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LAST YEAR my co-workers and I reported in a preliminary study on the relation of cysteine treatment to x-ray damage of the rabbit's eye which had been exposed locally to a single dose of 1,500 r of penetrating x-rays. There was at this time strongly suggestive evidence that among the signs of radiation damage to the eye two characteristic late effects of such radiation, epilation and x-ray cataract, were partially prevented by the intravenous use of 2 gm. of cysteine prior to irradiation. These animals have been followed now over periods of 12 to 16 months. Total cataract has developed in the control group in 12 of 14 animals within the observation time of 14 months. None of the cysteine-pretreated eyes showed at this time a lenticular opacity which was dense enough or extensive enough to interfere substantially with the visibility of fundus details. However, all these lenses exhibited some

Worldwide Abstracts of Published Papers Pertaining to Contact Lenses. Pp 170. Morrison Laboratories, Inc., Green & Division St, Harrisburg, Pa, 1963. The important role of optometrists, lens technicians, and optical manufacturers in the development and improvement of corneal contact lenses should be fully recognized. After the unsuccessful experience with contact lenses in the 1930's most ophthalmologists were backward-looking and skeptical about all developments in contact lenses. In large measure it remained for para medical groups to do the work that led to the development of the small corneal lens which is now held in such favor by the ophthalmic community. The two volumes under review attest to the importance of these groups in advancing our knowledge of contact lenses. Although the papers presented at the second American Optometric Association Contact Lens Symposium are uneven, some of them are first-rate; and many practicing ophthalmologists now fitting contact lenses would benefit

Most of this book is, of course, neuro-ophthalmology. Some of Bender's classic articles on eye movement abnormalities are reproduced in facsimile along with some of his important work on perception. About 10% of the 366 articles he published between 1935 and 1983 appear in this book. Comments by his friends and former associates on Bender the man and on various aspects of his work are to be found throughout the volume. These comments were contributed by Robert Friedland, Edwin Weinstein, Macdonald Critchley, Bernard Cohen, Howard Krieger, and Robert Jaffe. This is a book that should be owned and read by everyone interested in neuro-ophthalmology—if only to see how much in neuro-ophthalmology we owe to Morris Bender.

Purpose Macular schisis or detachment is frequently observed in eyes with optic pits or colobomas. Although spontaneous resolution of the maculopathy has been reported, concurrent changes in the optic nerve coloboma have not. We report three cases of atypical optic nerve colobomas in which dynamic optic nerve changes coincide with the development and subsequent resolution of the associated maculopathy. Methods We reviewed the records of three patients with dynamic optic nerve changes associated with maculopathy. All patients were observed for at least 6 months. Fundus photography and fluorescein angiography were used to document the optic nerve and macular changes. Results Three patients were noted to have macular detachments without apparent optic nerve excavation. With observation, the maculopathy spontaneously resolved in each case. We documented concurrent optic nerve changes whereby atypical optic nerve colobomas became apparent over several months in all cases. In one case, we noted the simultaneous development of maculopathy in association with obscuration of a prior disc anomaly. None of the eyes had a posterior vitreous detachment. We could not identify any associated systemic conditions or reproduce the findings with external stimulation. Initial Snellen acuity ranged from 20/60 to 20/200. Final Snellen acuity ranged from 20/20 to 20/40. Conclusions Fluctuating optic nerve changes may occur in the setting of atypical optic nerve coloboma and associated maculopathy. In cases of macular schisis or detachment where an optic nerve coloboma is not readily apparent, and no other causes are identified, consideration of a period of observation prior to therapeutic intervention seems appropriate.

THE PROPER use of adrenal corticosteroids and corticotropin in ocular diseases has been clarified gradually, so that ophthalmologists have become aware of many of the limitations inherent in this type of therapy. The purpose of this paper is to present information obtained from the treatment of a large series with a view to establishing a therapeutic regimen in certain types of ocular lesions. A number of the ocular complications we have encountered seem to have resulted from overtreatment or from an untoward response to steroid therapy. Therefore it is deemed advisable to emphasize the nature of some lesions and to discuss the undesirable effects resulting from the injudicious use of such therapy in specific types of disease. A brief description of the characteristics of each of the hormones commonly used in ophthalmology will be given, together with a discussion of their correct and incorrect therapeutic use. ADRENAL CORTICOSTEROIDS Cortisone (Compound

THE RECENT introduction of my preset lens into the United States by lectures of Lindner, 1 as well as the fact that this lens is now being manufactured in the United States under the name the "Hruby diagnostic lens" gives me an opportunity of publishing a short paper on my technic of examination. Only thirty years have passed since the slit lamp was used for the first time for examination of the posterior section of the eyeball through the efforts of Koeppe. 2 He was the first to recognize that the deeper parts of the eye can be made visible only if, in general, two conditions are complied with. These are, on the one hand, the smallest possible angle between the optical axis of observation and that of illumination, and, on the other, such an intense dispersion of the rays coming from the depth of the eye and leaving it

PRIMARY chorioretinal aberrations with night blindness was the subject of a symposium 1 at the 1949 meeting of the American Academy of Ophthalmology and Otolaryngology. The first abnormality considered in that symposium, and the subject of this paper, was characterized by one of us (F. D. C.) as night blindness present at birth, stationary, occurring in an approximately equal number of males and females, and with no associated abnormalities. Bell 2 collected 19 pedigrees of this disease. 3 A few sporadic cases have probably been encountered in the examination of candidates for the air force in this country 4 and in Canada, 5 and Langdon, 6 in 1915, reported the cases of a father and daughter in Philadelphia who had a reduced light sense and normal fundi. Except for Langdon's observation, however, we believe that the following report is the first to record a family affected typically with this abnormality

One of the results of the increasing application of chemicals in industry is a widening of the field of industrial risks. Although improved methods of manufacture have eliminated many of the occupational hazards previously encountered, new ones have appeared, and some previously considered eliminated have reappeared. Such is the case with regard to carbon disulfide. Sixty years ago the literature contained many reports of carbon disulfide poisoning occurring among those who worked with rubber. Articles to be vulcanized were passed through a solution of sulfur chloride and carbon disulfide. Changes in the method of manufacture and adequate protection of the worker have practically eliminated this source of intoxication from the rubber industry. Today carbon disulfide is being used extensively in this country in the rayon and the transparent paper industry and to a much lesser extent in the manufacture of dipped rubber goods and water-proof cements and in certain extractive

In our previous study, 1 donor-recipient reaction after corneal heterograft appeared to be extremely mild in the lyophilized graft. This evidence suggested the reduction of antigenicity of the lyophilized graft. Mild denaturation of corneal proteins during lyophilization and subsequent preservation had been presumed. The original purpose of lyophilization in corneal grafting was the preservation of the graft for a long period. In addition to this, we found that lyophilization was an effective method for reduction of the donor-recipient reaction especially in corneal heterograft. The present study was carried out to determine the reduction of antigenicity and the degree of denaturation of corneal proteins during the lyophilization and the preservation by means of precipita tion test, polarography, and paper electrophoresis. Precipitation Test Materials and Methods. —Grafts were resected from fresh ox eyes (8 mm. in diameter, 0.5 mm. in thickness) and immersed in 15% glycerine isotonic saline mixture for one hour.

The examination of the aqueous humor by electrophoresis is not yet used as a routine procedure. In fact, it is difficult because of the small quantities of protein and the large quantities of salts present in the fluid of the anterior chamber. In the normal aqueous humor, the concentration of the water-soluble proteins varies generally between 10 and 50 mg. %, i.e., it is 20 to 100 times smaller than the optimal concentration of serum proteins used for routine paper electrophoresis. For satisfactory electrophoresis, the percentage of protein of the solution should be sufficiently high, hence, the need to concentrate the fluid from 50 to 100 times. This in turn greatly raises the salt content above the normal 1% (approximately) to a degree that may cause protein precipitation, which makes concentration of the aqueous humor by simple evaporation impossible. As a result of improvements that we have been able to apply

THE VALUE of individualized preanesthetic medication to produce effective sedation and analgesia for eye surgery is well recognized. This is particularly true of intraocular surgery done with local anesthesia. It is difficult to exaggerate the importance of good anesthesia and akinesia, and to obtain them careful attention to the details of the preanesthetic preparation of the patient is essential. Although the need for this is well known, many surgeons fail to give it the attention it deserves. Thus many operations are made more hazardous and eyes are needlessly damaged. With the improved anesthesia and operative technique now generally practiced. it becomes increasingly difficult to decrease appreciably the number of mishaps in operations, such as those for cataract extraction. However, any measure that will improve our percentage of good results by even a fraction of 1% seems worthy of consideration. Hartmann 1 has recently emphasized the importance of careful psychologic preparation

ALTHOUGH congenital absence of tears is a rare defect, its existence has been known since Thurnam's 1 report of two cases in 1848. Under the title of alacrimia congenita Sjogren and Eriksen, 2 in 1950, discussed this subject, and in 1952 Sjogren 3 reviewed 14 of the cases reported in the ophthalmic literature without establishing a common etiologic factor. Among the ascribed causes were (1) persistence of the physiologic condition of the newborn, (2) hypoplasia or absence of the lacrimal gland, and (3) disturbance of innervation of the lacrimal gland. In addition to the previously reported cases, there is a condition in which congenital alacrima is a constant finding. Credit for the recognition of this clinical entity goes to Riley 4 and his co-workers, who in 1949 reported five such cases under the title of "Central Autonomic Dysfunction with Defective Lacrimation." Largely as the result of subsequent studies by Riley

Paralysis of the third cranial nerve presents a discouraging problem from a clinical standpoint, for too often, even after intensive investigation, the cause remains obscure.1Even when a cause is found, the exact manner in which conduction through the nerve is interrupted remains uncertain. In order to clarify the mechanism by which the third cranial nerve is interrupted and to establish the site of involvement in various diseases, we examined the brains of a number of patients seen at the Mayo Clinic who had exhibited impaired function of the nerve during life. We shall present a few representative examples of the more frequent causes of third-nerve paralysis. Anatomic Aspects To comprehend the pathogenesis of paralysis of the third cranial nerve, complete cognizance of its course and relationships is necessary. The oculomotor nerves extend from the midbrain into the orbits (Fig. 1a). They leave the midbrain between the cerebral

CYSTINOSIS is a metabolic disorder that is better known to pediatricians than to ophthalmologists. The reason is that all of the victims are infants and children and do not live to become adults. Most of the discussion concerning the condition is in the pediatric literature, where the disorder may be known by various names, such as the de Toni-Fanconi syndrome, renal rickets, or intractable rickets. McCune and associates, 1 in discussing the group of cases with hypophosphatemic rickets, renal glycosuria, and acidosis, occasionally accompanied by cystinosis, remarked, "The state of the subject remains confused; it is, however, not quite chaotic." It is certainly confusing to one who is not skilled in biochemistry. At this writing only three cases have been reported in the American ophthalmic literature—those of Walsh and his co-workers 2 and that of Kennedy. 3 We wish to add two cases, as it seems certain that the condition

In a recent report 1 on the responses of the ocular tissues to injury an analysis was made of the role the various components of connective tissue play in wound repair. These studies, which clearly indicate the importance of the initial events, aroused further interest in the nature of these responses. With suspicion that the normal cell constituents of connective tissue adjacent to an injury play a vital part in repair, the healing of wounds in normal and devitalized corneas was investigated. The purpose of this study is twofold: to evaluate the importance to healing of those cell constituents at the edge of a fresh wound and to describe the time and site of formation of sulfated mucopolysaccharides in a cornea recovering from injury. Methods Maumenee's 2 method of killing corneal cells by freezing was used because it is believed this technique does not directly degrade the chemical constituents of