Case Report
It Is Not Just the Eyes - a Description of Abnormal Vestibulocochlear Anatomy in Duane’s Retraction Syndrome (DRS)
Issue:
Volume 11, Issue 3, September 2026
Pages:
31-34
Received:
23 February 2026
Accepted:
29 April 2026
Published:
22 July 2026
Abstract: This case study presents a 2-month old male with Duane’s type I syndrome and bilateral severe to profound sensorineural hearing loss. The patient was referred to audiology after failing newborn hearing screen. Audiology testing revealed elevated thresholds, particularly in the left ear. Subsequent imaging demonstrated abnormal cochlear and vestibular structures, indicating an incomplete partition type I. Genetic screening for common deafness-related genes, an electrocardiogram, and infection screening for cytomegalovirus were all negative. The patient was subsequently diagnosed with left Duane’s syndrome type I at 11 months. He had a normal perinatal period and birth, with the exception of a hematoma detected around 8 weeks into gestation, which resolved without further complications. The mother received a Coronavirus-disease (COVID) vaccine during her first trimester. Family history is unremarkable for auditory or ophthalmological conditions. Duane’s retraction syndrome (DRS) is a rare form of strabismus. There is limited literature on its association with hearing loss and accompanying auditory abnormalities. We hope that this can gain further insight and provide clues to the pathogenesis and aberrant embryogenesis in this condition. Auditory screening is also important especially in settings where newborn hearing evaluation is not routine.
Abstract: This case study presents a 2-month old male with Duane’s type I syndrome and bilateral severe to profound sensorineural hearing loss. The patient was referred to audiology after failing newborn hearing screen. Audiology testing revealed elevated thresholds, particularly in the left ear. Subsequent imaging demonstrated abnormal cochlear and vestibul...
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Research Article
Infrared Auto Refractor Based Evaluation of Meibomian Gland Morphology, Its Correlation with Tear Film Parameters in Patients with Dry Eye Disease
Issue:
Volume 11, Issue 3, September 2026
Pages:
35-43
Received:
25 March 2026
Accepted:
27 July 2026
Published:
27 August 2026
DOI:
10.11648/j.ijovs.20261103.12
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Abstract: Background: Dry eye disease (DED) is a prevalent ocular surface disorder causing symptoms of watering, redness of eyes, ocular discomfort, visual disturbance, and signs of congestion, reduced tear meniscus, particulate debris in the tear film, changes in the meibomian gland number and morphology, and increased tear osmolarity. Conventional meibography offers detailed imaging of Meibomian glands but remains costly and unavailable in routine practice. This study evaluated gland morphology using a standard infra red autorefractor with an infra red imaging device and correlated findings with tear-film parameters. Methods: In this cross-sectional study, 106 patients who met the inclusion, exclusion criteria with clinically diagnosed DED were examined at a tertiary care center. Each participant underwent Schirmer’s II test and tear break-up time (TBUT) measurement. Meibomian gland morphology was imaged using the infrared module of the AR-UNIQUE.RK auto-refractometer. Parameters such as acini visibility, main duct exposure, orifice morphology, and lid margin irregularities were graded and correlated with tear-film indices using Spearman’s correlation and non-parametric tests (p < 0.05 significant). Results: Poor or moderate acini visibility (Grades 2–3) was observed in 75.5% of patients, and orifice abnormalities in 68%. Mean Schirmer’s values were 7.7 ± 1.9 mm (RE) and 7.4 ± 1.8 mm (LE), while mean TBUT was 6.4 ± 1.6 s and 6.2 ± 1.5 s, respectively. Acini visibility grade correlated negatively with Schirmer’s (r = –0.42, p < 0.001) and TBUT (r = –0.39, p = 0.002). Increased morphological severity was significantly associated with reduced tear-film stability (p < 0.001). Conclusion: Infrared imaging using an auto refractometer effectively identified Meibomian gland abnormalities correlating with functional tear film deficits. This approach provides a practical, low cost alternative for early detection of Meibomian gland dysfunction in resource limited ophthalmic settings.
Abstract: Background: Dry eye disease (DED) is a prevalent ocular surface disorder causing symptoms of watering, redness of eyes, ocular discomfort, visual disturbance, and signs of congestion, reduced tear meniscus, particulate debris in the tear film, changes in the meibomian gland number and morphology, and increased tear osmolarity. Conventional meibogra...
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Ka Lam Janice Wu*
