Ozge Sarac - Academia.edu (original) (raw)

Papers by Ozge Sarac

Research paper thumbnail of Evaluation of Corneal and Anterior Chamber Changes Following Pterygium Surgery Using a Pentacam Scheimplug System: A Prospective Study

Seminars in Ophthalmology, 2013

The aim of this study was to evaluate the effects of pterygium surgery on the corneal topography ... more The aim of this study was to evaluate the effects of pterygium surgery on the corneal topography and anterior chamber parameters using a Pentacam system. Prospective clinical study. Scheimpflug camera was performed in 21 eyes of 21 patients with primary pterygium, both before and 2 months after pterygium excision using conjunctival autograft technique. The topographic parameters such as total mean refractive power, index of surface variance, aberration coefficent, anterior chamber depth, anterior chamber angle were evaluated. The best corrected visual acuity (BCVA) changes were also noted. Differences between preoperative and postoperative values were compared. The mean refractive power was 42.59 ± 3.44 dioptry (D) preoperatively and 43.72 ± 2.07 D postoperatively (p = 0.154). The mean preoperative index of surface variance was 72.24 ± 48.72. It was decreased to 32 ± 23.13 after surgery (p = 0.003). The mean aberration coefficent was 3.04 ± 1.27 preoperatively. It was decreased to 2.4 ± 1.06 postoperatively (p = 0.017). The preoperative and postoperative values of the mean anterior chamber depth were 2.91 ± 0.49 mm and 2.91 ± 0.52 mm, respectively (p = 0.638). The mean preoperative anterior chamber angle was 33.13 ± 6.89°. It was measured as 32.77 ± 4.86° postoperatively (p = 0.779). The mean overall preoperative BCVA was logMar 0.13 ± 0.29. It was significantly improved to logMar 0.0238 ± 0.07 after pterygium surgery (p = 0.011). Corneal topographic changes induced by pterygium are almost reversible after surgical treatment of the pterygium. Pterygium surgery significantly improves the BCVA, and decreases the aberration coefficient and index of surface variance; however, it does not have any effect on the anterior chamber parameters.

Research paper thumbnail of Assessment of the visual pathways in patients with neurofibromatosis-1 by 3d-space technique at 3-tesla

TURKISH JOURNAL OF MEDICAL SCIENCES, 2019

Background/aim: We aimed to evaluate the size/tortuosity of the optic nerve (ON) and the dilatati... more Background/aim: We aimed to evaluate the size/tortuosity of the optic nerve (ON) and the dilatation of the ON sheath (ONS) in neurofibromatosis type 1 (NF-1) patients with 3T-MRI, and to assess the usefulness of 3D-SPACE in imaging the optic pathway, ON, and ONS in NF-1 patients. Materials and methods: Twenty consecutive NF-1 patients without optic pathway glioma (OPG) (Group 1), 16 consecutive NF-1 patients with OPG (Group 2), and 19 controls were included in this study. The thickness and tortuosity of the ON and the diameter of the ONS were measured on STIR and 3D-SPACE images. Results: The thickness of the ON was similar in all groups on STIR images (P>0.05). The mean ONS diameter was higher in Group 2 with this sequence (P=0.009). Controls had significantly lower grades of ON tortuosity than Groups 1 and 2 (P=0.001), and Group 1 had significantly lower ON tortuosity compared to Group 2 (P=0.001). Severe tortuosity was only detected in Group 2. Conclusion: ON tortuosity and ONS diameter were increased in NF-1 patients in the presence of OPG. High-resolution cranium imaging with the 3D-SPACE technique using 3T-MRI seems to be helpful for detection of the optic pathway morphology and pathologies in NF-1 patients.

Research paper thumbnail of Long-Term Results of Punctal Plug Applied to Dry Eye Patients

Türk Oftalmoloji Dergisi, 2011

Kuru göz hastalar›nda punktum t›kac› uygulamas›n›n uzun dönem sonuçlar› ve beraberinde geliflebil... more Kuru göz hastalar›nda punktum t›kac› uygulamas›n›n uzun dönem sonuçlar› ve beraberinde geliflebilecek problemleri de¤erlendirmek. Gereç ve Yöntem: Bu çal›flmada orta-ileri düzeyde kuru gözü olan, tedavi amac›yla punktum t›kac› (5 mm) uygulanan ve en az 12 ay takip süresi bulunan 15 hastan›n 30 gözü retrospektif olarak de¤erlendirildi. Hastalar›n punktum t›kac› tak›lmadan önce, tak›ld›ktan sonra 6. ve 12. aylarda yap›lan oküler yüzey hastal›¤› indeksi skorlamas› (OSDI), Schirmer-1 testi (topikal anestezisiz), gözyafl› filmi k›r›lma zaman› (GKZ) ve floreseinle oküler yüzey boyama sonuçlar› de¤erlendirildi. Hastalara punktum t›kaç tedavisinden 2 ay önce topikal antiinflamatuar ve suni gözyafl› tedavisi baflland›. Sonuçlar istatistiksel olarak karfl›laflt›r›larak, anlaml›l›k ve güvenilirlik bak›m›ndan incelendi. Sonuçlar: Hastalar›n yafl ortalamas› 56,4±2,3 (36-70 aras›) y›l, ortalama takip süresi 15 (12-30) ay idi. Ortalama OSDI skoru 6. ayda ve 12. ayda bafllang›ç de¤erine göre istatistiksel olarak da anlaml› bir flekilde azalm›flt› (p<0,05). Ortalama Schirmer-1 testi de¤erleri 6. ayda ve 12. ayda bafllang›ç de¤erlerine göre istatistiksel olarak da anlaml› olarak artm›flt› (p<0,05). Onikinci aydaki ortalama Schirmer-1 testi de¤eri 6. aydaki ile karfl›laflt›r›ld›¤›nda da anlaml› oranda artm›flt› (p<0,05). Ortalama GKZ de¤eri 12. ayda bafllang›ç ve 6. aydaki de¤erlere göre istatistiksel olarak da anlaml› bir flekilde artm›flt› (p<0,05). Floreseinli oküler yüzey boyamas› skorlar› de¤erlendirildi¤inde 6. ve 12. aylarda al›nan de¤erler bafllang›ça göre istatistiksel olarak anlaml› bir flekilde azalm›flt› (p<0,05). Tart›flma: Orta-ileri kuru göz hastalar›nda antiinflamatuar tedavi ile birlikte uygulanan punktum t›kaç tedavisi güvenilir bir yöntemdir. Uzun dönemde kuru göz semptom ve bulgular›n› azaltmaktad›r.

Research paper thumbnail of Silikon Hidrojel Kontakt Lens Kullanımının Kornea Morfolojisi Üzerindeki Uzun Dönem Etkileri

Türk Oftalmoloji Dergisi, 2012

Silikon hidrojel kontakt lenslerin (SHKL); santral kornea kalınlığına (SKK), kornea endotel hücre... more Silikon hidrojel kontakt lenslerin (SHKL); santral kornea kalınlığına (SKK), kornea endotel hücre morfolojisine ve gözyaşı fonksiyonlarına etkilerinin değerlendirilmesi. Ge reç ve Yön tem: Silikon hidrojel kontakt lens kullanan 28 olgunun 55 gözü ile (Grup 1), kontakt lens kullanmayan 26 sağlıklı bireylerin 52 gözü (Grup 2) çalışma kapsamına alındı. Lens kullanan olgular kontakt lens kullanım 'sürelerine göre Grup 1a: 1 yıldan az, Grup 1b: 1 yıldan fazla olmak üzere ikiye ayrıldı. Tüm olgularda SKK ve kornea epitel kalınlığı, kornea endotel hücre morfolojisi, oküler yüzey hastalık indeks skoru (OSDİ) ve gözyaşı kırılma zamanı (GKZ) değerlendirildi.

Research paper thumbnail of Comparison of Electrocoagulation and Conventional Medical Drops for Treatment of Conjunctivochalasis: Short-Term Results

Türk Oftalmoloji Dergisi, 2018

Objectives: To compare the effectiveness of electrocoagulation and conventional medical drops for... more Objectives: To compare the effectiveness of electrocoagulation and conventional medical drops for treatment of conjunctivochalasis using anterior segment-optical coherence tomography (AS-OCT). Materials and Methods: Forty eyes of 20 patients with bilateral conjunctivochalasis were included in this prospective study. Twenty eyes of 10 patients were assigned to Group 1 and underwent electrocoagulation. The other 20 eyes of 10 patients were assigned to Group 2 and received conventional medical treatment consisting of non-steroidal antiinflammatory drop (topical 0.5% ketorolac tromethamine) 4 times a day and artificial tears (0.15% sodium hyaluronate) 6 times a day for 4 weeks. Before and 4 weeks after treatment, all patients were evaluated by slit-lamp biomicroscopy, tear film break-up time (TBUT) test, and ocular surface disease index (OSDI) questionnaire. Tear meniscus height (TMH), tear meniscus area (TMA), and conjunctivochalasis area (CCA) were measured with AS-OCT. Results: In Group 1, posttreatment values of TMH, TMA, and TBUT were significantly higher (p<0.001, p=0.006, and p<0.001, respectively), while CCA and OSDI scores were significantly lower than pretreatment values (p<0.001 for both values). In Group 2, only OSDI decreased significantly between pretreatment and posttreatment values (p<0.001). The other parameters did not change significantly after treatment (p>0.05 for all values). Conclusion: Electrocoagulation is an effective modality for treatment of conjunctivochalasis

Research paper thumbnail of Evaluation of the Tear Function Tests and the Ocular Surface in First-Time Users of Silicone Hydrogel Contact Lenses

Current Eye Research, 2017

Purpose: To evaluate the effects of three different silicone hydrogel contact lenses (SHCL), (bal... more Purpose: To evaluate the effects of three different silicone hydrogel contact lenses (SHCL), (balafilcon A, senofilcon A, and comfilcon A) on tear function tests, corneal thickness, and ocular surface cytology in first time contact lens users. Materials and methods: In this prospective study, 120 eyes of 60 subjects were evaluated. Balafilcon A users were designated as group 1, senofilcon A users as group 2, and comfilcon A users as group 3. In all cases, before and after 6 months of contact lens wear, ocular surface disease index score (OSDI), tear breakup time (TBUT), Schirmer 1 test, central corneal thickness (CCT), central corneal epithelium thickness (CCET), and conjunctival impression cytology samples were evaluated. Results: In group 1, 40 eyes of the 20 patients, in group 2, 40 eyes of the 20 patients, and in group 3, 40 eyes of the 20 patients were evaluated. The mean OSDI scores did not differ between the three groups after contact lens wear (p > 0.05). In group 1 and group 2, significant decrease was found in the mean TBUT 6 months after contact lens wear (p = 0.04, p < 0.001, respectively). In group 3, after 6 months of contact lens wear, the mean Schirmer 1 tear test was decreased significantly (p = 0.021). In all 3 groups, no significant change was observed in the mean CCT and CCET after contact lens wear (p > 0.05). After 6 months, the morphological changes in temporal and superior conjunctival epithelial cells were found to be significant in all groups (p < 0.001). Conclusion: Six months after SHCL wear, marked morphological changes occurred in the conjunctival epithelium. Tear function tests were also affected, while corneal thickness did not show any significant difference.

Research paper thumbnail of Histopathologic Evaluation and Tensile Strength of the Levator Aponeurosis-Tarsus Junction after Ptosis Surgery - Original Article

Türk Oftalmoloji Dergisi, 2010

The aim of this study was to investigate the recovery period histopathologically and the tensile ... more The aim of this study was to investigate the recovery period histopathologically and the tensile strength of the levator aponeurosis (LA)-tarsus junction following LA surgery. Material and Method: Twenty-one New Zealand rabbits were used in this prospective study. The left eye of each rabbit had LA surgery and formed the study group; the right eyes formed the control group. According to the postoperative follow-up time, the study group was divided into 5 as follows: group 1-5 days, group 2-10 days, group 3-2 weeks, group 4-4 weeks, and group 5-6 weeks. The control group had no ptosis surgery. After the follow-up period determined for each group, total eyelid excision was performed. The LA and the tarsus were evaluated histopathologically, and the stretching test was applied. Results: The average separation force in the control group was detected to be 14.36 Newtons (N). It was 1.41 N in group 1, 2.74 N in group 2, 3.56 N in group 3, 4.4 N in group 4, and 6.03 N in group 5. The histopathological evaluation performed in group 1 revealed vascularisation and polymorphonuclear cell infiltration. In group 5, the histopathological appearance of the tissue was close to normal, except for intense eosinophilic infiltration. Discussion: After ptosis surgery at the postoperative 6th week, the healing process was almost complete histopathologically, however, the tensile strength of the LA-tarsus junction did not return to the preoperative level.

Research paper thumbnail of Effects of Toric and Soft Spherical Contact Lenses on Visual Performance and Wavefront Aberrations in Patients with Low Levels of Astigmatism

Türk Oftalmoloji Dergisi, 2011

Research paper thumbnail of Silikon Hidrojel Kontakt Lenslerin Oküler Yüzeye ve Gözyaşı Fonksiyon Testlerine Uzun Dönem Etkileri

Türk Oftalmoloji Dergisi, 2014

Research paper thumbnail of Kuru Göz Hastalarında Optik Koherans Tomografi ile Gözyaşı Menisküs Parametrelerinin Değerlendirilmesi

Türk Oftalmoloji Dergisi, 2013

Özet Amaç: Optik Koherans Tomografi (OKT) ile kuru göz hastalarında ölçülen gözyaşı menisküs para... more Özet Amaç: Optik Koherans Tomografi (OKT) ile kuru göz hastalarında ölçülen gözyaşı menisküs parametrelerinin suni gözyaşı tedavisi ile değişimi ve OKT parametrelerinin geleneksel kuru göz testleri ile korelasyonun değerlendirilmesi amaçlandı. Ge reç ve Yön tem: Yeni tanı alan 32 kuru göz hastasının sağ gözleriyle, 30 sağlıklı göz çalışmaya dahil edildi. Hastaların; görme keskinliği, biomikroskopik muayenesi, Schirmer-I testi, gözyaşı kırılma zamanı (GKZ), OKT ile alt gözyaşı menisküs parametreleri değerlendirildi. Oküler yüzey hastalığı indeksi (OSDI) ile semptom sorgulaması yapıldı. Ölçümler; suni gözyaşı ile tedavinin 10. günü ve 1.ayında tekrarlandı. Alt gözyaşı menisküs yüksekliği (AGMY),derinliği (AGMD), kesitsel alanı (AGMA) ve kornea ile yaptığı açı (α açısı) ölçüldü. Kuru göz grubunda tedavi öncesi gözyaşı menisküs değerleri kontrol grubuyla kıyaslandı, geleneksel kuru göz testleri ve OKT değerleri arasındaki korelasyon değerlendirildi. Tedaviyle kuru göz testleri ve OKT değişimleri gözlemlendi. So nuç lar: Hastaların yaş ortalamaları ve cinsiyet dağılımları açısından gruplar arasında istatistiksel olarak anlamlı bir fark bulunmadı. Tedavi öncesi ortalama Schirmer-I testi, GKZ ve OSDI skorları iki grup arasında anlamlı farklıydı. OKT parametrelerinden AGMY ve AGMA kontrol grubunda yüksek olacak şekilde iki grup arasında anlamlı farklı idi. Kuru göz grubunda tedavi öncesi ortalama OSDI skoruyla AGMY ve AGMA arasında istatistiksel olarak anlamlı negatif korelasyon varken, diğer tanı testleri ile OKT parametreleri arasında anlamlı korelasyon saptanmadı. OKT parametrelerinden AGMD ve α açısında tedavi süresince anlamlı değişiklik gözlenmezken; AGMY ve AGMA 'nın 1. ay değerleri tedavi öncesi ve 10. gün değerlere kıyasla anlamı şekilde yüksek olduğu görüldü. Tar t›fl ma: Kuru göz tanısı koymada GKZ ve OSDI ile semptom sorgulamasının, Schirmer-I testine kıyasla daha faydalı olduğu, OKT ile ölçülen gözyaşı menisküs parametrelerinin tanı koymada tek başına yeterli olmamakla birlikte, tedaviye yanıtı izlemde özellikle AGMY ve AGMA'nın yardımcı olabileceği ve bu iki parametrenin OSDI skoru ile korelasyonunun semptom sorgulamada objektifliği artırabileceği düşünüldü.

Research paper thumbnail of Comparison of tear osmolarity and ocular comfort between daily disposable contact lenses: hilafilcon B hydrogel versus narafilcon A silicone hydrogel

International Ophthalmology, 2012

The aim of this study was to evaluate tear osmolarity and ocular comfort with two different types... more The aim of this study was to evaluate tear osmolarity and ocular comfort with two different types of hydrogel daily disposable lenses. The right eyes of 15 first-time contact lens users were included in this prospective study. All eyes wore hilafilcon B silicone hydrogel contact lenses for 8 h (group 1). After 1 week without contact lenses, all eyes wore narafilcon A silicone hydrogel contact lenses for 8 h (group 2). Tear osmolarity measurement was performed before and after 4 and 8 h of each contact lens wear. Ocular comfort was assessed after 4 and 8 h of each contact lens wear. In group 1, the mean baseline, 4-and 8-h tear osmolarity values were 293 ± 10.57, 303.00 ± 10.5 mOsm/L (p = 0.023), and 295.0 ± 1.4 mOsm/L (p [ 0.05), respectively. In group 2, the mean baseline, 4-and 8-h tear osmolarity values were 294 ± 13.65, 300.9 ± 11.3 mOsm/L (p = 0.007), and 298.80 ± 7.2 mOsm/ L (p [ 0.05), respectively. In group 1, the mean comfort score was 7.20 ± 0.45 and 8.60 ± 0.45 at 4 and 8 h, respectively (p = 0.038). In group 2, the mean comfort score significantly decreased from 9.80 ± 0.45 to 7.80 ± 0.84 at 4 h (p = 0.039). Both hydrogel and silicone hydrogel daily disposable contact lenses elevated tear osmolarity during 8 h of contact lens wear. The increase in tear osmolarity with both contact lenses was below the cutoff value for dry eye and was not associated with ocular comfort.

Research paper thumbnail of Tear Meniscus Analysis with Fourier-Domain Optical Coherence Tomography in Keratoconus

Current Eye Research, 2011

Research paper thumbnail of Neuro-ophthalmologic findings in humans with quadrupedal locomotion

Ophthalmic Genetics, 2012

Purpose: To report the neuro-ophthalmologic findings in four patients from the same family with c... more Purpose: To report the neuro-ophthalmologic findings in four patients from the same family with cerebellar ataxia, mental retardation, and dysequilibrium syndrome (CAMRQ)2 associated with quadrupedal locomotion. Method: A case series. Results: All four patients carry the private missense mutation, WDR81 p.P856L. The brain Magnetic Resonance Imaging (MRI) of these patients revealed morphological abnormalities including mild hypoplasia of the corpus callosum, and atrophy of superior, middle, and inferior peduncles of the cerebellum. All patients had down-beat nystagmus, while two male patients additionally had bilateral temporal disc pallor along with ring-shaped macular atrophy. Conclusions: The neuro-ophthalmic examination in CAMRQ2 revealed downbeat nystagmus in all patients, and temporal disc pallor and macular atrophy in two patients. It remains to be determined whether these findings are consistent in other forms of CAMRQ with mutations in VLDLR or CA8.

Research paper thumbnail of Efficacy of Intralesional Bevacizumab Administration in Primary Pterygium

Eye & Contact Lens: Science & Clinical Practice, 2014

To analyze the regression of the pterygium tissue quantitatively after intralesional bevacizumab ... more To analyze the regression of the pterygium tissue quantitatively after intralesional bevacizumab administration in patients with primary pterygium. Thirty-three eyes of 33 patients with primary pterygium who underwent intralesional bevacizumab (1.25 mg per 0.05 mL) administration were included in this prospective study. The ocular irritation, best-corrected visual acuity (BCVA), slit-lamp and funduscopic examinations, corneal astigmatism, the horizontal length, and the thickness of the pterygium were assessed before and after 2 months of treatment. To evaluate the corneal astigmatism and the thickness of the pterygium, the Pentacam comprehensive eye scanner (Pentacam CES; Oculus GmbH) was used. After 2 months of bevacizumab administration, the average BCVA was improved (P=0.003). The average ocular irritation score, horizontal length, and the thickness of the pterygium were statistically significantly decreased (P&amp;amp;amp;amp;amp;amp;lt;0.001, P&amp;amp;amp;amp;amp;amp;lt;0.001, P&amp;amp;amp;amp;amp;amp;lt;0.001, respectively). After 2 months of intralesional bevacizumab administration, the average amount of decrease in the horizontal length and thickness of the pterygium was 0.6 mm and 37 μm, respectively. Intralesional bevacizumab administration is useful in the management of primary pterygium without having any local or systemic adverse effects; however, repeated administrations are needed to provide clinically more significant results.

Research paper thumbnail of Trochlear nerve palsy in herpes zoster opthalmicus

Neuro- …, 2001

Herpes zoster ophthalmicus (HZO) causes a wide range of ocular manifestations, and ophthalmoplegi... more Herpes zoster ophthalmicus (HZO) causes a wide range of ocular manifestations, and ophthalmoplegia is among the infrequent complications. The most commonly affected nerve is the third nerve, the least affected is the trochlear nerve. Herein, we describe two cases ...

Research paper thumbnail of Topical Cyclosporin in the Treatment of Chronic Sarcoidosis of the Conjunctiva

Archives of Ophthalmology, 2003

Research paper thumbnail of Management of strabismus in nanophthalmic patients-A long-term follow-up report

The purpose of this study is to identify the characteristics of strabismus that coexist with nano... more The purpose of this study is to identify the characteristics of strabismus that coexist with nanophthalmos and to report the results of strabismus surgery performed on these small eyes. Retrospective, consecutive, noncomparative interventional case series. Fifteen bilateral nanophthalmic patients, of whom five underwent horizontal muscle surgery, were included in this study. Chart review. The clinical examination included visual acuity assessments using the linear Snellen and the Lea charts, slit-lamp and fundus examinations, intraocular pressure, and axial length measurements. The orthoptic examination consisted of measurements of ocular deviations using the prism cover test with an accommodative target at both near and distance with and without refractive correction, assessment of ocular motility with ductions and versions, binocularity with Worth&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s four-dot test, and the Titmus test. Amblyopia was treated with part-time occlusion. Surgery for the correction of esotropia included bilateral medial rectus recessions or recess-resect procedures. Magnitude of strabismic deviation, best-corrected visual acuity, and the level of binocular vision achieved were monitored. The average age of enrollment in the study was 4.7 (range, 1-12) years. The patients were followed for an average of 7.0 (range, 4-14) years. The mean axial length was determined as 18.4 mm (range, 15.5-20.7). The mean refractive error in spherical equivalents was measured as +9.9 and ranged between +4.0 and +15.0 diopters. Five patients (33%) had nonaccommodative esotropia, four (27%) had partially refractive esotropia, four (27%) had microesotropia, and two (13%) had exotropia. Five patients, all having nonaccommodative esotropia, underwent surgery for the correction of ocular misalignment. Diminishing the surgical dose in these small eyes resulted in undercorrections. Despite patching, 3 patients (20%) had unilateral and 12 patients (80%) had bilateral amblyopia at the conclusion of the study. Strabismus in nanophthalmos usually manifests as nonaccommodative and partially refractive esotropia. Medial rectus recession should be applied with care to prevent adduction deficit and convergence insufficiency. Otherwise, there seems to be no need for decreasing the surgical dose with regard to the smaller axial length. Amblyopia tends to be persistent in these patients.

Research paper thumbnail of Periorbital Necrotizing Fasciitis Caused by Community-Associated Methicillin-Resistant Staphylococcus Aureus Periorbital Necrotizing Fasciitis

Orbit, 2010

To report a case of a patient with periorbital necrotizing fasciitis caused by community-associat... more To report a case of a patient with periorbital necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA). Case report. A previously healthy 33-year-old man was presented with pain and rapidly progressive swelling of the right upper eyelid following a minor trauma. Computed tomography scanning revealed soft tissue swelling and fracture of the anterior wall of the right frontal sinus. Oral amoxicillin + klavulanat 1 g, twice daily was started. Over the next 24 hours periorbital necrotizing fasciitis was developed. A wound swab was taken and sent for microscopic evaluation, culture, and antibiotic sensitivity. The patient was started on intravenous crystallized penicillin, third-generation cephalosporin, and metronidazol treatment. An urgent extensive necrotic tissue debridement and frontal sinus curettage were performed. Wound culture yielded MRSA which showed sensitivity to the given antibiotics. The patient responded to the treatment which was continued for 14 days. Monomicrobial MRSA should be considered in the etiology of periorbital necrotizing fasciitis. Early diagnosis and prompt surgical and medical therapy are essential in the management of periorbital necrotizing fasciitis.

Research paper thumbnail of Evaluation of Corneal and Anterior Chamber Changes Following Pterygium Surgery Using a Pentacam Scheimplug System: A Prospective Study

Seminars in Ophthalmology, 2013

The aim of this study was to evaluate the effects of pterygium surgery on the corneal topography ... more The aim of this study was to evaluate the effects of pterygium surgery on the corneal topography and anterior chamber parameters using a Pentacam system. Prospective clinical study. Scheimpflug camera was performed in 21 eyes of 21 patients with primary pterygium, both before and 2 months after pterygium excision using conjunctival autograft technique. The topographic parameters such as total mean refractive power, index of surface variance, aberration coefficent, anterior chamber depth, anterior chamber angle were evaluated. The best corrected visual acuity (BCVA) changes were also noted. Differences between preoperative and postoperative values were compared. The mean refractive power was 42.59 ± 3.44 dioptry (D) preoperatively and 43.72 ± 2.07 D postoperatively (p = 0.154). The mean preoperative index of surface variance was 72.24 ± 48.72. It was decreased to 32 ± 23.13 after surgery (p = 0.003). The mean aberration coefficent was 3.04 ± 1.27 preoperatively. It was decreased to 2.4 ± 1.06 postoperatively (p = 0.017). The preoperative and postoperative values of the mean anterior chamber depth were 2.91 ± 0.49 mm and 2.91 ± 0.52 mm, respectively (p = 0.638). The mean preoperative anterior chamber angle was 33.13 ± 6.89°. It was measured as 32.77 ± 4.86° postoperatively (p = 0.779). The mean overall preoperative BCVA was logMar 0.13 ± 0.29. It was significantly improved to logMar 0.0238 ± 0.07 after pterygium surgery (p = 0.011). Corneal topographic changes induced by pterygium are almost reversible after surgical treatment of the pterygium. Pterygium surgery significantly improves the BCVA, and decreases the aberration coefficient and index of surface variance; however, it does not have any effect on the anterior chamber parameters.

Research paper thumbnail of Assessment of the visual pathways in patients with neurofibromatosis-1 by 3d-space technique at 3-tesla

TURKISH JOURNAL OF MEDICAL SCIENCES, 2019

Background/aim: We aimed to evaluate the size/tortuosity of the optic nerve (ON) and the dilatati... more Background/aim: We aimed to evaluate the size/tortuosity of the optic nerve (ON) and the dilatation of the ON sheath (ONS) in neurofibromatosis type 1 (NF-1) patients with 3T-MRI, and to assess the usefulness of 3D-SPACE in imaging the optic pathway, ON, and ONS in NF-1 patients. Materials and methods: Twenty consecutive NF-1 patients without optic pathway glioma (OPG) (Group 1), 16 consecutive NF-1 patients with OPG (Group 2), and 19 controls were included in this study. The thickness and tortuosity of the ON and the diameter of the ONS were measured on STIR and 3D-SPACE images. Results: The thickness of the ON was similar in all groups on STIR images (P>0.05). The mean ONS diameter was higher in Group 2 with this sequence (P=0.009). Controls had significantly lower grades of ON tortuosity than Groups 1 and 2 (P=0.001), and Group 1 had significantly lower ON tortuosity compared to Group 2 (P=0.001). Severe tortuosity was only detected in Group 2. Conclusion: ON tortuosity and ONS diameter were increased in NF-1 patients in the presence of OPG. High-resolution cranium imaging with the 3D-SPACE technique using 3T-MRI seems to be helpful for detection of the optic pathway morphology and pathologies in NF-1 patients.

Research paper thumbnail of Long-Term Results of Punctal Plug Applied to Dry Eye Patients

Türk Oftalmoloji Dergisi, 2011

Kuru göz hastalar›nda punktum t›kac› uygulamas›n›n uzun dönem sonuçlar› ve beraberinde geliflebil... more Kuru göz hastalar›nda punktum t›kac› uygulamas›n›n uzun dönem sonuçlar› ve beraberinde geliflebilecek problemleri de¤erlendirmek. Gereç ve Yöntem: Bu çal›flmada orta-ileri düzeyde kuru gözü olan, tedavi amac›yla punktum t›kac› (5 mm) uygulanan ve en az 12 ay takip süresi bulunan 15 hastan›n 30 gözü retrospektif olarak de¤erlendirildi. Hastalar›n punktum t›kac› tak›lmadan önce, tak›ld›ktan sonra 6. ve 12. aylarda yap›lan oküler yüzey hastal›¤› indeksi skorlamas› (OSDI), Schirmer-1 testi (topikal anestezisiz), gözyafl› filmi k›r›lma zaman› (GKZ) ve floreseinle oküler yüzey boyama sonuçlar› de¤erlendirildi. Hastalara punktum t›kaç tedavisinden 2 ay önce topikal antiinflamatuar ve suni gözyafl› tedavisi baflland›. Sonuçlar istatistiksel olarak karfl›laflt›r›larak, anlaml›l›k ve güvenilirlik bak›m›ndan incelendi. Sonuçlar: Hastalar›n yafl ortalamas› 56,4±2,3 (36-70 aras›) y›l, ortalama takip süresi 15 (12-30) ay idi. Ortalama OSDI skoru 6. ayda ve 12. ayda bafllang›ç de¤erine göre istatistiksel olarak da anlaml› bir flekilde azalm›flt› (p<0,05). Ortalama Schirmer-1 testi de¤erleri 6. ayda ve 12. ayda bafllang›ç de¤erlerine göre istatistiksel olarak da anlaml› olarak artm›flt› (p<0,05). Onikinci aydaki ortalama Schirmer-1 testi de¤eri 6. aydaki ile karfl›laflt›r›ld›¤›nda da anlaml› oranda artm›flt› (p<0,05). Ortalama GKZ de¤eri 12. ayda bafllang›ç ve 6. aydaki de¤erlere göre istatistiksel olarak da anlaml› bir flekilde artm›flt› (p<0,05). Floreseinli oküler yüzey boyamas› skorlar› de¤erlendirildi¤inde 6. ve 12. aylarda al›nan de¤erler bafllang›ça göre istatistiksel olarak anlaml› bir flekilde azalm›flt› (p<0,05). Tart›flma: Orta-ileri kuru göz hastalar›nda antiinflamatuar tedavi ile birlikte uygulanan punktum t›kaç tedavisi güvenilir bir yöntemdir. Uzun dönemde kuru göz semptom ve bulgular›n› azaltmaktad›r.

Research paper thumbnail of Silikon Hidrojel Kontakt Lens Kullanımının Kornea Morfolojisi Üzerindeki Uzun Dönem Etkileri

Türk Oftalmoloji Dergisi, 2012

Silikon hidrojel kontakt lenslerin (SHKL); santral kornea kalınlığına (SKK), kornea endotel hücre... more Silikon hidrojel kontakt lenslerin (SHKL); santral kornea kalınlığına (SKK), kornea endotel hücre morfolojisine ve gözyaşı fonksiyonlarına etkilerinin değerlendirilmesi. Ge reç ve Yön tem: Silikon hidrojel kontakt lens kullanan 28 olgunun 55 gözü ile (Grup 1), kontakt lens kullanmayan 26 sağlıklı bireylerin 52 gözü (Grup 2) çalışma kapsamına alındı. Lens kullanan olgular kontakt lens kullanım 'sürelerine göre Grup 1a: 1 yıldan az, Grup 1b: 1 yıldan fazla olmak üzere ikiye ayrıldı. Tüm olgularda SKK ve kornea epitel kalınlığı, kornea endotel hücre morfolojisi, oküler yüzey hastalık indeks skoru (OSDİ) ve gözyaşı kırılma zamanı (GKZ) değerlendirildi.

Research paper thumbnail of Comparison of Electrocoagulation and Conventional Medical Drops for Treatment of Conjunctivochalasis: Short-Term Results

Türk Oftalmoloji Dergisi, 2018

Objectives: To compare the effectiveness of electrocoagulation and conventional medical drops for... more Objectives: To compare the effectiveness of electrocoagulation and conventional medical drops for treatment of conjunctivochalasis using anterior segment-optical coherence tomography (AS-OCT). Materials and Methods: Forty eyes of 20 patients with bilateral conjunctivochalasis were included in this prospective study. Twenty eyes of 10 patients were assigned to Group 1 and underwent electrocoagulation. The other 20 eyes of 10 patients were assigned to Group 2 and received conventional medical treatment consisting of non-steroidal antiinflammatory drop (topical 0.5% ketorolac tromethamine) 4 times a day and artificial tears (0.15% sodium hyaluronate) 6 times a day for 4 weeks. Before and 4 weeks after treatment, all patients were evaluated by slit-lamp biomicroscopy, tear film break-up time (TBUT) test, and ocular surface disease index (OSDI) questionnaire. Tear meniscus height (TMH), tear meniscus area (TMA), and conjunctivochalasis area (CCA) were measured with AS-OCT. Results: In Group 1, posttreatment values of TMH, TMA, and TBUT were significantly higher (p<0.001, p=0.006, and p<0.001, respectively), while CCA and OSDI scores were significantly lower than pretreatment values (p<0.001 for both values). In Group 2, only OSDI decreased significantly between pretreatment and posttreatment values (p<0.001). The other parameters did not change significantly after treatment (p>0.05 for all values). Conclusion: Electrocoagulation is an effective modality for treatment of conjunctivochalasis

Research paper thumbnail of Evaluation of the Tear Function Tests and the Ocular Surface in First-Time Users of Silicone Hydrogel Contact Lenses

Current Eye Research, 2017

Purpose: To evaluate the effects of three different silicone hydrogel contact lenses (SHCL), (bal... more Purpose: To evaluate the effects of three different silicone hydrogel contact lenses (SHCL), (balafilcon A, senofilcon A, and comfilcon A) on tear function tests, corneal thickness, and ocular surface cytology in first time contact lens users. Materials and methods: In this prospective study, 120 eyes of 60 subjects were evaluated. Balafilcon A users were designated as group 1, senofilcon A users as group 2, and comfilcon A users as group 3. In all cases, before and after 6 months of contact lens wear, ocular surface disease index score (OSDI), tear breakup time (TBUT), Schirmer 1 test, central corneal thickness (CCT), central corneal epithelium thickness (CCET), and conjunctival impression cytology samples were evaluated. Results: In group 1, 40 eyes of the 20 patients, in group 2, 40 eyes of the 20 patients, and in group 3, 40 eyes of the 20 patients were evaluated. The mean OSDI scores did not differ between the three groups after contact lens wear (p > 0.05). In group 1 and group 2, significant decrease was found in the mean TBUT 6 months after contact lens wear (p = 0.04, p < 0.001, respectively). In group 3, after 6 months of contact lens wear, the mean Schirmer 1 tear test was decreased significantly (p = 0.021). In all 3 groups, no significant change was observed in the mean CCT and CCET after contact lens wear (p > 0.05). After 6 months, the morphological changes in temporal and superior conjunctival epithelial cells were found to be significant in all groups (p < 0.001). Conclusion: Six months after SHCL wear, marked morphological changes occurred in the conjunctival epithelium. Tear function tests were also affected, while corneal thickness did not show any significant difference.

Research paper thumbnail of Histopathologic Evaluation and Tensile Strength of the Levator Aponeurosis-Tarsus Junction after Ptosis Surgery - Original Article

Türk Oftalmoloji Dergisi, 2010

The aim of this study was to investigate the recovery period histopathologically and the tensile ... more The aim of this study was to investigate the recovery period histopathologically and the tensile strength of the levator aponeurosis (LA)-tarsus junction following LA surgery. Material and Method: Twenty-one New Zealand rabbits were used in this prospective study. The left eye of each rabbit had LA surgery and formed the study group; the right eyes formed the control group. According to the postoperative follow-up time, the study group was divided into 5 as follows: group 1-5 days, group 2-10 days, group 3-2 weeks, group 4-4 weeks, and group 5-6 weeks. The control group had no ptosis surgery. After the follow-up period determined for each group, total eyelid excision was performed. The LA and the tarsus were evaluated histopathologically, and the stretching test was applied. Results: The average separation force in the control group was detected to be 14.36 Newtons (N). It was 1.41 N in group 1, 2.74 N in group 2, 3.56 N in group 3, 4.4 N in group 4, and 6.03 N in group 5. The histopathological evaluation performed in group 1 revealed vascularisation and polymorphonuclear cell infiltration. In group 5, the histopathological appearance of the tissue was close to normal, except for intense eosinophilic infiltration. Discussion: After ptosis surgery at the postoperative 6th week, the healing process was almost complete histopathologically, however, the tensile strength of the LA-tarsus junction did not return to the preoperative level.

Research paper thumbnail of Effects of Toric and Soft Spherical Contact Lenses on Visual Performance and Wavefront Aberrations in Patients with Low Levels of Astigmatism

Türk Oftalmoloji Dergisi, 2011

Research paper thumbnail of Silikon Hidrojel Kontakt Lenslerin Oküler Yüzeye ve Gözyaşı Fonksiyon Testlerine Uzun Dönem Etkileri

Türk Oftalmoloji Dergisi, 2014

Research paper thumbnail of Kuru Göz Hastalarında Optik Koherans Tomografi ile Gözyaşı Menisküs Parametrelerinin Değerlendirilmesi

Türk Oftalmoloji Dergisi, 2013

Özet Amaç: Optik Koherans Tomografi (OKT) ile kuru göz hastalarında ölçülen gözyaşı menisküs para... more Özet Amaç: Optik Koherans Tomografi (OKT) ile kuru göz hastalarında ölçülen gözyaşı menisküs parametrelerinin suni gözyaşı tedavisi ile değişimi ve OKT parametrelerinin geleneksel kuru göz testleri ile korelasyonun değerlendirilmesi amaçlandı. Ge reç ve Yön tem: Yeni tanı alan 32 kuru göz hastasının sağ gözleriyle, 30 sağlıklı göz çalışmaya dahil edildi. Hastaların; görme keskinliği, biomikroskopik muayenesi, Schirmer-I testi, gözyaşı kırılma zamanı (GKZ), OKT ile alt gözyaşı menisküs parametreleri değerlendirildi. Oküler yüzey hastalığı indeksi (OSDI) ile semptom sorgulaması yapıldı. Ölçümler; suni gözyaşı ile tedavinin 10. günü ve 1.ayında tekrarlandı. Alt gözyaşı menisküs yüksekliği (AGMY),derinliği (AGMD), kesitsel alanı (AGMA) ve kornea ile yaptığı açı (α açısı) ölçüldü. Kuru göz grubunda tedavi öncesi gözyaşı menisküs değerleri kontrol grubuyla kıyaslandı, geleneksel kuru göz testleri ve OKT değerleri arasındaki korelasyon değerlendirildi. Tedaviyle kuru göz testleri ve OKT değişimleri gözlemlendi. So nuç lar: Hastaların yaş ortalamaları ve cinsiyet dağılımları açısından gruplar arasında istatistiksel olarak anlamlı bir fark bulunmadı. Tedavi öncesi ortalama Schirmer-I testi, GKZ ve OSDI skorları iki grup arasında anlamlı farklıydı. OKT parametrelerinden AGMY ve AGMA kontrol grubunda yüksek olacak şekilde iki grup arasında anlamlı farklı idi. Kuru göz grubunda tedavi öncesi ortalama OSDI skoruyla AGMY ve AGMA arasında istatistiksel olarak anlamlı negatif korelasyon varken, diğer tanı testleri ile OKT parametreleri arasında anlamlı korelasyon saptanmadı. OKT parametrelerinden AGMD ve α açısında tedavi süresince anlamlı değişiklik gözlenmezken; AGMY ve AGMA 'nın 1. ay değerleri tedavi öncesi ve 10. gün değerlere kıyasla anlamı şekilde yüksek olduğu görüldü. Tar t›fl ma: Kuru göz tanısı koymada GKZ ve OSDI ile semptom sorgulamasının, Schirmer-I testine kıyasla daha faydalı olduğu, OKT ile ölçülen gözyaşı menisküs parametrelerinin tanı koymada tek başına yeterli olmamakla birlikte, tedaviye yanıtı izlemde özellikle AGMY ve AGMA'nın yardımcı olabileceği ve bu iki parametrenin OSDI skoru ile korelasyonunun semptom sorgulamada objektifliği artırabileceği düşünüldü.

Research paper thumbnail of Comparison of tear osmolarity and ocular comfort between daily disposable contact lenses: hilafilcon B hydrogel versus narafilcon A silicone hydrogel

International Ophthalmology, 2012

The aim of this study was to evaluate tear osmolarity and ocular comfort with two different types... more The aim of this study was to evaluate tear osmolarity and ocular comfort with two different types of hydrogel daily disposable lenses. The right eyes of 15 first-time contact lens users were included in this prospective study. All eyes wore hilafilcon B silicone hydrogel contact lenses for 8 h (group 1). After 1 week without contact lenses, all eyes wore narafilcon A silicone hydrogel contact lenses for 8 h (group 2). Tear osmolarity measurement was performed before and after 4 and 8 h of each contact lens wear. Ocular comfort was assessed after 4 and 8 h of each contact lens wear. In group 1, the mean baseline, 4-and 8-h tear osmolarity values were 293 ± 10.57, 303.00 ± 10.5 mOsm/L (p = 0.023), and 295.0 ± 1.4 mOsm/L (p [ 0.05), respectively. In group 2, the mean baseline, 4-and 8-h tear osmolarity values were 294 ± 13.65, 300.9 ± 11.3 mOsm/L (p = 0.007), and 298.80 ± 7.2 mOsm/ L (p [ 0.05), respectively. In group 1, the mean comfort score was 7.20 ± 0.45 and 8.60 ± 0.45 at 4 and 8 h, respectively (p = 0.038). In group 2, the mean comfort score significantly decreased from 9.80 ± 0.45 to 7.80 ± 0.84 at 4 h (p = 0.039). Both hydrogel and silicone hydrogel daily disposable contact lenses elevated tear osmolarity during 8 h of contact lens wear. The increase in tear osmolarity with both contact lenses was below the cutoff value for dry eye and was not associated with ocular comfort.

Research paper thumbnail of Tear Meniscus Analysis with Fourier-Domain Optical Coherence Tomography in Keratoconus

Current Eye Research, 2011

Research paper thumbnail of Neuro-ophthalmologic findings in humans with quadrupedal locomotion

Ophthalmic Genetics, 2012

Purpose: To report the neuro-ophthalmologic findings in four patients from the same family with c... more Purpose: To report the neuro-ophthalmologic findings in four patients from the same family with cerebellar ataxia, mental retardation, and dysequilibrium syndrome (CAMRQ)2 associated with quadrupedal locomotion. Method: A case series. Results: All four patients carry the private missense mutation, WDR81 p.P856L. The brain Magnetic Resonance Imaging (MRI) of these patients revealed morphological abnormalities including mild hypoplasia of the corpus callosum, and atrophy of superior, middle, and inferior peduncles of the cerebellum. All patients had down-beat nystagmus, while two male patients additionally had bilateral temporal disc pallor along with ring-shaped macular atrophy. Conclusions: The neuro-ophthalmic examination in CAMRQ2 revealed downbeat nystagmus in all patients, and temporal disc pallor and macular atrophy in two patients. It remains to be determined whether these findings are consistent in other forms of CAMRQ with mutations in VLDLR or CA8.

Research paper thumbnail of Efficacy of Intralesional Bevacizumab Administration in Primary Pterygium

Eye & Contact Lens: Science & Clinical Practice, 2014

To analyze the regression of the pterygium tissue quantitatively after intralesional bevacizumab ... more To analyze the regression of the pterygium tissue quantitatively after intralesional bevacizumab administration in patients with primary pterygium. Thirty-three eyes of 33 patients with primary pterygium who underwent intralesional bevacizumab (1.25 mg per 0.05 mL) administration were included in this prospective study. The ocular irritation, best-corrected visual acuity (BCVA), slit-lamp and funduscopic examinations, corneal astigmatism, the horizontal length, and the thickness of the pterygium were assessed before and after 2 months of treatment. To evaluate the corneal astigmatism and the thickness of the pterygium, the Pentacam comprehensive eye scanner (Pentacam CES; Oculus GmbH) was used. After 2 months of bevacizumab administration, the average BCVA was improved (P=0.003). The average ocular irritation score, horizontal length, and the thickness of the pterygium were statistically significantly decreased (P&amp;amp;amp;amp;amp;amp;lt;0.001, P&amp;amp;amp;amp;amp;amp;lt;0.001, P&amp;amp;amp;amp;amp;amp;lt;0.001, respectively). After 2 months of intralesional bevacizumab administration, the average amount of decrease in the horizontal length and thickness of the pterygium was 0.6 mm and 37 μm, respectively. Intralesional bevacizumab administration is useful in the management of primary pterygium without having any local or systemic adverse effects; however, repeated administrations are needed to provide clinically more significant results.

Research paper thumbnail of Trochlear nerve palsy in herpes zoster opthalmicus

Neuro- …, 2001

Herpes zoster ophthalmicus (HZO) causes a wide range of ocular manifestations, and ophthalmoplegi... more Herpes zoster ophthalmicus (HZO) causes a wide range of ocular manifestations, and ophthalmoplegia is among the infrequent complications. The most commonly affected nerve is the third nerve, the least affected is the trochlear nerve. Herein, we describe two cases ...

Research paper thumbnail of Topical Cyclosporin in the Treatment of Chronic Sarcoidosis of the Conjunctiva

Archives of Ophthalmology, 2003

Research paper thumbnail of Management of strabismus in nanophthalmic patients-A long-term follow-up report

The purpose of this study is to identify the characteristics of strabismus that coexist with nano... more The purpose of this study is to identify the characteristics of strabismus that coexist with nanophthalmos and to report the results of strabismus surgery performed on these small eyes. Retrospective, consecutive, noncomparative interventional case series. Fifteen bilateral nanophthalmic patients, of whom five underwent horizontal muscle surgery, were included in this study. Chart review. The clinical examination included visual acuity assessments using the linear Snellen and the Lea charts, slit-lamp and fundus examinations, intraocular pressure, and axial length measurements. The orthoptic examination consisted of measurements of ocular deviations using the prism cover test with an accommodative target at both near and distance with and without refractive correction, assessment of ocular motility with ductions and versions, binocularity with Worth&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s four-dot test, and the Titmus test. Amblyopia was treated with part-time occlusion. Surgery for the correction of esotropia included bilateral medial rectus recessions or recess-resect procedures. Magnitude of strabismic deviation, best-corrected visual acuity, and the level of binocular vision achieved were monitored. The average age of enrollment in the study was 4.7 (range, 1-12) years. The patients were followed for an average of 7.0 (range, 4-14) years. The mean axial length was determined as 18.4 mm (range, 15.5-20.7). The mean refractive error in spherical equivalents was measured as +9.9 and ranged between +4.0 and +15.0 diopters. Five patients (33%) had nonaccommodative esotropia, four (27%) had partially refractive esotropia, four (27%) had microesotropia, and two (13%) had exotropia. Five patients, all having nonaccommodative esotropia, underwent surgery for the correction of ocular misalignment. Diminishing the surgical dose in these small eyes resulted in undercorrections. Despite patching, 3 patients (20%) had unilateral and 12 patients (80%) had bilateral amblyopia at the conclusion of the study. Strabismus in nanophthalmos usually manifests as nonaccommodative and partially refractive esotropia. Medial rectus recession should be applied with care to prevent adduction deficit and convergence insufficiency. Otherwise, there seems to be no need for decreasing the surgical dose with regard to the smaller axial length. Amblyopia tends to be persistent in these patients.

Research paper thumbnail of Periorbital Necrotizing Fasciitis Caused by Community-Associated Methicillin-Resistant Staphylococcus Aureus Periorbital Necrotizing Fasciitis

Orbit, 2010

To report a case of a patient with periorbital necrotizing fasciitis caused by community-associat... more To report a case of a patient with periorbital necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA). Case report. A previously healthy 33-year-old man was presented with pain and rapidly progressive swelling of the right upper eyelid following a minor trauma. Computed tomography scanning revealed soft tissue swelling and fracture of the anterior wall of the right frontal sinus. Oral amoxicillin + klavulanat 1 g, twice daily was started. Over the next 24 hours periorbital necrotizing fasciitis was developed. A wound swab was taken and sent for microscopic evaluation, culture, and antibiotic sensitivity. The patient was started on intravenous crystallized penicillin, third-generation cephalosporin, and metronidazol treatment. An urgent extensive necrotic tissue debridement and frontal sinus curettage were performed. Wound culture yielded MRSA which showed sensitivity to the given antibiotics. The patient responded to the treatment which was continued for 14 days. Monomicrobial MRSA should be considered in the etiology of periorbital necrotizing fasciitis. Early diagnosis and prompt surgical and medical therapy are essential in the management of periorbital necrotizing fasciitis.