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Our purpose was to show how difficult it is to diagnose a dural fistula of the cavernous sinus, which is an anomalous arteriovenous shunt within the dura mater extending from meningeal arteries to the cavernous sinus.A dural fistula was suspected in four female patients aged between 61 and 80, presenting with a red eye, dilated episcleral veins, exophthalmos and elevated intraocular pressure. A cerebral hyperselective angiography was performed in all cases.The cerebral angiography confirmed the diagnosis of a dural fistula in all cases, showing the early filling of the cavernous sinus followed by the draining vessel (posterior in case n. 4, anterior in cases n degrees 1, 2, 3). Case n degrees 2 was unilateral and cases n. 1, 3, 3 were bilateral. The blood flow was low in all cases. A successful embolization was performed in all patients with resolution of all symptoms.The diagnosis of dural fistulas is often difficult because of misleading clinical signs. It is documented by a cerebral angiography showing the feeding vessels and helping to choose either venous or arterial embolization which is the most suitable treatment.

Pilomatricoma is a benign, solitary tumor. The histopathologic findings of viable basaloid cells in the periphery, shadow cells in the central part and foci of calcification are characteristic of pilomatricoma. The microscopic aspect of multiple pilomatricomas was not different from solitary pilomatricomas. Though, some consider them as a pathognomonic sign of myotonic dystrophy. Complete surgical excision is the best management.

Congenital microcoria, a bilateral condition of the iris dilatator, is defined as a pupil with a diameter of less than 2 mm when looking at a distant object. Although it is usually a hereditary condition resulting from autosomal dominant transmission with no marked difference between the sexes, it is sometimes sporadic. The ocular abnormalities associated with this condition (myopia, astigmatism, and glaucoma) have never been linked to the malformation.Forty-two members of a family were examined: 23 had microcoria and 19 did not. The two groups were studied to identify symptoms of the condition and its associated abnormalities.There was a very strong correlation between microcoria and myopia (Fisher's exact test, P0.00001), between microcoria and astigmatism (Fisher's exact test, P0.0001), and between microcoria and glaucoma (Fisher's exact test, P = 0.011).There is a statistical correlation among myopia, glaucoma, and microcoria, and the disorders are associated with the condition in a nonfortuitous way. The functional prognosis for microcoria appears to be extremely poor because of refractive disorders and, particularly, a link between microcoria and glaucoma that is difficult to explain.

Langerhans' cell granulomatosis of the orbit was observed in a 7-year-old boy successfully treated by a simple biopsy. Recovery can be established one year after the biopsy on the basis of bone defect healing on the standard X-ray of the skull.

Keratomycosis due to Aspergillus fumigatus occurs most often in immuno-competent patients who live and work in a fungus-rich atmosphere. Previous trauma with epithelial lesion are reported by most authors. While the new antifungal drugs may be effective, corneal graft is the most effective solution in uncontrolled cases. When performed early, good visual recovery was observed in most cases as reported in the literature and in our case.

Rhabdomyosarcoma accounts for 5% of childhood malignant tumours; in 10% it occurs in the orbit where it is the most frequent malignant tumour. Rhabdomyosarcoma is a mesenchymatous tumour with striated muscular differentiation. However, this myogenous differentiation is sometimes undiscernable on standard histological examination and requires immunohistochemical and ultrastructural studies to be shown. Treatment depends on the assessment of local extension, principally based on tomodensitometry. When the tumour is limited to the orbit, survival rate may reach 100% with todays therapeutic protocols. When the orbital walls are invaded the tumour is parameningeal and recovery can only be achieved by increasing chemotherapy at the cost of long-term side effects. Hence, this tumour must be diagnosed and treated very early. The authors report two cases of rhabdomyosarcoma dealing with the two main histological forms of the tumour and with their evolutive risks.

Oculo-dento-digital syndrome (SODD) as defined by Meyer-Schwickerath in 1957 is a rare entity (84 cases) which belongs to ectodermal dysplasias. It consists of: the characteristic features (long face, pinched nose); syndactyly; ocular, dental and bone abnormalities. This entity is usually transmitted on the autosomal dominant mode. We report two cases (a mother and daughter) with polymalformations which we classed as SODD. Furthermore, agenesis of lacrimal duct and genitourinary abnormalities were noted. The mother had a very particular complex hair shaft dysplasia (incomplete pili torti, "tiger tail" aspect, fractures) with alopecia since she was fifteen years old. The daughter's hair was normal at birth. In SODD, fine and sparse hair is often observed (44 p. 100). Only one patient had hair shaft investigation under polarized light: pili annulati and monilethrix were described but not found in our cases. These two reports incite to the systematic hair shaft study in SODD as other ectodermal dysplasia syndromes.

By typing of 90 patients with ocular pathology (uveitis, diseases of optic nerve, Eale's disease, pseudo-tumor cerebri) the authors have found a constant and significant increase in the frequency of H.L.A. A2 especially in uveitis by streptococcus. However, a frequency of H.L.A. B27 as elevated as in previous publications was not found--but the parallelism: H.L.A. B27--ankylosing spondylitis was always found. Finally, the authors emphasized the haplotype H.L.A. A2 H.L.A. B5 in two cases of pseudo-tumor cerebri.

Among clinical manifestations of the battered child syndrome, ophthalmic manifestations play a prominent role in the recognition of this syndrome. From personal cases, the authors describe different ocular findings, specially intraocular hemorrhages with the important risk of sequelae. They show the role of the ophthalmologist among several situations. As the ophthalmologist may be the first to examine these traumatized infants his prompt recognition is important to take all necessary steps.

Electrooculographic study on the movements of convergence among 53 young subjects clinically normal, in nine different conditions of symmetry, of laterality and of preponderance of the directing eye. The morphology of the graphs are described, the duration of latency, the velocities and the amplitudes were measured for the different types of response, and the statistical disturbances corresponding were compiled. For some of these characteristics were made unpublished acknowledgement.

The authors describe a new test for determining the visual acuity in pre-school children. It is a picture-test which is composed by pictures of animals of varying sizes, the child being asked to name them in turn. The six pictures (duck, rabbit, cock, elephant, fish, and butterfly) with an homogeneous density, can be utilized according to several manners-appariement or verbal expression--and several distances: 2,50 m or 5 m. That test gave good results on children aged from three years upwards, however the performances could be increased by prectising exercises.

The authors have examined three hundred cases of sclerosis (prospective study of an hundred patients, retrospective study of two hundred observations) in order to assess the frequency of uveitis during the disease and to make out a possible relation between the two diseases. The percentage of uveitis is small: 2% and the frequency of uveitis in multiple sclerosis appears not different of that of a normal population. In spite of the simularity of the pathogenic hypothesis, it does not look that a correlation may be made between the two diseases.

The authors report the study of 51 cases of conjunctivitis which the allergic character has been showed. They emphasize: 1. the special frequency with the young person (between 20 and 30 years for allergic conjunctivitis, generally before 7 years for vernal conjunctivitis); 2. the importance of atopic ground; 3. the weak incidence of business; 4. the difficulty of diagnosis, because the monosensibilisations are uncommon; 5. the favourable result of treatment.