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Following application of 2N sodium hydroxide, or 8.1N ammonium hydroxide to rabbit cornea, the aqueous humor pH reached a maximum of 10.2, 11.9, and 12 within six minutes following 20-, 50-, and 100-mu1 sodium hydroxide burns, respectively; after two hours the pH had fallen to 8.5, 10, and 10.5. The maximum rise following application of 100-mu1 of ammonium hydroxide was 10.8, declining to about 9 at two hours. The fall in pH following a 100-mu1 sodium hydroxide burn was not greatly influence by external lavage. However, the pH was significantly lowered (12 to 10) by paracentesis alone and further reduced by immediate or delayed intracameral administration of phosphate buffer. On the basis of these results moderately severe and severe alkali burns of the eye should be treated by paracentesis and if possible with anterior chamber reformation with a sterile solution.

Hydrophilic contact lenses were prescribed for 62 patients with a variety of corneal diseases. The lens was must successful for relief of pain in bullous keratropathy and in the healing of recurrent erosions. Its value in improving vision in bullous keratopathy depends on the stage of corneal edema and is not impressive in long-standing edema with scarring. The lens may be of value in patients with sterile indolent ulcers and in alkali-burned corneas with large epithelial defects after conventional therapy has failed. Caution is advised in fitting patients with the dry eye syndromes. Patients with minimal corneal scars due to keratoconus may benefit from a soft lens. Complications related to the use of hydrophilic lenses in this group of 62 patients are also discussed.

As a result of recent bomb explosions a total of 82 patients were treated at the Birmingham General Hospital, 61 with minor injuries. Bomb injuries may be divided into three main groups due to the blast effect (such as blast lung and ruptured tympanic membranes), the flash (such as burns to the exposed part of the body), and shrapnel (which may cause a wide variety of injuries). The amount of warning of such explosions is usually minimal, and so the prepared accident schemes of most hospitals are inappropriate. If the disaster occurs outside normal working hours much responsibility initially falls on the resident staff. This report gives some idea of the type of injuries they are likely to see.

The process of epithelial regeneration of alcali-burned rabbit cornea was observed in control animals and in animals treated with bovine embryonic corneal homogenates using scanning electron microscopy. It was found that regeneration is more rapid when homogenate treatment is applied, but follows the same stages as observed in the control animals.

Initial management of ophthalmic injury in the combat zone of guerrilla warfare has been discussed primarily from the vantage points of paramedical personnel and the physician nonophthalmologist. Details of surgical management have been greatly abbreviated and many areas not discussed at all, since they lie beyond the scope of this report. Continuing improvement and innovations in this report. Continuing improvement and innovations in this sphere require constant familiarity with current ophthalamic literature. Most, if not all, of the methods of examination and treatment described in this paper are as applicable to civilian trauma as to wartime injuries. The improved salvage rate of traumatized eyes and the conspicuous absence of sympathetic ophthalmia among US battle casualties since World War II are encouraging. If similar methods are used to evaluate, treat, and evacuate civilians inflicted with traumatic eye disease, the results should be similar.

The effects of a new therapeutic perfusion contact lens upon heavy infections and severe burns had been observed in 30 cases. We conclude that this method is advantageous, where there is a shortage of nursing personnel. We also consider the advisability of instructing sick bay attendants in large factories and military personnel in the use of the contact lens in order to bridge the critical phase between injury and hospital treatment.