Archives of Ophthalmology

VON SALLMANN, LUDWIG;MEYER, KARL

doi: 10.1001/archopht.1944.00890010019001pmid: N/A

Abstract The good results of penicillin in treatment of some experimental intraocular infections of the anterior segment of the eye1 and the antibacterial activity of penicillin in vitro against most organisms found in intraocular infections suggested the study of the penetration of penicillin into the anterior chamber. The investigations on the topical use of penicillin deal, first, with the entrance of penicillin into the aqueous of rabbits after iontophoresis as compared with that after the corneal bath ; second, with the influence of wetting agents on the penetration of penicillin, and, finally, with the possibility of its introduction by repeated use of solutions or ointments with and without wetting agents. The studies on the systemic application are limited to determinations of penicillin in the blood, the spinal fluid and the intraocular fluids after single intramuscular injections. The penicillin used in these experiments was obtained from a strain of Penicillium notatum grown References 1. von Sallmann, L.: Penicillin and Sulfadiazine in the Treatment of Experimental Intraocular Infection with Pneumococcus , Arch. Ophth. 30:426 ( (Oct.) ) 1943.Crossref 2. Meyer, K.; Chaffee, E.; Hobby, G. L.; Dawson, M. H.; Schwenk, E., and Fleischer, G.: On Penicillin , Science 96:20, 1942.Crossref 3. von Sallmann, L.: Sulfadiazine Iontophoresis in Pyocyaneus Infection of Rabbit Cornea , Am. J. Ophth. 25:1292, 1942. 4. This drug is supplied by the American Cyanamid and Chemical Corporation. 5. Hermann, F.; Sulzberger, M., and Baer, R.: New Penetrating Vehicles and Solvents , Science 96:451, 1942.Crossref 6. O'Brien, C. S., and Swan, K. C.: Carbaminoylcholine Chloride in the Treatment of Glaucoma Simplex , Arch. Ophth. 27:253 ( (Feb.) ) 1942.Crossref 7. Klein, N., and Scheffer, L.: Experimentelle Untersuchungen am Auge über die Resorption aus Salben , Arch. f. Ophth. 128:460, 1932. 8. Klein, M.: Beitrag zur Resorption aus Augensalben: II. Die Resorption des Atropins , Arch. f. Ophth. 129:413, 1932 9. Zur Kenntnis der Resorption aus Augensalben: III. Die Resorption des Homatropins, Pilocarpins, und Eserins , Klein Arch. f. Ophth. 131:25, 1933. 10. Fleming, A.: On the Antibacterial Action of Cultures of a Penicillium, with Special Reference to Their Use in the Isolation of B. Influenzae , Brit. J. Exper. Path 10:226, 1929. 11. Abraham, E. P.; Chain, E.; Fletcher, C. M.: Gardner, A. D.; Heatley, N. G.; Jennings, M. A., and Florey, H. W.: Further Observations on Penicillin , Lancet 2:177, 1941.Crossref 12. Fleming, A.: In Vitro Tests of Penicillin Potency , Lancet 1:732, 1942.Crossref 13. Rammelkamp, C. H.: A Method for Determining the Concentration of Penicillin in Body Fluids and Exudates , Proc. Soc. Exper. Biol. & Med. 51:95, 1942. 14. These values are subject to errors inherent in dilution methods. The calculated values for concentration of penicillin in the aqueous do not represent the actual weight of pure penicillin but are relative to the preparations used. It would probably be more accurate to express the concentrations in terms of activity. 15. Rammelkamp, C., and Keefer, C.: The Absorption, Excretion, and Distribution of Penicillin , J. Clin. Investigation 22:425, 1943. 16. Boyd, J. L.: Quantitative Comparison of Methods of Administering Physostigmine , Arch. Ophth. 30:521 ( (Oct.) ) 1943. 17. Gifford, S. : Personal communication to the author.

SAMUELS, BERNARD

doi: 10.1001/archopht.1944.00890010026002pmid: N/A

Abstract In a previous paper1 I described structural changes in a lens during the active stage of a corneal ulcer as they are seen microscopically, and in a second paper,2 the changes that may result long after an ulcer has been replaced by scar tissue. The present paper, the third in the series, has for its object a microscopic study of lesions occurring in a lens in nontraumatic iritis. Ordinarily, a lens remains clear after a first attack of iritis ; it is only after repeated attacks that opacities in the lens appear. I recall but 1 case, that of an able-bodied man of 54, in which cataract developed during a first attack of iritis. The iritis lasted about two months and was marked by an enormous infiltration in the stroma and a lenticular mass of exudate in the anterior chamber. The pain was of a rheumatic, intractable character. For References 1. Samuels, B.: Tr. Am. Ophth. Soc. 39:66, 1941. 2. Samuels, B.: Tr. Am. Ophth. Soc. 40:292, 1942.

DIMITRY, THEODORE J.

doi: 10.1001/archopht.1944.00890010036003pmid: N/A

Abstract HISTORICAL REVIEW Simple enucleation is not the most ancient surgical means of ridding the orbit of the eye. On the contrary, other surgical procedures were adopted until one hundred years ago. In the earlier period an operation that peeled the eye from its capsule was considered brutal as compared with procedures in which the eye was cut open rapidly and the contents eviscerated. To accomplish the latter, it was not unusual to cut away the cornea.Recall what was designated in an earlier period (1583) as an extirpation—today justifiably denominated the butchery of George Bartisch.1 He transfixed the eye, having passed through it a large curved needle threaded with tape, and then, pulling on the tape, cut the eye away.Though Cleoburey2 introduced the classic enucleation of the eye in 1826, his procedure was not adopted until 1855. Its performance was naturally slow, requiring dexterity and skill. Anesthetics References 1. Bartisch, G.: Augendienst , Dresden, M. Stöckel, 1583. 2. Cleoburey, W.: A Review of Different Operations Performed on the Eyes , London, T. & G. Underwood, 1826. 3. Ferrall, J. M.: Dublin J. M. Sc. 19:329, 1841.Crossref 4. Bonnet, A.: Ann. d'ocul. 5:1841. 5. If this statement is true, why should gauze be jammed into the socket after the enucleation ; why is the figure-eight bandage tightly applied, and why is hot water used to control "very little hemorrhage"? 6. Whitnall, S. E.: The Anatomy of the Human Orbit , London, H. Frowde, Hodder & Stoughton, 1921, p. 288. 7. Duke-Elder, W. S.: Textbook of Ophthalmology , St. Louis, C. V. Mosby Company, 1938, vol. 1, p. 179. 8. Grimsdale, H. B., and Brewerton, E.: Textbook of Ophthalmic Operations , ed. 2, New York, William Wood & Company, 1920, p. 186. 9. Müller, J.: United States Government patent, 1899. 10. Lang, W.: Tr. Ophth. Soc. U. Kingdom 7:286, 1887. 11. Müller, J.: Arch. f. Ophth. ( (pt. 3) ) 14:183, 1868. 12. Tuyl, G.: Arch. f. Ophth. 52:233, 1901. 13. Berlin, T.: Arch. f. Ophth. ( (pt. 2) ) 17:193, 1871. 14. Ludwig, P.: Klin. Monatsbl. f. Augenh. 41:389, 1904. 15. Peschel, M. : Centralbl. f. prakt. Augenh. 28:11, 1904. 16. Birch-Hirschfeld, in Graefe, A., and Saemisch, E. T.: Handbuch der gesamten Augenheilkunde , Berlin, Julius Springer, 1912, vol. 9, pt. 2. 17. Colomb, P.: United States Government patent 182539, 1905. 18. Müller, F., and Müller, A.: United States Government patent 5183-821, 1912. 19. Dimitry, T. J.: New Orleans M. & S. J. 69:205, 1916-1917. 20. Dimitry, T. J.: Am. J. Ophth. 2:653, 1919. 21. Mules, S. H.: Tr. Ophth. Soc. U. Kingdom 5:200, 1885. 22. Nicati, W.: Arch. d'opht. 232:347, 1903. 23. Ray, V.: South. M. J. 10:594, 1917. 24. Hall, E.: Am. J. Surg. 7:96, 1896. 25. Huizinga, J. G.: Eviscero-Neurotomy: A New Operation , J. A. M. A. 34:394 ( (Feb. 17) ) 1900. 26. Dimitry, T. J.: South. M. J. 10:594, 1917. 27. Frost, W. A.: Brit. M. J. 1:1150, 1887. 28. Berens, C.: Am. J. Ophth. 23:805, 1940. 29. Paré, A.: Les oeuvres de M. Ambroise Paré , conseiller et premier chirurgien du roy, Paris, G. Buon, 1575, book 23, chap. 1. 30. Footnote deleted by author. 31. It was said of Boissonneau, "He traveled the country looking up one-eyed people to fit with his created prothesis." 32. Jeyes, P.: United States Government patent, 1892. 33. Snellen, P.: Cong. internat. de méd., Rap. sect. d'opht. ( (pt. 2) ) 1:27, 1900.

GUNDERSEN, TRYGVE;LIEBMAN, SUMNER D.

doi: 10.1001/archopht.1944.00890010047004pmid: N/A

Abstract Our purpose in the present investigation was to determine experimentally the effect of various local anesthetics on the regeneration of corneal epithelium. Clinically it has been observed from time to time that local anesthetics have an inhibitory influence on the regeneration of corneal epithelium. In 1902 Fuchs,1 for this reason, stated that patients should be prohibited from using cocaine at home for the treatment of corneal abrasions. Many of the newer anesthetics are, however, said to be innocuous. Stallard2 stated that tetracaine has no toxic effect on the regenerating epithelium. According to Gifford,3 0.5 per cent butacaine sulfate or phenacaine hydrochloride causes little or no damage to the epithelium and may be used several times a day. Heretofore no attempt has been made to determine experimentally whether or not local anesthetics affect the regrowth of corneal epithelium. METHOD Guinea pigs (4 for the study of each drug) References 1. Fuchs, E.: Ueber Cocaine , Wien. klin. Wchnschr. 15:962, 1902. 2. Stallard, H. O., in Ridley, F., and Sorsby, A.: Modern Trends in Ophthalmology , London, Butterworth & Co., Ltd., 1940, chap. 49, p. 543. 3. Gifford, S. R.: A Handbook of Ocular Therapeutics , Philadelphia, Lea & Febiger, 1942, pp. 24 and 378. 4. Cats and rabbits were also used, but the results obtained were equivocal. It was thought that the nictitating membrane interfered with equal distribution of the drug on the cornea. Identical abrasions, 2 mm. wide, were made with a metal spatula in the two eyes, from limbus to limbus, across the centers of the corneas. The lesions were immediately stained with 2 per cent fluorescein sodium to make sure that equal areas had been abraded in the two corneas. The right eye of each animal was treated with the drug under investigation every hour day and night until both eyes showed no staining or until an unequivocal result had been obtained. Usually nothing was instilled into the left eye. The corneas were stained at various intervals, as indicated on the accompanying charts, and for comparative purposes the staining areas were recorded. 5. The ointment base consisted of 3 per cent oxycholesterol in petrolatum.

SUGAR, H. SAUL

doi: 10.1001/archopht.1944.00890010052005pmid: N/A

Abstract It is a well known fact that many persons who wear corrective lenses the prescription for which has been determined by accurate monocular refraction and who do not have abnormal lateral or vertical phorias are uncomfortable during binocular vision. In many cases the trouble is due to changes in the axes of cylinders when both eyes are used together for distant vision and during convergence accommodation. Several test methods have been devised to determine these changes; yet no cases were reported prior to those of Hughes,1 in 1941. It is the purpose of this paper to analyze the changes in the axis of astigmatism under varying conditions in a small series of 70 normal eyes with astigmatism of 1.00 D. or more and to introduce the use of the cross cylinder to determine these changes under binocular fixation. All these eyes were those of patients with binocular single vision. References 1. Hughes, W. L.: Change of Axis of Astigmatism on Accommodation , Arch. Ophth. 26:742 ( (Nov.) ) 1941.Crossref 2. Verhoeff, F. H.: Description of a Reflecting Phorometer , Am. J. Physiol. Optics 7:39, 1926. 3. Pascal, J. I.: The Axis of Astigmatism , Arch. Ophth. 27:189 ( (Jan.) ) 1942.Crossref 4. Copeland, J. C. : Locating the Astigmatic Axis Under Binocular Fixation , in Ten Years of Optical Developments (November 1940) , Chicago, Riggs Optical Company, 1942. 5. van Wien, S. : The Leland Refractor : Method for Refraction Under Binocular Conditions , Arch. Ophth. 23:104 ( (Jan.) ) 1940.Crossref 6. Crisp, W. H.: The Cross-Cylinder Tests Especially in Relation to the Astigmatism Axis , Tr. Ophth. Soc. U. Kingdom 60:495, 1931. 7. Jackson, E.: How to Use the Cross Cylinder , Am. J. Ophth. 13:321, 1930. 8. Williamson-Noble, F. A.: Possible Fallacy in the Use of the Cross-Cylinder , Brit. J. Ophth. 27:1, 1943.Crossref 9. Copeland, J. C.: Personal communication to the author. 10. Copeland, J. C.: A Study in the Application of Cylindric Corrections , Optom. Weekly 19:191 ( (April 5) ) 1928 11. Ten Years of Optical Development , Chicago, Riggs Optical Company, 1942 12. An Important Diagnostic Point in the Correction of Astigmatism, May-June 1931 13. Analysis and Use of the Crossed Cylinder, September 1931. 14. Prangen, A. de H.: The Significance of Sturm's Interval in Refraction , Am. J. Ophth. 24:413, 1941 15. Some Problems and Procedures in Refraction , Arch. Ophth. 18:432 ( (Sept.) ) 1937.Crossref

EVANS, JOHN N.;BROWDER, JEFFERSON

doi: 10.1001/archopht.1944.00890010061006pmid: N/A

Abstract The course and function of various fasciculi of the optic pathway have held the interest of ophthalmologists and neuroanatomists for many generations because knowledge in this field has a broad application to the diagnosis and treatment of ocular and cerebral disease. There are two general avenues of approach for studies of these fiber bundles. One may produce experimental lesions in various laboratory animals and study the resulting progress of fiber degeneration, or one may make functional studies on human beings who are suffering from certain localized lesions. The difficulties in making functional studies on the visual apparatus of even the subhuman primates are such that one cannot relate degenerative lesions to specific functional defects. For instance, accurate studies of visual acuity and visual fields are necessary to identify the defects caused by the damage to a particular group of fibers. It is recognized that such studies cannot be made on References 1. Horrax, G.: Contributions of the War to the Physiology of the Nervous System , Physiol. Rev. 1:269, 1921. 2. Cushing, H.: The Chiasmal Syndrome , Arch. Ophth. 3:505 ( (May) )Crossref 3. 704 (June) 1930. 4. Haden, H. C.: Studies of the Changes in the Optic Discs, Visual Fields, and Vision Following Bisection of the Optic Chiasm , Tr. Am. Ophth. Soc. 34:208, 1936. 5. It is necessary that we emphasize our attitude toward "relative defects." A relative defect is plotted in response to the subject's description of qualitative variations in the brightness of the (stimulating) object. Hence the scotoma can be no more than a qualitative indication, which may be quite different in size and shape at a subsequent examination, owing to the patient's selection of different descriptive language and standards of brightness. Any reliable defect can be, with appropriate technic, converted into an absolute defect. Under these conditions, the subject merely reports on the presence or absence of the stimulus. The plotted scotoma is measurable, and the conditions of study are reproducible and are less subject to the psychologic whims of the patient. One of us has emphasized elsewhere the clinical unreliability of color fields.7 6. Evans, J. N.: The Perimeter Spot-Light Object , Arch. Ophth. 7:614 ( (April) ) 1932.Crossref 7. White letters on a black background under 10 foot candles of illumination were used as the test object. These letters were checked for accuracy of size. 8. Evans, J. N.: An Introduction to Clinical Scotometry , Cambridge, Mass., Yale University Press, 1938, pp. 29-43. 9. Though the stereocampimeter was employed, it was used as a monocular device, the affected eye fixing the imaginary center of a drawn circle. A white spherical object was used against a black background at a distance of 190 mm. under 15 foot candles of illumination. 10. Evans, J. N.: Scotoma Associated with Strabismus , Am. J. Ophth. 12:194 ( (March) ) 1929. 11. To all intents and purposes this device is a camera which takes a continuous photograph of the corneal reflex on a moving picture film, which is in continuous motion. The result is a white tracing which represents fixation movements in the horizontal plane. 12. We have long been of the opinion that other workers have not given sufficient consideration to fixation movements when reporting on the shape and size of minute central defects. 13. For convenience, the photographs of these records are placed horizontally in the illustrations ; hence horizontal movements of the eyes are shown as vertical steps. 14. McFarland, R. A.; Holway, A. H., and Hurvich, L. M.: Studies of Visual Fatigue , Cambridge, Mass., Harvard University Press, 1942, p. 137. 15. It has been demonstrated elsewhere 7 that a normal angioscotoma extends horizontally 7 to 8 degrees from the blindspot. This region widened only with pressure on the globe in the present study. The remainder of the defect would thus seem to be due to damage to fiber bundles. 16. For the sake of a clearer mental picture, all consideration of the extramacular fibers of the pathway is omitted. 17. The word "half" is used not with the meaning of a mathematically precise portion but in a gross anatomic sense only. 18. Halstead, W.; Walker, A., and Bucy, P.: Sparing and Nonsparing of "Macular" Vision Associated with Occipital Lobectomy in Man , Tr. Sect. Ophth., A. M. A. , 1940, p. 193. 19. In Haden's case vision in the left eye was 6/6. "Electrical" cutting was used to divide the chiasm in this case.

VON SALLMANN, LUDWIG

doi: 10.1001/archopht.1944.00890010072007pmid: N/A

Abstract The study of the chemotherapy of intraocular infections of the anterior segment with Diplococcus pneumoniae1 was extended in these experiments to similar infections with Staphylococcus aureus, which stands second to D. pneumoniae in frequency as the cause of post-traumatic and postoperative purulent endophthalmitis, and Clostridium welchii was selected as a representative of the anaerobe group. The effect of the oral administration of sulfadiazine in combination with the topical use of its sodium salt was again compared with that of the local treatment with penicillin.2 INFECTIONS WITH STAPHYLOCOCCUS AUREUS Preliminary Experiments. —Eight strains of Staph. aureus, obtained in cultures of material from human conjunctivas and corneas,3 were tested in vitro for their sensitivity to penicillin. The determinations were made in accordance with the modified method of Fleming4 except for the use of a 10-2 dilution of the broth culture in place of a loopful of the References 1. von Sallmann, L. : Penicillin and Sulfadiazine in the Treatment of Experimental Intraocular Infection with Pneumococcus , Arch. Ophth. 30:426 ( (Oct.) ) 1943.Crossref 2. The penicillin was extracted and prepared in the laboratory of Dr. Karl Meyer. 3. Dr. Devorah Locatcher-Khorazo did all the bacteriologic work on the human eye in connection with this experimental study. 4. Fleming, A.: In-Vitro Tests of Penicillin Potency , Lancet 1:732, 1942.Crossref 5. (a) von Sallmann, L. : Sulfadiazine Iontophoresis in Pyocyaneus Infection of Rabbit Cornea , Am. J. Ophth. 25:1292, 1942. 6. (b) von Sallmann, L., and Meyer, K.: Penetration of Penicillin into the Eye , Arch. Ophth. , this issue, p. 1. 7. A calcium salt of penicillin was prepared by Dr. Karl Meyer for tentative experiments with iontophoresis in a series of 8 eyes. The iontophoretic introduction of a 0.25 per cent solution caused an extensive abrasion of the cornea and fibrinous exudate in the anterior chamber. 8. Poos, F.: Ueber die histologischen und klinischen Erscheinungen bei akuten, lokalen Capillarkreislaufstörungen am Auge , Arch. f. Ophth. 127:489, 1931. 9. Verhoeff, F. H. : Observations on Parinaud's Conjunctivitis (Leptothricosis Conjunctivae) , Am. J. Ophth. 1:706, 1918. 10. Thygeson, P.: Sulfonamide Compounds in Treatment of Ocular Infections , Arch. Ophth. 29:1000 ( (June) ) 1943.Crossref 11. Guyton, J. S., and Woods. A. C.: Use of Sulfanilamide in Ophthalmology , Am. J. Ophth. 24:428, 1941. 12. Meoni, M.: La chemioterapia sulfamidica nelle affezioni oculari , Arch. di ottal. 46: 183, 1939. 13. Robson, J. M., and Scott, G. I.: Local Chemotherapy in Experimental Lesions of the Eye Produced by Staphylococcus Aureus , Lancet 1:100, 1943.Crossref 14. "Solubilized" Sulfathiazole is a 15 per cent solution of sulfathiazole sodium formaldehyde sulfoxylate.12 15. Tyrothricin consists of 15 per cent gramicidin and 85 per cent tyrocidin. 16. Florey, M. E., and Florey, H. W.: General and Local Administration of Penicillin , Lancet 1:387, 1943.Crossref 17. An applicator tube, similar to that of van Heuven, and made of lucite by Obrig Laboratories, New York, was found useful for clinical purposes. One end of the tube has a broad flare, in the form of the scleral part of a contact lens. The diameter of the opening is approximately that of the cornea. Five millimeters above this aperture a spiral of platinum wire is contained in a widening of the tube. An extension of the wire provides a connection to the lead of the apparatus for iontophoresis. 18. Bellows, J. G.: Chemotherapy in Ophthalmology , Arch. Ophth. 29:888 ( (June) ) 1943.Crossref 19. Hobby, G. L.; Meyer, K., and Chaffee, E.: Activity of Penicillin in Vitro , Proc. Soc. Exper. Biol. & Med. 50:277, 1942. 20. Morax, V.: Des infections du globe oculaire par microorganismes anaérobies , Bull. Acad. roy. de méd. de Belgique 7:321, 1927. 21. Ridley, F.: Gas Gangrene Panophthalmitis , Tr. Ophth. Soc. U. Kingdom 49:221, 1929. 22. Hamilton, J. B.: Notes on B. Welchii Infection of the Globe , Brit. J. Ophth. 14:452, 1930. 23. Rieger, H.: Ueber Wundinfektion des Augapfels mit Erregern der Gasbrandgruppe , Arch. f. Ophth. 137:61, 1937. 24. Chaillous, J.: Deux cas d'infection traumatique du globe oculaire par un microbe anaérobie (Bacillus perfringens) , Ann. d'ocul. 134:115, 1905. 25. Schumacher, G.: Anaёrobe Bazillen bei Augenverletzungen , Klin. Monatsbl. f. Augenh. 46:34, 1908. 26. Morax, V., and Chiazzaro: Sur l'infection du cristallin: Recherches cliniques et expérimentales , Ann. d'ocul. 164:241, 1927. 27. Bellows, J. G., and Chinn, H.: Penetration of Sulfathiazole in the Eye , Arch. Ophth. 25:294 ( (Feb.) ) 1941. 28. P'an, S. Y.: Ocular Absorption of Sulfonamide Derivatives After Local Application , Proc. Soc. Exper. Biol. & Med. 49:384, 1942.

LEE, OTIS S.

doi: 10.1001/archopht.1944.00890010082008pmid: N/A

Abstract Molluscum contagiosum is an infectious disease of the skin characterized by the formation of multiple, small, discrete, umbilicated epithelial nodules. These nodules, appearing most commonly on the face and hands of young persons, are usually circular, average 2 mm. in diameter and are covered with normal epithelium. In the center of the characteristic umbilication is an orifice from which a cheesy mass consisting of ovoid cells, termed molluscum bodies, can be expressed. Microscopically these bodies are composed of swollen and vacuolated epithelial cells having an atrophic nucleus which has been pushed to one side by an acidophilic cytoplasmic inclusion body. These inclusions are composed of minute elementary bodies, first described by Lipschütz,1 and are thought by some investigators to be the causative virus. The virus origin of molluscum contagiosum was established in 1905 by Juliusberg,2 who demonstrated that the disease was transmissible from person to person by material References 1. Lipschütz, B.: Weitere Beiträge zur Kenntnis des Molluscum contagiosum , Arch. f. Dermat. u. Syph. 107:387, 1911.Crossref 2. Juliusberg, M.: Zur Kenntnis des Virus des Molluscum contagiosum des Menschen , Deutsche med. Wchnschr. 31:1598, 1905.Crossref 3. Elschnig, A.: The Significance of Molluscum Contagiosum as an Aetiological Factor of Conjunctival and Corneal Disease , Arch. Ophth. 51:237, 1922. 4. Quill, T. H.: Molluscum Contagiosum of Eyelid and Cornea: Report of a Case , Proc. Staff Meet., Mayo Clin. 15:139, 1940. 5. de Wecker: Klin Monatsbl. f. Augenh. 34:64, 1896 6. Elschnig, A.: Molluscum contagiosum und Conjunctivitis follicularis , Wien. klin. Wchnschr. 10:943, 1897. 7. Gifford, H., and Gifford, S. R.: Molluscum Conjunctivitis , Arch. Ophth. 50:227, 1921. 8. Cavara, V.: Le congiuntiviti da mollusco contagioso , Boll. d'ocul. 3:1, 1924. 9. Offret, G., and Duperrat, R.: Les manifestations oculaires du molluscum contagiosum , Arch. d'opht. 2: 993, 1938. 10. Thygeson, P.: Viruses and Virus Diseases of Eye , Arch. Ophth. 29:488 ( (March) ) 1943.Crossref 11. Holmes, W. J.: Epidemic Infectious Conjunctivitis , Hawaii M. J. 1:11, 1941. 12. Berliner, M. L. : Epidemic Keratoconjunctivitis , Am. J. Ophth. 26:50, 1943. 13. The riboflavin was given in the form of flavaxin niphanoid (Winthrop Chemical Company, Inc.). 14. Norris, W. F., and Oliver, C. A.: A Text-Book of Ophthalmology , ed. 2, Philadelphia, Lea Bros. & Co., 1900. 15. Ball, J. M., Jr.: Modern Ophthalmology , Philadelphia, F. A. Davis Co., 1904. 16. Fuchs, E.: Text-Book of Ophthalmology , authorized translation from the twelfth, revised and greatly enlarged German edition by A. Duane, ed. 8, Philadelphia, J. B. Lippincott Company, 1924. 17. Atkinson, D. T.: External Diseases of the Eye , Philadelphia, Lea & Febiger, 1934. 18. Parsons, J. H.: Diseases of the Eye , ed. 2, New York, The Macmillan Company, 1936. 19. Berens, C.: The Eye and Its Diseases , Philadelphia, W. B. Saunders Company, 1936. 20. de Schweinitz, G.: Diseases of the Eye , ed. 10, Philadelphia, W. B. Saunders Company, 1924. 21. Axenfeld, T.: Lehrbuch und Atlas der Augenheilkunde , ed. 8, Jena, Gustav Fischer, 1935. 22. Duke-Elder, W. S.: Text-Book of Ophthalmology , St. Louis, C. V. Mosby Company, 1938, vol. 2. 23. O'Brien, C. S., and Braley, A. E. : Common Tumors of the Eyelids , J. A. M. A. 107:933 ( (Sept. 19) ) 1936.Crossref

KRUG, ERNEST F.

doi: 10.1001/archopht.1944.00890010086009pmid: N/A

Abstract REPORT OF CASE History. —G. R. a boy then 6 years old, was first brought to me in 1929 for removal of a facial rash and correction of the right upper eyelid. I noted that he had an angioma of the right upper lid, measuring about 6 by 10 mm., and that his face—both cheeks and the nose—was covered with a reddish brownish rash. Each small nodule apparently had a fine vascular loop. Careful ophthalmic examination, with instillation of drops, revealed that he was slightly far sighted ; otherwise, his eyes were normal. The fundi were normal, and vision was 20/20 with a +0.75 D. sphere.He was referred to a dermatologist, but the diagnosis of adenoma sebaceum was not made. The dermatologist suggested electrolysis for removal of what was apparently a congenital lesion, but permission for this was refused.I saw the patient again in 1936, when an examination of References 1. Vogt, H.: Zur Pathologie und pathologischen Anatomie der verschiedenen Idiotieformen: II. Tuberöse sklerose , Monatschr. f. Psychiat. u. Neurol. 24:106-150, 1908.Crossref 2. Schuster, P.: Die Beziehungen der sogenannten tuberösen Sklerose des Gehirns zur Dermatologie , Dermat. Wchnschr. 57:1475, 1913. 3. (a) van der Hoeve, J.: Augengeschwülste bei der tuberösen Hirnsklerose (Bourneville) , Arch. f. Ophth. 105:880-898, 1921 4. (b) Eye Diseases in Tuberous Sclerosis of the Brain and in Recklinghausen's Disease , Tr. Ophth. Soc. U. Kingdom 43:534-541, 1923. 5. Messinger, H. C., and Clarke. B. E.: Retinal Tumors in Tuberous Sclerosis: Review of the Literature and Report of a Case, with Special Attention to Microscopic Structure , Arch. Ophth. 18:1-11 ( (July) ) 1937.Crossref 6. Globus, J. H.; Strauss, I., and Selinsky, H.: Das Neurospongioblastom, eine primäre Gehirngeschwulst bei disseminierter Neurospongioblastose (tuberöse Sklerose) , Ztschr. f. d. ges. Neurol. u. Psychiat. 140: 1-29, 1932.Crossref 7. Reese, A. B.: Relation to Drusen of Optic Nerve to Tuberous Sclerosis , Arch. Ophth. 24:187-205 ( (July) ) 1940.Crossref 8. Loewenstein, A., and Steel, J.: Retinal Tuberous Sclerosis (Bourneville's Disease) , Am. J. Ophth. 24: 731-741, 1941.

LOWENSTEIN, OTTO;LEVINE, ARNOLD S.

doi: 10.1001/archopht.1944.00890010092010pmid: N/A

Abstract The syndrome of alternating spastic and paretic phases of a periodic (cyclic) nature in paralysis of the third cranial (oculomotor) nerve has frequently been observed since it was first described by Rampoldi, in 1884. In 1942 Lowenstein and Givner,1 on the basis of pupillographic studies, showed that there is no real paralysis of the sphincter muscle and suggested therefore that the syndrome be spoken of no longer as a cyclic oculomotor paralysis but as an intermittent spasm of the third nerve with irregular periodicity (periodic spasmus mobilis oculomotorii). They showed that it is the result of partial destruction of the nucleus for the sphincter of the iris combined with supranuclear lesions, involving particularly the connections between the nucleus for the sphincter and the hypothalamus. In contrast to this, periodic spasm of the sympathetic pupillary innervation has, to our knowledge, never been reported. In 1907 Westphal2 described the phenomenon References 1. Lowenstein, O., and Givner, I.: Cyclic Oculomotor Paralysis (Spasmus Mobilis Oculomotorius) , Arch. Ophth. 28:821-833 ( (Nov.) ) 1942.Crossref 2. Westphal, A.: Ueber bisher nicht beschriebene Pupillenerscheinungen im katatonischen Stupor , Allg. Ztschr. f. Psychiat. 64:694, 1907. 3. Lowenstein, O.: Experimentelle Beiträge zur Lehre von den katatonischen Pupillenveränderungen , Monatschr. f. Psychiat. u. Neurol. 47:194, 1920Crossref 4. Pool, J. L. : Manual Reflex : The Ulnar Adductor Reflex , Bull. Neurol. Inst. New york 6:372-377, 1937. 5. Gradle and Eisendrath ( Klin. Monatsbl. f. Augenh. 71:311-313, 1923) 6. Gradle and Ackerman ( Reaction Time of the Normal Pupil , J. A. M. A. 99:1334-1336 [ (Oct. 15) ] 1932)Crossref 7. Lowenstein, O., and Friedman, E. D.: Present State of Pupillography : Its Method and Diagnostic Significance , Arch. Ophth. 27:969-993 ( (May) ) 1942.Crossref 8. Hess, W. R.: Pupille und Zwischenhirn , Klin. Monatsbl. f. Augenh. 103:407-413, 1939. 9. Foerster, O., and Gagel, O.: Die Vorderseitenstrangdurchschneidung beim Menschen , Ztschr. f. d. ges. Neurol. u. Psychiat. 138:1-92, 1932.Crossref 10. Lowenstein, O., and Westphal, A.: Experimentelle und klinische Studien zur Physiologie und Pathologie der Pupillenbewegungen mit besonderer Berücksichtigung der Schizophrenie , Berlin, S. Karger, 1933.