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A 35-year-old physician had radial keratotomy (RK) for correction of myopia. Combined radial and transecting circumferential incisions were used which resulted in wound gape, persistent epithelial defect, and severe sterile keratitis. Progressive corneal decompensation required an initial patch graft followed by a penetrating keratoplasty four months after RK. Histopathology of the cornea demonstrated epithelial edema and persistent incisional epithelial plug formation, deep and superficial vascularization, variable incision depth (superficial to full thickness), endothelial cell loss, and inflammatory cell infiltration at all levels of the cornea. A review of the reported complications of RK is included in the discussion of this case.

This rare tumor which contains a combination of mesenchymal elements is believed to be the only one of its kind appearing in the orbit. The mesenchymoma has been described in detail by Stout. 1,2 These tumors which are derived from mesenchyme appear microscopically to arise from supportive and reticuloendothelial tissues. Stout 1 believes that most of the mixed mesenchymal tumors are probably initiated as the result of a developmental fault and so are regarded as dysontogenic growths. He believes that metaplasia plays some part in their development. There has been considerable discussion regarding this tumor, for it demonstrates two tissues arising from basic mesenchyme. The principal one represents a hemangiopericytoma, in which the tumor cells are believed to arise from the pericyte of Zimmerman and lie outside the reticulum sheath of the capillary, differentiating it from the hemangioendothelioma. 3 In addition, there appears in this tumor a growth of chondroblastic

The recurrent pterygium and repeated surgical operations destroy the normal Bowman's membrane which acts as a barrier to the ingrowth of conjunctival tissues. The insertion of a lamellar corneoscleral graft in the area of involvement seems to be a logical approach. Measurements are made on both the recipient and donor eye using the limbus as a point of reference. The dissections are made by hand. The 10-0 monofilament suture can be left indefinitely with little discomfort. The interrupted sutures are absorbed after the sclera has become adequately fixed by fibrous tissue.

To the Editor: —I read with considerable interest your article in the August issue regarding school testing of vision. It is my belief that this is a necessary and a vital step forward. In Oregon, and I presume in the majority of states, physicians are encountering more and more difficulty with optometrists who are trying with great effort to enhance their prestige and position by virtue of political maneuvers. During the past year the Oregon ophthalmologists encountered an extremely hard fight in the Legislature when the optometrists attempted to place a member of their profession on the Board of Health. During the hearings it became quite evident that they look upon the school testing of vision as something falling within their province. We soon became aware of their energetic drive and intense desire to exclude others from this particular field of endeavor. Unfortunately, the lay public and the members of

To the Editor: —There has been much discussion and considerable written about the additional certification in ophthalmic surgery. There seems to be too great a lack of agreement in this field to make one feel that the movement is fully understood and accepted by the ophthalmologists throughout the United States. We are a democracy and are proud of our heritage in which everyone has the right to be heard. I believe that it was wise to poll all of the members who hold certification from the Board of Ophthalmology and determine whether or not they were in favor of the additional certification.