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These various intraocular disorders, which, either in their primary manifestations or after the fundus picture has become obscured by secondary developments, may suggest the existence of intraocular malignancy, are discussed seriatim from the point of view of differential diagnosis and as to their literary history. Some personal cases are reported, historically significant illustrations from the literature are reproduced, and the monograph is supplemented by ample bibliographies under the respective heads. (In addition to the text illustrations, see the colored frontispiece, containing a drawing of the author's case of Hippel's disease and a drawing of a large choroidal tuberculoma.)

The case of intraocular tumor here reported is of especial interest because its course was followed five years before its removal, and it illustrates the unreliability of intraocular tension, in differentiating intraocular tumor from simple detachment of the retina. Read before the American Ophthalmological Society, June, 1920.

The difficulty of determining whether a detached retina hides an intraocular tumor makes every symptom bearing on the subject important. Two cases are reported in which deep ocular pain was present and an intraocular tumor found when the eye was enucleated. Read before the American Ophthalmological Society, June, 1923.

A patient had Ewing's sarcoma of the rib which metastasized to the choroid. Clinically, he showed a solid retinal detachment and recurrent episodes of anterior nongranulomatous uveitis. The uveitis responded to steroid therapy. While metastasis of Ewing's tumor to the orbit is well known, no previous cases of Ewing's tumor in the choroid were found, and the extreme rarity of intraocular tumor metastasis in childhood is discussed.

The possibility that malignant melanoma may be transmitted in a hereditary manner is not often considered. However, Falls 1 lists malignant melanoma of the choroid under those eye conditions which may show a dominant hereditary transmission. The following is an example of choroidal malignant melanoma occurring in two successive generations. Report of Cases Case 1. —A 45-year-old white female was admitted to the hospital on May 19, 1953, with a diagnosis of retinal detachment and intraocular tumor, right eye. For three months prior to admission the patient noted a "scum" over right eye. One week prior to admission there was loss of all but light perception in the eye. On examination, the vision in the right eye was limited to light perception. There was a massive retinal detachment with a solid mass behind it. Examination of the patient for metastatic disease revealed no metastases. The family history contained no evidence

The anatomical identification of a white intraocular tumor in an adult can occasionally be very difficult. Accurate recognition of the nature of the lesion is, of course, important from the standpoint of prognosis, but such cases also have academic interest as a diagnostic challenge especially to the pathologist. Some of the differential diagnostic features that may be presented under such circumstances are shown in an illustrative case. As our title indicates, one of the chief considerations suggested by that case is the possible occurrence of retinoblastoma in adult life. Report of Case A 46-year-old man noticed gradual diminution of vision in the right eye beginning about November, 1956. By July, 1957, there was no vision in that eye, but the patient did not seek medical attention until the eye became painful in 1958. He was first seen on the service of Dr. Michael J. Buonaguro at the Brooklyn Eye and

Recognition of the malignant intraocular tumor in the earliest possible stage of its growth is of obvious importance. Diagnosis by ophthalmoscopy is not difficult in the initial stage, before the development of subretinal transudation and retinal detachment. Such an extremely early stage is practically never seen, except in some rare instances in which the tumor is near enough to the macula to create a serious disturbance of the central vision. Once transudation and retinal detachment have occurred, and especially if the tumor is located in the posterior half of the eyeball, diagnosis becomes extremely difficult and is seldom more than presumptive. Consequently, the addition of any pathognomonic feature to the present meager knowledge of this clinical picture, even though it is limited to half of the cases, should be of distinct value. The present paper reports such a feature, viz., detachment of the pars ciliaris retinae, which I observed in

Judged by its literature, the causation of glaucoma is unsettled. No effort to harmonize undoubted facts has met with general support. Whether glaucoma is a deformity or a disease, remains an open question. Thus Priestly Smith and his followers claim that glaucoma is a deformity of the eyeball, that an engorgement of the blood vessels in the posterior chamber pushes forward the lens and crowds the ciliary body and iris into the anterior angle, effectually blocking the outlet from the eye for the intraocular secretion. From the resultant intraocular tension he deduces the phenomena of primary glaucoma. The failure of this view to account for glaucomatous attacks in the young, in persons having no iris, in cases of intraocular tumor or dislocated lens, etc., has prevented its universal acceptance. Of those holding that glaucoma is a disease, part affirm that it is purely local; and part that it is the