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Diplopia is an uncommon but distressing result of orbital changes in Graves' disease. Significant extraocular muscle disorders occur usually when there is severe orbital involvement, as described under such terms as exophthalmic ophthalmoplegia (Brain and Turnbull1), thyrotropic exophthalmos (Mulvaney2), and infiltrative ophthalmopathy (Day3). Less frequently, muscle dysfunction is found with only minimal orbital swelling.Limitation of ocular movement generally develops after appearance of other signs of orbital congestion—conjunctival hyperemia and edema, lid edema, exophthalmos, and increase in intraorbital pressure with resistance to palpation. Usually there is an initial limitation of upward gaze; if the restricted movement is greater in one eye, diplopia occurs. Later there may be limitation of lateral motion. In extreme cases, the eyes may become more or less fixed in a position of depression. The degree of extraocular muscle involvement is exceedingly variable. In mild forms of orbital disease, myopathy is minimal and often

Epithelial invasion of the anterior chamber was first recognized by Collins and Cross,1 in 1892, and has since been adequately described and classified by Perera,2 Calhoun,3 Pincus,4 Maumenee and Shannon,5,6 and others. It is an uncommon but extremely serious complication of perforating wound of the eye or intraocular surgery. Untreated, it may lead to serious visual impairment or loss of the globe. Figures 1, 2, and 3, taken from pathological specimens in the University of Colorado Ophthalmic Pathology Laboratory, illustrate the epithelial downgrowth type of epithelial invasion of the anterior chamber.These sections demonstrate the mechanism of invasion through the corneal wound into the anterior chamber. The posterior corneal surface, the angle of the anterior chamber, the anterior surface of the iris, and the vitreous face become lined with squamous epithelium. These eyes were enucleated because of intractible glaucoma as a result of obstruction of

DESPITE progressive advance in the clinical diagnosis of intraocular tumors, there are occasional cases in which diagnosis is doubtful. Most confusion arises from inability to distinguish between serous retinal detachment and detachment which is partly solid and partly serous. In the days before successful retinal detachment surgery, no great harm was caused by the removal of the eye on suspicion of tumor. The eye was destined to blindness under any circumstance. With the present high rate of cures following retinal detachment surgery, enucleation is not considered unless there is very strong evidence of tumor. Usually careful clinical study of the eye will make the diagnosis of intraocular tumor almost certain. Rarely, owing to hazy media or very high detachment, reasonable doubt as to the presence of tumor may exist. In such cases aspiration biopsy has been suggested.Intraocular biopsy by scleral puncture is not a new procedure. Von Grósz,1

An antiserum against human fetal thymus was prepared in rabbits and absorbed with liver cells from the thymus donor and lymphocytes from a patient with chronic lymphocytic leukemia (CLL). The antiserum reacted with 80%–95% of the peripheral small lymphocytes from 12 normal controls but with only 1%–11% of cells from 12 patients with CLL. The antithymocyte antiserum demonstrates a cell surface antigen present on the majority of normal human lymphocytes, but absent from the neoplastic CLL cell. This finding is consistent with the view that the CLL lymphocyte is devoid of T-cell antigen and with other evidence that this lymphocyte closely resembles the B-cell of experimental animals. It appears likely that leukemic cells will prove useful in presenting an antihuman thymocyte antiserum that reacts exclusively with cells by removing B-cell reactivity.

Recent observations, particularly from Australia, seem to indicate that rubella during early pregnancy may lead to multiple serious congenital defects in the offspring. This was first noted in 1941 by Gregg1 following a severe Australian epidemic of German measles. It is thought that crowding and troop movements may have made possible the rapid transfer of the virus from one person to another, and thus not only may have spread the epidemic but also may have caused some change in the virus.Gregg described 78 cases of congenital cataract, 20 examined personally and the remainder reported to him by his colleagues. In 68 of these cases there was a definite history of German measles in the pregnant mother. Cardiac lesions were present in at least 44 of the 78 infants. A research team sponsored by the National Health and Medical Research Council of Australia, consisting of Drs. Swan, Tostevin, Moore,

A letter to the editor is presented in response to an article about U.S. business ratings.

Presents letters to the editor referencing to articles and topics discussed in previous issues of the periodical "Saturday Evening Post." "Long Live Imperialism," which discussed imperialism; "The Secret of Life," which discussed the longevity of biblical men and women; "Heston: Larger Than Life," which focused on celebrity Charlton Heston.