Various microorganisms, including bacteria, viruses, fungi, protozoa, and parasites, produce a variety of signs and symptoms. History taking and physical examination are the basis of diagnosis in infectious diseases, followed by laboratory confirmation of causative agents. Infectious diseases can be diagnosed by careful neuro-ophthalmologic examination. Infections in the central nervous system show a clinical picture of brain abscess, encephalitis, or meningitis, and localized lesions may additionally reveal site-specific neuro-ophthalmologic findings. Even systemic infections may have characteristic neuro-ophthalmologic signs. Careful examination is the key to true diagnosis.

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We frequently examine patients with a simultaneous presentation of a headache and dry eye in normal practice due to increase in VDT work by the IT equipment used. However，there are extremely few reports presenting a direct relationship between them and specialists who are familiar with both symptoms. The aim of this paper was to elucidate the relationship between headache and dry eye, based on the results obtained by previous studies. We concluded that although there is a correlation, the cause-and-effect relationship is partial. Asthenopia by VDT syndrome is the main cause of either symptom, which consequently seems to show a correlation between the two symptoms. However, in recent years, various studies conducted detailed examinations using a control group, as well as a direct approach by examining brain function imaging. Recent studies have shown a direct relationship between cutaneous allodynia, triggered by wearing contact lenses, and migraine through the trigeminal nerve systems. Therefore, examination of the pathological condition has shown a partial causal relationship.

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It has been known that there are functionally and morphologically diverse retinal ganglion cells in the retina of mammals such as mice, rabbits, and primates. When classified by dendritic morphology and stratification, there are at least 11 types of ganglion cells. Functionally, different types of retinal ganglion cells have been reported, such as direction selective ganglion cells, blue-ON/yellow-OFF ganglion cells, local edge detector ganglion cells, and melanopsin ganglion cells. In this review, I provide an overview of this morphological and functional diversity in retinal ganglion cells and discuss its impact on vision and diseases.

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Body lateropulsion (BL) is defined as uncontrollable falling to one side without any motor weakness and may be caused due to partial involvement of the lateral medulla oblongata, pons, midbrain, cerebellum, or superior and inferior cerebellar peduncles. In the lateral medulla oblongata, impairment of the vestibular nucleus, lateral vestibulospinal tract, or posterior spinocerebellar tract may induce BL. If the vestibular nucleus is damaged, in addition to BL, nystagmus, vertigo, ocular tilt reaction, and ocular lateropulsion is also observed. One hypothesis suggests that involvement of the posterior spinocerebellar tract may cause BL with hemiataxia, while damage to the posterior spinocerebellar tract may induce BL without hemiataxia. However, this hypothesis does not apply to all cases of BL secondary to a lateral medullary lesion. In the pons, involvement of the ascending graviceptive pathway (GP) may cause BL. However, the precise location of the GP is yet to be ascertained. Based on previous reports, it is speculated that GP from the vestibular nuclei to the interstitial nucleus of Cajal may run into the pontine tegmentum and cross the midline into the caudal pons, just above the level of the vestibular nuclei. In the caudal and middle pons, GP may be located from the dorsal region to the medial lemniscus. Further, in the rostral pons, GP may run between the medial longitudinal fasciculus and ventral trigemino-thalamic tract. In the midbrain, involvement of the red nucleus, ascending vestibulothalamic pathway, cerebellothalamic pathway, or GP may cause BL. In the cerebellum, impairment of the vermis may often induce BL. It is speculated that unilateral involvement of the nodulus may cause BL to the contralateral side, while unilateral damage to the culmen may induce BL to the ipsilateral side without vertigo. Notably, there is only one reported case of isolated BL secondary to localized demyelinated lesions in the superior cerebellar peduncle and inferior cerebellar peduncle.

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We report 5 patients with congenital nystagmus accompanying macular disease using spectral domain optical coherence tomography (SD-OCT). Three patients showed pendular nystagmus and 2 revealed jerky nystagmus without null zone in all cases. Binocular vision was 0.3 in 4 patients and 0.5 in 1 patient. Four of the 5 patients revealed macular hypoplasia without foveal structure in the OCT, and the remaining patient revealed disappearance of the ellipsoid zone, which we diagnosed as cone dystrophy based on its appearance. Three patients underwent extraocular muscle surgery for nystagmus. After surgery, binocular vision showed a 3-level improvement in a 16-year-old boy, and abnormal head posture had disappeared in an 8-year-old boy. Congenital nystagmus with poor vision may be accompanied by macular hypoplasia, and therefore, OCT should be performed. In addition, conservative and surgical treatment should be performed in such cases.

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A 22-year-old man complained of double vision after receiving a craniotomy procedure due to hemorrhage caused by cerebral arteriovenous malformation in the right parieto-occipital area. The patient was referred to us from the hospital for strabismus surgery 2 years after the onset of double vision. He manifested right exotropia with convergence insufficiency. Visual field testing showed a left inferior quadrantanopia. Version eye movement was unrestricted in all directions. Furthermore, accommodative function showed a reduction in the amplitude of accommodation of the right eye, and convergence reaction in the right eye was slightly decreased. However, using an electronic pupillometer, the pupillary light reaction was normal with no difference between the right and the left eye. After undergoing an 8-mm right external rectus muscle recession, convergence became possible and an orthophoric eye position was maintained. The right parieto-occipital area plays an important role in eliciting near reflexes which led us to hypothesize that this area might be responsible for exotropia with convergence insufficiency.

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