bluuebunny/crossref_metadata_2025 huggingface dataset:
Matrix models using fine size classes and their application to the population dynamics of tree species: Bayesian non‐parametric estimation
Authors: SHIMATANI ICHIRO K. , KUBOTA YASUHIRO , ARAKI KIWAKO , AIKAWA SHIN‐ICHI , MANABE TOHRU
Published: November 2007

Matrix models have been widely used to investigate the population dynamics of plant species. To make use of this method, we first divide individuals into groups and estimate transition probabilities per pair of groups. When a continuous variable, such as plant size, is used for grouping, there is often a trade‐off: if the class intervals are narrow each group will only include a small number of samples, but if the intervals are wider, this may obscure some changes. This paper introduces a new matrix model in which we no longer have to divide individuals into arbitrarily defined size classes. The methodology is based on the Bayesian non‐parametric binary regression. We first divide the data into ‘very fine’ intervals. For estimating transition probabilities in a ‘large’ matrix, we do not use the observed transition rate per class directly, but we smooth neighboring observed rates and select the most appropriate degree of smoothing using an information criterion called the Akaike Bayesian Information Criterion (ABIC). Our approach is illustrated using long‐term forest monitoring data from an old‐growth, warm‐temperate evergreen forest, in which we examined the population dynamics of four evergreen subcanopy tree species. Transition probabilities allowed us to represent d.b.h.‐related growth and mortality patterns graphically, and matrix analysis provided stable size distributions, reproductive values and elasticity that vary smoothly for trees of different sizes. The quantitative approach makes it possible to determine characteristic patterns of population dynamics for qualitatively similar species.
Basic seed germination characteristics of the endemic species Nepeta rtanjensis (Lamiaceae)
Authors: TODOROVIĆ SLAÐANA , ŽIVKOVIĆ SUZANA , GIBA ZLATKO , GRUBIŠIĆ DRAGOLJUB , MIŠIĆ DANIJELA
Published: November 2007

Nepeta rtanjensis is an endemic plant species that was first recorded in 1974 in the eastern part of Serbia. Because of the small number of discovered specimens and low seed viability, it has been difficult to determine the seed germination characteristics of this species. Using in vitro culture techniques, we obtained sufficient plants for successful reintroduction. In the first year approximately 500 000 seeds were collected and subjected to various seed germination tests. The seeds were positive photoblastic and germination was under the control of the phytochrome pigment system. The requirement for light could be substituted by gibberellins. The seeds were nitrate insensitive, but responded to treatment with liquid smoke.
Common Errors in the Use of the Operating Microscope*
Authors: Ming Lim Siew , Yew Khoo Chong , Chong Ang Beng
Published: November 2007

Summary

The operating microscope enables accurate surgery with minimal surgical trauma and the prevention of complications due to poor wound closure.

Despite these advantages, only 30% of ophthalmic surgeons in developed countries are using the operating microscope. The main reason is adjustment difficulty. Three common errors associated with this are: first, high magnification; second, changing techniques; third, lack of practice. Based on these common errors, three main principles in the use of the operating microscopes are recommended as guidelines for surgeons who are adjusting to the operating microscope.

Ophthalmic surgery under the microscope improves the quality of conventional anterior segment surgery and should be available to all ophthalmic surgeons. To achieve this, microscopes and microinstruments should be kept simple and inexpensive.
MICROSURGERY OF CHOROIDAL MELANOMA—SURGICAL TECHNIQUES OF LOCAL EXCISION
Authors: FRACO FRANK A. BILLSON
Published: November 2007

Six cases of malignant choroidal melanoma were treated by microsurgical excision under hypotensive anaesthesia with follow‐up periods varying from four months to four years. This paper presents the case for local excision of malignant choroidal melanoma in the light of the current controversy surrounding the management and natural history of choroidal melanoma. The indications for surgery, techniques, and results are described. Vision was preserved best in tumours with diameters of less than 10mm. No deaths and no evidence of extraocular recurrence occurred.
OPHTHALMIC FINDINGS AMONG ONE THOUSAND INHABITANTS OF RAROTONGA, COOK ISLANDS
Authors: HERIOT W. J. , CROCK G. W. , TAYLOR R. , ZIMMET P.
Published: November 2007

A survey of 986 Polynesians was conducted in Rarotonga, Cook Islands, for the complications of diabetes. The ophthalmologists in the team made a general assessment of eye health. Trauma was a major cause of blindness. Diabetic retinopathy, trachoma, cataract and macular degeneration were not common findings.

The initial criteria of nuclear cataract were pigmentation or opacification with loss of fetal suture detail. This was invalidated by the finding in young adults of enhanced pigmentation without any visual handicap. This finding supports current concepts of cataractogenesis. Pigmentation may augment the intrinsic filter of near ultraviolet light.

Of the 118 people with chorioretinal scars, 25 shared features with cases reported from the Pacific region attributed to filariasis. The majority, however, were typical of toxoplasmosis.

Cases of pseudoexfoliation were rare. This is surprising in view of the high prevalence reported among Australian Aborigines at a comparable latitude.
PHACOEMULSIFICATION OF CATARACT WITH POSTERIOR CHAMBER LENS IMPLANTATION AND OPERATIVE POSTERIOR CAPSULOTOMY
Authors: FRACO J. PETERS
Published: November 2007

An initial series of 500 eyes with cataract was managed with phacoemulsification and posterior chamber lens implantation, with operative capsulotomy. The operative technique, complications and visual results are presented. Complications reported with other lens implant techniques are discussed and reviewed. It was found that the complication rate associated with this technique was lower than that associated with routine intracapsular surgery, and that visual rehabilitation was far superior. Key words: phacoemulsification, posterior chamber lens implantation, A‐scan.
EXPERIENCE WITH DIPIVALYL EPINEPHRINE: ITS EFFECTIVENESS, ALONE OR IN COMBINATION, AND ITS SIDE EFFECTS
Authors: CEBON L. , WEST R. H. , GILLIES W. E.
Published: November 2007

Dipivalyl epinephrine was as effective as adrenaline as an eyedrop for glaucoma. It was responsible for fewer side effects, though side effects did occur. It had an additive effect when used with timolol maleate and. in 12 of 14 patients on long‐term medication with both drugs, a rise of pressure of 3 mmHg or more occurred when dipivalyl epinephrine was stopped. As sole therapy dipivalyl epinephrine was effective in chronic simple open‐angle glaucoma, ocular hypertension and pseudoexfoliative glaucoma, and may be useful on its own in the latter two conditions. In low‐tension glaucoma it seemed the best therapy when combined with timolol. Headache and ocular pain were uncommon but prominent side effects.
LASER TRABECULOPLASTY: EARLY EXPERIENCE WITH A NEW PROCEDURE
Authors: FRACO RALPH A. HIGGINS
Published: November 2007

Twenty‐live laser trabeculoplasty procedures were performed on 20 patients. All patients were treated as inpatients so that early changes in intraocular pressure could be monitored. The range of fall was recorded: in four cases there was a significant rise in intraocular pressure in the first four hours which, if sustained, could have lead to a further visual field loss in patients with advanced chronic simple open‐angle glaucoma. Patients with a high initial intraocular pressure had the greatest fall in intraocular pressure. Those patients with a more pigmented trabecular meshwork with wide open angles were the easiest to treat and gave the best signs of effective laser endpoint reaction. Gonioplasty was performed in many patients with narrow angles, which gave much better access to the posterior trabecular meshwork.
DIABETIC RETINOPATHY IN A NATURAL POPULATION
Authors: MB W. J. HERIOT , FRACO J. P. BORGER , FRACP P. ZIMMET , MBBS H. KING , MRCP R. TAYLOR , RAPER L R.
Published: November 2007

Most epidemiological studies of diabetic retinopathy have been based on clinic populations. This produces a bias for the more severe cases and later stages of the disease. To avoid this bias, 1567 Micronesian adults of Nauru (82% of total adult population) were examined. Diabetic retinopathy was classified by both the World Health Organization (WHO) criteria and the Airlie House reference photographs. Results were subject to multiple logistic regression model analysis.

Diabetic retinopathy was present in 7% of the general population and in 24% of diabetics. Of the signs, microaneurysms and microhaemorrhages were the most important, being present alone in 19.5%; and in 68.1% when associated with exudates. Proliferative retinopathy was present in 4.5% of cases. Exudates alone were found in two cases (2.2%). Duration of diabetes was the strongest predictor variable and increasing two‐hour plasma glucose levels significantly increased the risk of developing retinopathy.
EPIDEMIC KERATOCONJUNCTIVITIS
Authors: MB JAMES‐ROCHE
Published: November 2007

An outbreak of epidemic keratoconjunctivitis (EKC) in a rural area is described. It was characterised by its explosive outbreak, relatively short duration and high infectivity. The aetiology is discussed.
SUPERIOR OBLIQUE TUCK FOR SUPERIOR OBLIQUE PALSY
Authors: MD EUGENE M. HELVESTON , MD FORREST D. ELLIS
Published: November 2007

Fifty‐nine patients with a superior oblique palsy had a superior oblique tuck as part of their surgical treatment. The average size of the tuck was 12.0 mm. All cases had a decrease in the hyperdeviation in the primary position and some decrease in elevation in adduction in the operated eye (Brown's syndrome). Seventeen per cent of the patients required take‐down of the tuck three to 24 months after surgery (average time for reoperation, 9.1 months). Symptoms forming indications for take‐down of the tuck were head tilt, vertical diplopia, torsional diplopia, and a tight feeling on elevation in adduction. No patient who had a tuck alone required take‐down. Brown's syndrome was more likely to occur in cases with weakening of the antagonist inferior oblique and when a bilateral tuck of the superior oblique had been done. Taking down of the tucked tendon relieved the symptoms of Brown's syndrome in seven of 10 patients, without a recurrence of superior oblique underaction. After superior oblique tuck in all patients, a residual vertical deviation could be measured and in nearly every case a Brown's syndrome could be found.
THE OPHTHALMOLOGICAL SIGNIFICANCE OF THE BASAL CELL NAEVUS SYNDROME
Authors: FRACO PETER A. ROGERS
Published: November 2007

Ten cases of the basal cell naevus syndrome (BCNS) are reported. The study is based on clinical findings with no investigations beyond two skull radiographs. The diagnosis is made on some or all of the following findings: family history, jaw cysts, progressive development of basal cell carcinomas (BCCs), pitting of the palms and soles, frontal bossing, abnormality of the skeletal system and ectopic calcification.

Eight of the cases are in one family covering three generations. With the exception of a one‐year‐old child in the third generation (not included) all of this group have the syndrome. The dominant trait is demonstrated, as is the high degree of expressivity and penetrance. Genetic counselling is essential where applicable. Sympathetic regular clinical examination over a lifetime is recommended to avoid disastrous complications.
EVOKED RESPONSES TO DISTINCT AND NEBULOUS STEREOSCOPIC STIMULI
Authors: DUNLOP DONALD B. , DUNLOP PATRICIA DBO (D) , FENELON BERNARD , NEILL ROGER A.
Published: November 2007

When geometric or contoured shapes are generated as disparity regions in dynamic random‐dot stereograms, the question of whether the subject's response is evoked largely by boundaries and corners of the disparate region arises. To examine this question a disparate square was shifted randomly within a focal region at one millisecond intervals, resulting in a nebulous stimulus which “welled up” in the centre of the field of view. The technique may be regarded as an analogue of the defocusing technique used to resolve similar questions about evoked potentials to patterned stimuli.

Average visual evoked potentials (VEP) were recorded from homolateral pairs of occipital and posterior temporal electrodes referred to a common midline prefrontal site. The latencies and amplitudes of VEP to distinct and nebulous stimuli were compared in a group of young normal adults, of whom 14 succeeded in perceiving and 14 failed to perceive the presented stimuli.

Latencies of maximal response to distinct and nebulous stimuli were closely similar in the two groups (range N242‐N252). Mean amplitudes of the peak response differed between perceivers and non‐perceivers. The responses to nebulous stimuli were smaller than those to distinct stimuli in site‐for‐site comparisons in both groups. Even in short averaging runs a substantial VEP (about 3 microvolt) was recorded to nebulous stimuli in the perceiver group.

It is suggested that both disparity and boundary features contribute to the VEP when this particular display system is used.
AN OUTLINE HISTORY OF OPHTHALMOLOGY IN AUSTRALIA
Authors: MD RONALD F. LOWE
Published: November 2007

The first ophthalmologists came to Australia from Great Britain in the early 1860s and founded charitable eye hospitals on the British pattern. For many years, during which Australian States remained colonies of Great Britain, all specialist medical training was obtained overseas. World War II greatly accelerated Australian independence and stimulated Australian technology, science, education, culture and economics. Australian ophthalmologists met the challenge with tight organization, home‐based training, academic responsibilities and research.
ENVIRONMENTAL STANDARDS FOR INTRAOCULAR LENS IMPLANTATION*
Authors: FRACO B. A. CRAWFORD , FRACO D. V. KAUFMAN
Published: November 2007

Successful implantation of prosthetic devices depends upon their freedom from postoperative inflammation and infection. Techniques and lessons learned in orthopaedic and other implant surgery should be applied to intraocular lens implantation. The avoidance of contamination by particles and micro‐organisms is one essential principle of the surgical procedure. Practical steps are described to reduce both types of contamination. These measures taken together are recommended for adoption as a standard of environmental safety for lens implantation.
INTRAOCULAR LENS IMPLANTATION: SHOULD WE ABANDON INTRACAPSULAR SURGERY?
Authors: FRCS HUNG CHENG
Published: November 2007

The most important late complication of a longitudinal study of iris‐supported lens was bullous keratopathy. Endothelial cell loss after using the closed chamber technique for lens insertion was more than halved.

The cell loss rate after intracapsular extraction with a Federov I lens was compared with that after extracapsular extraction with an indocapsular lens. The intermediate results did not show any significant difference between groups and there were eyes in both groups with a large initial loss which appeared to lose cells at a faster rate.
CLINICAL MANAGEMENT IN THE FACE OF THE UVEAL MELANOMA CONTROVERSY
Authors: FRACO A. B. L. HUNYOR
Published: November 2007

The modalities used to diagnose choroidal melanoma are described. The use of these procedures has reduced the misdiagnosis rate from 20% in the 1960s to less than 5% today. Observation and reinvestigation of small tumours is recommended. Surgery may cause dissemination of tumour emboli, which may be prevented by gentle handling of tissue, use of intravenous mannitol and hypotensive anaesthesia. Measures other than enucleation are available to treat choroidal melanoma, but few tumours meet the criteria for their use.
BARDET‐BIEDL SYNDROME
Authors: FRACS C. G. KEITH
Published: November 2007

The Bardet‐Biedl syndrome is characterized by five main features: obesity, Polydactyly, pigmentary retinopathy, mental deficiency and hypogonadism; recently a sixth feature, renal disease, has been described. It was formerly known as the Laurence‐Moon‐Biedl syndrome, but Laurence and Moon described a different entity in which the main feature was paraplegia. Fourteen cases have been seen: all had pigmentary retinopathy which, in most cases, was severe and tended to affect central vision early in life. All had subnormal intelligence, twelve were obese, ten had Polydactyly, eight hypogonadism, and two had renal disease. The condition was thought to be rare, but this may have been due to the failure to diagnose incomplete or partial cases. It is suggested that the prevalence is 1:160 000 of the population.
NEOVASCULAR GLAUCOMA ASSOCIATED WITH OCULAR HYPOPERFUSION SECONDARY TO CAROTID ARTERY DISEASE
Authors: FRACO RALPH A. HIGGINS
Published: November 2007

Three cases of neovascular glaucoma associated with ocular hypoperfusion secondary to carotid artery disease are reported. In two cases, anastomosis of the internal and external carotid artery systems via a superficial temporal artery to the middle cerebral artery (Yasargil procedure) resulted in resolution of the rubeosis, relief of the ocular pain and improvement of the circulation of the globe. The third case, which did not have this procedure, resulted in a blind eye with severe rubeotic glaucoma.
A SIMPLIFIED CRYOTHERAPY TECHNIQUE FOR TRICHIASIS AND DISTICHIASIS
Authors: FRACO M. R. DELANEY , FRACO P. A. ROGERS
Published: November 2007

A simplified cryotherapy technique for the treatment of trichiasis and distichiasis is described. The success rate of aberrant lash ablation with one treatment was 82%; this was increased to 95% with a repeat treatment. There have been minimal long‐term side effects. This paper shows that a simplified time‐based technique without the use of a thermocouple has produced results similar to other series using thermocouple control. A nitrous oxide cryo unit was used in a double freeze‐thaw cycle to treat the area of aberrant lash growth. The times in the double freeze‐thaw cycle found to be effective were 45 seconds freezing with a four‐minute thaw in the first cycle and a repeat freezing cycle of 45 seconds' duration.
SOME ASPECTS OF EARLY‐ONSET ESOTROPIA
Authors: HARCOURT BRIAN
Published: November 2007

Early‐onset estropia comprises a heterogenous group of conditions. It is very important that all the features of the strabismus should be determined from the very earliest stage. Only then can appropriate treatment and an accurate prognosis be given and the outcome of management evaluated adequately. Key words: esotropia, accommodative, V‐pattern, congenital, infantile, small‐angle.
OCULAR RIGIDITY AND INTRAOCULAR PRESSURE IN KERATOCONUS
Authors: BROOKS ANNE M. V. , ROBERTSON IAN F. , MAHONEY ANNE‐MARIE
Published: November 2007

Eighty‐five patients with keratoconus and 20 normal controls were studied. Ocular rigidity, calculated using the Friedenwald nomogram, correlated with corneal thinning (p < 0.001) and area of cone (p = 0.05). Schiøtz pressures with increasing weights fell more than normal in Grades 0 to 3 keratoconus, but returned to normal following corneal grafting, as did ocular rigidity. Goldmann applanation pressures were low over the apex of the cone, varying most in eyes with lowest ocular rigidity and with greatest corneal thinning, but also in large sagging cones which had only minimal corneal thinning. Pressures by Mackay‐Marg tonometry were normal in keratoconus. The axial length of eyes with keratoconus even after corneal grafting was longer than normal and correlated with myopia.

It is concluded that abnormalities of ocular rigidity, Schiøtz and Goldmann pressures in keratoconus are determined by abnormal corneal rigidity. If corneal rigidity is low or corneal thinning is present, Goldmann applanation pressures are falsely low and Mackay‐Marg tonometry more closely approximates the true intraocular pressure. The cone develops by stretching with limited loss of tissue and the lower rigidity and reduced apical stress decrease the likelihood of rupture.
THE USE OF EXTENDED WEAR CONTACT LENSES IN APHAKIA
Authors: SABISTON D. W.
Published: November 2007

Guidelines for the selection and fitting of extended wear contact lenses in aphakia are presented. Important points in the management and the visual results of patients with these lenses are discussed.
VISUAL ACUITY IN THE PRIMARY SCHOOL CHILD AGED FOUR TO TWELVE YEARS: A REVIEW OF AMBLYOPIA TREATMENT IN THIS AGE GROUP AT PRINCESS MARGARET HOSPITAL
Authors: BREMNER MARY H.
Published: November 2007

A survey of the incidence in Western Australia of amblyopia assessed through the school vision screening programme and Princess Margaret Hospital (PMH) eye clinics shows the figure to be 0.12%, being new cases detected in primary school children each year.

Occlusion methods of treatment for amblyopia acceptable in the younger age‐group are much less tolerated by both parents and child in the school‐age group. The PMH series involving 240 children between the ages of four and 12 years showed that an amblyopic eye with macula or paramacula fixation can be successfully treated up to the age of 10 years without constant occlusion. Also, eccentric fixation can be cured up to the 7th birthday, but no alternative has been found for the mandatory constant occlusion.

Medical, developmental and behavioural problems can influence the management and response in the four to twelve‐year‐old child; if these are not recognized and the child treated as a whole during the critical stages of natural development of the visual system, these children can be left with an unnecessary visual disadvantage for the next 70 years of their life.
MASSIVE CHOROIDAL HAEMORRHAGE AS A COMPLICATION OF KRYPTON RED LASER PHOTOCOAGULATION FOR DISCIFORM DEGENERATION
Authors: GOLE G. A.
Published: November 2007

A 78‐year‐old man with perifoveal subretinal neovascularization originally treated with krypton red laser was re‐treated. An attempt was made to produce a “chalky white” burn at the site of the neovascular frond. Immediately after a bum, a brisk choroidal haemorrhage followed, apparently from a ruptured choroidal vessel. Bleeding occurred subretinally and into the vitreous, blinding the patient. While the krypton red laser carries advantages over the argon laser in the treatment of subretinal neovascular fronds, this case indicates that hard burns with the krypton laser carry a risk of massive subretinal haemorrhage.
CLINICAL EXPERIENCE WITH THE OTAGO PHOTOSCREENER
Authors: MOLTENO A. C. B. , SANDERSON G. F. , HOARE‐NAIRNE J.
Published: November 2007

The Otago Photoscreener provides a sensitive indication of whether or not an infant is able to fix and focus binocularly on nearby objects. This instrument was designed for mass screening to identify infants with strabismus and/or amblyopia who do not fix and focus binocularly. This communication reports the authors' experience with the machine in the diagnosis and treatment of strabismus and amblyopia.
CYTOGENESIS IN THE DEVELOPING RETINA OF THE CAT
Authors: RAPAPORT DAVID H. , ROBINSON STEPHEN R. , STONE JONATHAN
Published: November 2007

Cytogenesis in the cat retina was studied using tritiated pH) thymidine autoradiography and nuclear stains. Three zones of cell division were recognized. In the first zone cell cleavage occurs at the outer limiting membrane. The distribution of these mitotic figures is uniform as early as an embryonic age of 29 days (E29) until E50. At about E50 a “cold spot”, made apparent by the absence of mitotic figures, is evident at the site of the developing area centralis. This spreads to encompass the whole retina by postnatal day 10 (P10). A second zone of cell division was recognized by the presence in the developing inner nuclear layer of 3H‐thymidine labelled nuclei which do not migrate to the outer limiting membrane (ventricular surface) to divide. Some of these labelled nuclei are located in regions of the retina where cytogenesis at the ventricular surface has ceased. A third zone was observed in the optic nerve fibre/ganglion cell layers from about E54 until beyond the first postnatal month. This activity gives rise to vascular endothelial cells in the nerve fibre/ganglion cell layers. Once established, the developing vascular cells invade the inner plexiform and inner nuclear layers to form the deeper capillary net.
LASER THERAPY FOR GLAUCOMA
Authors: MISHIMA SAIICHI , KITAZAWA YOSHIAKI , SHIRATO SHIROAKI
Published: November 2007

Three laser techniques for the treatment of glaucoma are described. The short‐burn technique of argon laser iridotomy permitted perforation of the peripheral iris in one session without serious complications, thereby alleviating pupillary block in angle‐closure glaucoma. The rates of successful intraocular pressure (IOP) control and visual acuity loss due to cataract progression were similar in laser iridotomy and surgical iridectomy. The tonographic outflow facility remained unchanged after argon laser iridotomy.

Techniques of argon laser trabeculoplasty (AL TJ to the anterior and posterior aspects of the trabecular band were evaluated. The anterior ALT gave fewer complications, but a lower IOP control rate than the posterior ALT. Posterior ALT over 180° with about 50 burns gave fewer complications than treatment over 360° with about 100 burns, yet the final effects in IOP control were better after the 180° than after the 360° treatment.

Nd‐YAG laser irradiation can separate dysgenetic iris insertion from the trabecular band in developmental glaucoma without serious complications. This Nd‐YAG laser goniotomy may be useful for the treatment of juvenile primary developmental glaucoma.
THE CAT AS A MODEL FOR VISUAL DEPRIVATION
Authors: CLELAND B. G. , CREWTHER S. G. , CREWTHER D. P.
Published: November 2007

Both behavioural and neurophysiological changes can be observed in cats that have experienced interference with their normal visual environment. This visual deprivation may result from alterations to the path of light forming the normal image on the retina, and includes changes that cause the image to fall on an inappropriate part of the retina so that normal binocular interactions are affected. While some neurophysiological changes can be observed at the level of the lateral geniculate nucleus they become more prominent as information reaches the visual cortex, where cells commonly receive neural excitation from both eyes and require the information to come from corresponding parts of the two retinas and that the stimulus should have appropriate orientation and direction of movement. Many of the observations of deprivation in animals have clear parallels in the human environment.
ACUTE ORBITAL MYOSITIS: A CASE REPORT
Authors: LOCKIE PATRICK
Published: November 2007

A case of acute orbital myositis is presented in this report. CT scanning provided an immediate diagnosis and hence institution of treatment. There was a typically rapid response to steroids. A previous presentation, prior to the advent of CT, had been misdiagnosed as Tolosa‐Hunt syndrome.

Orbital pseudotumor can be acute or chronic, and acute orbital myositis is now regarded as one of five subtypes of the former.
OCULAR INVOLVEMENT IN THE ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
Authors: McCLUSKEY P. J. , WAKEFIELD D.
Published: November 2007

The acquired immune deficiency syndrome (AIDS) has reached epidemic proportions in the USA and the incidence of this potentially fatal viral infection is increasing rapidly in Australia. The loss of normal cellular immunity in affected individuals predisposes them to severe opportunistic infections and neoplasms, especially Kaposi's sarcoma. Both of these pathological processes may affect the eye, and ocular involvement with an opportunistic infection or malignancy may be the first clue to the presence of AIDS. We present here the first Australian report of a patient with AIDS presenting with ocular involvement. The case is discussed in relation to current concepts of AIDS.
OPHTHALMOLOGY IN AFRICA
Authors: BOLLIGER PETER A.
Published: November 2007

Problems of prevention and treatment of blindness in Africa are discussed with particular reference to Tanzania. Cataract accounts for fully half this blindness, and present measures to treat it are totally inadequate.

The relationship between measles and vitamin A deficiency is discussed. Measles with its attendant corneal destruction accounts for most blindness in children.

Blinding trachoma is seen as a community disease needing a community approach to factors such as waste disposal, water supply and cyclic reinfection.

Primary eye care is seen as the key, through education at village level, to prevention and treatment of blindness. Training of village health workers is the essential first step.
Abstracts from the Publications of the Late Sir Norman McAlister Gregg
Authors: HERTZBERG R.
Published: November 2007

This paper contains Abstracts from publications of the late Sir Norman McAlister Gregg, published in 1941 and 1944, in which he demonstrated the association between rubella in pregnancy and defects in the baby. Besides cataract and retinopathy with which ophthalmologists are familiar, there occur deafness, deafmutism, cardiac defects, mental retardation, pulmonary and renal abnormalities and diabetes.
PIGMENTARY GLAUCOMA: A CLINICAL REVIEW OF ANTERIOR SEGMENT PIGMENT DISPERSAL SYNDROME
Authors: GILLIES W. E.
Published: November 2007

Sixty‐eight cases (44 males, 24 females) of anterior segment pigment dispersal syndrome are reviewed. Five patients had no rise in intraocular pressure, 38 had ocular hypertension and 25 had glaucoma as shown by optic disc cupping and field loss. All cases had heavy deposition of pigment in the drainage angle together with Krukenberg spindles and/or light reflux through the iris. Other evidence of anterior segment pigment dispersal was common. The condition was commonest in young adult males, but could present at any age and in women. Medical treatment was often successful initially, but continued to control pressure in only 17 of 42 patients.

Laser trabeculoplasty helped some patients. Drainage operations of various types were successful in 19 of 23 cases. Iris angiography showed evidence of vascular hypoperfusion of the iris which probably precedes pigment dispersal and suggests that the ultimate aetiology may be a congenital deficiency of the mesodermal support tissues of the iris. Some degree of iris stromal atrophy is also common and may become marked. Pigment dispersal from the pigment epithelium of the iris occurs in susceptible individuals and may be associated with the insertion of the dilator muscle. The term anterior segment pigment dispersal seems appropriate as the condition is limited to the anterior segment.
TRUE EXFOLIATION OF THE LENS CAPSULE. A CLINICOPATHOLOGICAL REPORT
Authors: ANDERSON I. L. , BOCKXMEER F. M. VAN
Published: November 2007

A case of true senile exfoliation of the lens capsule is reported. Electron microscopic examination of the capsule confirmed capsular delamination. The proteins in the remaining sample of exfoliated capsule and in normal capsules were analysed by polyacrylamide gel electrophoresis in the presence of the dissociating agent, sodium dodecyl sulphate, and under reducing conditions (SDS–PAGE). Densitometry scans of electrophoretograms indicated the virtual absence of a 58 kilodalton (kDa) component and approximately half the level of a 74 kDa component in the exfoliated capsule relative to normal capsule. The remaining protein components detected were of identical molecular weight and abundance compared with the normal lens capsule.
CLINICAL USE OF THE WIDE FIELD SPECULAR MICROSCOPE
Authors: STASIUK RONALD M. , ROBERTSON IAN F. , REINEHR DOUGLAS P.
Published: November 2007

The Pocklington (Keeler‐Konan) wide field specular microscope has been in use for 18 months at the Corneal Diseases Unit, The Royal Victorian Eye and Ear Hospital, Melbourne.

In this study, the microscope has been applied clinically to assess the state of the corneal endothelium and to evaluate comparative endothelial cell density and morphology in certain anterior segment microsurgical procedures. The clinical conditions studied are primary posterior chamber intraocular tens implantatbn, secondary intraocular lens implantation, intraocular lens exchange, and penetrating keratoplasty.
ANDREW SEXTON GRAY (1826–1907). A FOUNDER OF AUSTRALIAN OPHTHALMOLOGY: HIS LIFE AND TIMES
Authors: LOWE RONALD F.
Published: November 2007

Andrew Sexton Gray was born in Limerick, Ireland, medically trained in Dublin, and was assistant to William Wilde, the distinguished oculist and aurist. He migrated to Victoria in 1859, was surgeon to a railway's construction company, then in 1862 began practice as a surgeon and oculist in Melbourne. In 1863 he founded a charitable eye and ear hospital, and had a very active, long life devoted mostly to ophthalmology. The hospital progressively expanded and became the centre for training for many ophthalmologists, as well as the nucleus for the cohesion of Victorian ophthalmology. History shows Andrew Sexton Gray to have been a founder of Australian ophthalmology.
INFECTION AFTER RETINAL DETACHMENT SURGERY
Authors: HADDEN OSMOND BRUCE
Published: November 2007

In 250 consecutive retinal detachment operations performed by the author, there were 14 cases (56%) of infection of the scleral buckle The commonest infecting organism was Staphylococcus aureus.

The surgery in these infected cases took longer than average, and utilized more than the usual amount of silicone sponge, a higher proportion were reoperations After an average follow‐up of 22 months, only six of the 14 had vision of 6/36 or better and of these, two had persisting inferior traction detachments.

On the basis of this study and others, the preferred management of infected scleral buckles is to remove the sponge as soon as the diagnosis is made The risk of redetachment is a lesser evil than the sequelae of prolonged inflammation which include traction retinal detachment, massive perirebnal proliferabon, and premacular fibrosis.
RESULTS OF VITRECTOMY IN CHILDREN
Authors: MANNING L. M.
Published: November 2007

Though vitrectomy results in the general population are being well established, the results in children particularly of amblyopic age are still largely unknown This paper details the results in 44 children aged one month to 13 years, of whom 28 were seen years of age or less The most frequent indication for vitrectomy was penetrating ocular trauma (61%) Of the total 44 cases, 28 (63%) were rendered unilaterally aphakic, 18 of these being less than 7 years old Improvement in vision occurred in 34 (77%) of the 44 patients, and 10 (23%) remained unchanged In the 18 children aged one month to seven years who became unilaterally aphakic, 11 (61%) improved and seven (39%) remained unchanged The management of amblyopia and contact lenses in children is stressed These results indicate that vitreous surgery plays a significant role in the restoration of vision in children.
BASIC ASPECTS AND PRACTICAL CONSIDERATIONS IN RETINAL DETACHMENT SURGERY
Authors: FOULDS WALLACE S.
Published: November 2007

Factors responsible for retinal attachment include structural factors such as the integrity of the retina and the interdigitation of receptor cells with the retinal pigment epithelium combined with dynamic factors which include the movement of water from the vitreous to the choroid under the influence of colloid osmotic pressure in the presence of an intact posterior blood‐ocular barrier.

In successful retinal detachment surgery an intact cortical vitreous is important. Retinal detachments can be subdivided into simple or complex according to the degree of vitreous abnormality present. Complex detachments demand vitreous surgery and the use of vitreous substitutes. Silicone oil may have a dual role in the eye, tamponade of retinal breaks and waterproofing of the retina with which it is in contact, so reducing transretinal water movement and lightening the load on the mechanisms responsible for retinal reaffachment.
SUCCESSFUL MEDICAL TREATMENT OF A CORNEAL ULCER DUE TO ACANTHAMOEBA POLYPHAGA
Authors: JACKSON THOMAS N. , HEINZE JULIAN B. , TUXEN JEAN , WEINER JOHN M.
Published: November 2007

A 19‐year‐old man, who was a soft contact lens wearer for correction of myoia, presented with right corneal ulceration. The diagnosis of Acanthamoeba polyphaga infection was made by culture and serology. In‐vitro sensitivity tests suggested that the organism was sensitive to Neosporin (polyrnyxin, neomycin and gramicidin) and natamycin. Topical therapy with these agents resulted in complete healing of the corneal ulcer in two months. To our knowledge, our patient is the only case of successful medical treatment of this condition that has achieved a good visual result.
DERMIS‐FAT GRAFT: EVOLUTION OF A LIVING PROSTHESIS
Authors: MARTIN PETER A. , ROGERS PETER A. , BILLSON FRANK
Published: November 2007

Over the past two years 15 dermis‐fat grafts were performed Ten were primary grafts, two were implanted because of migrated implants, two for extruding implants and one to correct deep superior sulcus recession.

Our experience showed dermis‐tat grafts to be an effective method of correcting orbital volume deficit, of maintaining satisfactory prosthetic motility and of preventing the development of conjunctival deficiency.

In primary dermis‐tat grafts fat atrophy was less than 70%, whilst in secondary implants fat atrophy was less than 30% Complications were minimal in our small series
OPHTHALMIC DISEASE IN WESTERN SAMOA
Authors: EGBERT PETER R.
Published: November 2007

Since the last report on eye disease in Western Samoa in 1959 by Dr Elliott, the population has increased from 97 000 to 158 000 The country now has a full‐time ophthalmologist but could benefit from a larger eye care service.

The distribution of disease is very similar to that found in 7959, with pterygium, cataract and injuries comprising the most frequent eye problems Acute angle‐closure glaucoma is much more common than open‐angle glaucoma and is associated with a plateau ins configuration.
UVEITIS: AETIOLOGY AND DISEASE ASSOCIATIONS IN AN AUSTRALIAN POPULATION
Authors: WAKEFIELD DENIS , DUNLOP IAN , McCLUSKEY PETER J. , PENNY RONALD
Published: November 2007

Over a five‐year period 245 Patients with uveitis were investigated at the Uveitis Clinic, Sydney Eye Hospital, for possible aetiological and relevant disease associations. Uveitis was anterior in 75% of patients, posterior in 21% and generalized in 4%. Anterior uveitis (AU) was idiopathic in 52% of cases. In patients tested for the HLA‐B27 antigen, 47% were HLA‐B27 positive, including all cases of ankylosing spondylitis (8% of cases) and Reiter's syndrome (3% of cases). There was a marked male predominance in patients with AU, especially in HLA‐B27 positive individuals. Posterior uveitis (PU) was most frequently unilateral, chronic and idiopathic (24% of cases), whilst recognizable aetiologies included toxoplasmosis (20%), Behçet's syndrome (14%), sarcoidosis (12%) and pars planitis (12%). The peak age of onset in patients presenting with AU was 30 to 40 years, whilst patients with PU presented a decade earlier. There were no major differences between males and females in the age of onset of their uveitis.
THE RELATIONSHIP BETWEEN TOXOCARA ELISA ABSORBANCE VALUES AND TOXOCARA ELISA TITRES: A COMPARATIVE STUDY
Authors: CLEMETT R. S. , HIDAJAT R. R. , ALLARDYCE R. A. , BSc A. C. S. STEWART
Published: November 2007

Enzyme‐linked immunosorbent assays (ELlSAs) may be made by a variety of techniques at one or several serum dilutions which is very confusing for clinicians This study compares the ELlSA results from two centres on sera from 12 patients investigated for ocular toxocarrasis by two common ELSA methods —the absorbance and titration techniques With one exception, ELSA results by the two methods correlated well For reasons outlined, the absorbance ELlSA method is likely to remain the preferred method in New Zealand and Australia Attention is drawn to the implications of the serum response to Toxocara canis larvae. and the need to evaluate ELlSA results against clinical findings is emphasized.
COMBINED HAMARTOMA OF THE RETINA AND RPE: AN UNUSUAL CAUSE OF THE DRAGGED DISC APPEARANCE
Authors: HARPER C. ALEX , GOLE GLEN A.
Published: November 2007

Combined hamartoma of the retina and retinal pigment epithelium (RPE) is a rare, benign, congenital fundal lesion which contains a mixture of glial tissue, blood vessels and pigment epithelium. Such turnours are variably pigmented and may be wrongly diagnosed as malignant melanoma or retinoblastoma. We report two cases which were located in the periphery of the fundus and which produced a dragged disc appearance.
THE ACQUIRED IMMUNE DEFICIENCY SYNDROME: OCULAR FINDINGS AND INFECTION CONTROL GUIDELINES
Authors: WOODS SHANE L. , WAKEFIELD DENIS , MCCLUSKEY PETER
Published: November 2007

The acquired immune deficiency syndrome (AIDS) is characterised by a loss of normal cellular immunity in affected individuals which predisposes them to severe opportunistic infections and neoplasms These pathological processes may affect the eye, and ocular involvement with an opportunistic infection or malignancy may be the first clue to the presence of AlDS

This article reviews the ocular manifestations of ADS and concludes with infection control guidelines for ophthalmologists treating patients with AlDS and related conditions
PILOCARPINE‐INDUCED MOVEMENT OF THE TRABECULAR MESH
Authors: MOSES ROBERT A. , GOLDBERG IVAN
Published: November 2007

From geometrical considerations of the trabecular meshwork, ciliary muscle contraction has been predicted to produce an inward movement of the mesh. Goniophotographs taken under carefully controlled conditions before and after topical administration of pilocarpine showed a change in angle between cornea and mesh that is consistent with the predicted change.
LASER IRIDOTOMY
Authors: RICHARDSON P. , COOPER R. L.
Published: November 2007

The outcome of 64 consecutive argon laser iridotomies was examined retrospectively The patients were followed for a mean of 18 months Argon laser iridotomy was shown to be effective in treating chronic angle‐closure glaucoma, those patients without field loss faring better than those with field loss 34% of the latter group eventually required a trabeculectomy It is suggested that patients be carefully followed‐up after iridotomy, particularly those with loss of visual field.
EYE PROTECTORS FOR SQUASH PLAYERS
Authors: CLEMETT R. S. , GLOGAU T. H. , JACKSON B. R. , McKENZlE K. D. , STEVENSON D. C.
Published: November 2007

Eye injuries have occurred to squash players wearing commercial open‐type eyeguards, suggesting inadequacies in their design This study reports experimental observations on the deformation of high velocity squash balls at an aperture simulating an open‐type of eyeguard Open eyeguards were shown to be inadequate in preventing eye trauma by ballstrike Recommendations for improvement of eyeguard design have been made
ASSESSMENT OF THE QUEENSLAND SCHOOL HEALTH SERVICE VISION SCREENING PROGRAMME
Authors: MACFARLANE D. J. , FITZGERALD W. J. , STARK D. J.
Published: November 2007

Despite the widespread acceptance of vision screening programmes as a means of detecting ocular disorders in children, there has been little formal assessment of their validity and reliability One such screening programme is conducted in Queensland State Primary Schools by the Division of School Health Services of the State Department of Health A group of 877 children was screened by the Service and subsequently subjected to a formal independent ophthalmological examination A comparison of the results of these procedures revealed that the visual screen as performed by the Service was highly accurate in the determination of distant visual acuity Detection of manifest strabismus was less satisfactory, with between 30 and 74% of sufferers being detected There is no evidence to suggest that a more complex protocol will improve the detection of ocular disorders Rather. a more effective implementation of the current screening procedure is required
COMBINED EXTRACAPSULAR CATARACT EXTRACTION AND POSTERIOR CHAMBER INTRAOCULAR LENS IMPLANTATION AND TRABECULECTOMY
Authors: BOREHAM COLLEEN
Published: November 2007

In a retrospective study in a consecutive series of operations performed by the author, 13 eyes in 10 patients underwent combined extracapsular cataract extraction, posterior chamber intraocular lens (IOL) implantation and trabeculectomy All had significant cataract and chronic open‐angle glaucoma with field loss, uncontrolled or marginally controlled on maximum tolerable medical treatment

All had a postoperative reduction in intraocular pressure Significant complications included malignant glaucoma (in two eyes) and a late choroidal detachment (in one eye)

The indications for and the advantages of the combined procedure are discussed, emphasising the advantages of extracapsular cataract extraction (ECCE) and posterior chamber lens implantation, in patients with chronic open‐angle glaucoma (COAG)
CILIARY‐BLOCK GLAUCOMA TREATED BY POSTERIOR CAPSULOTOMY
Authors: LOCKIE PATRICK
Published: November 2007

Ciliary‐block glaucoma occurred in one eye of a 65‐year‐old‐male, following a combined trabeculectomy and extracapsular lens extraction for long‐standing angle‐closure glaucoma.

After pupillary block was excluded as a cause, a posterior capsulotomy resolved the condition. This procedure was repeated successfully when a flat anterior chamber recurred on spontaneous closure of the initial capsulotomy. The ciliary block appeared to be caused by the residual zonule and lens capsule.
UVEITIS: A STRATEGY FOR DIAGNOSIS
Authors: McCLELLAN K. A. , COSTER D. J.
Published: November 2007

Uveitis may be the first presentation of a wide variety of underlying ocular and systemic diseases. It is important for the ophthalmologist to make a specific diagnosis in order to instigate specific therapy and give an accurate prognosis.

The ability to recognise the clinical patterns of uveitis and to initiate appropriate investigations should form the basis of the ophthalmologist's management of the condition. To this end, we have considered uveitis under four major patterns of presentation—anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis—with subclasses within each of these four groups. We have outlined both the investigations which facilitate diagnosis of the possible underlying causes of inflammation and the interpretation of the results of such investigations.
TOPICAL FIBRONECTIN THERAPY IN PERSISTENT CORNEAL ULCERATION
Authors: Mccluskey PETER , Wakefield DENIS , York LUCY
Published: November 2007

Fifteen patients with 20 episodes of persistent corneal ulceration, resistant to conventional therapy, were treated with topical autologous fibronectin Thirteen corneal ulcers (eight patients) developed following penetrating keratoplasty, three patients had mucous membrane pemphigold, two patients had herpetic keratltis and one each had Sjögren's syndrome and a trophic corneal ulcer A standard protocol for fibronectin administration was followed This therapy healed 16 of the 20 ulcers after a mean duration of treatment of 23 months Corneal ulceration associated with mucous membrane pemphigoid failed to respond to fibronectin Corneal ulcers which recurred after cessation of fibronectm responded to reintroduction of this therapy Topical fibronectin is an effective therapy for refractory corneal ulceration and is free of major side effects