bluuebunny/crossref_metadata_2025 huggingface dataset:
DROP ATTACK IN GLAUCOMA: THE MELBOURNE EXPERIENCE WITH TOPICAL MIOTICS, ADRENERGIC AND NEURONAL BLOCKING DROPS
Authors: WEST R. H. , CEBON L. , GILLIES W. E.
Published: November 2007

We have considered the effectiveness of miotics (pilocarpine 2% and ecothiopate iodide (Phospholine Iodide) 0.125 or 0.25%), adrenaline (Eppy/N 1 %) or adrenaline precursors (dipivalyl epinephrine or dipivefrin hydrochloride (Propine) 0.1%) and neuronal blockers (timolol maleate (Timoptol) 0.5%) in 165 patients in the clinical situation. All drops were effective in lowering intraocular pressure with an average fall of 6.6 mmHg for timolol (160 eyes), 8.21 mmHg for pilocarpine (79 eyes), 5.77 mmHg for dipivalyl epinephrine (57 eyes), 7.23 mmHg for adrenaline (17 eyes) and 10.5 mmHg for ecothiopate iodide (16 eyes). In chronic simple open‐angle glaucoma, ocular hypertension and pseudoexfoliative glaucoma, pilocarpine and timolol were almost equally effective while dipivalyl epinephrine and adrenaline were also effective, but more as additive therapy, though dipivalyl epinephrine may be useful on its own in ocular hypertension. In low‐tension glaucoma timolol and dipivalyl epinephrine together seemed best, while in secondary glaucomas all were effective at times, but ecothiopate iodide was best in aphakic glaucoma and fluorometholone (FML Liquifilm) 0.1% was important in inflammatory glaucoma. Side effects were frequent with dipivalyl epinephrine and timolol, with respiratory disease a strong contraindication to timolol.
TIMOPTOL—THREE YEARS ON: A STUDY OF TIMOLOL MALEATE DROPS OVER A LONGER PERIOD
Authors: GILLIES W. E. , WEST R. H. , CEBON L.
Published: November 2007

A group of 130 patients with chronic glaucoma has been followed from one to more than three years on timolol maleate drops; this confirms that these drops remain effective in long‐term therapy though added therapy is usually needed. Of 54 patients originally controlled by timolol alone or in combination, only four were not controlled more than three years later, though some needed further additional therapy. Of 35 patients followed for two to three years, only six could not be controlled by timolol alone or in combination; and of 41 followed for one to two years, 18 were controlled on timolol alone while 23 needed additional therapy. Attention is drawn to side effects including a mild keratopathy and in particular the occurrence of bronchospasm or other severe respiratory disease in 10 patients, not all of whom had a previous history of respiratory disease. Great care should be exercised with timolol in the presence of present or past respiratory disease as the complication is not generally recognised and it falls to the ophthalmologist to act to stop the drop.
COMBINED TRABECULECTOMY AND CATARACT EXTRACTION
Authors: FRACO R. H. WEST
Published: November 2007

A small personal series of patients with chronic open‐angle glaucoma who underwent combined trabeculectomy and cataract extraction is analysed with regard to the effect of the operation on the control of intraocular pressure. The results support the regular use of the operation as an effective means of reducing intraocular pressure.
CONGENITAL ANTERIOR SEGMENT EPITHELIALISATION (CASE)
Authors: FRACO LAWRENCE W. HIRST
Published: November 2007

Posterior polymorphous endothelial dystrophy and iridocorneal endothelial syndrome share common specular microscopic findings, clinical course, and some histopathological features. Despite differences in inherited trait and severity of disease a common pathogenetic mechanism for the two diseases is suggested. This consists of congenital epithelialisation of the posterior corneal surface during embryogenesis with migration of these cells around the anterior segment uninhibited by surrounding normal endothelium.
BENIGN INTRACRANIAL HYPERTENSION
Authors: Colebatch J. G. , Lance J. W.
Published: November 2007

Benign intracranial hypertension is caused by defective cerebrospinal fluid (CSF) absorption which may sometimes be secondary to partial superior sagittal sinus obstruction. It may appear in obese young women for obscure hormonal reasons or may be a reaction to head injury, infections or certain medications. It commonly presents with headache and papilloedema, sometimes with associated ocular palsies. Conservative management comprises repeated lumbar puncture, salt and fluid restriction and the use of diuretics or steroids. Surgical treatment such as CSF shunting procedures, optic nerve decompression or subtemporal decompression may become necessary. The results of treatment have not been subjected to adequate evaluation, but the patient usually recovers well, although some 10% suffer severe visual impairment and 10% are subject to recurrence.
THE EFFECT OF ALCOHOL ON THE VISUAL AND OCULAR MOTOR SYSTEMS
Authors: WILSON GAYLE , MITCHELL REG
Published: November 2007

Alcohol is generally considered to be a central nervous system (CNS) depressant. This effect is progressive from higher cortical centres through to fundamental body functions. The effect of alcohol ingestion on the visual and ocular motor systems of ten healthy subjects was the basis of this study. Significant changes in the following resulted from the ingestion of 0. 375 g/kg of 10% ethanol alcohol: prism measurements of deviations for near and distance, ocular movements, convergence near point, and visual acuity at six metres.

No significant change was observed following testing of stereopsis or near visual acuity.
CAUSES OF BINOCULAR LEGAL BLINDNESS IN AN AUSTRALIAN METROPOLITAN COMMUNITY
Authors: FRACO FERGUS M. YEATES
Published: November 2007

Australian legal blindness is defined as bilateral corrected visual acuity less than 6/60: if visual acuity is better than this, collateral visual impairments may be included. Persons thus affected qualify for the Invalid Pension (Blindness). From October 1975 to June 1982, I studied clinical data of 311 persons assessed as legally blind, and recorded diagnoses. I personally examined 259 of these persons and a medical colleague examined 52. Examinees were resident in Brisbane (or environs), Australia. Eleven persons had asymmetrical conditions (analysed separately), and 300 had symmetrical conditions. Causes of the latter were genetically transmissible (20.3%), adult maculopathy (18%), congenital (12.7%), vascular (non‐diabetic) (8. 7%), adult glaucoma (8. 3%), diabetes (7. 3%), trauma (6%), and others (18. 7%). Of 61 symmetrical genetic cases causes were retinitis pigmentosa (34.4%), congenital cataracts (16.4%), retinal dystrophy and maculopathy (13. 1%), Leber's optic atrophy (9. 8%), and others (26. 3%).

These results suggest that more attention should be directed to genetic counselling.
BASIC OCULOPLASTIC SURGERY
Authors: Milverton E. John
Published: November 2007

Oculoplastic procedures well within the capabilities of most ophthalmic surgeons are described. Only those conditions most commonly encountered are discussed and the corrective surgery is illustrated. If required, all procedures described may be carried out under local anaesthesia in a minor operations room. The operative techniques described are those used by the author.
COMBINED VITRECTOMY, INTRAOCULAR MICROSURGERY AND LIQUID SILICONE IN THE TREATMENT OF PROLIFERATIVE VITREORETINOPATHY
Authors: FRACO JAMES D. CAIRNS , MB NEERAJ ANAND
Published: November 2007

This study investigates the effectiveness of combining vitrectomy, scleral buckling, intraocular microsurgery and liquid silicone injection for the treatment of retinal detachment complicated by proliferative vitreoretinopathy: 48 eyes were treated using these techniques combined. Complete attachment was achieved in 16 eyes (33%), partial attachment in 20 eyes (42%), and 12 eyes (25%) remained detached. Vision was improved in 17 eyes (35%), unchanged in 17 eyes (35%), and worse in 14 eyes (30%). Complications included emulsification of the silicone, glaucoma, cataract, band degeneration of the cornea, reproliferation of membranes and passage of silicone into the subretinal space. Significant preservation of mobility vision was achieved. A larger series of patients with longer follow‐up will ultimately determine the place of this technique in the management of this complicated problem.
EPITHELIAL DOWNGROWTH
Authors: MD RICHARD D. GRUTZMACHER , MB DOUGLAS W. HENDERSON , FRACO DOUGLAS J. COSTER
Published: November 2007

Epithelial downgrowth following intraocular surgery is uncommon but serious. Various forms of Epithelialization of the anterior chamber occur including cysts, pearl tumour of the iris, and sheet‐like downgrowth. The presentation is now always typical. Three such cases are reported. Epithelialization in these cases presented as endophthalmitis, a persistent fistula, and as an unexpected finding at keratoplasty done in a stable eye with bullous keratopathy. Although the condition is usually progressive, early diagnosis and treatment can produce good results. Key words: epithelial downgrowth, fistula, endophthalmitis, bullous keratopathy, keratoplasty.
SURGERY FOR CONGENITAL ESOTROPIA
Authors: MD EUGENE M. HELVESTON
Published: November 2007

Esotropia in the neonatal period is significant if it is prolonged or recurrent, while exotropia is not. Straight eyes for most of the waking hours is the rule rather than the exception in the newborn.

Successful surgical management of congenital esotropia depends on equal attention to diagnosis, planning and treatment These are preceded by proper timing of the surgical procedure and followed by careful, comprehensive attention to the needs of the patient. The manifest cosmetic and hoped‐for functional benefit of early surgery, when supported by competent paediatric anaesthesia, makes early surgery the logical choice for treatment of congenital esotropia.
MAGNIFICATION FOR OPERATIVE PROCEDURES DURING RETINAL DETACHMENT SURGERY
Authors: FRACO ROBERT W. LAZELL
Published: November 2007

During retinal detachment surgery certain procedures such as drainage of subretinal fluid and placement of sutures in the sclera are facilitated if performed with the aid of magnifying loupes.

While it is possible for the surgeon to replace his indirect ophthalmoscope with a separate magnifying loupe during the operation it is much more convenient if the two functions can be combined in the one instrument.

Much work has been done in this field by the Melbourne University Department of Ophthalmology and commercial models of their instrument have been produced.

However, a simpler solution to the problem is to mount a small indirect ophthalmoscope above the magnifying telescopes of a spectacle loupe. This is possible because the line of sight when using the ophthalmoscope is much closer to the straight‐ahead position.
REPOSITIONING OF DESCEMET'S MEMBRANE: A CASE REPORT
Authors: BOOTH FRANCES M. , KURDIAN PAUL , LIU HENRY
Published: November 2007

An 80‐year‐old Australian was admitted to Concord Hospital for right cataract extraction and intraocular implant. During the procedure under local anaesthesia, two‐thirds of Descemet's membrane was stripped down into the anterior chamber. The membrane was later repositioned by air injection into the anterior chamber. Sixteen months later, her right visual acuity is 6/9 and she reads the newspapers.
MACULAR ELECTRORETINOGRAMS: THEIR ACCURACY, SPECIFICITY AND IMPLEMENTATION FOR CLINICAL USE
Authors: VAEGAN PhD  , BILLSON F. , KEMP S. , MORGAN M. , MB M. DONNELLEY , MONTGOMERY P.
Published: November 2007

The pattern and the focal electroretinogram (ERG) are both non‐invasive, electrophysiological responses recorded from circumscribed retinal areas and are most easily recorded from the macula. This paper describes how our department has incorporated these tests into our clinical protocol, shows how the recording technique and the method of electrode construction may be improved, and describes the normal limits of the macular responses we obtain. The ERG signal‐noise ratio we obtained was better than that of the binocular visual evoked potentials (VEPs) recorded simultaneously.

Pattern and focal ERGs, using improved methods of recording, show promise of being a valuable addition to the clinical investigation of subtle maculopathies and some forms of optic nerve dysfunction. Three illustrative cases are described. The first demonstrates normal macular ERG responses with abnormal Ganzfeld ERGs due to peripheral retinal damage. The second reveals differential pattern ERG reduction with normal focal ERG in recent optic neuritis. The third case demonstrates reversible simultaneous loss of Ganzfeld ERGs and macular ERGs in vitamin A deficiency.
CLOSED MICROSURGERY IN TRAUMA
Authors: McLEOD DAVID
Published: November 2007

Blunt and penetrating injuries to the eye provide ophthalmologists with a wide range of surgical challenges. The reconstruction and visual rehabilitation of traumatized eyes are described with particular emphasis on the role of closed microsurgical techniques in the posterior segment.
OCULAR TOXICOLOGY UPDATE*
Authors: FRAUNFELDER F. T. , MEYER S. MARTHA
Published: November 2007

The National Registry of Drug‐induced Ocular Side Effects has accumulated 13 cases of possible major haemopoietic responses from topical ocular chloramphenicol. Over 75 cases of major haemopoietic events from carbonic anhydrase inhibitors are also reviewed. While numerous reports of local ocular effects secondary to timolol have been received by the Registry, the more significant adverse effects are the same systemic side effects seen with any beta‐receptor blocking agent. Data in the Registry have shown that allopurinol may be possibly associated with cataract formation. Severe cardiovascular effects with elevated blood pressure and stroke are uncommon systemic adverse reactions following topical ophthalmic 10% phenylephrine, but these systemic effects have also been seen secondary to concentrations of 2.5%. Other drugs, such as adrenaline (epinephrine), ecothiopate (echothiophate), practolol, thiabendazole, and penicillamine are suspected of causing ocular pseudopemphigoid.
DIAGNOSIS AND MANAGEMENT OF LOST MUSCLE FOLLOWING STRABISMUS SURGERY
Authors: BILLSON F. , FITZGERALD A.
Published: November 2007

Of all the complications of strabismus surgery, the lost muscle is one of the most alarming, and yet with patience and careful management it may be one of the most amenable to treatment.

This paper reports seven cases of lost muscle following strabismus surgery, in six of the seven cases referred to the Department of Clinical Ophthalmology there had been delay in diagnosis for periods varying from six weeks to 17 years. All the lost muscles were successfully retrieved.

With good illumination and magnification and a careful search of the sub‐Tenon's capsule space it is unusual to need to explore the orbital fat to retrieve the muscle.
ORBITAL FLOOR FRACTURES AND THEIR TREATMENT
Authors: JANAKARAJAH N. , SUKUMARAN K.
Published: November 2007

Orbital floor fractures can occur with or without any associated fractures of the middle third of the facial skeleton. Fifty‐one patients with a unilateral “black eye” after motor vehicle accidents were reviewed. The fractures involving the orbital floor were analysed. The clinical signs and symptoms, with results ol radiological examination, are discussed. The various treatment modalities and their postoperative complications are discussed.
SCLERITIS AND THE SPECTRUM OF EXTERNAL INFLAMMATORY EYE DISEASE
Authors: McCLUSKEY P. J. , WAKEFIELD D. , PENNY R.
Published: November 2007

Scleritis, episcleritis and Mooren's ulcer form a poorly understood spectrum of inflammatory syndromes involving the ocular surface. Their pathogenesis is thought to be a vasculitis and may be related to immune complex deposition, as these syndromes are often associated with systemic diseases which are assumed to be vasculitic in aetiology. Scleritis and Mooren's ulcer are amongst the most severe external inflammatory diseases, often causing extensive damage to the sclera and cornea. They require aggressive investigation and management, often including systemic anti‐inflammatory therapy. Systemic immunosuppression may be necessary to control severe disease.
A MICROPROCESSOR‐DRIVEN ONE‐OPERATOR FORCED‐CHOICE PREFERENTIAL LOOKING APPARATUS
Authors: GOLE GLEN A. , COSTER DOUGLAS J.
Published: November 2007

Forced‐choice preferential looking (FPL) is a behavioural technique for the estimation of visual acuity in preverbal children. We have constructed an electromechanical FPL apparatus controlled by a microprocessor requiring just one operator. Sixty‐three babies aged between six weeks and eleven months were evaluated with an overall success rate of 83% in obtaining an acuity measurement. FPL is a practical method for measurement of infant visual acuity in the ophthalmic clinic setting.
CONJUNCTIVAL AND LIMBAL TUMOURS
Authors: HARRISON MARK , GLASSON WILLIAM
Published: November 2007

One hundred cases of histologically proven corneal and conjunctival tumours were extracted from the records at the Princess Alexandra Hospital and from the senior author's private practice in the last ten years. The tumours were analysed according to Duke‐Elder's classification. There were 78 epithelial tumours, 15 pigmented naevi, four melanomas, two dermolipomas and one limbal dermoid. Fourteen of the 41 epithelial carcinomas were followed for three years or more. None of the 14 recurred.
DEVELOPMENT OF CORTICAL AFFERENTS AND CORTICO‐TECTAL EFFERENTS OF THE MAMMALIAN (RAT) PRIMARY VISUAL CORTEX
Authors: DREHER BOGDAN , THONG IAN G. , SHAMEEM NALINI , McCALL MURRAY J.
Published: November 2007

At the time when the fibres from the striate cortex (area 17) begin to innervate the superficial layers of the superior coliiculus of the young rat (postnatal days 4 and 5) a high degree of specificity in the organization of this newly formed cortico‐tectal projection is already apparent. Thus, in young rats, as in adult mammals of virtually all species studied so far, the somata of cortico‐tectal neurones are confined to lamina V of the ipsilateral cortex. However, this high degree of laminar (radial) specificity in young animals is accompanied by a substantial degree of exuberance as indicated by a tangential distribution of the cortico‐tectal cells which is wider than that in the adult. The exuberant projections are pruned during the second postnatal week.

The cortico‐cortical associational and commissural fibres start to enter the grey matter of the rat striate cortex after postnatal day 7. Again a high degree of specificity in the laminar distribution of those newly established projections is apparent. However, the cortico‐cortical projection, at the time when cortico‐cortical fibres enter the cortical laminae, is clearly exuberant since the tangential spread of cortical cells projecting to the striate cortex is wider than that in the adult. Pruning of these excessive projections takes place some time after postnatal day 14.

It is believed that understanding the mechanism(s) underlying the development of connections of the rat visual cortex might be of general importance in understanding developmental abnormalities in the pattern of interconnections of the visual cortices of other mammalian orders.
OUTLINE FOR A COMPREHENSIVE CLASSIFICATION OF RETINAL DYSTROPHY AND ITS CONSEQUENCES
Authors: Halliday Francis B. , Ross Ann F.
Published: November 2007

Classification of all relevant factors is a prerequisite to the formulation of specific objectives to attain goals of prevention of retinal dystrophy (RD) and effective provision of services. National and international agreement on a classification is sought. This outline stresses the importance of a sound conceptual basis. The root meaning of dystrophy (difficult nourishment), and the concepts given in the World Organization's International Classification of Impairments, Disabilities and Handicaps are emphasized. The proposed classification is designed to be statistical as well as assisting diagnosis and case management. The scheme for RD entities takes into account special features, in contrast to most treatable eye diseases. Genetics is stressed because of the importance of genetic counselling and rapid research advances.

Three appendices illustrate portions of a comprehensive classification already in operation at the Retinal Dystrophy Service of NSW.
A REVIEW OF LEISKE STYLE SEMI‐FLEXIBLE INTRAOCULAR LENSES 1981–1984
Authors: FRACO D. MORAN , McGUINNESS R. , KENNEDY I.
Published: November 2007

A consecutive series of 205 patients had 237 intracapsular cataract extractions performed with the insertion of a semi‐flexible intraocular lens in the period 1981–1983. The average follow‐up period was 17.8 months; 87.0% of cases obtained a visual acuity of 6/12 or better after operation, compared with 80.6% of cases whose preoperative visual acuity was 6/36 or worse. Twenty‐six eyes (11 %) had clinical cystoid macular oedema at some stage after operation, and seven eyes (3%) had persistent cystoid macular oedema at final follow‐up. Only one eye had a postoperative retinal detachment. Thirty eyes (14.1%) required treatment for elevated intraocular pressure at some time after operation.
THE GRANULOMATOUS REACTION IN HERPETIC STROMAL KERATITIS: IMMUNOHISTOLOGICAL AND ULTRASTRUCTURAL FINDINGS
Authors: WEINER JOHN M. , CARROLL NANETTE , ROBERTSON IAN F.
Published: November 2007

A granulomatous reaction was identified in six corneal buttons obtained from patients with herpetic stromal keratitis. The inflammation, characterized by lymphocytes, plasma cells, macrophages and multinucleate giant cells, was associated with Descemet's membrane in five cases and with a break in Bowman's membrane in one case. The ultrastructural changes were documented by scanning electron microscopy in all cases. Transmission electron microscopy, performed in four cases, failed to disclose the presence of viral inclusions. Immunoperoxidase stains utilizing antibodies to the herpes simplex virus were done on all cases. Positivity (the presence of herpes simplex virus antigen or herpes simplex‐like antigen) was detected within epithelium (three cases), within stroma (three cases), and within some inflammatory cells of the granulomatous reaction at Bowman's membrane. Positive staining was not detected in cells of the granulomatous reaction at Descemet's membrane. These results suggest that the reaction at Descemet's membrane, which has been found in a variety of corneal conditions, may be due to a poorly understood alteration in the antigenicity of Descemet's membrane.
ARGYROL, ARGYROSIS AND THE ACQUISITION OF ART
Authors: HODSON T. J. P. , GILLIES W. E.
Published: November 2007

Argyrosis is a now unfamiliar ocular condition with the lapsing ofArgyrol and other related silver compounds from the ophthalmic dispensary. It gives rise to a characteristic clinical picture in the conjunctiva and cornea. Argyrol was invented by Albert Barnes and, with the fortune he made, he was able to gather one of the greatest collections of modern art. The collection is displayed at the Barnes Foundation in Philadelphia.
RESULTS IN THE TREATMENT OF BACTERIAL ENDOPHTHALMITIS
Authors: HAYMET T.
Published: November 2007

Fifteen cases of confirmed and clinically suspected bacterial endophthalmitis seen at the Vitreous Clinic of Sydney Eye Hospital in the three‐year period from July 1981 to July 1984 are reviewed.

The predisposing factors are summarized; two cases followed secondary implantation of an intraocular lens and one case followed removal of sutures from a cataract section. All but one of the patients had been given topical, subconjunctival or systemic antibiotics prior to surgery. All but two of the patients had vitreous biopsies performed, and all of these patients in turn received intravitreal antibiotics, usually gentamicin and cephalothin.

Positive cultures were obtained in nine cases (69%), including the two cases who had not received antibiotics prior to vitreous biopsy.

Final visual acuities ranged from 6/6 to no perception of light (NPL). Delay of more than 36 hours between the onset of severe symptoms and intravitreal antibiotic treatment was associated with a poor visual outcome.
MASS SCREENING OF THE OPTIC DISC FOR GLAUCOMA: A FOLLOW‐UP STUDY
Authors: COOPER R. L. , GROSE G. C. , CONSTABLE I. J.
Published: November 2007

Because of the high false positive and negative rates for detection of suspects when screening for glaucoma by tonometry, we screened 12 156 subjects over the age of 40 years or with a stated family history of glaucoma by examining the optic discs. This was followed by Schiotz tonometry. Eight hundred and twelve (6.7%) suspects were referred to their primary physician for investigation by an ophthalmologist. A database program was used to send out follow‐up letters to both suspects and ophthalmologists. Three hundred and seventynine replies were received from ophthalmologists: 100 (26.4%) of these suspects had ocular hypertension and 68 (17.9%) had glaucoma. Of these 68, 60 (15.8%) had chronic simple glaucoma, five (1.3%) had secondary open‐angle glaucoma, and three (0.79%) had primary closed‐angle glaucoma. The prevalence of all types of glaucoma in this group for which follow‐up was obtained was at least 0.56% of the total number screened. Assuming that the prevalence was similar for the group for whom no replies were obtained, the prevalence of glaucoma in this population is approximately 1.19%. Screening by optic disc examination is therefore likely to detect most cases of glaucoma.
OCULAR MANIFESTATIONS OF ADULT NIEMANN‐PICK DISEASE: A CASE REPORT
Authors: LOWE D. , MARTIN F. , SARKS J.
Published: November 2007

Niemann‐Pick Disease Type B in a 33‐year‐old man is described. No family, racial or hereditary factors were noted in this case as in other reports in the literature.

The ocular abnormalities in our patient were mild myopia, a mild generalized colour abnormality. and fundi showing a lipid ring‐form opacity about the foveolas resulting in minimal visual impairment.

Sphingomyelinase deficiency was found with the resulting deposition of phospholipid occurring most probably in the Müller cell. No neurological features were present and the patient was otherwise well.
PENICILLINASE‐PRODUCING NEISSERIA GONORRHOEA AS A CAUSE OF NEONATAL AND ADULT OPHTHALMIA
Authors: LOCKIE PATRICK , LEONG LAU KWOK , LOUIS ANN
Published: November 2007

A retrospective analysis of 80 cases of gonococcal ophthalmia revealed six (7.5%) to be due to penicillinase‐producing Neisseria gonorrhoeae (PPNG), five neonatal cases and one adult. All six cases were finally cured, but best results were obtained with topical chloramphenicol and single‐dose spectinomycin (40 mg/kg) given intramuscularly. All gonococcal isolates should be tested promptly for penicillinase production, and if this is present systemic treatment, modified to spectinomycin or penicillinase‐stable cephalosporin, should be given as single‐dose treatment.
INTERSTITIAL KERATITIS IN UNTREATED LATENT (LATE) SYPHILIS
Authors: BROOKS ANNE M. V. , WEINER JOHN M. , ROBERTSON IAN F.
Published: November 2007

Untreated latent syphilis with interstitial keratitis is not uncommon in the older age group who may present with refractive problems. It is important to investigate these patients with a full range of serological rests for syphilis to determine whether they have been treated adequately in the past If there is evidence of untreated latent syphilis, examination of the cerebrospinal fluid is important to exclude asymptomatic neurosyphilis for which intensive systemic therapy in hospital is indicated. If there is no evidence of central nervous system involvement a course of penicillin is still indicated, but may be given on an outpatient basis. This is illustrated by the histories of six patients who presented to The Royal Victorian Eye and Ear Hospital between 1962 and 1979.
CORNEAL GRAFT SURVIVAL: A RETROSPECTIVE AUSTRALIAN STUDY
Authors: BISHOP VIRGINIA L. M. , ROBINSON LYON P. , WECHSLER ALFRED W. , BILLSON FRANK A.
Published: November 2007

Four hundred and forty‐eight consecutive corneal grafts are analysed and their survival calculated usin the actuarial life‐table method. Overall survival at two years is 81 ± 4%and at five years is 65 ± 5%. Within diagnostic subgroups keratoconus has the best prognosis. Previous graft failure and recipient corneal vascularization are shown to have a negative effect on graft survival. Sex of patient, urgency of operation and use of combined procedures do not affect survival and second regrafts fare no worse than first regraits. The use of the actuarial life‐table method of analysing graft survival is discussed and its importance emphasized.
ADJUSTABLE SUTURES IN STRABISMUS SURGERY: A PERSONAL SERIES OF CASES
Authors: AGNELLO ROSS
Published: November 2007

A personal series of 77 separate primary adjustable suture procedures performed on 69 patients is analysed. Adjustable suture surgery was performed on patients over ten years of age undergoing rectus muscle surgery, and a few selected younger patients. The ages ranged from 7 to 74 years. A 24‐month‐old infant who had a two‐stage‐anaesthesia is included in the series.

Thirty‐eight of the 69 patients were reoperations. Of the 77 primary procedures, 48 (62.3%) required postoperative adjustment; 29 (37.7%) were tied down without adjustment.

Sixty‐two of the 69 patients (89.8%) achieved a “cure”. A further four patients (5.8%) were initially in desired alignment, but deteriorated within the follow‐up period. Three of these were successfully reoperated. Of the three primary failures (4.4 %) two were reoperated with one achieving orthophoria.

Apart from alignment failure in the primary procedure, complications were minimal. Current follow‐up periods range from one to 24 months.
VIDEO AND DIGITAL FLUORESCEIN ANGIOGRAPHY
Authors: FAVILLA I. , BARRY W. R. , TURNER I. J.
Published: November 2007

A video recording system, which provides real‐time imaing and instant reporting of retinal fluorescein angiograms, with improved patient comfort, is described. Agital image‐processing methods can be applied to video angiograms to improve image qualify, quantitate retinal blood flow, measure areas, improve storage and access, and send images via phone lines or other electronic communication channels. Video image quality is somewhat inferior to conventional photographic techniques, but is more than adequate for diagnostic interpretation.
THE DETECTION AND MANAGEMENT OF THE ACUTE RISE IN INTRAOCULAR PRESSURE FOLLOWING LASER TRABECULOPLASTY
Authors: LEUNG K. W. , GlLLlES W. E.
Published: November 2007

A series of 64 patients undergoing laser trabeculoplasty had pressures estimated immediately before treatment and at one, two and three hours and in some patients at four, 24 and 48 hours after treatment. Pilocarpine 4% was given topically to 33 patients in order to assess its effect in preventing a pressure rise. The mean pressure rise for the whole series was 4 mmHg, for those not using pilocarpine it was 4.9 mmHg, and for those using pilocarpine it was 3.2 mmHg. A significant pressure rise of 5 mmHg or more was usually apparent by two hours, and patients with no rise or a fall at two hours were very unlikely to develop a rise in pressure.

Patients with an initial pressure greater than 20 mmHg, pseudoexfoliation of the lens capsule, and a shallow anterior chamber seemed more susceptible to a pressure rise while those with an initial pressure of 17 mmHg or less and only a slight reaction in the anterior chamber seemed very unlikely to develop a pressure rise. Treatment with acetazolamide, fluorometholone drops and hypotensive drops was usually successful in controlling the raised pressure.
CAUSES OF BLINDNESS IN AUSTRALIA: ANALYSIS OF PENSIONS GRANTED BY THE DEPARTMENT OF SOCIAL SECURITY ON THE GROUND OF BLINDNESS FOR THE YEAR ENDING 30 JUNE 1984
Authors: BANKS C. NEVILLE , KRATOCHVIL ROMAN
Published: November 2007

The principal and contributing causes of blindness for all pensions granted by the Department of Social Security on account of blindness in Australia during the year ending 30 June 1984 have been coded according to the lnternational Classification of Diseases, 7975 (lCD9). The results are presented in tables which show the major diagnosis for symmetrical and asymmetrical cases according to frequency and age, and the combination of major and contributing diagnosis according to age, sex and prevalence per 100 persons.
INVESTIGATION AND PROGNOSIS IN THE RETINAL PIGMENT EPITHELIOPATHIES
Authors: FOULDS WALLACE S. , DAMATO BERTIL E.
Published: November 2007

Eighty‐three patients with retinal pigment epitheliopathy have been identified from the photographic and fluorescein records of the Tennent Institute of Ophthalmology in Glasgow. Many have been brought back for follow‐up assessment. Twenty‐seven patients had placoid lesions. 22 geographic lesions and 15 a condition which we propose to rename the 'not ocular histoplasmosis' (NOH) syndrome. Patients with placoid lesions could be divided into typical acute multifocal placoid pigment epitheliopathy (AMPPE), where the long‐term visual prognosis was poor because of recurrent disease leading to extensive areas of atrophy, and acute diffuse placoid pigment epitheliopathy which seemed to be self‐limiting. No consistent evidence of viral or immunological abnormality was found in either group of patients

Geographic lesions appeared to result either from a coalescence of focal lesions or from a slow (serpiginous) spread from a single focus.

Four patients with helicoid atrophy lost central vision from disciform lesions.

Seven patients had pigment epithelial disorder associated with sarcoidosis. The pigment epithelial disease was unresponsive to systemic corticosteroid therapy and tended to be complicated by disciform lesions.

Disciform lesions may occur in any type of pigment epitheliopathy, as may serous retinal detachment or pigment epithelial detachment.

A technique for the biopsy of choroid and retinal pigment epithelium is described. This may lead to a better understanding of these disorders.
TWENTY‐TWO CASES OF CLEAR CORNEA TRABECULECTOMY
Authors: KEILLOR R. B. , MOLTENO A. C. B.
Published: November 2007

The essential feature of clear cornea trabeculectomy is the use of a corneal approach, to create an intrascleral cleft communicating freely with the anterior chamber, without disturbing fenon's tissue and conjunctiva. In this small series the procedure produced diffuse thick walled blebs with normalisation of intraocular pressure without medication in 11 eyes This relatively poor result may be due to lack of the specialised instruments used by Cairns The technique deserves further investigation.
TEN YEARS' EXPERIENCE IN LOW VISION PRACTICE
Authors: BOULTON LESLEY
Published: November 2007

The Low Vision Clinic at the Palmerston North Hospital has now been oerating for 70 years. Over the course of these ten years a number of factors have emerged which can be as readily applied to general ophthalmological practice as to low vision practice. The philosophy of low vision care is one of which all ophthalmologists should be aware and includes factors to be taken into account when dealing with children, people in the workplace, and everyday factors involved in daily living activities, all of which are equally relevant in routine ophthalmological practice. This paper endeavours to share some thoughts on these factors and also discusses means by which the visually handicapped can be helped in areas where specialist low vision services are not readily available.
LOOKING, MOVING AND SEEING
Authors: CRAWFORD B. A.
Published: November 2007

Why are there eye movements? To shift images across the retina There is a system for fast centring of an image on the retina, a system for tracking a slowly moving image. and a vestibular system for main taining the same field of view How is the perception of the visual world rendered stable in the face of all these eye movements and yet the movement of particular objects within the environment is accurately seen?
STRATEGIES FOR THE CONTROL OF TRACHOMA
Authors: TAYLOR HUGH R.
Published: November 2007

Trachoma is still a major cause of blindness in many developing areas. Trachoma can be viewed as a community‐based disease, and treatment or intervening strategies must be aimed at the community level. The more conventional approaches of treatment using either topical or systemic antibiotics do not seem to offer an appropriate cost‐benefit ratio for widespread use. A number of the recent advances in epidemiological field research offer new methods and techniques for studying trachoma. Carefully designed epidemiological field studies can evaluate the role of many different community, family and personal practices and behaviours that could be associated with trachoma. Two recent studies have now shown a clear association between trachoma and infrequent face washing in children. Further studies are in progress to identify ways to alter this behaviour and assess the impact of such an intervention on trachoma. An appropriately designed intervention strategy using a public health approach to alter hygiene practices should have a lasting impact on trachoma at the community level.
SERUM TRYPTOPHAN AND CATARACT
Authors: AUGUSTEYN ROBERT C. , BOYD ANNA , CARROLL NANETTE , MACLEAN HECTOR , MERKREBS JOHN
Published: November 2007

Total serum tryptophan concentrations were measured in 74 cataractous patients and 124 controls No significant diferences were observed in the mean values for the cataractous and normal subjects, 11.4 ± 2.6 and 11.3 ± 2.2 µg/ml respectively, or in the range of values 7.–17.1 and 7.3–17.4 µg/ml respectively These results do not support previous reports that serum tryptophan is elevated in cataractous subjects
VITAMIN E AND RABBIT CORNEAL ENDOTHELIAL CELL SURVIVAL
Authors: Neuwirth‐lux ORA , Billson FRANK
Published: November 2007

In this study, vitamin E (alpha‐tocopherol), a powerful antioxidant, is shown to double the survival time of isolated perfused rabbit corneal endothelium. The results are discussed and evidence concerning vitamin E in ocular tissue function is reviewed.
THE IDENTIFICATION OF DIFFERENT VASCULAR CELLS ON THE CORNEAL ENDOTHELIUM BY SPECULAR MICROSCOPY I. RED BLOOD CELLS AND CORNEAL ENDOTHELIAL CHANGES IN HYPHAEMA SECONDARY TO CONTUSION INJURY
Authors: BROOKS ANNE M. V. , GRANT GLENYS , GILLIES W.E.
Published: November 2007

In order to differentiate clearly red blood cells and their relationship to the corneal endothelium, specular microscopy was performed in patients with hyphaema due to contusion injury. This enabled the clear identification of red blood cells as rounded, umbilicated or flattened spheroidal structures depending on whether they were seen side on or end on. They were seen best in the relief mode lying on the posterior endothelial surface and not infiltrating the corneal endothelium. It also disclosed the presence of subendohelial blebs one to three cells in diameter seen at the level of the corneal mosaic and not in the relief mode. These are probably due to mild oedema following the contusion injury and were distinct from the red blood cells. The corneal endothelial cell count and morphology were similar to that in the other eye when the changes resolved a week or so after the injury.
THRESHOLD PERIMETRY AND THE DIAGNOSIS OF GLAUCOMA
Authors: SOMMER ALFRED
Published: November 2007

Visual field examinations are one of the commonest, presumably most sensitive practical indices of optic nerve dysfunction in glaucoma. Given the difficulties in training and retaining good technicians, and presumed vagaries of the Goldmann‐type isopter examination technique, interest has turned to computer‐controlled automated suprathreshold and threshold static perimetry. Despite the enthusiasm for these approaches, we lack rigorous tests of their value, criteria of abnormality and progressive deterioration, and even normal standards. These important issues are now being addressed. In the interim ophthalmologists must be cautious in their use and interpretation.
MANAGEMENT OF DYSTHYROID EYE DISEASE
Authors: FELLS PETER , LAWTON NICHOLAS F. , SHINE BRIAN , McCARRY BERNADETTE
Published: November 2007

Once the diagnosis of thyroid eye disease has been made the doctor's problems begin because the management is long term with a condition that has many ramifications over a period of years. Short‐term heroics to save vision by use of high‐dose systemic steroids, orbital decompression or radiotherapy may have to be followed by control of diplopia by muscle surgery and prisms. Lid retraction, both upper and lower, may merit surgery, and even those patients who have come to terms with their facial appearance may still complain of lacrimation, irritation and grittiness. The advantages of a thyroid clinic, run jointly by a physician and an ophthalmologist, are presented and the patient is helped to live with this distressing condition.
CLINICAL INVESTIGATION OF RETINITIS PIGMENTOSA
Authors: BIRD ALAN C.
Published: November 2007

The diagnostic features and future research directions of retinitis pigmentosa were documented in this update and review of the subject. An extensive and current bibliography is provided.
DOPPLER ULTRASOUND OF ORBITAL VESSELS
Authors: CANNING C. R. , RESTORI M.
Published: November 2007

The techniques of doppler ultrasound have been applied to blood vessels within the orbit. The doppler frequency shifts of ultrasonic pulses scattered from blood cells moving within orbital vessels are a measure of velocities rather than the amount of blood flow. The doppler signal from the ophthalmic artery behind the globe is responsive to changes in ocular blood flow. Blood flow can also be detected at the optic nerve head, and from the coats of the eye adjacent to the nerve head. Flow rate in the ophthalmic artery is reduced following retrobulbar anaesthesia. The source of the pulsatile retrograde flow signal which can be detected in some cases of internal carotid stenosis is located in the region of the ophthalmic artery.
THE USE OF SPECULAR MICROSCOPY TO INVESTIGATE UNUSUAL FINDINGS IN THE CORNEAL ENDOTHELIUM AND ITS ADJACENT STRUCTURES
Authors: BROOKS ANNE M. V. , GRANT GLENYS , FRACO W. E. GILLIES
Published: November 2007

The use of specular microscopy is not confined to the corneal endothelial mosaic, but may be used at any level through the corneal stroma to the posterior endothelial surface. In the stroma the not very dense, irregularly rounded deposits of corneal dystrophies may be differentiated from the dense, geometric shapes of crystalline deposits. At the level of Descemet's membrane the fine parallel lines of tears in Descemet's are distinct from the multiple fine vertical deep stromal lines seen in advanced keratoconus. At the level of the endothelial mosaic the cells may be counted and their morphology examined, while blebs may also be seen in a wide variety of pathological conditions including superficial keratopathies, contact lens wearers, deep keratopathies, anterior uveitis and contusion injury. These blebs vary in size in different conditions and are often transient. They must be distinguished from guttae which are permanent and although an occasional finding in normal corneas are a constant feature of cornea gutatta and Fuchs' dystrophy. On the posterior endothelial surface the relief mode enables the examination of numerous deposits including red blood cells, white blood cells, keratitic precipitates, pigment granules and pseudoexfoliative KP. The morphology of these various findings is discussed.
PSEUDOPHAKIC CYSTOID MACULAR OEDEMA AND ITS TREATMENT WITH LOCAL STEROIDS
Authors: SUCKLING R. D. , MASLIN K. F.
Published: November 2007

The treatment of 26 cases of cystoid macular oedema following cataract extraction is reviewed. Cases treated early and more aggressively with betamethazone drops and subtenons injection of methyl‐prednisolone, responded well to treatment. Those given later and fess aggressive treatment had a less satisfactory outcome. Our results would suggest that local steroids are effective in the treatment of pseudophakic cystoid macular oedema.
THE DIFFUSION OF OPHTHALMIC LASER IN AUSTRALIA*
Authors: HERTZBERG R.
Published: November 2007

This paper demonstrates the diffusion of ophthalmic laser into the Australian health care system. Australian ophthalmologists were quick to adopt the use of laser. Argon laser was introduced three years after its first use in the USA; YAG laser the same year as its use in the USA and Dye laser two years after its introduction in the USA. In the years 1975‐84 there had been a gradual introduction of laser into ophthalmic practice growing from three to 39 in that period. From the end of 1984 to June 1986 the number increased by 68, an increase so sharp as almost to defy the classical S curve. The rapid rise can be attributed to its increased use in diabetic retinopathy, retinal vascular disease, senile macular degeneration, glaucoma and to perforate thickened posterior capsules.
MEASUREMENT OF CHOROIDAL MELANOMAS: A COMPARISON OF METHODS
Authors: FAVILLA IAN , BARRY WILLIAM , McNEIL JOHN , McKENZIE JOHN , GOSBELL ANDREW , ELLIMS PETER
Published: November 2007

The prognosis for death from metastatic choroidal melanoma following enucleation has been shown to be strongly correlated with a number of risk factors of which the most important are age of onset, aggressive cell types and tumour volume. The advantages of enucleation for the treatment of choroidal melanomas are put into question by the singular lack of a parallel increase in life expectancy following this treatment, and evidence that it may promote the development of metastatic disease. Alternative forms of treatment have been introduced including observation of small and asymptomatic tumours. We are using a computer‐aided system for serial measurement and statistical analysis of area and volume of choroidal melanomas. A comparison of results using our method and the conventional method of estimating volume by the product of basal area and height for 51 measurements on 15 eyes over a 6‐month period showed an overestimate of volume by conventional methods which could be corrected by applying a “shape constant” determined by linear regression. Calculation of tumour growth rates is also shape‐dependent, and a slowing in growth rate or even a reduction in melanoma size is possible.
MICROHOLES OF THE FOVEA CENTRALIS
Authors: CAIRNS JAMES D. , McCOMBE MARK F.
Published: November 2007

Foveal microholes are a possible cause of unilateral or bilateral small central visual defects in the absence of other macular pathology. In 18 eyes of 17 patients we noted the following features: small, dark‐reddish holes in the centre of the fovea ranging from 50 to 750 μm in size; normal adjacent retinal pigment epithelium and neuroepithelium; unilateral in most cases; males and females are equally affected; mean age 40 years; insidious onset; no history of direct eye trauma orsungazing; non‐progressive; relatively favourable visual outcome; no relationship with regular macular holes; aetiology unknown. These distinctive features justify reporting these patients as an important separate group.
IOL PREDICTION: AN EVALUATION OF PREOPERATIVELY DETERMINED INTRAOCULAR LENS POWER ACCURACY
Authors: DOBA C. PRIOR , O'DAY J. , RAMSAY R. J. , STEPHENS R.
Published: November 2007

A retrospective survey of 612 eyes that had undergone cataract extraction and IOL implantation was undertaken to evaluate the accuracy of ultrasound biometry combined with keratometry using the SRK regression formula, for the preoperative prediction of intraocular lens pwoers. A mean error of +0.35 dioptre sphere (DS) (SD±0.98) was found for the series overall, with a significant (P < 0.005) difference between the distribution of postoperative refractive errors using the S.R.K. formula for IOL prediction and the use of a standard lens of 19.5 DS.

The consistency of results was tested for those patients with greater or less than normal axial length. Linear regression analysis showed no correlation between axial length and postoperative refractive error and therefore does not support the adjustment of predicted IOL powers by a factor based on axial length. Statistically significant differences were found between surgeons' results, supporting the practice of A‐constant modification for individual surgeons.