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34 patients with monosymptomatic optic neuritis were examined ophthalmologically and by magnetic resonance imaging (MRI). In 18 patients subclinical lesions with a high MRI signal intensity were found. The distribution of these lesions was similar to that seen in multiple sclerosis. Neither the severity of the visual impairment nor the course of remission correlated to the MRI findings. Pathologic MRI findings were more common in patients aged over 27 than in younger patients (57% vs. 42%).

In a group of healthy subjects of varying ages, the flow velocities in the central retinal artery and vein were measured with a B-mode-guided pulsed duplex scanner. The first measurements were taken in the unaffected eye. The maximal systolic flow velocities ranged from 2.9 to 10 cm/s (mean 5.7 cm/s) in the central vein and from 4 to 20 cm/s (mean 9.5 cm/s) in the central artery. The correct assignment of the measuring points in the papillary region was verified by the close correlation between the flow velocity and artificially elevated intraocular pressure. After evaluating 158 clinical examinations, we try to outline the diagnostic possibilities of the method with respect to single observations in patients with ocular circulatory disturbances.

Between 1983 and 1987 the authors studied 64 patients with dilated episcleral vessels and open-angle glaucoma. Elevated episcleral venous pressure was found to be the cause of the increased intraocular pressure. Clinically, the cause of elevation of venous pressure included spontaneous carotid cavernous fistulas, Sturge-Weber syndrome, orbital tumors, endocrine exophthalmos, anterior scleritis and idiopathic cases. A variety of pathophysiological mechanisms causing elevated episcleral venous pressure were found. The clinical course and complications associated with elevated episcleral venous pressure are discussed.

Enlargement of the orbital optic nerve was examined in patients by means of A- and B-scan ultrasonography and NMR imaging techniques; the results were then compared. We found that separation of the optical nerve sheets and the nerve structures themselves can be demonstrated with both methods, and increased width of the subarachnoidal space can be differentiated from the axonal cylinder. Our findings in meningeomas and gliomas are analyzed, as are the various reasons for edema of the disc. The pathogenesis of fluid collection in the subarachnoidal space in tumors of the optic nerve is discussed.

The present paper reports on a case of severe dacryocystitis with a dacryolith, caused by Aeromonas hydrophila. On the basis of this case the authors show that a therapy effective in vitro does not lead to elimination of bacteria in all cases, so that further therapeutic considerations are necessary.

The pathophysiological influence of spontaneous carotid cavernous fistula (CCF) on retinal/orbital circulation is discussed. Of 20 patients, 1 case of papilloedema, 4 of choroidal detachment (CD), 2 of exudative retinal detachment (ERD) and 3 cases of central venous thrombosis (CVT) were seen, associations that on rarely reported in the literature. An elevation in the episcleral venous pressure was measured that was more than twice the normal, which explains the ophthalmoscopic findings.

Clinical features of posterior scleritis were noted in 12 eyes of nine patients followed up for one to seven years. The signs of this clinical entity varied from transitory choroidal folds in the fundus to extensive scleral and choroidal edema with associated edema of Tenon's space and of the optic nerve sheath. These were detected only by ultrasonography. Histopathologic examination of one eye disclosed granulomatous inflammatory reaction in the involved scleral and choroidal areas. Local and systemic treatment with corticosteroids seemed not to affect the clinical course or outcome.

In various states of refraction axial eye length and thickness of the posterior ocular coats were measured echographically. As proved in previously performed experimental studies, retina, choroid and sclera were resolved in a considerable percentage of cases by combining the A- and B-mode techniques of modern ultrasonic equipment. The supposed close negative correlation between length of the globe and ocular coat dimensions was confirmed by statistical analysis of our data. This result should provide additional help, when interpreting the reflections of the ocular wall under normal and pathological conditions.

The indications for and long-term results of about 200 Lester-Jones tube insertions are reported. Follow-up was possible in 165 patients, of which 83% ended up with a comfortable dry eye. Reimplantations had been necessary in a certain percentage, dependent upon the primary cause of epiphora. The best results were achieved after herpetic canalicular obstructions, and the highest ratio of complications occurred when unsuccessful lacrimal surgery had been the indication for bypass surgery.

Report of a 71-year-old woman with acute closed-angle glaucoma. Echography shows an intraocular tumor of the choroid, and the histological diagnosis is necrotic malignant melanoma of the choroid. The clinical, echographical and histological findings are discussed.

Diabetic retinopathy is the most important causative factor of all vitreous hemorrhages. Early vitrectomies improve the prognosis with regard to function and enable panretinal coagulation to be completed.

A formula to calculate the volume of biconvex-shaped malignant melanomata of the choroid is presented. The axial length of the eye, whatever the refractive error, has nearly no influence on the results. A computer printout of the range of results is added for clinical use. The reliability of contact B-Scan ultrasonography to obtain those parameters is examined using various tumor models of defined sizes.

The ultrasonographic findings in 39 cases of malignant melanoma of the choroid has been correlated with histopathological results. Tumors with hemorrhages and/or necrosis showed a lower reflectivity than those with a higher amount of connection tissue. B-scan ultrasonography was found to be reliable for the measurement of the extent of the tumor in all three dimensions.

In 159 eyes with a spherical correction varying from +14.0 to -27.0 diopters, the axial length and thickness of posterior ocular coats were measured ultrasonographically. As proven in experimental studies, retina, choroid, and sclera were resolved in a considerable percentage of cases by combining A- and B-mode techniques of modern ultrasonographic equipment. The presumed close inverse correlation between the axial length of the eye and ocular coat dimensions was confirmed by statistical analysis. These values were used to calculate the approximative volume of the posterior half of the ocular coats. There was evidence for a constant tissue volume regardless of the difference in surface and axial length parameters between hyperopic and myopic eyes. Results are discussed and compared with theories of axial growth under physiological and pathological conditions.