP-2 

Sebaceous Gland Carcinoma Masquerading as a Large 

Molluscum Contagiosum Nodule 

Emerson Jay B. Molina, Jacinto U. Dy-Liacco, 



Objective: To report a case of a lower eyelid sebaceous 

gland carcinoma with features resembling a large molluscum 

contagiosum nodule. 


Results: A 70-year old Filipino male presented with an enlarging 

mass in the left lower eyelid. The lesion was noted 1 year prior 

to consultation to a private ophthalmologist in Cardinal Santos 

Medical Center. He had previously undergone incision and 

curettage of the lesion three times but with rapid recurrence and 

hence was referred to one of the authors. External exam on the 

right eye was unremarkable. Best corrected vision for both eyes 

is 20/25. There is a grade 2 nuclear cataract on both eyes, with 

the rest of the anterior segment findings unremarkable. He had 

a 1.0 x 0.9 x 0.4 cm firm, non-tender, non-movable and wellcircumscribed 

pearly-white nodule with central umbilication on 

the left lower lid encroaching the margin. The initial impression 

was molluscum contagiosum nodule. Patient underwent excision 

biopsy. However, the histopathologic diagnosis was sebaceous 

carcinoma with resection margins free of tumor. The patient is 

currently under observation and no recurrence so far has been 

noted. 

Conclusion: Sebaceous gland carcinoma is a relatively rare but 

potentially lethal malignancy of the eyelid. Clinical presentation 

may vary and it may demonstrate atypical features which could 

be confused with molluscum contagiosum nodule, a benign 

condition. 

Key Words: Sebaceous gland carcinoma, Molluscum 

contagiosum nodule 

PP-3 


Effect of Topical Anesthetic in Pupillary Dilation in Filipino Eyes 

Joyce Ann L. Lo, Richard Raymund L. Nepomuceno 


Objective: This study aims to determine if topical anesthetic 

hastens pupillary dilation in Filipino eyes. 

Methods: This is a prospective single blinded clinical trial. 

Thirty healthy subjects (60 eyes) ages 18 to 40 years old were 

recruited in the study. Pre-treatment photographs of both eyes 

were taken at the start of each part of the study. In the first part, 

a drop of topical proparacaine was instilled into both eyes and 

then the left eye was instilled with a drop of 0.5% tropicamide + 

0.5% phenylephrine 3 minutes after. In the second part, a drop 

of balanced salt solution was instilled to the right eye then a drop 

of 0.5% tropicamide + 0.5% phenylephrine 3 minutes after. The 

left eye was instilled with a drop of topical proparacaine then a 

drop of 0.5% tropicamide + 0.5% phenylephrine 3 minutes after. 

Photographs were taken of both eyes until 30 minutes. Horizontal 

pupil diameter was measured using Scion Image Software. 

Measurements were then analyzed using Pearson Correlation 

Coefficient and Paired Sample T-test. 

Results: Cross reactivity between the two eyes was analyzed 

using Pearson Correlation Coefficient. Analysis showed that 

there is a significant difference between both eyes horizontal 

pupil diameter even before treatment was given (p=0.794, 

99% confidence interval). There was also an increase in the 

measurement of the right eye (topical proparacaine only) as the 

measurement of the left eye (topical proparacaine and dilating 

28


agent) increased at 5 minutes. Conversely, there was a decrease 

in the measurement of the right eye as the measurement in the left 

eye decreased (p=0.734, 99% confidence interval). Correlation 

became non-significant between eyes from 10 to 30 minutes 

(p=0.121 ± 0.353, 99% confidence interval). Comparison of the 

right eye given a drop of balanced salt solution then a drop of 

0.5% tropicamide + 0.5% phenylephrine 3 minutes after and the 

left eye given a drop of topical proparacaine then a drop of 0.5% 

tropicamide + 0.5% phenylephrine 3 minutes after was analyzed 

using Paired Sample T-test. It showed significant difference at 5 

minutes measurement (p=0.041). However, correlation was nonsignificant 

at 10 to 30 minutes measurement (p=0.225 ± 0.901). 

Conclusion: Topical anesthetic did not hasten the dilation of 

Filipino eyes. 

Key Words: Tropicamide, Phenylephrine 

PP-4 

A Case of Cogan’s Syndrome in the Philippines 

Ann Krystine C. Balmaceda, Jessica Marie R. Abaño, 

Rene Louie C. Gutierrez 


Objective: This paper aims to present one of the first, if not the 

first, reported case of Cogan’s syndrome in the Philippines. 

Methods: This paper is presented as a case report. 

Results: Cogan’s Syndrome is an inflammatory disease with 

a possible autoimmune etiology. It usually presents with 

non-syphilitic interstitial keratitis with Meniere’s disease-like 

symptoms such as vertigo and progressive hearing loss. Two 

thirds of cases present with systemic symptoms involving the 

cardiovascular, musculoskeletal, neurological, gastrointestinal 

and mucocutaneous systems. A third of cases present with 

vasculitis. At present, there is no proven effective therapy for 

this condition. The disease is mainly managed with high dose 

corticosteroids. This is a case of a 37 year old male with a history 

of cough and colds that spontaneously resolved, followed by 

progressive hearing loss, loss of balance, dizziness, an enlarging 

whitish opacity on both eyes with accompanying eye pain, foreign 

body sensation and blurring of vision. He later presented with 

cardiovascular symptoms and vasculitis. Physical examination 

revealed bilateral corneal infiltrates with vascularization and 

ghost vessels, bilateral loss of gross hearing, bibasal crackles 

and systolic murmurs on the 2nd and 5th ICS. The patient was 

treated with cardiac medications, prednisolone acetate eyedrops 

and oral prednisone 40mg per day. 

Conclusion: High dose steroid therapy was not done in the 

patient. Future cases may benefit from a more aggressive 

treatment of high dose corticosteroids or steroid-sparing 

therapeutics such as TNF-alpha inhibitors. 

Key Words: Cogan’s syndrome, interstitial keratitis, corneal 

opacities, paracentral corneal infiltrates. 

29 

PP-5 

A Case of Cogan Syndrome 

Jose Mari G. Sagmit, Jacinto S. Bautista, Jr., Noel Castillo 


Objective: To describe the course of a patient diagnosed with 

Cogan syndrome. 

Methods: This is a retrospective, non-comparative case report of 

a patient who was diagnosed with Cogan syndrome. 

Result: A 29 year old male deaf came in due to bilateral coneal 

opacity. Visual acuity was 20/50 on both eye. Slitlamp examination 

showed peripheral stromal opacities on both eyes. Further eye 

examination showed normal findings. 

Conclusion: Cogan syndrome is a disease which presents with 

blurring secondary to coneal dystrophy accompanied by bilateral 

hearing loss 

Key Words: cogan, cogan syndrome, case of cogan, a case of 

cogan syndrome 

PP-6 

Prevalence of Dry Eye Syndrome and Diabetic Retinopathy 

in Type 2 Diabetes in the Hospital of the Infant Jesus 

Ophthalmology Outpatient Department 

Jamil Laurence R. So-Reyes, Jacinto S. Bautista, Jr. 


Objective: This study is performed to evaluate the prevalence of 

dry eye syndrome in type 2 diabetics seen at the Hospital of the 

Infant Jesus Ophthalmology OPD. To have an evaluation using 

our local setting and using the Filipino population. 

Methods: We evaluated 102 type 2 diabetic patients referred 

to the Hospital of Infant Jesus Department of Ophthalmology 

from January 2012 to June 2012. All subjects were given 

questionnaires regarding other diseases, drugs taken orally or 

other eyedrops and previous eye surgeries both recent and past. 

Dry eye syndrome was assessed with tear break up time tests 

and Schirmer. To determine whether Diabetic retinopathy was 

present, fluorescein angiography were done and evaluated by 

our retina consultant. 

Results: 58 patients (57%) out of the 102 type 2 diabetic patients 

suffer from dry eye syndrome based on tear break up time and 

Schirmer’s test. Dry eye syndrome was more frequently seen in 

patients with diabetic retinopathy 82 patients (80%). 24 patients 

with mild non proliferative diabetic retinopathy, 22 patients with 

moderate non proliferative diabetic retinopathy, 16 patients with 

severe non proliferative diabetic retinopathy, and 18 patients 

with proliferative diabetic retinopathy. There were significant 

relationship between age, sex and duration of diabetes and 

diabetic retinopathy. 

Conclusion: In our local setting using the Filipino population, 

prevalence of dry eye syndrome among type 2 diabetics was

57%. There is a strong association between dry eye syndrome 

and diabetes. Therefore this study strongly suggest dry eye 

screening in type 2 diabetic patients to address their risk for dry 

eye complications. 

Key Words: prevalence, dry eye syndrome, type 2 diabetes 

Glaucoma 

PP-7 

Axenfeld -Rieger Syndrome: Case Report 

Reggie R. Revilla, Ian Benjamin T. Hizon 



To report the case of a patient who was previously diagnosed 

with Congenital Glaucoma. Patient also has buphthalmos and 

had underwent enucleation of the right eye. 

Objective: A case of 43 year old female patient, who came in 

due to blurring of vision of the left eye with associated pain of 3 

days duration. Patient underwent enucleation of the right eye at 

age 5 and was lost to follow-up since then. Thirteen years ago, 

patient began to experience blurring of vision of the left eye. 

Patient sought consult after 6 years and was advised to undergo 

filter surgery. She refused and was subsequently lost to followup 

again. Two months prior to admission, patient was seen at 

the UERMMMCI Outpatient Department and was diagnosed with 

Congenital Glaucoma, OS. 

Results: Patient was non-compliant with the prescribed 

medications resulting to elevated IOP of 54mmHg and was 

admitted. Based on history and further examination, she was 

found to have Axenfeld-Rieger Syndrome. 

Conclusion: This presentation aims to illustrate a rare case 

of Axenfeld-Rieger syndrome. A 43 year old female patient 

seen at the Emergency room due to painful blurring of vision 

of a few hours duration. Elevated IOP was managed. Careful 

review of patient’s history and thorough physical examination 

reveal buphthalmos, posterior embryotoxon and other findings 

pointing to Axenfeld-Rieger Syndrome. The patient subsequently 

underwent trans-scleral photocoagulation and resolution of eye 

pain was observed. This presentation is intended to highlight the 

importance of thorough history taking and physical examination 

for the recognition of patients experiencing this condition 

Key Words: axenfeld-rieger syndrome, congenital glaucoma, 

posterior embryotoxon, buphthalmos 

PP-8 


Treatment Option for the Management of 

Neovascular Glaucoma 

Mark Gil J. Marasigan, Ronaldo Jarin 


Objective: 1. To describe a treatment option for the management 

of neovascular glaucoma. 2. To evaluate the recommended 

treatment option for the management of neovascular glaucoma. 

3. To describe the visual acuity, intraocular pressure, and the 

presence of iris and/or angle neovascularization as the primary 

outcome measure. 4. To recommend this treatment option for 

patients with neovascular glaucoma. 

Methods: Observational Case Series. Quirino Memorial Medical 

Center. All patients diagnosed with neovascular glaucoma are 

identified from January 2012 to September 2012. Standard 

ophthalmic data were recorded in each case including age, sex, 

visual acuity, intraocular pressure (IOP), co-morbid conditions 

such as hypertension and diabetes mellitus and laterality of 

affected eye at the time of first consult. Initial treatment option is 

then applied and the outcome evaluated in terms of visual acuity, 

control of intraocular pressure, and the presence of iris and/or 

angle neovascularization. 

Results: 16 eyes of 16 patients were seen with neovascular 

glaucoma during the period of January 2012-September 2012. 

The study group included 7 males and 9 females aged 30 to 64 

years. Out of the 16 cases, 9 had proliferative diabetic retinopathy, 

and 7 were secondary to ischemic central retinal vein occlusion, 

of whom 1 had undergone vitrectomy for vitreous hemorrhage. 

All patients were followed for at least 6 months. 5 patients 

improved their visual acuity from hand movement and 20/400 to 

20/200 and 20/100 respectively. Iris and anterior chamber angle 

neovascularisation receded in all eyes after 1 to 3 injections of 

Bevacizumab (Avastin) prior to trabeculectomy and panretinal 

photocoagulation. The intraocular pressure normalized in 12 

eyes during the ff up period while 4 eyes needed anti-glaucoma 

medications for further IOP lowering. 

Conclusion: Several treatment options are available for the 

management of neovascular glaucoma. In our setting, we have 

applied a treatment option that will be suitable for our patient’s 

profile especially those who are not capable of acquiring a valve 

implant for IOP lowering. This treatment option have given a good 

outcome in terms of its IOP control after trabeculectomy and iris/ 

angle neovascularization regression after intravitreal injection 

of Bevacizumab (Avastin). Visual acuity, in the other hand, may 

have improved owing to the lowering of the intraocular pressure 

and reduction in corneal edema. 

Key Words: Neovascular Glaucoma, Anterior chamber 

angle neovascularisation, Intravitreal bevacizumab, Iris 

neovascularisation 

30


Lens and Cataract Surgery 

PP-9 

Comparison of Axial Length Measurements Taken by 

Partial Optical Coherence Interferometry (IOL Master®) and 

Immersion Scan 

Jessica De Leon, Richard Raymund L. Nepomuceno 


Objective: The importance of accurate axial length measurements 

in cataract and refractive surgeries cannot be overemphasized 

because a difference of as little as 0.3mm from true value of AXL 

will result in 1 diopter error in the IOL power. This study aims 

to compare the axial length measurements taken by the IOL 

Master and Pacscan Immersion Biometry, especially in short 

and long eyeballs (AXL 25mm respectively). If this 

study will show a significant difference between the two, then we 

can determine which eyeball size do the two techniques vary. If 

this study will not show a significant difference between the two 

machines, then this can reinforce our confidence in using the 

immersion A scan for AXL measurements. 

Methods: This is a cross sectional study comparing axial length 

measurements taken by IOL master and Pacscan Immersion 

biometry. Subjects include patients undergoing biometry at the 

St. Luke’s Medical Center QC from December 2011 to June 2012. 

Axial lengths of 117 eyes were measured and were categorized 

into Group A (short eyeballs), Group B (medium-sized eyeballs) 

and Group C (long eyeballs). Two mean axial lengths will be 

obtained per eye (IOL master and immersion biometry), and 

comparison between the two measurements are done. A p value 

< 0.05 is considered significant. 

Results: statistical analysis of the 117 eyes showed no significant 

difference between AXL measured by IOL Master and Immersion 

biometry. This is when all the eyes are considered as a whole. 

Conclusion: there is no significant difference between AXL 

measured by the IOL Master and Immersion biometry if eyes with 

short, medium and long AXL are taken as a whole. 

Key Words: Immersion biometry, Optical coherence biometry, 

optical coherence vs immersion biometry, axial length, Pacscan, 

IOL Master 

PP-10 

Effect of Heat from Gaseous Sterilization on Antimicrobial 

Efficacy of Moxifloxacin 0.5% Eye Drops 

Mark Christian R. Rivera 


Objective: To compare the antimicrobial efficacy of a newly 

opened Moxifloxacin 0.5% eye drops with a Moxifloxacin 0.5% eye 

drops exposed to heat from gaseous sterilization by measuring 

zones of inhibition using the Kirby-Bauer disc diffusion test. 

Methods: This is an experimental study where in vitro inoculation 

of test organisms were used and zones of inhibition to both newly 

31 

opened and heat-exposed Moxifloxacin 0.5% eye drops were 

determined after 24 hours of incubation at 37oC. The zone sizes 

in millimeters were compared with each other using the two-tailed 

T-test to determine if significant differences were observed. 

Results: The zones of inhibition using the Kirby Bauer 

disc diffusion test to both newly opened and heat-exposed 

Moxifloxacin 0.5% eye drops showed no significant difference in 

all test organisms using the two-tailed T-test. 

Conclusion: Moxifloxacin 0.5% eye drops exposed to heat from 

gaseous sterilization showed non-inferior antimicrobial efficacy 

compared to a newly opened 0.5% Moxifloxacin eye drops in 

vitro. Re-sterilization of the eye drops bottle with its content for 

multiple intracameral use may be an option for cost-effectiveness. 

However its safety profile is undetermined. 

Key Words: intracameral prophylaxis, gas sterilization 

PP-11 

Comparison of the Sealing Ability Between the Wong Incision 

and Standard Stromal Hydration of Clear Cornea Incisions in 

Phacoemulsification Surgery: An Animal Eye Study 

Raymond Nelson C. Regalado, Ruben Lim Bon Siong, 

Jay Marianito S. Vicencio, Lee Verzosa 


Objective: The primary objective is to determine the efficacy 

of the Wong incision in providing CCI wound seal against influx 

of ocular surface fluid compared to the standard lateral stromal 

wall hydration using pig’s eyes. Secondary objectives include: 

to document the presence of refluxed ocular surface fluid in the 

corneal incision tract by microscopic examination of histologic 

corneal sample, to assess the magnitude of ocular surface fluid 

influx in the anterior chamber of the using trypan blue dye and 

UV spectrophotometry, and to assess wound leakage of the main 

incision after hydration. 

Methods: A total of 10 pig’s eyes were used. Half were placed 

in the stromal wall hydration group (control) and half in the 

Wong incision group (experimental). On a globe holder, a side 

port was made and viscoelastic placed in the AC. The main 

incision was made 180 degrees away; in the experimental group, 

a Wong incision was made prior. Phacoemulsification with IOL 

implantation was simulated. The main incision was sealed. An AC 

maintainer was placed. A sample from the AC was taken and sent 

for analysis. Trypan blue was then dripped over the main incision. 

At this time, another sample was taken from the AC and sent for 

analysis. The whole eyeball was sent for histopathology. 

Results: All samples showed no significant change in 

spectrophotometric absorbance, indicating that in both, no 

significant amount of trypan blue was able to enter the AC. 

Histological samples failed to show trypan blue staining in 

both incision tracts, suggesting that no passage of trypan blue 

occurred. Video documentation showed significant wound 

leakage in the control group and none in the experimental. 

Conclusion: The Wong incision provided no significant benefit 

compared to stromal wall hydration in preventing fluid influx after 

cataract surgery simulation. The Wong incision, however, showed

a more stable wound seal against wound leakage. 

Key Words: Wong incision, Superior stromal pocket, Sutureless 

clear corneal incision, Endophthalmitis 

PP-12 

Evaluation of the Effectiveness of the Angled Sinskey Hook 

for Vertical Quick-Chop Nucleotomy in Phacoemulsification 

Lenard Paul Concepcion, Antonio Say, Alex Sua 


Objective: To evaluate the effectiveness of the unmodified angled 

Sinskey hook when used as a phaco chopper in performing the 

vertical quick-chop nucleotomy technique in phacoemulsification. 

Methods: This is a prospective randomized study involving 18 

eyes of 18 consecutive patients randomly assigned to undergo 

vertical quick-chop nucleotomy in phacoemulsification using 

the angled Sinskey hook, or the Chang vertical chopper for 

vertical chop nucleotomy. Vertical quick-chop nucleotomy in 

phacoemulsification was performed by 1 surgeon (L.P.A.C, a 

SENIOR RESIDENT IN TRAINING) using the INFINITIR phaco 

machine. The parameters, the vertical chop success, number 

of vertical chop attempts, and Effective Phaco Time (E.P.T.) 

/ Cumulative Dissipated Energy (C.D.E.), measured were in 

relation to nuclear density. The chi-square test, independentsamples 

t test, and analysis of covariance were used to compare 

the groups for statistical significance. 

Results: The chi-square showed that the difference between 

overall chop successes of the 2 groups was not statistically 

significant (P value: 0.527). The independent-samples t test 

showed that there is no significant difference between the 2 

groups in terms of the number of vertical quick-chop attempts 

(P value: 0.653) and EPT/CDE (P value: 0.859). Analysis of 

covariance comparing the relationship of nuclear density to chop 

successes of the 2 groups showed that the difference between the 

numbers of chop attempts (P value: 0.547) was not statistically 

significant. Analysis of covariance comparing the relationship of 

nuclear density to the EPT/CDE of the 2 groups showed that the 

difference between the EPT/CDE (P value: 0.666) of the 2 groups 

was not statistically significant. 

Conclusion: The angled Sinskey hook, with proper surgical 

competency in vertical quick-chop, may be used as an effective 

primary chopping instrument for vertical quick-chop nucleotomy 

in phacoemulsification. 

Key Words: Nucleotomy, Nagahara horizontal chop, Sinskey 

hook, phacoemulsification, Vertical quick-chop, Nucleotomy, 

Sinskey hook, phacoemulsification, Nagahara horizontal chop 

Neuro-ophthalmology 

PP-13 

Ocular Myasthenia Gravis with Probable Thymoma in a 

Prepubertal Male 

Jennifer Aurea S. Sarmiento, Karen B. Reyes 


Objective: To report a case of a prepubertal male with ocular 

myasthenia gravis and probable thymoma. 


Results: A 10-year old Filipino male presented with a one-month 

history of drooping of the left eyelid. Eyelids are apparently well 

upon waking up, but droop towards the end of the day. There 

were no noted diplopia, blurring of vision and eye pain. No history 

of trauma or any previous eye insults. The patient denied difficulty 

in swallowing or breathing. He was born full-term via normal 

delivery born to a primi-mother. On examination, visual acuity 

was 20/20 in both eyes. Ductions and versions were normal, with 

no deviation. Left ptosis was noted. The interpalpebral fissure 

measured 9mm on the right and 4 mm on the left. Margin Reflex 

Distance (MRD) on the right eye was 4/5 while it was 0/4 mm 

on the left. The levator functions were good. There were no lid 

swelling, lagophthalmos, and proptosis. Cogan’s lid twitch sign and 

Gorlick’s test were positive. Ice pack test showed improvement 

of ptosis. Single Fiber electromyogram (EMG) results support 

the diagnosis of ocular myasthenia gravis. Chest computed 

tomography confirmed the presence of an anterior mediastinal 

mass, probably thymoma. The patient was co-managed with 

Pediatric service and was started on Pyridostigmine 60mg/tab, 

which was gradually increased to 27.8mg/pptab. At 10-month 

follow-up, patient showed improvement with pyridostigmine. 

Conclusion: We present a rare case of ocular myasthenia 

gravis with probable thymoma in a prepubertal male. Ocular 

manifestations have stabilized with Pyridostigmine alone. 

Key Words: Ocular Myasthenia Gravis, Thymoma, Pyridostigmine 

PP-14 


A Review of Prevalence of Neuro-Ophthalmic Disorders in a 

Government Tertiary Hospital in Quezon City, Philippines - 

A 4 years Study 

Ryan R. Bacani 


Objective: Determine the pattern, co morbidities and prevalence 

of Neuro-Ophthalmologic cases in a government tertiary hospital 

in the Philippines. 

Methods: This is a retrospective study of all neuro-ophthalmologic 

cases within 4 years - period (January 2008 to December 2011) in 

the DOH Eye Center East Avenue Medical Center, East Avenue, 

Quezon City, Philippines. 

Results: There were a total of 460 neuro-ophthalmic cases 

seen during the 4 years study period. With 2011 has the highest 

number of cases. The estimated prevalence rate of neuroophthalmic 

cases was noted by having the total number of 

General ophthalmology consult as denominator per year. Overall, 

Vision-related disorders were the most frequently seen, followed 

by ocular motility related diseases. Traumatic related disorders 

(n = 85 cases, 18.48%) were the most commonly encountered 

among neuro-ophthalmic consults. Other primary causes include 

Optic Neuritis (11.78%), and Ethambutol toxicity optic neuropathy 

(7.83%). Other etiologies noted for the vision related disorders 

32

are ischemia and compressive disorders. For specific neuroophthalmic 

entities, palsies of the abducens nerve (9.13%), 

oculomotor nerve (6.3%), and multiple cranial nerve palsy 

(4.35%) were observed with most number of cases. 

Conclusion: During the 4 years retrospective study, traumatic 

related disorder was noted to be the leading cause of neuroophthalmology 

diseases in our setting. The burden of this disorder 

should be addressed in a multi center approach. Risk factors 

and other co- morbdities that affects other Neuro-ophthalmology 

etiologies are to be properly determined and resolve. 

Key Words: Neuro-ophthalmic disorders, prevalence, 

retrospective study, DOH Eye Center East Avenue Medical 

Center 

PP-15 


Ptosis and Ophthalmoplegia in a 56 Year Old Post Corneal 

Transplant Patient: A Case Report 

Kristine Belen Pascua, Leonides Karlo C. Melendres, III 

DOH Eye Center- East Avenue Medical Center, Philippines 

Objective: To present a case of an early onset, progressive 

ptosis and ophthalmoplegia who underwent lid surgery and 

presented with lagaophthalmos, chronic exposure keratopathy 

and ruptured corneal ulcer 

Case: This is a case of a 56 year old female who presented with 

ptosis and ophthalmoplegia. 

Methods: The patient presented with progressive drooping of 

both upper lids with limited extraocular muscle movement 30 

years prior to consult. Due to persistence of symptoms patient 

underwent a lid surgery. Following lid surgery there was note of 

lagophthalmos and exposure keratopathy. 

Results: Patient came in to our institution with a ruptured 

corneal ulcer secondary to Central Microbial Keratitis and chronic 

exposure keratitis of the right eye necessitating penetrating 

keratoplasty. 

Conclusion: Patients with chronic progressive external 

ophthalmoplegia have a limited ability to protect the eye from 

chronic exposure leading to corneal damage. Lagophthalmos 

in the presence of extraocular movement dysfunction requires 

preventive measures to avoid exposure keratopathy. Also, 

meticulous history taking and ophthalmologic exam before the lid 

surgery should have prevented the sequalae of chronic exposure 

keratopathy. 

Key Words: lagophthalmos, mitochondrial myopathy, exposure 

keratopathy, ptosis, chronic progressive external ophthalmoplegia 

33 

PP-16 

Unilateral Optic Nerve Atrophy in a Child with Schizencephaly: 

A Case Report 

Denver K. Ching, Leonides Karlo Melendres, III 


Objective: To present a case of unilateral optic atrophy in a child 

with schizencephaly. 

Method: This is a case report 

Result: An 8 year old female presented with a month history 

of progressive blurring of vision on the left eye and slurring of 

speech. Left sided body weakness was already noted since 1 

year of age. Visual acuity of the affected eye on initial consult 

was counting fingers at 2 feet. Funduscopic exam showed left 

optic nerve pallor while the rest of ophthalmologic examination 

findings were unremarkable. Cranial MRI revealed open lip 

schizencephaly involving the right frontal lobe with evidence of 

polymicrogyria. The corpus callosum and septum pellucidum are 

intact. Optical coherence tomography showed severe generalized 

rim thinning of the left optic nerve. 

Conclusion: Neuroimaging studies and detailed clinical 

examination are equally important for the diagnosis and 

appropriate management of schizencephaly presenting both with 

neurologic and visual symptoms. 

Key Words: schizencephaly, optic nerve atrophy, polymicrogyria 

PP-17 

Third Nerve Palsy Probably Ischemic: A Non Resolving Palsy 

in a 58 Year Old Male 

Abegaile O. Bartolome, Erwin D. Palisoc, Emilio Macias, III, 

Evelyn S. Morabe 


Objective: To present a case of ischemic third nerve palsy with 

pupillary involvement and persistent course 

Method: Case Report 

Results: A 58 year old hypertensive male, smoker was seen 

at the OPD JRRMMC 2 years ago with complaint of drooping 

of right eyelid. Impression then was complete third nerve palsy 

with pupillary involvement. CT Scan revealed: Atherosclerotic 

bilateral internal carotid and vertebral arteries; Unremarkable 

plain and contrast enhanced orbital CT scan. He was referred to 

Neurology Service but was lost to follow-up until 4 months ago 

when he came back still with drooping of right eyelid, associated 

with blurring of vision on both eyes. On examination, visual acuity 

on the right is 20/63 improved to 20/40 and on the left is 20/63 

improved to 20/25. Right pupil is 3-4 mm sluggishly reactive to 

light and left pupil is 2-3 mm briskly reactive to light. The right 

eyelid was ptotic. The right eye was deviated outward and there 

was limitation of elevation, depression, and adduction. The lenses 

were cataractous. The rest of the eye findings were unremarkable. 

Neurological examination was likewise unremarkable except

for Cranial nerve III palsy. Magnetic Resonance Imaging with 

angiography showed: Mild chronic small vessel ischemic changes 

involving the fronto-parietal white matter bilaterally. Small 

abnormal signal in the left subinsular region which is non specific, 

could be due to focus of infarct, chronic small vessels change or 

venous angioma. 

Conclusion: Ischemic third nerve palsy often spares the pupil 

and is usually self limiting. In this 58 year old hypertensive male, 

the pupil was involved, the findings on MR angiography showed 

microvascular injury with no aneurysm, and the condition has 

persisted for 2 years from onset. The non resolution of the 

findings may be attributed to poor control of the hypertension, 

which caused permanent microvascular injury. 

Key Words: third nerve palsy, ischemia, neuro-ophthalmology 

PP-18 

Post Operative Abducens Nerve Palsy 

Caesar Percival F. Sunio, Karen B. Reyes 

Ospital ng Makati, Philippines 

Objectives: To report a case of unilateral abducens nerve palsy 

in a post repeat mastoidectomy patient. 


Results: This is a case report of a 4 y/o female with the complaint 

of abducens nerve palsy after undergoing repeat mastoidectomy. 

The patient had a history of Bell’s palsy and chronic otitis media. 

Ophthalmologic and neurologic examination revealed a left 

facial nerve paralysis and abducens nerve palsy. Orbital CT 

and Temporal CT scan was done which showed a soft tissue 

mass involving the pons, clivus and temporal petrous bone. 

Histopathology test done during the operation showed a soft tissue 

sarcoma, further histoimmunological test for sarcomeric actin and 

desmin were both positive, indicative of a Rhabdomyosarcoma. 

Patient was referred to the Pediatric Oncology service for 

chemotherapy with cyclophosphamide and vincristine. 

Conclusion: The presence of sudden abducens nerve palsy in 

a pediatric patient requires a thorough history and neurologic 

examination, this in turn, would aid in the proper diagnostic 

approach to help determine the etiology of the disease, especially 

in life-threatening cases. 

Key Words: Abducens nerve palsy, Facial nerve palsy, 

Rhabdomyosarcoma, Chemotherapy 

PP-19 

Dengue Fever with Optic Neuropathy 

Pius Jonas F. Ocampo, Buenjim Mariano 


Objective: The purpose of this study is to report a case of optic 

neuropathy associated with dengue fever. 

Method: The study design is a case report. The patient is an 18 

year old male admitted because of dengue fever who complained 

of blurring of vision of both eyes. Visual acuity was 20/20 on the 

right and 20/400 on the left. Optic nerve examination showed 

no edema. Fluorescein angiography and optical coherence 

tomography of the macula were done and revealed normal 

results. Color vision using Ishihara chart showed 15/17 on the 

right and 0/17 on the left. Visual Field examination revealed 

central scotoma on both eyes. The patient was started on 

methylprednisolone 250mg/ IV every 6 hours for 3 days and was 

tapered slowly. 

Results: Improvement of visual acuity, color vision and visual 

fields were noted on the second day of steroid treatment 

Conclusions: Since severe and permanent visual loss have 

been reported in cases of optic neuropathy in patients with 

dengue fever, steroid therapy using IV methylprednisolone can 

be a treatment option aside from observation. 

Key Words: Dengue, Fever, Optic, Neuropathy 

PP-20 

Giant Cell Arteritis: A Case Report of a 77 year old Female 

Almira A. Manzano, Roberto Uy 


Objective: To report a patient diagnosed with Giant cell arteritis 

in the Philippines. 



Results: A case of a 77 year old Filipino female who presented 

with sudden painless blurring of vision on left eye accompanied 

by headache, jaw claudication and body weakness. Visual acuity 

on the left eye was no light perception. Laboratory work-up was 

initially done which showed elevated erythrocyte sedimentation 

rate of 110, CRP of 21.06mg/L and thrombocytosis. Treatment 

with oral Prednisone 60mg/day was immediately initiated. 

Because of high index of suspicion of giant cell arteritis, biopsy of 

the left temporal artery was done which revealed multinucleated 

giant cells with numerous neutrophils, lympho-plasmacytic 

inflammatory cell infiltrates and histiocytes concentrated in elastic 

laminae. 

Conclusion: Giant cell arteritis commonly affects elderly in 

Western world but not in Southeast Asia. It is usually suspected 

in cases of severe unilateral sudden visual loss in the elderly 

however, temporal artery biopsy which is the gold standard for its 

diagnosis is rarely done to document the disease. It is significant 

to diagnose it early because the second eye can be involved 

later in the course and less often it may lead to other serious 

complications. 

Key Words: temporal artery biopsy, giant cell arteritis, giant cell 

arteritis, temporal artery biopsy 

34



PP-21 

Comparison of Visual and Refractive Outcomes Using a 

Microkeratome Versus Femtosecond Laser in Creating a 

Flap for Corneal Inlay Implantation 

Vincent Joseph Corpus, Robert Edward T. Ang 


Objective: To compare post-operative visual, refractive 

outcomes and patient satisfaction in eyes that underwent corneal 

inlay implantation underneath a thick flap created using either a 

femtosecond laser (FS) or a microkeratome (MK). 

Methods: This is a retrospective study of patients who underwent 

monocular implantation of Acufocus KAMRA ACI7000PDT inlay 

in the nondominant eye using either a mechanical keratome 

or a femtosecond laser from July 2008 to January 2012. We 

reviewed the records of 48 patients implanted with the inlay with 

at least a 6-month follow-up. The main outcome measures were 

postoperative monocular and binocular uncorrected distance, 

(UDVA), intermediate (UIVA), and near (UNVA) visual acuities. 

Postoperative refractive errors, subjective assessment of 

symptoms and patient satisfaction were also evaluated. 

Results: The mean UDVA and UIVA remained stable at 20/20 

or better monocularly and binocularly for both groups, while the 

mean monocular and binocular UNVA improved from J5 to J1 in 

both groups. No significant difference between preoperative and 

postoperative mean manifest refraction spherical equivalent was 

noted between the FS and MK groups. 85% of patients in the FS 

group and 77% in the MK group were satisfied with the procedure. 

In the MK group, implantation with the corneal inlay was aborted 

in three eyes due to inadequate flap thickness. 

Conclusion: Visual and refractive outcomes and patient 

satisfaction were similar between the two groups. Achieving 

the desired flap thickness was less predictable using the 

microkeratome as compared to the femtosecond laser. We 

recommend using the femtosecond laser for flap creation to avoid 

aborted inlay implantation. 

Key Words: Corneal Inlay, Presbyopia, Mechanical Keratome, 

Acufocus 


PP-22 

Beveled Osteotomies in Lateral Orbitotomy Using a 

Customized Rotating Bone Saw for Orbital Neoplasms 

Ma. Donna D. Santiago 

Far Eastern University - Nicanor Reyes Memorial Foundation, 

Philippines 

Objective: To evaluate the outcome of beveled osteotomies 

in lateral orbitotomy using a customized rotating bone saw for 

orbital neoplasms. This method involves creating the bone flap in 

35 

a manner that promotes osseous union and eliminates the need 

for miniplate titanium hardware. 

Methods: This paper represents a case series (19 orbits from 

18 patients) of lateral orbitotomies for excision biopsy of orbital 

neoplasms, over a 10-year period (from September 2001 to 

October 2011). Preoperative and postoperative measurements 

were tabulated and statistically analyzed. 

Results: The case series demonstrated that beveled osteotomies 

in lateral orbitotomy are technically possible for excision biopsy of 

all neoplasms in this study. No patient needed the use of miniplate 

hardware for lateral orbital wall repositioning, nor complained of 

a palpable orbital wall deformity. Ninety-five percent (95%) of 

cases demonstrated significant improvement in proptosis with an 

average Hertel exophthalmometry reduction of 3.5 mm. Evidence 

of osseous union was demonstrated in 5 patients who underwent 

postoperative computed tomography scan. 

Conclusion: Beveled osteotomies in lateral orbitotomy using 

a customized rotating bone saw is a modified technique that 

provides excellent access to the lateral subperiorbital, peripheral 

and central surgical spaces. The exposure was adequate for 

excision biopsy of all neoplasms in this study. The technique 

promotes osseous union without the use of miniplate hardware. 

Key Words: Osteotomy, Lateral orbitotomy, Orbital neoplasms, 

Excision biopsy 

PP-23 

Mixed Capillary and Cavernous Hemangioma: A Case Report 

Jesilyn Penny E. Lim, Ma. Donna D. Santiago 



Objective: To present a case of a 14-year old male with an orbital 

mass diagnosed with histopathology as Mixed Capillary and 

Cavernous Hemangioma. 

Methods: Complete ophthalmologic examination and computed 

tomography were done which led to a preoperative impression of 

Cavernous Hemangioma. The patient underwent excision biopsy 

of the orbital mass through a medial orbitotomy. 

Results: A well-circumscribed ovoid mass was excised, which, 

histopathology revealed as a mixed capillary and cavernous 

hemangioma with thrombus formation. The intra-operative and 

post-operative courses were unremarkable. The vision on the 

operated eye was maintained at its preoperative level of 20/20 

even post-operatively. Resolution of proptosis and diplopia were 

also noted 

Conclusion: Vascular lesions of the orbit can be confusing with 

diagnostic imaging features that may overlap. The differentiation 

with this group of lesions is usually possible through correlation 

of characteristic imaging features with significant clinical findings. 

The choice of surgical intervention should consider lesion 

accessibility while minimizing possible complications.

Key Words: Mixed Hemangioma, Antero-medial Orbitotomy, 

Cavernous Hemangioma 

PP-24 

Recurrent Orbital Inflammatory Disease in a Pediatric Patient 

Jerica Paula D. Berdon, Ma. Donna D. Santiago 



Objective: To present a case of an 8-year old female with 

orbital inflammatory disease which presented as a mass on the 

superolateral aspect of the orbit. There was no resolution using 

standard steroid therapy, thus, excision biopsy was done through 

a lateral orbitotomy with bone flap but with recurrence three 

months postoperatively. 

Methods: Physical and diagnostic examinations led to an initial 

impression of orbital inflammatory disease. There was absence 

of resolution of orbital signs and symptoms on steroid therapy. 

Excision biopsy of orbital mass through a lateral orbitotomy with 

bone flap, with frozen section, was done. 

Results: Excision biopsy revealed an irregular reddish brown 

mass which on histopathology showed a chronic inflammatory 

process. Three months postoperatively, there was recurrence of 

swelling of the left upper lid. Repeat Orbital CT scan revealed 

an enhancing soft tissue mass that could be one or combination 

of fibrosing tissue or recurrence. Review of the histopathologic 

specimen was done for which the diagnosis of chronic 

inflammatory disease was re-affirmed. The patient was referred 

back to Pediatric service where steroid therapy was restarted. 

Orbital inflammatory signs were noted to respond favorably to 

steroid treatment. 

Conclusion: Orbital diseases may be inflammatory or 

non-inflammatory. Differentiating them is crucial to provide 

appropriate treatment for our patients. A detailed history, followed 

by a comprehensive physical examination and complimented 

by appropriate radiological evaluation is the optimal approach 

to arrive at the correct diagnosis. Surgical intervention should 

be reserved for cases of orbital inflammatory disease where an 

aggressive lesion or malignancy is being ruled out. The surgical 

approach should provide optimal exposure while minimizing 

perioperative morbidity. 

Key Words: Pseudotumor, lateral orbitotomy, chronic 

inflammation 

PP-25 

The Efficacy of Topical Mitomycin-C in the Prevention of 

Recurrence of Conjunctival Squamous Cell Carcinoma in a 

36-year Old Male 

Kate Concepcion-Torio, Ma. Rachelle Katrina C. Solis 

Jo Anne P. Hernandez 


Objective: To report a case of conjunctival squamous cell 

carcinoma treated with Mitomycin C (MMC) 0.04% Post Excision 

for Prevention of Tumor Recurrence. 

Method: This a case report. 

Results: A 36-year old male came for consult due to conjunctival 

mass on the right eye. This was preceded 6 months ago with 

conjunctival hyperemia with no accompanying pain, itchiness 

or discharge. Two months after, with the persistence of the 

hyperemia, there was note of limbal mass. He was then assessed 

to have pterygium and was advised excision. Patient refused at 

the time and sought consult in our institution. On examination, 

visual acuity on the right is 20/25, on the left is 20/20. Anterior 

segment was unremarkable except for a raised, pinkish, 

conjunctival mass on the right eye with frond-like surface and 

dilated vessels measuring about 4x4 mm extending 1 mm into 

the temporal cornea. Patient underwent excision biopsy with 

cryotherapy. Histopathology of the mass revealed squamous 

cell carcinoma. A regimen of 4 times daily dosing of MMC 0.04% 

for 3 weeks, then discontinued for 3 weeks, then restarted for 

another 3 weeks, to complete 3 cycles was done postoperatively. 

Patient then followed up closely every 2 weeks. After completion 

of 3 cycles, there was no noted recurrence of the tumor and only 

conjunctival hyperemia was the adverse effect observed. This, 

however, disappeared upon discontinuation of the regimen. 

Conclusion: Squamous cell carcinoma of the conjunctiva is a 

slow growing tumor capable of extensive local tissue damage. 

Treatment would include complete surgical excision with 

cryotherapy. However, tumor recurrence is a concern. In this 

case, topical MMC proved to be an effective surgical adjunct in 

preventing its recurrence although longer period of follow up is 

recommended for further observation of recurrence. 

Key Words: Topical Mitomycin C, Conjunctival Mass, Excision 

Biopsy, Cryotherapy 

PP-26 

Wide Excision of a Large Upper Lid Sebaceous Gland 

Carcinoma with Reconstruction Using the Modified Cutler- 

Beard Technique 

Emerson Jay B. Molina, Alex U. Pisig, 

Margarita Justine O. Bondoc, Jo Anne P. Hernandez 


Objective: To report a case of a large upper eyelid sebaceous 

gland carcinoma, with subsequent reconstruction of the frozen 

section-guided excision defect using the modified Cutler-Beard 

procedure. 



Results: An 81-year old Filipino female presented with an 

enlarging mass in the right upper eyelid. The lesion was noted 

8 months prior to consultation at our department. External exam 

on the left eye was unremarkable. Vision is 20/70 on the right 

and 20/100 on the left eye, with BCVA 20/50 for both. She is 

pseudophakic on both eyes, with the rest of the anterior segment 

36


findings unremarkable. She had previously undergone incision 

and curettage of the same lesion at another institution, recurring 

rapidly after 4 weeks. She had a 1.5 x 1.5 cm multinodular, firm, 

non-tender, non-movable and well-circumscribed mass with some 

ulceration on her right upper eyelid and distortion of the lid margin. 

Subsequent referral and incision biopsy confirmed a sebaceous 

gland carcinoma. She underwent frozen-section guided wide 

excision of the tumor until resection margins were found to be 

clear. However, the conjunctiva was positive for pagetoid spread 

and focal subepithelial invasion. Orbital exenteration was not 

favored by the patient. Reconstruction was performed with the 

Modified Cutler-Beard technique followed by release of the bridge 

flap after 4 weeks as a second stage. Oncologic work-up was 

advised. Adjuvant treatment with Mitomycin C 0.04% eye drop 

solution was initiated at four times daily for a course of 2 weeks. 

The cosmetic result was satisfactory. The patient developed 

a corneal epithelial defect on the 2nd week after flap division. 

Mitomycin C was discontinued and the defect was treated 

successfully by bandage contact lens, topical antibiotics and 

lubrication. She remains stable at 3 months following excision 

with no recurrence observed. 

Conclusion: Sebaceous gland carcinoma is a relatively rare but 

potentially lethal malignancy of the eyelid. Wide excision of the 

tumor is mandatory and the resulting defect can be successfully 

repaired using the Cutler-Beard technique, producing a 

cosmetically favorable result. 

Key Words: Sebaceous gland carcinoma, Cutler-Beard 

procedure, Mitomycin C, Pagetoid spread 

PP-27 

Pfeiffer Syndrome-A Case Report 

Christine S. Siguan, Marissa N. Valbuena, Prospero Ma. C. Tuaño 


Philippines 

Objective: To report on a case of Pfeiffer Syndrome, discussing 

the diagnostic features of the disease and characteristics of each 

type. 

Methods: This is a descriptive, prospective report of one case 

seen at the UP-PGH, referred to the Department of Ophthalmology 

Orbit and Pediatric Ophthalmology Service. 

Results: The authors describe a newborn with cloverleaf skull, 

craniosynostosis, bilateral exorbitism, low-set ears, high arched 

palate, flat nasal bridge with fused elbows, long thin fingers on 

hands, broad thumbs, and medially deviated 2nd and 4th digit. 

The case reported was Pfeiffer syndrome type 2, which usually 

has poor prognosis. 

Conclusion: Pfeiffer syndrome is a clinically variable disorder. 

It has been divided into three types. Type 1 is associated with 

mild manifestations and normal intelligence and good prognosis. 

Types 2 and 3 have severe neurological compromise, poor 

prognosis and sporadic occurrence. Management for Pfeiffer 

syndrome is the primary treatment of craniofacial abnormalities 

associated with craniosynostosis. 

37 

Key Words: Pfeiffer syndrome, Cloverleaf skull, Craniosynostosis, 

Syndactyly 

PP-28 

Eyelid Neurilemmoma: A Vanishing Rarity 

Neal Vincent L. Torre, Fatima G. Regala 


Objectives: To present a supposedly rare case of eyelid 

neurilemmoma and attempt to elucidate how this is possible. 

Methods: This is a case report of a 34-year old male who 

presented at Oculoplasty Clinic with an upper lid mass. 

Results: A 34-year old male was referred to the Oculoplasty 

Clinic with a slowly enlarging painless mass in his right upper 

eyelid for one and a half years. Eye examination revealed a 

round, well circumscribed, firm, slightly mobile, nontender mass, 

3.5 cm in diameter, the bulk of which was located in the medial 

third of the left upper eyelid. Orbital CT scan revealed a left 

medial orbital ovoid mass with well defined border measuring 3.3 

x 3.6 x 3.0 cm medial to and pressing the eyeball against the 

lateral orbital wall. Histopathologic evaluation revealed neoplastic 

Schwann cells whose nuclei tend to pallisade. They are arranged 

in interwoven ribbon bundles of pallisading cells alternating with 

acellular areas. The mass was removed en bloc with the aid of 

cryoexcision. One year after surgery, no recurrence was noted, lid 

function was not diminished and it was aesthetically acceptable. 

In this case the lesion could come from any of the nerve branches 

supplying the upper eyelid, specifically its medial half, namely 

the superior orbital nerve, superior trochlear nerve, and inferior 

trochlear nerve, all of which contribute to the ophthalmic division 

of the trigeminal nerve, and the terminal twigs of the temporal 

branch of the facial nerve. Online review of literature revealed that 

there have been already 18 similar cases published. 

Conclusion: A slowly growing painless mass in the upper eyelid 

could be neurilemmoma. This report, as well as the growing 

number of case reports on this presentation, makes it a tenable 

differential diagnosis. 

Key Words: neurilemmoma, eyelid 

PP-29 

A Case of Basosquamous Carcinoma of the Central and 

Midface Area in a 62 year old Filipino Male 

Rhyan Francis T. Monsanto, Charmaine Y. Ang 

Fatima G. Regala 


Objective: To describe the complications and surgical treatment 

of a case of neglected Basosquamous Carcinoma (10 years) 

involving the central and midface area in a 62 year old Filipino 

male. 

Method: Case Report

Results: The patient presented with a non-healing, spreading 

wound that involved the central forehead, medial right and 

left eyelids, nose and both mid-cheek areas. CT scan showed 

irregular shaped superficial soft tissue mass involving the skin and 

subcutaneous fat of both naso-glabellar and pre-maxillary areas. 

Previous biopsy revealed Basosquamous carcinoma. Patient 

underwent wide excision with 5mm clearance and rush frozen 

section for control of margins of resection. Permanent medial 

tarsorrhapy done and the rest left to granulate. Reconstruction 

to be done later. 

Conclusion: Early treatment of Basosquamous Carcinoma will 

prevent its local destructive effect. Surgery with margin control 

can offer cure for these patients. 

Key Words: wide excision, neglected Filipino, basosquamous 

carcinoma, basosquamous, carcinoma, midface 

PP-30 

A Case Report on an Unusual Intraorbital Foreign Body 

Jessica Guzman, Fatima G. Regala, Charmaine Y. Ang 


Objective: To present a case of an orbital trauma, producing an 

unusual intraorbital foreign body with no globe involvement. 

Methods: This is a case report on an 18 year-old male with an 

intraorbital toothbrush extending to the nasal cavity. He presented 

with an embedded handle in the right orbit associated with 

periorbital swelling. Initial visual acuity was OD 20/80 improved to 

20/32-2 by pinhole, with commotio retinae and limited extraocular 

muscle movement in all gazes. He underwent removal of the 

toothbrush head, repair of inferior oblique and upper tarsus. 

Reinsertion of levator aponeurosis into the tarsal plate and repair 

of lid margin were also done. Intraoperative findings revealed that 

the toothbrush went through the medial wall into the nasal cavity 

with transection of the inferior oblique, levator aponeurosis and 

upper lid margin. 

Results: A 6cm by 1cm toothbrush with intact bristles was 

removed from the wound. The swab specimen revealed moderate 

growth of Enterobacter species. The patient was maintained on 

topical antibiotics, intravenous antibiotics for 3 days then oral 

antibiotics for 7 days. Visual acuity improved with resolution 

of commotio retinae. Improvements in extraocular muscle 

movements were observed, however there was residual ptosis. 

Conclusion: Intraorbital foreign bodies are quite uncommon, 

especially those with no globe involvement. Imaging is needed 

prior to planning the removal of intraorbital foreign body to assess 

the exact location. Indications for removing an intraorbital foreign 

body include the nature of the foreign body and wound exposure. 

Antibiotic coverage is important to prevent secondary infections. 

Key Words: intraorbital foreign body 

PP-31 

Bilateral Proptosis with Visual Loss: A Case Report 

J. Rotsen Evaristo, Fatima G. Regala 


Objective: To report a case of chronic bilateral proptosis with 

visual loss. 

Methods: This is a descriptive case report of an 18-year-old 

male presenting with bilateral proptosis and visual loss caused by 

a tumor originating from the nasal cavity. 

Results: Biopsy of the nasal mass revealed histopathologic 

findings consistent with a nasal polyp. 

Conclusion: This is a case presentation of a nasal mass which 

extended intracranially, causing bilateral proptosis and visual 

loss. A tissue biopsy of the mass revealed it was a nasal polyp, 

however, the progression of signs and symptoms raises the 

suspicion that a malignant process is involved. 

Key Words: Bilateral, Visual loss 

PP-32 

Carcinosarcoma in a Newborn 

Aimee C. Ng Tsai 


Objective: To describe a rare case of carcinosarcoma, probably 

from a metastatic Wilm’s tumor. 

Method: This is a case report. 


Result: A newborn was noted to have a mass on the left eye 

upon delivery and was subsequently referred to our institution 

for evaluation. On initial consult at 4 days of age, a 3.5 x 3cm 

bleeding, fungating mass with areas of hematoma was noted 

arising from the conjunctiva. Initial impression was embryonal 

conjunctival mass, to consider malignancy. Other physical 

examination findings were normal except for the conjunctival 

mass. There was rapidly progressive enlargement of the mass 

accompanied by profuse bleeding. She subsequently underwent 

examination under anesthesia, cryoexcision of conjunctival 

mass, and lid repair. Intraoperatively, the mass was found to 

be originating from the preseptal orbicularis muscle and was 

therefore thought to be a rhabdomyosarcoma. A 70 x 50 x 40 

mm3 tan-brown, encapsulated, lobulated, and smooth mass was 

obtained. Histopathologic findings turned out to be consistent 

with carcinosarcoma, rule out metastatic Wilm’s tumor. Contrastenhanced 

cranial CT scan done post-operatively only showed soft 

tissue thickening in the left eyelid. Patient is still for Nephrologic 

work up and immunostaining. 

Conclusion: Metastatic process can present with a conjunctival 

mass and should be included in the differential diagnosis of such 

masses. 

Key Words: carcinosarcoma, embryonal tumor, 

rhabdomyosarcoma, wilm’s tumor 

38

PP-33 

Comparative Study of Using Dermal Fat Graft Alone and 

Dermal Fat Graft with an Orbital Implant in Children 

Majourette Dy Varela, Fatima G. Regala, Charmaine Y. Ang 


Objective: To compare the outcome of using Dermal Fat 

Transplant alone and Dermal Fat Grafting with a small orbital 

implant in the pediatric age group. 

Methods: Autologous DFG was use in 3 children with pthisis 

bulbi and one who had an enucleation without any orbital implant. 

A 1 x 1.5 x 1 cm dermal fat graft harvested from the buttock 

was used in all patients. Two patients with pthisis bulbi had a 

10mm sphere implanted in the posterior Tenon’s followed by 

dermal fat grafting. Both horizontal recti muscles were sutured 

to the inferior edge of the dermis. The two other patients had 

immediate dermal fat grafting. No intra-operative complications 

were noted. Follow-up range from16 to 78 weeks. No signs of 

graft rejection were observed. This was also seen in the patient 

who had chemotherapy for retinoblastoma. There was also no 

clinical difference in both groups. 

Results: The surface area problem in the patients were corrected 

at the same time having successfully fitted with a prosthesis 

Conclusion: In the pediatric age group, the use of dermal fat 

graft as the sole source or together with an orbital implant can 

correct volume loss. At the same time, correction of the surface 

area deficiency was observed. 

Key Words: Children, Contracted socket, Dermal Fat Graft, 

Contracted socket, Dermal Fat Graft 

PP-34 

Use of a Modified Metal Guide of a Bicanalicular Intubation 

Stent in Transected Canalicular Repair 

Marco A. Tumalad, Charmaine Y. Ang, Fatima G. Regala 


Objectives: To describe the use of a modified metal guide of 

a Bicanalicular Intubation Stent in the repair of a traumatically 

transected canaliculus. To outline modification of the metal guide 

of a bicanalicular stent into a pigtail probe. To report outcome in 

terms of surgical facilitation and patency restoration. 

Methods: All patients with traumatically transected canaliculi less 

than 24-hours from incident were recruited from the East Avenue 

Medical Center, Emergency Room Department. All transected 

canaliculi were repaired using our modified bicanalicular stents under 

general anesthesia within 48 hours. We modified a bicanalicular stent, 

by fashioning its malleable metal guide into a pigtail probe creating a 

one-piece instrument consisting of a pigtail probe, complete with the 

silicon tube trailing behind. This allowed us to stent the canaliculus up 

through the transection by passing the probe through the unaffected 

upper punctum and out the transection with the silicon stent threaded 

into place. After successful repair, silicon stents were kept in-place for 

three months. After removal, dye disappearance testing was done. 

39 


Results: There were 10 patients included in this study. All 

underwent repair using a bicanalicular stent whose metal guide 

was fashioned into a pigtail probe. This eliminated the need to 

thread the stent and facilitated reattachment of the transected 

canaliculus. The silicone stent was removed after 3 months. 

Surgeries were successful in stenting the transected canaliculi, 

with anatomical restoration of the lid. All had normal DDT. 

Conclusion: Modifying the metal guide of a bicanalicular stent 

into a pigtail probe facilitated canalicular repair and is associated 

with a high degree of success. 

Key Words: Bicanalicular Silicon Stent, Prolene, Transected 

Canaliculus, Pigtail Probe Dye, Disappearance Test 

PP-35 

Cavernous Hemangioma of the Orbit: An Unusual Presentation 

Clarissa H. Tuliao, Anthony Christopher G. Ortiz, Evelyn S. 

Morabe, Ma. Lourdes R. Nañagas 


Objective: To present a case of cavernous hemangioma of the 

orbit presenting as multiple lobulated lesions. 

Method: Case presentation 

Discussion: A 59 year old female with a two year history of 

gradual progressive proptosis of the right eye with associated 

blurring of vision of the same eye. Ophthalmologic examination 

showed a VA of hand movement with good light projection, OD 

and a BCVA of 20/20, OS. The right eye was displaced forward, 

downward and medially. Hertel’s exophthalmometry showed 5 

mm proptosis. Mature cataract was noted on the right eye, which 

could explain the concomitant blurring of vision. Ophthalmologic 

findings for the left eye were normal. CT Scan with contrast 

showed lobulated hyperdense strongly enhancing mass in the 

right orbit involving the conal/intraconal region closely abutting 

the optic nerve sheath and lacrimal gland. The ocular wall was 

smooth, sharply defined and of normal thickness. Operative 

findings showed 3 discrete sausage-shaped masses connected 

by a fibrous band which were excised completely and submitted 

for histologic examination. Histopathology showed large 

cavernous spaces containing red blood cells, consistent with 

cavernous hemangioma. Cavernous hemangioma is the most 

common neoplasm of the orbit in adults. Growth of this mass 

usually causes axial proptosis but our patient presented with 

forward, downward, and inward deviation, likely due to extension 

of the mass to the area of the lacrimal gland as seen on CT scan. 

Thus, pleomorphic adenoma of the lacrimal gland was included 

in our differential diagnosis. The multiple nodular presentation of 

the tumor also led to a consideration of lymphangioma. Inspite 

of the atypical lobulation and seeming extension into the area 

of the lacrimal gland, cavernous hemangioma was still mainly 

considered because of its frequency of occurrence, the slowly 

progressive course of the patient’s condition, and the CT scan 

findings of a homogenous, hyperdense, strongly enhancing 

mass with no sign of bone invasion. Timothy et. al. reviewed 

the presentation of cavernous hemangioma and found 4 reports

that described multiple lesions in the one orbit in none of six, one 

of 13, two of 66, and five of 85 patients. Mirjana Nagulic, et. al. 

reported a case of multiple recurrences after complete excision 

in a case of multi-lobulated tumor. Hence, long term followup 

is recommended especially in multi-lobulated cavernous 

hemangioma. 

Conclusion: Cavernous hemangioma may present as a multilobulated 

strongly enhancing mass and must be included in 

the differential diagnosis of such orbital lesions in adults. Long 

term follow-up is recommended because of reports of multiple 

recurrences after excision, especially of multi-lobulated tumors. 

Key Words: Multi-lobulated, Hemangioma, Intraconal, Orbit, 

Tumor, Proptosis 

PP-36 

Sebaceous Gland Carcinoma of the Eyelid Presenting as a 

Chalazion: A Case Report 

Pearl Trisha M. Padilla, Leonardo R. Mangubat 


Objective: To discuss a case of a 38-year old female 

presenting with a slowly enlarging, painless, irregular nodular 

lesion resembling a chalazion on the left upper lid, diagnosed 

histopathologically with sebaceous gland carcinoma. 

Methods: Complete eye exam and baseline measurements were 

acquired. A prompt excision of the nodule with tissue biopsy was 

done under local anesthesia. 

Results: Tissue biopsy results confirmed the diagnosis 

of Sebaceous Gland Carcinoma of the eyelid. The goal of 

management is to perform wide excision and to determine the 

extent of malignant spread, if any. Management included a 

referral to orbit and oculoplastic service. The proposed surgical 

plan six weeks post-operatively is to perform wide excision with 

frozen section of the lines of excision and reconstruction under 

local anesthesia. 

Conclusion: Current recommended treatment for Sebaceous 

Gland Carcinoma of the lid is wide excision of the involved tissue 

with histological monitoring of surgical margins. For extensive 

involvement, however, total exenteration may be necessary. This 

report emphasizes the importance of maintaining a high index of 

suspicion on the ophthalmologists part when presented with such 

a history and a progressing nodular lesion. An early biopsy may 

likewise prove useful and lifesaving in potentially lethal tumors. 

Key Words: Wide excision 

PP-37 

Orbital Metastasis Arising From Adenocarcinoma of the Lung 

Bernardo Joaquin Tuaño, Yvette Marie Santiago 


Objective: To present a case report of a 57 year old female with 

a one year history of ptosis of the left eye. 

Methods: On physical examination, there was a 2mm left 

hypoglobus with fullness over the left eyebrow. There was no 

resistance to retropulsion. Exophthalmometry revealed a 5mm 

proptosis on the left eye (15mm) when compared to the right 

(10mm). The initial approach to orbital disease of this patient 

was to determine if the proptosis was due to a vascular lesion, 

endocrine problem, inflammatory condition or a neoplastic 

disease. 

Results: After narrowing the differentials, a computed 

tomography (CT) scan of the orbits was requested to help 

determine the type of orbital disease. The CT scan showed lytic 

calvarial lesions involving the left frontal and sphenoid bones, 

including the left lateral orbital wall, with associated intraorbital 

and intracranial soft tissue densities. A metastatic process (from 

a yet unspecified primary focus) is primarily considered. Further 

work up was done and it revealed a right retrobronchial mass 

abutting the major fissure and slightly indenting on the posterior 

wall of the right mainstem bronchus. A CT guided biopsy of the 

right retrobronchial lung mass showed findings consistent with 

adenocarcinoma. 

Conclusion: Although rare, orbital metastasis from a primary 

cancer should always be a consideration and should be 

investigated, because patients can initially present with proptosis. 

Key Words: Adenocarcinoma of the lung, Orbital Metastasis, 

Proptosis 

PP-38 


Spontaneous Resolution of Dilated Superior Ophthalmic Vein 

in a Patient with Indirect Carotid-cavernous Sinus Fistula 

Karen Joyce G. Castro, Prospero Ma. C. Tuaño 

St Luke’s Medical Center, Philippines 

Objective: To describe a case of spontaneous resolution of 

dilated superior ophthalmic vein in a patient with indirect carotidcavernous 

sinus fistula presenting with proptosis and marked 

congestive ophthalmopathy. 

Method: A 58 y/o male, Filipino, diabetic, presented with sudden 

pain, blurring of vision, diplopia, and proptosis of the right eye. 

There was no history of trauma. Examination revealed vision 

of 20/400 on the right eye, with ptosis, marked congestion, 

chemosis, limitation of ocular motility, and (+) RAPD. There was 

no bruit. The intraocular pressure (IOP) was 17mmHg. 

Results: CT scan and MRI/MRA of brain and orbits revealed 

dilated superior ophthalmic vein on the right with undue 

enhancement of walls. The extraocular muscles of the right eye 

showed diffused thickening and enhancement. Cavernous sinus 

also showed haziness and enhancement. No distinct mass lesion 

was noted. An initial diagnosis of orbital inflammatory disease 

versus an infectious etiology was considered. Patient was started 

on antibiotics and steroid. There was marked improvement 

after 3 weeks with vision of 20/40 on the right and improved 

ocular motility. However, chemosis and dilated conjunctival 

vessels persisted. Steroid was slowly tapered. Review of orbital 

40


imaging was done and indirect carotid-cavernous sinus fistula 

was considered. CT angiography was planned to confirm the 

diagnosis. While waiting for funds for the procedure, chemosis 

and dilated conjunctival vessels resolved. Repeat orbital CT scan 

with contrast after 4 months revealed spontaneous resolution of 

dilated superior ophthalmic vein. 

Conclusion: A high index of suspicion is necessary in diagnosing 

a case of indirect carotid-cavernous sinus fistula in a patient 

without any history of trauma presenting with proptosis, marked 

congestive ophthalmopathy, and orbital imaging showing dilated 

superior ophthalmic vein. Spontaneous resolution of dilated 

superior ophthalmic vein occurs in an indirect type of carotidcavernous 

sinus fistula. Orbital imaging such as CT scan and 

MRI/MRA are important in the diagnosis. 

Key Words: dilated superior ophthalmic vein, proptosis, carotid 

cavernous-sinus fistula 

PP-39 

Two-Stage Reconstruction of Upper and Lower Anterior 

Lamellar Eyelid Defect after Excision of Intradermal Nevus 

Pius Jonas F. Ocampo, Mary Rose Pe-Yan 

St. Luke’s Medical Center, Philippines 

Objective: The purpose of this study is to report a two-stage 

surgical procedure to reconstruct a large upper and lower anterior 

lamellar eyelid defect. 

Methods: The study design is a case report. The patient has 

an upper and lower eyelid (anterior lamellae) defect (horizontal 

extent: >90%, both upper and lower, vertical extent: > 15mm) 

after tumor excision (Intradermal Nevus). A two-stage eyelid 

reconstruction using a full thickness skin graft with apposition of 

upper and lower eyelid skin and a secondary release and repair 

of blepharoptosis were done. The outcomes were an upper and 

lower eyelid anatomic cosmetic appearance and lid closure 

function. 

Results: Good anatomic cosmetic appearance and lid closure 

function were achieved after the second surgery. No remarkable 

ocular and extra-ocular side effects or complications were noted. 

Conclusions: In a two-stage procedure, assuring the integrity 

and viability of the graft prior to repair of blepharoptosis was done 

to repair large upper and lower eyelid (anterior lamellae) defect. 

Key Words: Eyelid, anterior, Reconstruction, lamellae 

PP-40 

Painful Ophthalmoplegia 

Honeylen Maryl Tiu Teo, Prospero Ma. C. Tuaño, 

Buenjim Mariano 


Objective: To present a case report on painful ophthalmoplegia 

diagnosed as Tolosa Hunt Syndrome (THS) 

41 

Methods: We reported a case of a 49 year-old male who 

presented with periorbital pain, eye redness, blurred vision, lid 

drooping, and limited movement of the right eye. Physical exam 

revealed no light perception, proptosis; and involvement of all 

extraocular muscles, optic nerve, and conjunctival vessels on the 

right eye. History and ophthalmologic exam gave clues on the 

possible location of the lesion, and was confirmed through MRI. 

Trial of steroids using intravenous dexamethasone 5mg every 

6 hours for 3 days was done, and the patient was observed for 

improvement of the ophthalmologic signs and symptoms. 

Results: Orbital MRI with contrast revealed a homogeneously 

enhancing right intraconal soft tissue mass extending into 

the posterior right eyeball, with radiologic considerations of 

inflammatory, infectious, and neoplastic lesion. The patient 

was diagnosed with THS based on the International Headache 

Society 2004 Criteria for THS. There is currently no protocol or 

standardized dose of steroids for the treatment of THS. With 

the trial of steroids, the signs and symptoms of periorbital pain, 

conjunctival congestion, ptosis, ophthalmoplegia, and proptosis 

improved during the three-day admission. However, the visual 

acuity showed no improvement. 

Conclusion: Painful ophthalmoplegia has various etiologies. 

A thorough history, ophthalmologic exam, imaging, and trial of 

steroids are necessary to confirm the diagnosis of Tolosa Hunt 

Syndrome. 

Key Words: Hunt, Syndrome, ophthalmoplegia, Tolosa, Hunt, 

Syndrome, ophthalmoplegia 

PP-41 

Canalicular Reconstruction in Long Standing Healed 

Canalicular Laceration 

Simeon Arni A. Pagdanganan, Reynaldo M. Javate 


Objective: Canalicular reconstruction in long standing healed 

canalicular laceration can be managed by dacryocystotomy 

followed by retrograde canalicular intubation. The surgical 

technique and significance of this procedure are discussed. 

Methods: A retrospective case study of a 26 year old male who had 

a history of long standing healed canalicular laceration following 

trauma to his right lower lid. He underwent dacryocystotomy with 

retrograde canalicular intubation under general anesthesia at 

University of Santo Tomas Hospital Eye Center on year 2012. 

Results: Epiphora improved. 

Conclusion: Dacryocystotomy followed by retrograde canalicular 

intubation is a technique that can be used for canalicular 

reconstruction in patients with long standing healed canalicular 

laceration. 

Key Words: Dacryocystotomy followed by retrograde canalicular 

intubation, long standing healed canalicular laceration

PP-42 

Microendoscopic Recanalization with Silicone Intubation 

for the Treatment of Canalicular and Primary Acquired 

Nasolacrimal Duct Obstruction 

Armida L. Suller, Reynaldo M. Javate, Raul T. Cruz, Jr. 


Objective: To determine the surgical outcome of microendoscopic 

canalicular trephination (MCT) and endoscopic lacrimal duct 

recanalization (ELDR) with silicone intubation in restoring the 

passage of tears in patients with canalicular and primary acquired 

nasolacrimal duct obstruction (PANDO). 

Methods: This is a prospective, noncomparative, interventional 

case series of patients presenting with epiphora secondary to 

canalicular and/or nasolacrimal duct obstruction (NLDO) who 

underwent MCT and ELDR with silicone intubation from June 

2009 to March 2012. A mean follow-up period of 10.2 months (3.0 

to 28.6 months) was conducted after stent removal and evaluation 

for anatomical and functional patency was done. 

Results: Twenty-five patients with a mean age of 64.6 years 

(36 to 86 years) were included in the study. Nineteen cases had 

canalicular obstruction while 26 cases had complete NLDO. 

Silicone stents were removed at a mean of 8.1 months (3.1 to 

12.0 months) after the surgery. The anatomic and functional 

success rate for patients with canalicular obstruction was 94.7% 

(95% CI, 74 to 99.9%). Patients with complete NLDO achieved 

an anatomic success rate of 96.2% (95% CI, 80.4 to 99.9%) 

and a functional success rate of 84.6% (95% CI, 65.1 to 95.6%). 

Two cases, 4.44% (95% Cl, 0.5 to 15.1%) had punctal slitting 

associated with silicone intubation. No other minor or major 

complication was observed. 

Conclusion: MCT and ELDR with silicone intubation allow 

precise localization, removal of obstruction, avoiding creation of 

a false passage, preventing adhesion of the mucosal lining of the 

lacrimal excretory system; thus, increasing the success rates of 

the procedures. 

Key Words: endoscopic lacrimal duct recanalization, silicone 

intubation, microendoscopic canalicular, trephination, canalicular 

obstruction, nasolacrimal duct obstruction 


PP-43 

Adenoid Cystic Carcinoma of the Lacrimal Gland: A Case Report 

Mamerto G. Capero, Jr., Anthony Christopher G. Ortiz, 

Evelyn S. Morabe, Ma. Lourdes M. Nañagas 


Case Summary: Adenoid cystic carcinoma of the lacrimal gland 

is a very rare condition, accounting for only 1.6% of all orbital 

tumors. This is a case of a 31yo male seen at our clinic due to 

a 3 month history of protrusion of the left eye with pain scale of 

3/10, associated with progressive blurring of vision and redness. 

Patient had a visual acuity of Counting fingers at 3ft, Proptosis 

of 9mm with Hertel?s Exophthalmometry, and EOM of -3 on all 

fields of gaze OS. A palpable, firm, tender, non-movable mass on 

the superolateral aspect of the left orbit was noted. CT scan with 

Orbital cuts revealed lacrimal Gland Mass probably malignant with 

metastasis to the left part of the frontal lobe of the brain and bone 

invasion. Exenteration of the left eye with Craniotomy excision 

of the tumor at the left frontal lobe was done together with the 

neurosurgery team. TNM staging was noted at T2NoM1 with a 

Histologic Grade of G3 due to malignant cells mainly basaloid 

(solid) pattern. Perineural invasion was also noted. Adenoid 

cystic Carcinoma is a very aggressive tumor in which there is no 

established treatment protocol yet. However, early detection and 

prompt intervention may improve treatment outcome and survival 

rate. On the basis of cases previously studied, exenteration plus 

radiation was the most efficacious treatment. 

Key Words: Adenoid Cystic Carcinoma of the Lacrimal Gland 

PP-44 


Primitive Neuroectodermal Tumour of the Orbit in a 14 Year 

Old Male with Absolute Glaucoma Post Evisceration: 

A Case Report 

Manuel Benjamin B. Ibañez, IV, Leonardo R. Mangubat, 

Ramon Mario Ongsiako 


Objective: To describe a rare case of a peripheral primitive 

neuroectodermal tumour of the orbit in a 14 year old boy. 

Methods: A 14 year old male presented with a 2 month history 

of an enlarging, mass on an anophthalmic socket. Complete 

eye exam was done and baseline characteristics were taken on 

presentation. A wedge biopsy of the orbital mass was done and 

specimens were sent for histopathology and immunostaining. 

Results: Wedge biopsy results showed round cell tumour, to 

consider high grade lymphoma. Further immunostaining revealed 

primitive neuroectodermal tumour. 

Conclusion: Primitive neuroectodermal tumour occurring 

peripherally is rare with only 9 reported cases. It is diagnosed 

through immunohistochemistry. There is no standardized 

treatment but goal of therapy is to remove as much tumour tissue 

as possible followed by chemotherapy and possible irradiation. 

Key Words: Primitive Neuroectodermal Tumour, Orbital Mass 

42



PP-45 

A Case of Bilateral Persistent Fetal Vasculature in a 

Premature Infant 

Arturo B. Capulong, Emilio Macias, III, Evelyn Morabe 


Case Summary: While frequently unilateral, persistent fetal 

vasculature (PFV) has been reported to be bilateral in 2.4-14% 

of cases. We report an interesting case of a 5month old baby 

born premature, 1st of twins, with bilateral leukocoria. ROP was 

considered in the differential diagnosis of this case because of 

the bilaterality, the history of prematurity and the LBW of 1500 

gms. However, because of the findings of microphthalmia, the 

presence of retrolental membrane and optic stalk without the 

peripheral retinal cicatricial findings of ROP, PFV was considered 

the more likely diagnosis. 

Key Words: optic stalk, persistent primary vitreous 

PP-46 

Moebius Syndrome Associated with Exposure to Misoprostol 

JC Martin S. Cabrera, Bibhuti R. Thapa, Emilio L. Macias, III, 

Evelyn S. Morabe, Ma. Lourdes Nañagas 


Objective: To discuss and help in recognition of a rare 

developmental anomaly. To report a case of child, born with 

Moebius Syndrome following exposure in utero to misoprostol for 

elective abortion. 

Method: A case report 

Case: An 8 years old boy, born full term by NSD to 21 years 

old primigravid at health center delivered by midwife with-out 

any fetomaternal complications. At 3 months age of gestation, 

the mother attempted abortion with misopro-stol taking 1 tablet 

orally. At birth, deviation of the eyes was noted. At 1 year of 

age, deviation of mouth with incomplete closure of left eye was 

noted. Patient had normal growth but delay in development of 

speech. On ophthalmologic examination, VA was 20/50 -> 20/25 

on right, 20/160 -> 20/63 on left eye. Restriction of movement of 

eye laterally on both eyes was noted. Lagophthalmos, bilateral 

epicanthal folds with microcornea of left eye was observed. On 

slit lamp examination, positive punctuate epithelial dye uptake 

was present. Fundus examination was normal. Krimsky test on 

Right eye fixating was 35 prism diopter LHT and on cover uncover 

test, 35LHT on primary gaze, 20RET on right gaze and 45LHT 

with 50LET on left gaze was found. Atropine refraction was+ 2.50 

diopter sph -1.50 diopter cyl X180 on right eye and +4.50 diopter 

sph - 1.00 diopter cyl X180 on left eye. Amblyopia in this patient 

was most probably due to strabismus and anisometropia. Other 

non ophthalmologic findings were deviation mouth with deviation 

of tongue on protusion, and could not properly smile causing 

mask like face and club foot. Eye glasses was provided which 

improved the visual acuity to 20/32 on right eye and 20/100 on left 

43 

eye. Symptomatic treatment was done with ointments and eye 

patching started. Patient was suggested for regular followup and 

muscle surgery was planned. 

Case Discussion: In the clinical setting, the findings like various 

gaze palsies, associated with mask-like facies, incomplete eyelid 

closure, deviation of mouth and tongue, and speech impairment 

raises a high index of suspicion for Möbius syndrome, a disorder 

primarily involving the facial and abducens motor nerves. Ocular 

conditions that may present with with limited lateral rectus 

function include congenital sixth-cranial-nerve palsy, and Duane 

syndrome. These conditions, however, do not have signs and 

symptoms characteristic of facial nerve involvement. Facial nerve 

involvement with deviation of mouth can be seen in Assemetric 

crying facies but doesn’t have any ocular involvement. All these 

ocular and non-ocular findings can be seen in Möbius syndrome. 

Von Graefe initially described a patient with congenital facial 

diplegia in 1880 but Paul Julius Möbius, a German neurologist, 

reviewed more cases and reported an association with congenital, 

nonprogressive bilateral facial and abducens nerve palsy along 

with other systemic abnormalities.Later, Verzijl suggested 

facial palsy with impairment of ocular abduction as the primary 

criterion for Möbius syndrome. The etiology of Möbius syndrome 

is multifactorial, and several theories have been proposed, with 

the most supported theory being that of transient ischemic or 

hypoxic insult to the fetus. Other infectious and genetic etiologies 

have also been proposed. In addition, the use of misoprostol, a 

prostaglandin-E1 analog and abortifacient during pregnancy, has 

also been implicated. Misoprostol is a synthetic prostaglandin 

E analogue with greater antisecretory and mucosal-protective 

activity than natural prostaglandins. It is used to prevent and treat 

gastrointestinal lesions induced by nonsteroidal anti-inflammatory 

drugs and upper gastrointestinal ulceration. It is not 

recomended during early pregnancy, because it may mended 

stimulate uterine contractions and cause vaginal bleeding, 

which may endanger fetal survival. Misoprostol has been 

used for the elective induction of abortion. Congenital defects 

following prenatal exposure in early pregnancy to misoprostol 

include skull defects, bladder exstrophy, arthrogryposis, cranial 

nerve palsies, facial malformations, terminal transverse limb 

defects, and Moebius sequence. Möbius syndrome is congenital, 

non progressive. No definitive treatment available. Nonsurgical 

ophthalmologic management include early detection and 

treatment of amblyopia giving best correction and symptomatic 

treatment. Amblyopia in these patient might be due to strabismus 

or anisometropia. There is no single surgical approach to correct 

strabismus of patients with Möbius sequence, though muscles 

recessions and transpositions can be the option. Treatment for 

facial nerve palsy involves reconstructive plastic surgery with 

muscle transplantation ideally performed in patients just before 

they reach school age at 4 or 5 years. 

Conclusion: We therefore conclude that the public should be 

educated on the potential teratogenic effects of misoprostol in 

order to eliminate its use as an abortifacient. Awareness about 

this syndrome for early diagnosis and treatment of the patient is 

needed. Parents counseling and education are invaluable. 

Key Words: Moebius syndrome, Misoprostol.

PP-47 

Strabismus Surgery in a Child with Moebius Syndrome 

Maureen M. Resonable, Michelle M. Hernandez 

Ospital ng Maynila Medical Center, Philippines 

Objective: To report a case of Moebius syndrome with surgical 

management of strabismus. 

Methods: This is a case report 

Results: This is a case of a 9 year old male diagnosed with 

Moebius syndrome. The patient presented with loss of ocular 

abduction, esotropia of 65 PD by Krimsky, lagophthalmos, masklike 

facies and speech difficulties. Medial rectus recession with 

botulinum toxin injection and full tendon transposition of vertical 

muscles with ciliary sparing, OU was done. Esotropia was 

reduced to 15 PD by Krimsky 5 weeks post-operatively with no 

hypertropia nor anterior segment ischemia noted. Full cycloplegic 

refraction was prescribed to neutralize the residual esotropia. 

Conclusion: Moebius syndrome is a rare congenital disorder 

characterized by facial diplegia and lateral gaze paralysis. The 

management of strabismus in patients with Moebius syndrome 

is complex and no single surgical approach is successful in all 

patients. The family must be counseled prior to surgery to avoid 

non-realistic expectations. 

Key Words: esotropia, Moebius syndrome, strabismus surgery 

PP-48 

Prevalence of Amblyopia in School Aged Children in 

Maybunga Elementary School 

Airene M. Oloroso 

Rizal Medical Center, Philippines 

Objective: Amblyopia is responsible for more unilaterally 

reduced vision of childhood onset than other causes, with the 

prevalence of 2-4%. In children, vision impairment can affect 

school performance and other functions, such as ability to safely 

participate in sports. Strabismus, the most common contributing 

factor to amblyopia, can also result in loss of stereopsis, leading 

to impaired depth perception, as well as teasing and other 

psychosocial consequences. Amblyopia is therefore considered 

to be a developmental disorder that is most effectively treated 

during an early, sensitive period. This understanding has been 

one of the key justifications for vision screening. The other main 

justification for vision screening is that it provides an opportunity 

to correct any vision problems and potentially promoting school 

performance during an important period of social and functional 

development. 

Methods: This is a prospective study that includes all schoolaged 

children of Maybunga, Elementary School. 

Results: We screened 1050 students of Maybunga, Elementary 

School. 140 students were refracted using cyclopentolate. 

Conclusion: The school doctors or nurse need to be more 

diligent in identifying children with problems in vision or alignment 

in order to have a proper referral to o ophthalmologist to prevent 

or early treatment of amblyopia. 

PP-49 

Self-inflicted, Traumatic Disinsertion of the Lateral Rectus: 

A Case Report 

Patricia Isabel C. Manalastas, Fay Charmaine S. Cruz 



Objective: To present a case of a 23-year old male who presented 

with acute onset diplopia secondary to a self-inflicted disinsertion 

of the lateral rectus. 

Methods: A case of a self-inflicted disinsertion of the lateral 

rectus will be reviewed. Clinical findings as well as management 

of the case were compared with those reported in literature. 

Results: The ideal management for lost muscle is to retrieve 

and re-attach to the original insertion. However, in cases wherein 

the muscle is not located, a Hummelsheim procedure with 

Foster modification was effective in achieving orthophoria on 

primary gaze. The patient’s ability to fuse and early intervention 

contributed to the success of the surgery. 

Conclusion: The case of a 23-year old male who presented with 

acute onset diplopia secondary to a self-inflicted disinsertion of the 

lateral rectus was successfully treated by doing a Hummelsheim 

procedure with Foster modification. 

Key Words: Acute Esotropia, Avulsed conjunctiva, Hummelshei, 

Foster modification 


PP-50 


Neuritis and Neuro-retinitis as Initial Presentations of HIV 

Elenor Reina S. Aquino, Jessica Marie R. Abaño, Jocelyn Sy 


Objective: To describe ocular findings of two patients presenting 

with neuritis and neuro-retinitis who subsequently tested positive 

for HIV. 

Methods: This is a report of 2 cases. 

Results: Case 1 is that of an apparently healthy 27 year old male 

who consulted because of blurring of vision. Pertinent findings on 

the affected eye were vision of 20/30, quiet anterior segment and 

a swollen optic nerve with blurred disc margin and surrounding 

flame-shaped hemorrhages. Chest X-ray was normal, pure 

protein derivative (PPD) was zero and CBC showed leucopenia. 

Fluorescein angiography showed optic nerve hyperfluorescence 

with vessel leakage and staining. He further disclosed a history 

of cat scratch. He was diagnosed with probable Batonella 

44

Henselae infection and was treated with oral antibiotic with good 

response. An HIV screening later revealed positive result. Case 

2 is that of a 23-year old male who had a history of on and of 

fever accompanied by rashes. He consulted because of blurring 

of vision. Pertinent findings on the affected eye were vision of 

20/30, quiet anterior segment and a swollen optic nerve, blurred 

disc margin with surrounding flame-shaped hemorrhages and 

exudates involving the papillo-macular area. Chest X-ray was 

normal, PPD was negative and CBC showed leucocytosis. CMV 

antigenemia was elevated. He was diagnosed to have CMV 

retinitis and was treated accordingly. An HIV screening later 

revealed positive result 

Conclusion: With the increasing incidence of HIV/AIDS in the 

Philippines, HIV-associated ocular infections should therefore be 

considered as differentials in patients with uveitis presenting as 

neuritis or neuro-retinitis. 

Key Words: HIV, Neuroretinitis, Cat-scratch disease, Bartonella 

henselae, CMV 

PP-51 

Bilateral Serous Retinal Detachment in Toxemia of 

Pregnancy: A Case Series 

Mayjane Joan G. Tumulak, Jocelyn Sy 


Objective: To describe a series of gravid patients with toxemia 

of pregnancy presenting with bilateral retinal detachment. 

To describe the clinical course and management of retinal 

detachment in patients with preeclampsia, eclampsia and HELLP 

syndrome 

Method: This is a case series of three pregnancy induced 

hypertensive patients (1 eclampsia, 1 preeclampsia, 1 

preeclampsia with HELLP syndrome) at the East Avenue Medical 

Center Department of Obstetrics delivery room who complained 

of blurring of vision, which on fundus examination revealed 

bilateral serous retinal detachment. Baseline VA: CF to HM in 

both eyes. All patients underwent emergency caesarean section 

and all eyes were managed clinically. One case had subtenon 

triamcinolone, acetazolamide and hypertension control and the 2 

cases had hypertension control only. Fundus photos were taken 

to monitor reattachment. 

Results: After 1 week postpartum, all eyes had improvement 

of vision at 20/32 with note of resorption of the bilateral retinal 

detachment, 2 cases had stabilization of the systemic disease, 

however 1 case had poor hypertension control whose eyes had 

bilateral central retinal vein occlusion. 

Conclusion: Early assessment of blurring of vision in pregnant 

patients should be warranted for this may give a clue for maternal 

and fetal prognosis. Although bilateral retinal detachment in this 

case is managed clinically, this will assure the patient that there is 

good visual recovery. The need for an eye consult in all patients 

with pregnancy induced hypertension is strongly recommended 

especially in a community based set-up. 

45 


Key Words: Bilateral serous retinal detachment, toxemia in 

pregnancy, preeclampsia, eclampsia, HELLP syndrome 

PP-52 

Choroidal Hemangioma: A Case Report 

Jan Carlo Y. Alegre, Jocelyn Sy 


Objective: To report investigative and treatment measures in a 

patient with choroidal hemangioma. 


Results: A 15 year old female complaining of progressive 

blurring of vision of the right eye for two years duration. On eye 

examination, visual acuity was 20/200 over the right eye with 

positive RAPD and 30 degrees exotropia. Fundus examination 

showed a reddish-orange mass with overlying exudative retinal 

detachment, around two disc diameters temporal to the optic 

nerve of the right eye. Fundus photo, orbital MRI with contrast, 

T1/T2 weighted, fluorescein angiography and macular OCT were 

requested. Transpupillary Thermotherapy was then initiated 

followed by anti-VEGF treatment. 

Conclusion: Choroidal hemangiomas are rare, benign vascular 

tumors, which can be mistaken for other malignant intraocular 

tumors. With the use new technologies, confusion regarding the 

diagnosis can be minimized. Transpupillary Thermotherapy is still 

the gold standard for treatment however, anti-VEGF medications 

can be an adjunct to therapy in order to provide better resolution 

of symptoms. 

Key Words: anti-VEGF, choroidal hemangioma, intraocular 

tumor, transpupillary thermotherapy 

PP-53 

Central Retinal Artery Occlusion in the Young 

Erica Blanca Daquil 


Objectives: To present a rare case of Central Retinal Artery 

Occlusion (CRAO) in a 15 year old young, Filipino female. 

Methods: This is an emergency room case of a young female 

with a complaint of sudden blurring of vision in the right eye which 

was thoroughly investigated. 

Results: This is a case report of a 15 year old, Filipino, female 

which developed a Central Retinal Artery Occlusion of the right 

eye. The symptoms started a few hours upon waking up where 

patient had sudden blurring of her vision. The fundus exam 

revealed a pale retina with a cherry red spot in the macula and 

noted an obstruction in the inferior retinal vessel. A prompt 

emergency treatment for CRAO was administered upon note of the 

findings. Further laboratory work up was done and concomitantly 

managed with the Pediatric Department to investigate the cause 

and for proper evaluation and treatment administration. Persistent

investigation resulted into the diagnosis of Rheumatic Heart 

Disease in the patient in which clenched the probable cause of 

the obstruction. 

Conclusion: This report shows a rare case of CRAO in the young 

wherein the retinal obstructive symptoms preceded the systemic 

symptoms and finding of the cardiac problem. The patient was 

for a long time asymptomatic systemically until the manifestation 

of the sudden blurring of vision which lead to the finding of the 

presence of the cardiac disease after thorough investigation. 

This prompt evaluation has helped the clinicians to properly treat 

and more importantly minimize additional systemic and ocular 

morbidity in this young individual. 

Key Words: Central Retinal Artery Occlusion, Cherry Red Spot, 

Rheumatic Heart Disease 

PP-54 

Best’s Vitelliform Macular Dystrophy with Normal EOG: 

A Case Report 

Nikki Doreen Angbue Te 


Objective: To describe a case of Best’s Disease with normal 

EOG. 

Methods: This is a case report of a 14 year old female with a 1 

year history of central scotoma on the right eye. 

Results: Vision on the right eye was 20/100, 20/20 on the left 

eye. Fundoscopy of the right eye showed a round retinal elevation 

at the center of the macula with vitelliform changes inferiorly and 

subretinal hemorrhage superiorly. The left eye likewise showed 

retinal elevation at the macula with vitelliform changes. Fluorescein 

angiography of the right eye showed a hyperfluorescent patch 

at the macula with areas of blocked fluorescence. The left eye 

similarly revealed a hyperfluorescent patch. ICG of both eyes 

showed hypofluorescent patches which corresponds to the 

vitelliform changes with areas of hyperfluorescence in the right 

eye. ERG and EOG were normal. Patient subsequently underwent 

PDT on the right eye with improvement of vision. 

Conclusion: A normal EOG light rise is uncommon in Best’s 

disease. However, this does not rule out the diagnosis. 

Key Words: Best Vitelliform Maculary Dystrophy, Best disease, 

Normal EOG, Best disease, Best Vitelliform Maculary Dystrophy 

PP-55 

Neovascular Glaucoma and Exudative Retinal Detachment in 

a Young Male: A Case Report 

Mark Angelo B. Hosaka 


Objective: The purpose of this report is to present a case of 

a retinal detachment which eventually leads to neovascular 

glaucoma. Highlighting the clinical course, evaluation and 

management of the case. 

Methods: A case report series 

Results: B-scan ultrasonography showed a dome shaped 

elevation connected to the optic nerve. Hyperechoic subretinal 

punctate densities with after movement were seen. Moderate 

amplitude echo was noted in the midvitreous cavity. Fundus 

photo of the left eye showed total bullous retinal detachment with 

extensive exudates and hemorrhage. Patient had undergone 

diode cyclophotocoagulation which relieves the patient’s pain and 

reduces the patient’s IOP. 

Conclusions: Patient was diagnosed with Neovascular 

Glaucoma and Exudative Detachment secondary to Coat’s 

Disease. Coats disease is a distinct clinical entity characterized 

by idiopathic retinal telangiectasia with subsequent sequelae 

of exudative retinal exudation and if left untreated can cause 

neovascular glaucoma. The clinician should follow strict criteria 

as stated by Shields in making the diagnosis, to avoid confusing 

Coats disease with other forms of exudative retinopathy that have 

often been called Coats disease erroneously. The differential 

diagnosis of Coats disease includes retinoblastoma and many 

other conditions that produce exudative retinopathy, particularly 

in children. 

Key Words: Retina, Neovascular Glaucoma, Pediatric Patients 

PP-56 


Treatment of Polypoidal Choroidal Vasculopathy 

Paul Samuel Del Mundo, Johanna T. Cervantes 

Pearl Tamesis-Villalon 

St. Luke’s Medical Center International Eye Institute, Philippines 

Objective: To describe new modalities in the treatment of 

Polypoidal Choroidal Vasculopathy (PCV). 

Methods: This is a retrospective, non-comparative case series of 

3 patients with PCV who were treated with newer methods. 

Results: All three patients were diagnosed to have PCV causing 

blurred vision. All patients were treated with either focal laser, 

photodynamic therapy with Verteporfin (PDT), intravitreal 

Ranibizumab injection (IVR) or both PDT+IVR. Treatment showed 

improvement in the visual acuity and resolution of the PCV with 

PDT + IVR and IVR alone. 

Conclusion: New treatment modalities must be considered in the 

treatment of PCV. 

Key Words: Polypoidal Choroidal Vasculopathy, Photodynamic 

Therapy with Verteporfin 

46


PP-57 

Retinopathy of Prematurity Screening in a Tertiary 

Care Center: Incidence and Percentage of Referrals by 

Neonatologists 

Anna Karina D. Leopando 


Objective: To determine the percentage of premature neonates 

referred for retinopathy ofm prematurity (ROP) screening among 

admitted infants in a Neonatal Intensive care Unit (NICU) and 

to identify the incidence of ROP in a tertiary care center in a 

developing country. 

Methods: A retrospective case control observational study on 

preterm infants admitted to the NICU of a tertiary hospital between 

2009 to 2011, with either birthweight


PP-60 

Vogt-Koyanagi-Harada Syndrome: A Case Report 

Anna Francesca B. Bayrante, Jessica Marie R. Abaño 


Objective: A case of Vogt-Koyanagi-Harada Syndrome, from 

diagnosis to treatment, is presented. 

Method: A case report of a 28 year old Filipino female 

who presented with bilateral blurring of vision, associated 

with dermatological and neurosensory symptoms, with the 

development of serous retinal detachment in both eyes. 

Result: A diagnosis of Vogt-Koyanagi-Harada Disease (VKH) was 

made. Treatment with high-dose intravenous and oral steroids 

was initiated with concurrent optical coherence tomography 

studies of the macula. Improvement in visual acuity and resolution 

of subretinal fluid on serial OCT scans was observed within 

2 months of treatment. Methotrexate was likewise started to 

facilitate tapering of the oral steroids. 

Conclusion: The case demonstrated that immediate diagnosis 

and treatment, guided by standard drug protocols, and close 

monitoring of patients with the aid of optical diagnostic modalities, 

are essential in controlling and ceasing the destructive 

inflammatory process in VKH, resulting in good visual outcomes. 

Key Words: Vogt-Koyanagi-Harada, methotrexate,methylprednisolone, 

exudative retinal detachment 

PP-61 

Ocular Involvement in Adamantiades-Beh’et Disease (ABD) 

Aileen Viguilla, Egidio Jose S. Fortuna 


Objective: To discuss the clinical history, diagnosis, associated 

ocular manifestations, treatment and long-term visual morbidity of 

Adamantiades-Beh’et Disease (ABD). 


Results: We reviewed a case of a 31 year old Filipino male who 

presented with intermittent bilateral blurring of vision associated 

with recurrent oral ulcers. Upon ophthalmologic evaluation, 

visual acuity was counting fingers with anterior and vitreous 

inflammation, and bilateral vasculitis on both eyes. Fluorescein 

angiogram showed consistent findings of bilateral vasculitis. He 

underwent two sessions of cyclophosphamide infusion and was 

maintained on oral prednisone and azathioprine. Visual acuity 

gradually improved to 20/50 (right eye) and 20/25 (left eye). There 

was note of resolution of inflammation and vasculitis. Optimal 

dose of prednisone was noted to be at 50mg. He was lost to 

follow-up for two months, and upon consult, visual acuity was at 

20/150 (right eye) and 20/400 (left eye), with new retinal lesions 


noted. He underwent 3rd infusion of cyclophosphamide. Visual 

acuity improved and the retinal lesions resolved. Oral prednisone 

and azathioprine were maintained. 

Conclusion: Adamantiades- Beh’et disease (ABD) is a clinical 

diagnosis that relies mainly on the history and recognition of 

signs and symptoms. For ophthalmologists, the ultimate goal for 

patients with the disease is to preserve vision through control of 

inflammation, prevention of recurrent attacks and early detection 

of retinal involvement that may lead to blindness if left untreated. 

Treatment is individualized and adjusted according to the patient’s 

need. Close follow-up is warranted to prevent further morbidity. 

Key Words: Adamantiades-Beh’et disease, ocular inflammation, 

steroids, retinal vasculitis, oral ulcers, blurring of vision, 

cyclophosphamide, blurring of vision, ocular inflammation 

48

Notes 

49

Notes 

50

Notes 

51

ACS 2012 EFOCAL POINT PAO 2012 PJO

Table of Contents - PAO Annual Meeting 2012

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