British Journal of Ophthalmology

Clarke, M.; Jagger, J.

doi: 10.1136/bjo.70.12.877pmid: 3801363

Forty-three patients who had suffered an episode of angle closure glaucoma had an assessment of glucose tolerance. Two patients were known diabetics and one new diabetic was found as a result of the study. The prevalence of diabetes in this series did not differ significantly from the normal in view of the age distribution of the patients.

Crock, G. W.; Janakiraman, P.; Reddy, P.

doi: 10.1136/bjo.70.12.879pmid: 3801364

The intraocular magnet (IOM) is a new device based on permanent magnetism providing controlled energy for removal of magnetic intraocular foreign bodies. Its use is reported in 11 cases.

Lavin, M.; Jagger, J.

doi: 10.1136/bjo.70.12.886pmid: 3801365

Pupillary capture is an unusual complication of posterior chamber intraocular lens implantation and may occur in the early or late postoperative period. We describe a series of patients with early or late onset pupillary capture and describe the pathogenesis. Early capture results from mechanical factors and is usually preventable. Late capture may be mechanical but is usually a sequel to the formation and subsequent contraction of iridocapsular synechiae. Synechiae result from lens epithelial or iris stromal hyperplasia and myofibroblastic metaplasia; they may be minimised by an atraumatic technique and adequate control of postoperative inflammation. The effect of pupillary capture is largely cosmetic, and we encountered no specific complications attributable to it.

Howe, J. W.; Mitchell, K. W.; Mahabaleswara, M.; Abdel-Khalek, M. N.

doi: 10.1136/bjo.70.12.890pmid: 3801366

An electrophysiological investigation of visual evoked potential (VEP) latency and contrast sensitivity was performed in a group of 13 patients who had undergone extracapsular cataract surgery with posterior chamber lens implantation. In spite of good postoperative visual acuity, abnormalities were detected in nine of the group (69%). This study suggests that, even with successfully implanted lenses, there may be a reduction in visual function which could be the result of altered transmission through the plastic lenticulus or fibrosis of the posterior lens capsule, and/or subtle changes in retinal architecture, not observed ophthalmoscopically.

McMenamin, P. G.; Lee, W. R.

doi: 10.1136/bjo.70.12.895pmid: 3801367

A patient presented with a heavily pigmented ciliary body tumour accompanied by diffuse pigmentation of the iris and chamber angle and secondary open angle glaucoma. The case was diagnosed clinically as malignant melanoma and melanomalytic glaucoma, and the eye was enucleated. Routine histopathology, immunohistochemistry, and ultrastructural studies revealed the tumour as being of the spindle cell type with extensive necrosis accompanied by a massive macrophagic response. The iridocorneal angle was heavily infiltrated by large pigmented cells, which were identified as being predominantly melanomacrophages. This is consistent with the few previous descriptions of this condition and confirms the view that the aqueous outflow obstruction is simply a mechanical process. Most of the native trabecular endothelial cells, which had also phagocytosed large quantities of melanin, still maintained their normal relationship to the trabeculae, though there were signs of activation. Immunohistochemistry and electron microscopy revealed the presence of moderate numbers of tumour cells on the iris surface and in the trabecular meshwork distant from the primary tumour site. The importance of these findings to the management of anterior uveal melanomas with secondary open angle glaucoma is discussed.

Roper, J. P.; Jones, T.; Common, J. D.

doi: 10.1136/bjo.70.12.907pmid: 3542016

Desmoplastic malignant melanoma is a rare and highly malignant tumour, which usually occurs in the head and neck. This is demonstrated by a case history of a patient with this lesion on the lower lid, which has not been previously described in the British ophthalmological literature. The lesion often presents considerable problems of histological diagnosis.

Stern, W. H.; Johnson, R. N.; Irvine, A. R.; Barricks, M. E.; Boyden, B. S.; Hilton, G. F.; Lonn, L. I.; Schwartz, A.

doi: 10.1136/bjo.70.12.911pmid: 3801368

We have used intraocular sulphur hexafluoride or liquid silicone as an adjunct to vitreous surgery in the treatment of a non-randomised sequential series of 19 eyes with retinal detachment complicated by proliferative vitreoretinopathy. We have studied the surgical results and complications of these two tamponades and drawn preliminary conclusions on their use in retinal reattachment surgery. After a seven-month minimum follow-up 13 (68%) of the eyes have reattached retinas. Six (60%) of 10 eyes treated only with silicone have reattached retinas, and four (67%) of six eyes treated only with sulphur hexafluoride gas tamponade have reattached retinas. An additional three eyes treated initially with silicone oil subsequently developed retinal detachments; all were successfully reattached with sulphur hexafluoride tamponade after silicone oil removal. Intraoperative pneumatic retinal reattachment to assess relief of retinal traction combined with the production of widespread chorioretinal adhesions to wall off persistent anterior traction and detachment, as well as extended postoperative gas tamponade of the retina, appears to enhance the surgical results in retinal detachment complicated by proliferative vitreoretinopathy. Silicone oil tamponade of the retina appears to be useful in cases where retinal traction cannot be entirely relieved and in patients who are unable to tolerate the head positioning required for effective gas tamponade of the retina. A controlled clinical study recently begun will be required to define further the precise role of these methods of retinal tamponade.

Sanders, E. A.; Volkers, A. C.; van der Poel, J. C.; van Lith, G. H.

doi: 10.1136/bjo.70.12.918pmid: 3801369

A group of 53 patients who had suffered an attack of unilateral (n = 45) or bilateral (n = 8) optic neuritis more than six months before were subjected to a battery of tests to determine their spatial contrast sensitivity, visual field, and colour vision. The 106 eyes investigated were classified according to their clinical status and visual acuity at the time of the study into unaffected (n = 45), recovered (n = 33), and non-recovered (n = 28). At least one of the three tests gave an abnormal result in 67%, 88%, 100% of the three groups respectively. The results obtained with these three tests showed a significant statistical association.

Weale, R. A.

doi: 10.1136/bjo.70.12.925pmid: 3801370

When the illuminating beam of a slit-lamp is polarised and one of the viewing oculars and the camera lens are provided with crossed analysers, the image of the lens generally darkens. The effect is enhanced by the insertion of a quarter-wave plate. The contrast of lenticular discontinuities is consequently greatly accentuated. This makes it possible to quantify them.

Khurana, A. K.; Ahluwalia, B. K.; Mehtani, V. G.

doi: 10.1136/bjo.70.12.931pmid: 3801371

Epitarsus is a rare congenital anomaly or may be acquired following severe conjunctivitis, usually of a cicatrising nature. The terms primary and secondary epitarsus are suggested to denote the two different aetiological varieties. On its clinical and histopathological features the present case conforms to the interfornix variety of primary epitarsus.