bluuebunny/crossref_metadata_2025 huggingface dataset:
Eclogites from the Chinese continental scientific drilling borehole, their petrology and different P‐T evolutions
Authors: Zhu Yong‐Feng , Massonne Hans‐Joachim , Theye Thomas
Published: November 2007

Abstract  Four phengite‐bearing eclogites, taken from different depths of the Chinese continental scientific drilling (CCSD) borehole in the Sulu ultrahigh pressure terrane, eastern China, were studied with the electron microprobe. The compositional zonations of garnet and omphacite are moderate, whereas phengite compositions generally vary significantly in a single sample from core to rim by decrease of the Si content. Various geothermobarometric methods were applied to constrain the P‐T conditions of these eclogites on the basis of the compositional variability of the above minerals. The constrained P‐T path for sample B218 is characterized by pressure decrease from ca 3.0 GPa (ca 600°C) to 1.3 GPa (ca 550°C). Eclogite B310 yielded P‐T conditions of 3.0 GPa and 750°C. The path for eclogite B1008 starts at about 650°C and 3.6–3.9 GPa (stage I) followed by a pressure decrease to 2.8–3.0 GPa and a significant temperature rise (stages II and IIIa, 750–810°C). Afterwards, this rock cooled down to 620–660°C at still high pressures (2.5–2.7 GPa, stage IIIb). Retrograde conditions were about 670°C and 1.3 GPa (stage IV). Eclogite B1039 yielded a P‐T path starting at ca 600°C and 3.3–3.9 GPa (stage I). A pressure decrease to about 3.0 GPa (stage II, 590–610°C) and then a moderate isobaric temperature increase to ca 630°C (stage III) followed. Stage IV is characterized by temperatures of 650°C at pressures close to 1.3 GPa. During and after this stage (hydrous) fluids partially rich in potassium penetrated the rocks causing minor changes. Relatively high oxygen fugacities led to andradite and magnetite among the newly formed minerals. We think that the above findings can be best explained by mass flow in a subduction channel. Thus, we conclude that the assembly of UHP rocks of the CCSD site, eclogites, quartzofeldspathic rocks, and peridotites, cannot represent a crustal section that was already coherent at UHP conditions as it is the common belief currently. The coherency was attained after significant exhumation of these UHP rocks.
Immunohistochemical expression of apoptosis regulating proteins and sex hormone receptors in meningiomas
Authors: Takei Hidehiro , Buckleair Linda W. , Powell Suzanne Z.
Published: November 2007

Meningiomas are well known to be responsive to estrogen/progesterone stimulation, and their expression of estrogen/progesterone receptor (ER/PR) has been documented. On the other hand, there are several reports studying expression of apoptosis‐regulating proteins (ARPs) and its significance in meningiomas. However, very limited published information exists on the exact relation among sex hormone receptor status, apoptosis, proliferation index (PI), and histological grade in meningiomas. A total of 57 cases of non‐malignant meningiomas were selected, and histologically reviewed and graded (WHO grades 1, 2). All these cases were immunostained for ER, PR, Ki‐67, and ARPs including bax, bcl‐2, and bcl‐xL. Sections were graded semiquantitatively for intensity and extent of immunostaining. PI was expressed as a percentage of Ki‐67 positive tumor cells. Expression of bax, bcl‐2, bcl‐xL, ER, and PR was seen in 100, 35.1, 24.6, 10.4, and 87.2% of cases, respectively. Bax was expressed diffusely and strongly, while Bcl‐2 tended to be expressed weakly and focally. Bcl‐xL appeared to be expressed relatively strongly and diffusely in a small subset. There was significantly higher PI as well as expression of PR in grade 1 group than in grade 2 group. A weak negative correlation was observed between Bcl‐2 and PR (r =−0.472, P < 0.0014). Given high‐level expression of pro‐apoptotic bax, which seems to be constitutionally expressed, in contrast to low‐level expression of antiapoptotic bcl‐2 and bcl‐xL, other antiapoptotic proteins may involve the proliferation of meningiomas. A significant negative relation exists between PR and Bcl‐2 in meningiomas, which might have some biological and clinical significance.
Amplification of the epidermal growth factor receptor gene in glioblastoma: An analysis of the relationship between genotype and phenotype by CISH method
Authors: Miyanaga Tomomi , Hirato Junko , Nakazato Yoichi
Published: November 2007

We examined epidermal growth factor receptor (EGFR) overexpression and EGFR gene amplification using immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH) in 109 glioblastomas, including 98 primary glioblastomas and 11 secondary glioblastomas. EGFR overexpression and EGFR gene amplification were found in 33% and 24% of glioblastoma, respectively, and all of those cases were primary glioblastoma. Large ischemic necrosis was significantly more frequent in primary glioblastomas than in secondary glioblastomas (54% vs. 18%), but pseudopalisading necrosis was not (65% vs. 54%). EGFR gene amplification was detected significantly more frequently in cases with both types of necrosis. Although glioblastomas with EGFR gene amplification invariably exhibited EGFR overexpression at the level of the whole tumor, tumor cells with EGFR gene amplification did not always show EGFR overexpression at the level of individual tumor cells. Cases of “strong” EGFR overexpression on IHC could be regarded as having EGFR gene amplification, and cases without EGFR overexpression could not. Cases of “weak” EGFR overexpression should be tested with CISH to confirm the presence of EGFR gene amplification. We found that 54% of glioblastomas with EGFR gene amplification were composed of areas with and without EGFR gene amplification; however, there were no obvious differences in morphology between tumor cells with and without EGFR gene amplification. Although small cell architecture might be associated with EGFR gene amplification at the level of the whole tumor, it did not always suggest amplification of the EGFR gene at the level of individual tumor cells. In one case, it seemed to suggest that a clone with EGFR gene amplification may arise in pre‐existing tumor tissue and extend into the surrounding area. In cases of overall EGFR amplification, CISH would be a useful tool to decide the tumor border in areas infiltrated by tumor cells.
Automatic Tear‐Delivery Spectacles—Recent Advances*
Authors: Flynn Rev. Frank
Published: November 2007

Summary

This paper describes a device for the treatment of aqueous lacrimal deficiency. Essentially it is a simple, self‐contained, compact, automatic, gravity‐activated mechanism by which a regular, continuous, controllable supply of aqueous tear‐substitute fluid can be delivered to the conjunctival sacs throughout the whole of each working day in a manner compatible with the normal requirements of an active ambulatory patient.
Glaucomatocyclitic Crises
Authors: Lowe Ronald F.
Published: November 2007

Summary

Three cases are reported. A man had his first glaucomatocyclitic crisis at the age of 52 years and none subsequently, to the age of 66 years. A woman had her first glaucomatocyclitic crisis at the age of 31 years, had four further attacks within 18 months that contributed to a total of 9 in 17 years, but none over the last six years, to the age of 54 years. Another woman had 17 attacks over 35 years and retinal venous occlusion in the affected eye at the age of 74 years. Her other eye developed mild chronic glaucoma at the age of 77 years. Vision became very poor from macula degeneration.
SUPRANUCLEAR OCULOMOTOR SYSTEMS: CLINICAL EXAMINATION
Authors: Crawford B. A.
Published: November 2007

A description is given of simple clinical tests of the saccadic, pursuit, vergence and vestibular systems and an interpretation is made of the range of abnormal findings that may be observed.
THE TREATMENT OF BETA IRRADIATION NECROSIS OF THE SCLERA
Authors: Cameron Malcolm E.
Published: November 2007

Although complications after using beta irradiation with pterygium excision are rather rare, they are serious. Methods of dealing with avascularity of the limbal area, and moderate and severe scleral necrosis are presented.
VISUAL HANDICAP IN CHILDREN
Authors: BULL MARGARET , EVANS PETER J. , MACLEAN HECTOR
Published: November 2007

Vision is the primary mode of learning and if it is absent or impaired, other pathways must be stimulated. The range of appropriate servicesavailableto visually handicapped children is explained in relation to the school run by the Royal Victorian Institution for the Blind in Melbourne. A period of residential education may be needed for children with multiple impairment. Those whose handicap is primarily visual can usually live at home and have their education integrated with that of their normal peers. Home‐based services and parent support systems for preschool and kindergarten age children are outlined. To be successful, they require sharing confidential medical and educational information. The school provides a major input to a discussion group of all professionals dealing with such children. Information from the group includes the causes, statistics, and educational implications of visual handicap in Victorian children. The commonest pathologies are macular problems and congenital cataract.
THE INCIDENCE AND THE RESULTS OF ACTIVE TREATMENT OF ACUTE RETROLENTAL FIBROPLASIA
Authors: STARK D. J. , MANNING L. M. , LENTON L.
Published: November 2007

Over a four year period three hundred and thirty‐nine (339) “at risk” premature neonates were examined, and sixty‐five (65) cases of acute R.L.F. (19%) were detected. The overall observed incidence of acute R.L.F. in those surviving babies under 1000 gms birthweight was 47%, in those whose birthweight was 1001–1500 gms the incidence was 22%. The incidence of acute R.L.F., in those babies whose birthweight was greater than 1501 ‐2000 gms was 4.0%. Most of the cases of acute R.L.F. that were detected, occurred in those infants with a birth weight less than 1500 gms. Seventy‐eight per cent (78%) of these cases of acute R.L.F. were mild and resolved spontaneously. Severe cases occurred only in those babies with a very low birthweight (<1100 gms). Active treatment with cryopexy or photocoagulation was undertaken in 15 eyes of 9 infants. Thirteen (13) of the fifteen (15) eyes treated resolved, and there were no blind patients in the series at the end of the study.19%
INTRAOCULAR LENSES: EXPERIENCE AT THE WILMER INSTITUTE
Authors: MD WALTER J. STARK , MD A. EDWARD MAUMENEE , MD WARREN R. FAGADAU , MD LAWRENCE W. HIRST , MD MANUEL B. DATILES
Published: November 2007

Nine hundred and thirty‐eight consecutive primary intraocular lens (IOL) implant cases performed at The Wilmer Institute during the past six years by two surgeons were reviewed. Progressive corneal endothelial cell loss and an increased rate of late‐onset corneal oedema were detected in the group with the Morcher (European) four‐loop iris‐clip Binkhorst IOLs. A higher rate of clinically‐significant cystoid macular oedema developed in eyes with the American‐manufactured four‐loop Binkhorst lens, presumably from chronic iritis caused by contaminants on the IOLs. Our short‐term results with the American‐manufactured Shearing‐type IOLs implanted at the time of extracapsular cataract extraction are encouraging, with 96% of cases achieving 20/40 vision or better, excluding those with known macular degeneration or amblyopia.

Analysis of data submitted to the United States Food and Drug Administration (FDA) indicates, that most of the four classes of intraocular lenses (anterior chamber, pupillary‐supported, iridocapsular. and posterior chamber) are safe and effective at one‐year follow‐up. During the past three years there has been a gradual shift of preference in the type of IOLs being implanted—away from pupillary‐supported and iridocapsular IOLs and, in part, from anterior chamber IOLs, to posterior chamber IOLs. A continued conservative approach to IOL implantation is recommended.
PROGRESS IN CONTINUAL EYE PRESSURE MONITORING
Authors: FRACO R. L. COOPER , BEE G. C. GROSE , BAppSc P. WASSER , FRACO I. J. CONSTABLE
Published: November 2007

Observations of intraocular pressure (IOP) variations in response to CO2, adrenaline, speech and compression of the neck veins were documented by continual monitoring of IOP by radiotelemetry. Carbon dioxide increased IOP in the supine, but not in the erect, conscious subject. Adrenaline 2% caused a rapid short‐lived painful increase in IOP, followed by a profound decrease. This was due to an increase in facility of outflow and was associated with paralysis of the sympathetic supply to the iris. Speech caused a small rise in IOP which was reversed by rest in silence. Compression of the neck veins caused a variable increase in IOP. These physiological variations in IOP may contribute to the errors of tonometry.
CONTUSIONAL EYE INJURIES: RETINAL AND CHOROIDAL LESIONS
Authors: FRCS D. B. ARCHER , MD Y. M. CANAVAN
Published: November 2007

The fundi of 114 patients were evaluated one to 14 years following contusional eye injury. Most injuries to children occurred at sport and play. Domestic and civil assaults, sporting injuries and industrial accidents were common. Males in the second and third decades of life were predominantly affected. Iris tears, pupillary abnormalities and angle recession were typically associated with the fundal lesions. Contusional injuries of the retina and choroid were found in 92 patients and were graded according to their location, extent and severity. Twenty‐six patients (grade 1) had focal or diffuse disturbances of the inner or outer retina. In 15 patients the lesions predominantly affected the receptor‐retinal pigment epithelial layers and in six patients there were associated breaks in Bruch's membrane. Five further patients had atrophic inner retinal alterations and lamellar holes at the macula. Most patients in this group retained good visual function. Thirty‐six patients (grade 2) had single or mutiple choroidal tears. In 21 instances the outer retina was primarily involved; however, in 15 cases there was associated inner retinal damage. Only three patients developed subretinal neovascularisation. Sixteen patients (grade 3) had extensive areas of chorioretinal atrophy associated with retinal pigment epithelial atrophy, proliferation, plaque and membrane formation. Fourteen patients (grade 4) developed retinal holes or tears and 10 proceeded to retinal detachment two weeks to 14 years following injury. Contusional retinal and choroidal lesions have an unfavourable visual prognosis, only 38.6% of patients regaining a visual acuity of 6/12 or better.
RETROSPECTIVE STUDY OF ALKALI BURNS OF THE EYE
Authors: MOON M. E. L. , ROBERTSON I. F.
Published: November 2007

This report examines the epidemiology, management and morbidity of 159 cases of alkali burns of the eye admitted to The Royal Victorian Eye and Ear Hospital from 1972 to 1981. It was intended to use this as a basis for future accurate assessment and management of this problem. Grading of burns on information provided within the histories was according to Hughes' classification as modified by Ballen. Aspects examined were type of alkali, nature of accident, treatment, complications and follow‐up.

Results showed that the majority of burns were grade 1 or 2; only a few grade 1 and slightly more grade 2 burn patients suffered any complications, and none of these resulted in loss of vision. All patients with grade 3 and 4 burns suffered severe complications. It would appear that grade 3 and 4 burns need a more specific and energetic plan of treatment. Lime was the most common agent, and the largest group involved comprised male workers who suffered injuries at work.

On the basis of the findings of the study the following points are raised: (i) a protocol for future study is suggested; (ii) there is a need tor a more discriminate use of EDTA: (iii) do grade 1 burns require hospital admission?; (iv) treatment of grade 3 and 4 burns is still unsatisfactory; (v) the public must be made aware of the existing dangers of alkali burns and their prevention.
A CLINICOPATHOLOGICAL REPORT OF A POSTERIOR CHAMBER LENS IMPLANT
Authors: BRUCE A. CRAWFORD FACS, FRACO  , JOHN M. WEINER
Published: November 2007

This report describes the clinical and pathological findings of a C‐loop posterior chamber intraocular lens 73 days after implantation. The supporting loops of the optic were seated in the iridociliary sulcus for almost 300 degrees of its circumference. Morphological changes included minimal degranulation of the pigmented epithelium adjacent to the loop and moulding of the lens capsular remnant around the loop. There was no erosion into uveal tissue. These findings are discussed with reference to the shape of the haptic element of this lens.
VITREOUS FLUOROPHOTOMETRY IN CHILDREN WITH TYPE I DIABETES MELLITUS
Authors: FRACO ANNE M. V. BROOKS , FRACO C. GREGORY KEITH , FRACP JOHN M. COURT , BSc MICHAEL A. HILL
Published: November 2007

A clinical, biochemical and ocular study was carried out on 17 children with type I diabetes mellitus. Eight had no clinical or angiographic evidence of retinopathy (Stage 0), seven had stage 1, one had stage 2 background retinopathy (Malone's classification) and one had intraretinal microvascular abnormalities. The vitreous fluorescein concentration 3 to 5 mm in front of the macula in those without retinopathy varied from low to abnormally high, while the concentrations in those with retinopathy were above normal. There was no correlation between haemoglobin A1 estimations taken at the time of the study and the vitreous fluorophotometry readings. This variation in fluorophotometry values obtained in diabetics with stage 0 disease differs from the findings in previous reports and may be of prognostic value in determining those patients at risk of developing retinopathy, and may be an indication for improving diabetic control.
A TEN‐YEAR HOSPITAL SURVEY OF EYELID CANCER
Authors: FRACO IAN C. FRANCIS , MB PETER. S. BENECKE , FRACO MEDDUMA. B. KAPPAGODA
Published: November 2007

Two hundred and four cases of malignant eyelid tumours, managed at the Concord Hospital, were reviewed. These cases spanned a ten‐year period between 1973 and 1982 and all were treated surgically. The nature of each tumour was confirmed by histopathological examination. Included in this review were the site of the tumour, the tumour pathology, the surgical management, the type of surgeon involved, the ocular complications, the management of recurrences and any mortality. The importance of preventing recurrences by adequate initial surgery with frozen section control is emphasized.
SURGERY IN THE MANAGEMENT OF ACCOMMODATIVE ESOTROPIA
Authors: FRACO JOHN HORNBROOK , DOBA ANN STEPHENS
Published: November 2007

Thirty‐nine consecutive cases of fully accommodative esotropia and partially accommodative esotropia with residual angle of less than 20Δ, treated by surgical correction between 1959 and 1983, were studied retrospectively. The purpose of surgery was to improve the appearance of the eyes when the spectacles were removed.

Surgery produced an improvement in appearance without spectacles in every case. Consecutive exotropia has not occurred.
POSTERIOR CHAMBER INTRAOCULAR LENSES IN DIABETICS
Authors: KENNEDY J. E. , FRACO A. S. M. LIM , FRACS B. C. ANG
Published: November 2007

Evaluation of posterior chamber intraocular lenses (IOLs) implanted in diabetics, with and without retinopathy, was undertaken as part of a survey of IOLs in Singapore.

Of the 63 eyes, 48 (76%) achieved a visual acuity of 6/12 or better at the latest follow‐up. Excluding eyes with diabetic maculopathy or other pre‐existing disease, 48 out of 51 (94 %) obtained a visual acuity of 6/12 or better.

The only specific problem relating to diabetes was pigment fallout from the posterior layer of the iris. It was not possible in this series to determine the influence of an IOL on the progression of the diabetic retinopathy.

Laser therapy was performed in five patients postoperatively, with no problems.

Recommendations are presented regarding the indications for IOL insertion in diabetics.
CLINICAL SPECULAR MICROSCOPY: THE AUSTRALIAN EXPERIENCE
Authors: MEDOWNICK MARK , ROBERTSON IAN F. , STASIUK RONALD M.
Published: November 2007

It is almost one year since the Corneal Diseases Unit of The Royal Victorian Eye and Ear Hospital began preliminary evaluation of the Pocklington Keeler‐Konan Wide‐Field Specular Microscope. With this instrument, approximately one square millimetre of living human corneal endothelial cells can be observed and photographed. This relatively large area gives a far more valid assessment of endothelial cell morphology and numbers than was possible with narrow field instruments. Reproducible lines enable the relocalization of the same area of endothelium. Observations of endothelial cells have been made in health and disease, including eyes with corneal dystrophy, following cataract surgery with and without intraocular lens implantation, corneal grafting, and after the use of Healon in the anterior chamber.
RETINAL CHANGES IN MYOTONIC DYSTROPHY: A CLINICOMORPHOLOGICAL STUDY
Authors: SARKS J. , LIU H. , KILLINGSWORTH M. , HOROWITZ G. , PENFOLD P. , SARKS S.
Published: November 2007

This report appears to be the first ultrastructural study of the maculopathy and peripheral pigmentary retinopathy in myotonic dystrophy. Nine eyes from five patients observed during life are described. The findings were similar in all eyes, the retinal pigment epithelium in the macular region containing an accumulation of lipofuscin in large hyperpigmented cells. Pigment‐laden cell profiles found in the subpigment epithelial space or subretinal space were interpreted as an attempt to discharge the pigment. Stress fibres of actin microfilaments were thrown into prominence by the irregularity of the pigment epithelium.

In the periphery migration of retinal pigment cells into the retina occasionally resulted in the formation of bone corpuscles around occluded vessels, as occurs in retinitis pigmentosa; but more often the dumps were coarser and surrounded basement membrane material. Central and peripheral epiretinal membranes were also observed.
HEREDITY IN ONE HUNDRED PATIENTS ADMITTED FOR EXCISION OF PTERYGIA
Authors: BOOTH FRANCES
Published: November 2007

One hundred consecutive patients admitted to hospital for excision of pterygia were compared with 100 control patients without pterygia. Of the pterygia group 38% had one or more relatives with pterygia, compared with 8% (? 12%) of the control group. Exposure to solar radiation was considered to be similar in both groups.
DEMODECTIC OPPOSITION IN THE EYELID
Authors: ENGLISH FRANK P. , NUTTING WILLIAM B. , COHN DAVID
Published: November 2007

The normally torpid existence of demodectic mites of the eyelid changes with the onset of oviposition. There occurs a burst of activity characterized by flexion, extension and rotation.
PATHOPHYSIOLOGY AND PHARMACOLOGY OF INTRAOCULAR SURGERY
Authors: MISHIMA SAIICHI , TANISHIMA TERUO , MASUDA KANJIRO
Published: November 2007

Meticulous studies of the pathophysiology of postoperative eyes are mandatory to find the means of reducing the risks of intraocular surgery. Various methods of examination developed for this purpose are described and their clinical significance discussed. The corneal endothelium shows no proliferative capacity even after injury and great care must be taken to protect this vulnerable cell layer. Drugs may be toxic to the corneal endothelium and their use during surgery must be exercized with caution, the intraocular irrigating solutions must contain calcium and have an appropriate salt composition.

Pupillary constriction that occurs during extracapsular cataract extraction is due mainly to prostaglandins synthesized as a result of surgical trauma; this can be prevented by the preoperative use of topical indomethacin. Breakdown of the blood‐aqueous barrier after intraocular surgery may also be due to a similar mechanism, and preoperative topical non‐steroidal anti‐inflammatory agents (indPtyethacin, flurbiprofen and diclofenac) can prevent this phenomenon, as studied by fluorophotometry. Topical indomethacin also prevents cystoid macular oedema after cataract surgery.

Based on the biochemical findings on inflammation after tissue injury, a protocol for the preoperative and postoperative use of corticosteroid and non‐steroidal anti‐inflammatory agents is proposed for anterior segment surgery.
EVALUATION OF NINE HUNDRED AND SIXTY‐SEVEN CONSECUTIVE INTRAOCULAR IMPLANTS
Authors: KENNEDY JOHN E. , FLAHERTY MAREE P. , HUNYOR ALEX B. L. , ROBINSON LYON P.
Published: November 2007

We undertook a survey of all intraocular lenses (lOLs) implanted by two surgeons from 1976 up to the end of 1983. Of the 967 implants, 164 were excluded because of lack of adequate follow‐up. Of the remaining 803 cases there were 104 anterior chamber lenses, 185 iris‐supported lenses, and 514 posterior chamber lenses.

The overall final visual acuity was 6/12 or better in 740 cases (92.2%). Of the remaining 63 cases, 32 had pre‐existing disease or associated conditions not directly related to the operation. By analysing the results within each major group of IOL we found that the posterior chamber lOLs had the best final visual acuity (94.4% 6/12 or better) and fewer postoperative complications. The major problems with iris‐supported lOLs were corneal decompensation and cystoid macular oedema.
KERATOPLASTY FOR PSEUDOPHAKIC KERATOPATHY
Authors: ROBERTSON IAN F. , STASIUK RONALD M. , CAMPBELL WILLIAM G.
Published: November 2007

Penetrating corneal grafts were performed on 15 eyes with keratopathy due to implantation of iris‐supported intraocular lenses, on one eye with keratopathy due to an anterior chamber lens, and one eye with keratopathy due to a posterior chamber lens.

A systematic meticulous surgical technique, with a softened eye, the use of a Flieringa ring, anterior vitrectomy and sodium hyaluronate (Healon) have resulted in clear grafts in all except in four eyes. Although most grafts have remained clear, the visual results are poor mainly due to glaucoma and/or maculopathy.

Every effort was made to retain the implants and some were repositioned and sutured to the iris. Long‐term postoperative follow‐up, with good patient compliance and the judicious use of topical corticosteroids and timolol, is essential to maintain clear grafts.
RELOCATION OF POSTERIOR CORNEAL RINGS IN CLINICAL WIDE FIELD SPECULAR MICROSCOPY
Authors: REINEHR DOUGLAS P. , ROBERTSON IAN F. , STASIUK RONALD M.
Published: November 2007

A clinical study of posterior corneal rings in human eyes was undertaken using the Pocklington (Keeler‐Konan) contact wide field specular microscope designed by Sherrard.

The method used to reproduce identical posterior corneal rings in the same human cornea, in vivo, using the contact wide field specular microscope camera, without the aid of a contact lens, is described. The technique enables the clinician to relocate and evaluate a selected area of human endothelial cells in the same eye.
MALIGNANT MELANOMA OF THE EYELID AND CONJUNCTIVA
Authors: COLLIN J. R. O. , ALLEN L. H. , GARNER A. , HUNGERFORD J. L.
Published: November 2007

Four patients with malignant melanoma of the eyelid skin and 74 patients with conjunctival malignant melanoma are presented Surgery was recommended for eyelid lesions and local excision followed by cryotherapy for conjunctival lesions One patient with an eyelid skin malignant melanoma died and two patients with extensive malignant melanoma of the conjunctiva died Nodular lesions involving the lid margin have the worst prognosis of eyelid skin malignant melanomas, and the greater the extent of conjunctival involvement the worse the prognosis for conjunctival malignant melanomas The complications of cryotherapy are minor, but the follow‐up period in this series is too short to comment on survival times.
HEREDITARY VITELLIFORM MACULAR DYSTROPHY
Authors: GODEL VICTOR , CHAINE GILLIES , REGENBOGEN LUCIAN , LAZAR MOSHE
Published: November 2007

Two families with vitelliform macular dystrophy were investigated ophthalmologically and genetically. The pedigree examination verified the usual expressivity. Macular pigmentary abnormalities or extramacular vitellin deposits were disclosed in some asymptomatic patients.
CANTHAXANTHINE (OROBRONZE) RETINOPATHY
Authors: McGUINNESS R. , BEAUMONT P.
Published: November 2007

A 50‐year‐old white Australian male was found on routine examination to have small golden particles in the macular region of both eyes. A history of canthaxanthine (Orobronze) ingestion to produce skin bronzing was obtained.
CONTUSION INJURIES OF THE OPTIC NERVE
Authors: BROOKS ANNE M. V. , CAIRNS JAMES D.
Published: November 2007

Indirect trauma to the optic nerve with secondary optic atrophy may result from minor trauma and has traditionally been associated with a poor visual prognosis. The case of a 32‐year‐old man who suffered a blow to his left supraorbital region and eyebrow in an automatic closing door is reported to draw attention to the uncommon but trivial nature of this injury which may result in profound visual loss. He suffered an initial inferonasal visual field loss which was related to vascular changes in the optic nerve head. Over the ensuing year there was deterioration in his central vision and visual field due to arachnoiditis.

Current trends in the management of optic nerve contusion injuries are discussed. There is currently a move towards primary medical management with high‐dose corticosteroids as in this case; surgery is reserved for those patients who fail to respond to steroids or deteriorate as the steroid dose is reduced.
OPTIC NERVE HYPOPLASIA: CHANGING PERSPECTIVES
Authors: HOYT CREIG S. , BILLSON FRANK A.
Published: November 2007

Optic nerve hypoplasia, having once been regarded as exceedingly rare, is now regarded as one of the major causes of visual loss in infancy. Recognition of subtle forms and segmental forms of optic nerve hypoplasia are important in explaining the evaluation of subnormal vision. and have an added significance in the recognised associations of central nervous system anomalies including abnormalities of the endocrine system. These changing clinical perspectives are reviewed, together with a discussion of the pathogenesis of optic nerve hypoplasia in the light of cell death and nerve fibre degeneration seen in normal development of the neural visual system.
MANAGEMENT OF UNCONTROLLED GLAUCOMA WITH THE MOLTENO SYSTEM
Authors: GOLDBERG IVAN
Published: November 2007

In glaucomatous eyes refractory to medication, laser techniques and conventional drainage surgery, intraocular pressure is often high, and visual loss rapid. In this situation a reliable, robust artificial outflow system is required. Molteno has evolved a plastic tube and plate device combined with a fibrosis suppression medication regimen. Thirty‐eight eyes of 32 patients with uncontrolled glaucoma were treated with the Molteno system. Six months after operation mean intraocular pressure had been reduced from 41.0 ± 13.6 to 16.2 ± 5.6 mmHg. Eighteen eyes had pressures of 20 mmHg or less on no hypotensive therapy, 17 on reduced treatment. Three eyes had a pressure of 21 to 35 mmHg on treatment at six months. The 13 aphakic eyes responded as well as 25 phakic eyes. Five eyes with rubeotic glaucoma demonstrated pressures of less than 20 mmHg without therapy, four eyes with traumatic glaucoma required continuing medication with three having pressures below 22 mmHg. Of the seven eyes with uveitic glaucoma, one was lost, two required maintenance therapy; five of six surviving eyes had pressures below 20 mmHg. Fifteen eyes with congenital or juvenile glaucoma achieved pressures below 20 mmHg, three of these with timolol drops, three with timolol and acetazolamide, and nine with no treatment. While seven of seven eyes with refractory primary open‐angle glaucoma attained pressures below 20 mmHg. all seven needed continuing mild hypotensive therapy. Eleven eyes underwent a one‐stage procedure, while 27 eyes required a two‐stage operation. Twenty‐eight eyes received fibrosis suppression medication after the second stage, and 24 maintained or improved their preoperative visual acuity.

Results have been encouraging: in general the Molteno system is recommended as the second drainage operation in all glaucomatous eyes in which conventional therapy has failed, and as the primary surgical procedure (after laser techniques) in eyes with rubeotic and uveitic glaucoma. Ciliary body destructive procedures should be restricted to control of symptoms in blind eyes.
THERAPEUTIC RESPONSE INTERACTIONS BETWEEN TIMOLOL MALEATE AND DIPIVEFRIN HYDROCHLORIDE
Authors: WEST ROBERT H. , GILLIES W. E. , BROOKS A. M. V.
Published: November 2007

Twenty‐one patients on long‐term treatment with topical timolol maleate and dipivefrin hydrochloride were studied to assess the effect of each agent when used m combined therapy The two agents are partially additive in most patients, but the relative contribution of each agent varies widely in individual patients and in separate diagnostic categories
OCULAR TOXOCARA CANIS INFECTIONS: DIAGNOSIS BY ENZYME IMMUNOASSAY
Authors: CLEMETT R. S. , WILLIAMSON H. J. E. , HlDAJAT R. R. , ALLARDYCE R. A. , STEWART A. C.
Published: November 2007

An enzyme‐linked immunoassay (ELISA) was used to establish the sero‐prevalence of Toxocara canis infection in several New Zealand populations including those who, through environment or occupation. had close contact with dogs. The prevalence of positive ELlSA values found reflected the degree of dog contact, e.g. positive ELISA'S occurred in 2.8% of urban adults, 13.9% of dog breeders and 28.4% of hydatid control officers emphasizing that a history of dog contact needs to be considered when ELISA results are interpreted in a clinical context. Ophthalmoscopy of 702 hydatid officers, 28.4% of whom were seropositive. disclosed no evidence of ocular toxocariasis and suggested that the officers might be immunoprotected. Preliminary immunoblot analysis of the range of toxocara excretory/secretory antigens bound to serum immunoglobulin from patients with presumed visceral larva migrans and ocular toxocariasis, showed the same reactivity profile as a positive reference serum and serum from a seroresponsive hydatid control officer.
ASSISTED LOCAL ANAESTHESIA FOR CATARACT SURGERY (ALACS)
Authors: FRANCIS IAN C. , STEVE SCHU R. MACHER , AYLEN MARGARET J. H.
Published: November 2007

This paper describes an assisted local anaesthetic technique which we have used almost exclusively for extracapsular cataract extraction and posterior chamber intraocular lens implant surgery over the last 12 months. This ALACS technique was developed from a combined neurolept‐local anaesthetic into an assisted local anaesthetic suitable for day‐stay cataract surgery. The technique combines the advantages of purely local (retrobulbar and facial) anaesthesia with the advantages usually inherent in a good general anaesthetic. Thus the patient is in a state of general quiescence and psychic indifference throughout the procedure. ALACS provides excellent and long‐lasting akinesia and analgesia, with adequate proptosis of the eye which facilitates surgical access. ALACS is suitable for almost all adult cataract and implant surgery. Our results in 704 cases of ALACS are reviewed in terms of visual results and complications both ocular and anaesthetic; the results appear good and the complications minimal. The results of blood gas estimations done intraoperatively in a small number of patients are also presented, and suggest that the technique is systemically safe.
BOTULINUM TOXIN IN OPHTHALMOLOGY
Authors: DUNLOP D. , PITTAR G. , DUNLOP C.
Published: November 2007

Alan B. Scott selected, researched and developed Type A Botulinum toxin for clinical use in ophthalmology. This unique drug has proved invaluable for treatment of a number of conditions which are difficult to treat in ophthalmology and in a variety of other disciplines. The indications, methods and problems of its use are described and the results of treatment of 133 patients are discussed. Up to December 1986 over 13 000 patients have been treated in a multicentre international trial without significant complications.
OCULAR ABNORMALITIES IN DEAF CHILDREN: A DISCUSSION OF DEAFNESS AND RETINAL PIGMENT CHANGES
Authors: NICOLL A. M. , HOUSE P.
Published: November 2007

In a survey of 78 hearing impaired children, 33% were found to have ocular abnormalities. The abnormalities were relatively minor, the most frequent being altered retinal pigmentation. Although congenital rubella infection was the most common cause of this finding the cause in others was more obscure. Possible causes for hearing loss associated with retinal pigment and other tissue changes are abnormal cilia, abnormalities in cells with similar embryological origins and genetic defects affecting pigmentation.
AMAUROSIS FUGAX: THE IMPORTANCE OF CAROTID PLAQUE MORPHOLOGY
Authors: LANGSFELD MARK , LUSBY ROBERT J.
Published: November 2007

Amaurosis fugax, or transient monocular blindness, was first associated with carotid bifurcation disease in 1951. Although amaurosis fugax is often considered by vascular surgeons to be premonitory for cerebral stroke, recent studies indicate that this disease process may be more benign than previously thought.

A total of 97 patients presented with amaurosis fugax to our vascular laboratory from November 1983 to January 1988. There were 81 males and 16 females, mean age 67.2 years. The common, internal and external carotid arteries were imaged in standard longitudinal and cross‐sectional views. Repeat scans were performed at six months and 12 months after the first visit, then yearly thereafter.

Out study confirms the correlation between heterogeneous, complex carotid plaques and the development of amaurosis fugax. Endarterectomy can safely be performed in this group of patients, preventing further symptoms or development of stroke. We advocate duplex scanning to assess the carotid bifurcation and allow non‐invasive follow‐up of disease progression.
SPONTANEOUS ONSET OF CILIARY BLOCK GLAUCOMA IN ACUTE HYDROPS IN DOWN'S SYNDROME
Authors: McCLELLAN KATHLEEN A. , BILLSON FRANK A.
Published: November 2007

A flat anterior chamber and raised intraocular pressure are unusual complications of acute hydrops. We report a case in which a patient with Down's Syndrome developed a flat anterior chamber, together with raised intraocular pressure, several weeks after the onset of acute hydrops.
ARGON LASER TRABECULOPLASTY FIVE YEARS ON
Authors: BROOKS ANNE M. V. , WEST R. H. , GILLIES W. E.
Published: November 2007

The results of argon laser trabeculoplasty (ALT) in a series of 252 patients are presented with follow‐up of up to five years. The procedure is effective in chronic open‐angle glaucoma (COAG), ocular hypertension and pseudoexfoliative (PXF) glaucoma. Most cases were treated initially over 180° of the angle and repeat treatment of the remaining 180° usually resulted in an additional fall in IOP which was maintained at two, three and four year follow‐up with only a small number of these retreated cases having no fall on later follow‐up. ALT was not very effective in further lowering IOP in eyes with IOP controlled to a low level before treatment or in low tension glaucoma. It was effective in most of a number of miscellaneous glaucomas including pigmentary glaucoma. Apart from the immediate high rise in IOP the main complication was a late high rise in IOP which was serious in degree and appeared mainly in PXF but also in two cases of ocular hypertension. The presence of a concomitant fall in IOP in the fellow untreated eye is important and probably due to better compliance with treatment. Almost all cases required medical treatment for glaucoma which could not be ceased after ALT. ALT should be seen as an adjunct to, but not a substitute for, medical treatment.
Ida Mann—her wartime career, 1939–1949
Authors: FRACO Dorothy Potter
Published: November 2007

Ida Mann's wartime accomplishments were most remarkable. Besides her Harley Street practice and her senior appointment at Moorfields (The Royal London Ophthalmic Hospital), she prevented its closure to ophthalmic patients and chaired the Hospital Management Committee; she investigated the pathology of mustard gas keratitis and formed a Chemical Defence Research Team to study ocular effects of warfare chemicals; she was appointed Margaret Ogilvie Reader in Ophthalmology and senior surgeon to the Oxford Eye Hospital; she established the Nuffield Research Laboratory and was awarded a personal professorship, the first in ophthalmology in Britain, the first professorship given to a woman and the only one in ophthalmology by the University of Oxford. Late in the war she married a cancer research pathologist in whose laboratory she cultured a malignant tumour of the lens. Furthermore, she produced a vast number of outstanding research papers, most notably the authoritative monograph on chemical injury to the anterior segment of the eye.
Management and visual acuity results of monocular congenital cataracts and persistent hyperplastic primary vitreous
Authors: Scott William E. , Drummond Garry T. , Keech Ronald V. , Karr Daniel J.
Published: November 2007

Sixty‐two patients, 48 with a diagnosis of persistent hyperplastic primary vitreous (PHPV) and 14 with monocular congenital cataract (MCC) are reported. Nineteen patients with a diagnosis of PHPV and all patients with MCC received surgery with attempted visual rehabilitation.

Early age of surgery, prompt optical correction with contact lens and aggressive patching therapy are required for successful visual rehabilitation. Glaucoma, retinal or optic nerve pathology, surgery later than three months of age or combinations of these factors were associated with poor prognosis. Isolated microphthalmos was not correlated with poor prognosis.

Binocular fixation pattern was used to monitor patching therapy. Optokinetic nystagmus, visual evoked potentials or forced preferential looking were not employed.

Of the 33 patients who underwent surgery, 10 (30%) achieved good (> 20/50) visual acuity, 8 (24%) achieved fair (20/60 to 20/100) and 15 (46%) achieved poor vision.

In selected patients with the diagnosis of PHPV or MCC, visual rehabilitation can be achieved.
A new method for continuous intraocular drug delivery
Authors: Ben‐Nun Joshua , Cooper Richard L. , Cringle Stephen J. , Constable Ian J.
Published: November 2007

A novel device for the continuous intraocular delivery of drugs is described. The active intraocular component of the device is made from hollow haemodialysis fibres. During operation, the drug to be administered diffuses from a small extraocular reservoir to the intraocular fibres, where it passes through the semipermeable walls and into the vitreous body. The delivery of gentamicin by the device into the vitreous body of the cat is compared with direct intraocular injection techniques. Characteristics of the process of drug delivery were influenced by the geometry and design of the device. A reservoir concentration of 10 g/L gentamicin sulphate in a device with four fibres, each 5 mm long, resulted in stable vitreal gentamicin levels of 104 to 128 mg/L at 10 hours. Intravitreal injection of 0.1 ml of a 10 g/L solution of gentamicin caused localised peaks of intravitreal gentamicin concentration in the range 1180 to 3296 mg/L, before falling to 356 to 665 mg/L at 10 hours. The device provides the opportunity of a more controlled and continuous drug delivery, thus avoiding the high localised concentrations that may occur with direct injection techniques in which the required dose is delivered as a bolus. Refinement of a device of this type may result in a clinically useful method of intraocular drug delivery for drugs which present a risk of localised retinal toxicity or require repetitive administration with conventional intraocular injection techniques.
Retinopathy of prematurity: Screening and optimal use of the ophthalmologist's time
Authors: Darlow B. A. , Clemett R. S.
Published: November 2007

In recent years it has been standard practice to recommend that indirect ophthalmoscopy be carried out between six and nine weeks of age in very low birthweight infants to screen for the presence of retinopathy of prematurity (ROP). Following this recommendation we examined 85 infants over a two‐year period. Acute ROP occurred in 29 (34%), and two (2.4%) developed cicatricial disease. One‐third of infants were initially examined slightly earlier or later than the strict six to nine week limits, but all except three infants were examined between 35 and 42 weeks gestation. One infant born at 26 weeks gestation, was examined ‘too late’ in that she had stage 4 disease when first seen at 11 weeks of age. Recent information on the natural history of ROP, and confirmation of the efficacy of treatment with cryotherapy, suggested that the timing of an initial screening examination for ROP needed reassessment. From our experience and a review of the literature we recommend that infants of less than 1000 g birthweight or less than 28 weeks gestation have an initial examination at six weeks of age; for infants of 1000 to 1250 g birthweight or 28 to 30 weeks gestation examination continue to be at six to nine weeks of age; and for infants of more than 1250 g birthweight or 31 weeks gestation screening at six to nine weeks of age is only necessary if the infant has had an unstable course or prolonged oxygen requirements. Such a protocol would not place too great a burden on ophthalmological services and would direct efforts towards the group of infants most at risk of severe visual handicap.
Single‐injection peribulbar local anaesthesia —A study of fifty consecutive cases
Authors: Apel Andrew , Woodward Robyn
Published: November 2007

Peribulbar anaesthesia is becoming an increasingly popular alternative to retrobulbar anaesthesia for local anaesthesia in intraocular surgery.

The results of 50 consecutive single‐injection peribulbar anaesthetics performed by the same surgeon are reported. A description of the procedure is included. The technique produced adequate conditions for surgery in all cases. Only 4% (two cases) were considered to have inadequate akinesia five minutes after the injection and required additional injections. None of the complications described with retrobulbar and other forms of peribulbar anaesthesia were observed.

The procedure is relatively easy to master. It can be performed by surgeons or anaesthetists and can be used in the in‐patient or day surgery setting. The study shows it to be a safe and reliable alternative to previously described methods of local anaesthesia.
An unusual ciliary body tumour: a haemangioblastoma
Authors: Jefferies Peter , Clemett Richard
Published: November 2007

A 23‐year‐old woman who presented with blurred vision in her right eye from increasing astigmatism had a vascular ciliary body tumour. After slow growth was documented over a 15‐month period the tumour was excised with an iridocyclectomy. Microscopically the tumour consisted of sheets of large polygonal cells with round nuclei and foamy cytoplasm, separated by numerous capillaries, findings consistent with a diagnosis of a haemangioblastoma. Haemangioblastomas occur in the retina in von Hippel's disease and this occurrence in the ciliary body is a rare event. Investigation of the patient with a CT of the head and an abdominal ultrasound revealed no systemic lesions suggestive of systemic angiomatosis or von Hippel‐Lindau disease.
A quantitative scale for the Barrett keratoscope
Authors: Lindsay P A , Morlet N
Published: November 2007

By allowing the surgeon to measure and modify corneal curvature during wound closure, intraoperative keratometry can reduce postoperative astigmatic errors. A number of keratometric devices have been developed over the last 10 years, each offering a compromise between cost, accuracy and ease of use. The Barrett keratoscope is a simple, inexpensive hand‐held device which gives a qualitative indication of the degree of astigmatism. Addition of a transparent overlay, as described in this paper, sets the distance at which the keratoscope is held and allows the magnitude of the astigmatism to be determined, thereby enabling refined adjustment of the suture tension during wound closure. We describe the error in estimation of astigmatism due to the effect of the distance at which the keratoscope is held from the cornea.