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The most significant recent advance in ophthalmology has been implantation of an intraocular plastic lens to replace the cataractous lens. The success rate is 75--85 percent. Complications are discussed, and the importance of this operation for the aged is stressed. Vitrectomy is now being used for stopping vitreous hemorrhages and for other therapy not previously attempted. New diagnostic methods involving ultrasound have been of special help when the eye tissue is opaque. Brain tumors compressing the optic nerve have been diagnosed by computerized axial tomography. The laser beam is now being applied for treatment of diabetic retinopathy, for obliteration of retinal holes, and for the creation of holes in the iris in the treatment of narrow-angle glaucoma. Electronic instruments can estimate the refractive error. The new devices for measuring intraocular pressure do not require the use of local anesthetics. Soft contact lenses for continuous wear have been perfected. The binocular operating microscope has been an outstanding innovation in intraocular and corneal surgery. Timolol, a new drug for the treatment of glaucoma, reduces intraocular pressure without contracting the pupil.

The objective of a low-vision clinic developed at the Jewish Home and Hospital for Aged was to improve the visual capabilities of the residents who were not helped by the regular eye clinics. Eighty-three patients (72 women, 11 men) were examined the first year. Ages ranged from 71 to 101 years. The causes of poor vision were mainly senile macular degeneration, cataract formation, chronic glaucoma, severe myopia, aphakia, and combinations of these diseases. Vision ranged from 10/50 at 10 feet (20/100 at 20 feet) in the better eye, to only the ability to distinguish hand movements or to perceive light. With the use of visual aids such as distance or reading glasses and various forms of magnifying glasses, some improvement occurred in 61 of the 83 patients. The follow-up examination was within one year in most cases. It was concluded that in order to examine and treat such patients properly, much more time and patience were required than is usually possible in a regular eye clinic. This involved the help of more social workers and volunteer assistants. Nevertheless, the results were worthwhile for this type of patient.

The choroids of 107 postmortem aged eyes were used in this study. Twenty-six eyes were from patients with a clinical history of senile macular degeneration. Five eyes had early or questionable evidence of this condition. The remaining 76 eyes were from normal-aged patients. The choroids were processed by the trypsin digestion technique of Kuwabara and Cogan, as modified by Friedman, Smith and Kuwabara. This study was limited to the choriocapillaris. The most important changes noted in eyes with senile macular degeneration were: (1) thickening and irregular shape of the intercapillary septa; (2) narrowing of the lumen of the capillaries; (3) diminution or loss of cellularity of the capillaries; and (4) basophila of the macular area. The possible effects of these changes on the transport of oxygen and metabolites from the choriocapillaris to the outer layers of the retina are discussed.