AAO Journal Archive
- Classification of Vitreous Seeds in Retinoblastoma
- Topical 5-Fluorouracil 1% as Primary Treatment for Ocular Surface Squamous Neoplasia
- Individualized Stabilization Criteria–Driven Ranibizumab versus Laser in Branch Retinal Vein Occlusion
- Correlation of Histologic Features with In Vivo Imaging of Reticular Pseudodrusen
- Pseudodrusen and Incidence of Late Age-Related Macular Degeneration in Fellow Eyes in the Comparison of Age-Related Macular Degeneration Treatments Trials
- Pharmacotherapies for Retinal Detachment
- Can Automated Imaging for Optic Disc and Retinal Nerve Fiber Layer Analysis Aid Glaucoma Detection?
- Suture Colonization Rate in Adjustable Strabismus Surgery
- Genetic and Dietary Factors Influencing the Progression of Nuclear Cataract
- Diagnostic Accuracy of Optical Coherence Tomography and Scanning Laser Tomography for Identifying Glaucoma in Myopic Eyes
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We appreciate the interest of Galvis et al in our article.1 Recent studies2–4 have shown that the posterior corneal surface has against-the-rule (ATR) astigmatism in most cases and keratometric astigmatism may misinterpret actual total corneal astigmatism. However, the exact reason remains unclear. In this article,1 focusing on distribution of corneal thickness, we explained the reason why posterior corneal surface tends to be ATR astigmatic. As Galvis et al pointed out, Koch et al2 and Tonn et al3 compared keratometric astigmatism with actual total corneal astigmatism using vector analysis to evaluate the contribution of posterior corneal astigmatism to total corneal astigmatism.
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We read with interest the article by Ueno et al1 on corneal thickness and astigmatism. The authors stated, “It was found that the cornea was thicker in the vertical than in the horizontal direction, which can explain why the posterior cornea surface tends to be more [against-the-rule] astigmatic than the anterior corneal surface, as demonstrated by recent studies.” Clarification would be helpful. A steeper posterior corneal meridian aligned vertically correlates with the finding that the cornea is thicker along the vertical meridian.
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A 61-year-old man was referred for a vascularized lesion of the conjunctival limbus suspicious for carcinoma in situ (Fig A). However, excisional biopsy demonstrated superficially invasive melanoma arising within conjunctival melanocytic intraepithelial neoplasia (C-MIN). Both the epithelial and invasive components lacked visible melanin. Roughly 80% of the conjunctival epithelium was replaced by atypical melanocytes (Fig B); that expressed MART-1 (melanocyte antigen marker; Fig C). The tumor extended 0.6 mm into substantia propria (Fig D).
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A 40-year-old woman noted fullness of her right upper eyelid for 3 months (Fig A). She had a history of recurrent conjunctival melanoma with multiple excisions over 7 years. One year earlier, she had unrelated filtering surgery for elevated intraocular pressure. Orbital biopsy confirmed the diagnosis of melanoma, and she underwent orbital exenteration. The specimen demonstrated orbital and intraocular extension of conjunctival melanoma (Fig B) with replacement of the choroid (Fig C) and retina (Fig D) with melanoma cells.