Archives of Ophthalmology

SMELSER, GEORGE K.;OZANICS, V.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190271001pmid: 21009148

Abstract It has long been recognized that the frequent topical application of anesthetics delays the repair of epithelial injuries of the cornea. This observation has been made clinically (Stallard1), and more rigorously controlled comparisons have been made on laboratory animals on which treated and untreated standardized corneal abrasions have been inflicted (Gundersen and Liebman,2 Friedenwald and Buschke3). Such studies have lead to attempts to secure less harmful drugs which are yet effective anesthetics. The search for an anesthetic agent which does not inhibit healing is obviously of practical value. It is of equal interest to determine whether inhibition of healing processes is proportional to the anesthetic properties and is, therefore, possibly due to the same factors which produce anesthesia. In such a case normal healing rate and anesthesia would be incompatible. It is the purpose of this paper to show that anesthesia and normal healing are compatible, to References 1. Stallard, H. B.: Methods of Anesthesia and Analgesia for Ophthalmic Operations , in Ridley, F., and Sorsby, A.: Modern Trends in Ophthalmology , London, Butterworth & Co., Ltd., 1940, chap. 49. 2. Gundersen, T., and Liebman, S. D.: Effect of Local Anesthetics on Regeneration of Corneal Epithelium , Arch. Ophth. 31:29 ( (Jan.) ) 1944.Crossref 3. Friedenwald, J. S., and Buschke, W.: The Influence of Some Experimental Variables on the Epithelial Movements in the Healing of Corneal Wounds , J. Cell. & Comp. Physiol. 23:95, 1944. 4. Arey, L. B.: Wound Healing , Physiol. Rev. 16:327, 1936. 5. Wigglesworth, V. B.: Wound Healing in an Insect (Rhodnius Prolixus Hemiptera) , J. Exper. Biol. 14:364, 1937. 6. Arey, L. B., and Covode, W. M.: The Method of Repair in Epithelial Wounds of the Cornea , Anat. Rec. 86:75, 1943. 7. Mann, I.: Study of Epithelial Regeneration in Living Eye , Brit. J. Ophth. 28:26, 1944. 8. Smelser, G. K., and Ozanics, V.: Effect of Chemotherapeutic Agents on Cell Division and Healing of Corneal Burns and Abrasions in the Rat , Am. J. Ophth. 27:1063, 1944. 9. Baba, H.: Vergleichende Beobachtungen über die durch Instillationen von verschiedenen lokalen Anaesthetica hervorgerufenen Augenveränderungen , abstracted, Zentralbl. f. d. ges. Ophth. 40:555, 1938. 10. The solutions of cocaine hydrochloride were obtained in the hospital pharmacy. The solutions of all other drugs were prepared in our laboratory. Some of the ointments were also prepared in our laboratory in the hydrous wool fat base mentioned; others were proprietary ointments, obtained as follows: Ophthalmic Ointment Butyn Sulfate 2% and Metaphen 1:3,000, Abbott Laboratories; Ophthalmic Ointment Butesin Picrate 1% and Butesin 1%, Abbott Laboratories; Pontocaine Base Eye Ointment (0.5 per cent tetracaine base), Winthrop Chemical Company, Inc.; Nupercainal (nupercaine base, 1 per cent), Ciba Pharmaceutical Products, Inc., and Holocaine Hydrochloride (2 per cent phenacaine hydrochloride), Abbott Laboratories. These products were purchased locally. 11. Friedenwald, J. S., and Buschke, W.: The Effects of Excitement, of Epinephrine and of Sympathectomy on the Mitotic Activity of the Corneal Epithelium in Rats , Am. J. Physiol. 141:689, 1944. 12. Friedenwald, J. S., and Buschke, W.: Mitotic and Wound-Healing Activities of Corneal Epithelium , Arch. Ophth. 32:410 ( (Nov.) ) 1944. 13. Since this article was submitted for publication, we have carried out similar experiments with metycaine hydrochloride (Lilly) solutions and ointments. The burned areas, treated with a 1 per cent solution of metycaine hydrochloride, were 134 per cent larger than the untreated control burns. This delay in healing was similar to that caused by a 0.1 per cent solution of nupercaine hydrochloride. There were 17 per cent fewer mitotic figures in these treated eyes, a depression similar to that caused by butacaine sulfate. The ointment containing 4 per cent metycaine hydrochloride delayed epithelization a little less than did the ointment containing 0.5 per cent tetracaine base. The burned area was 159 per cent greater than the average area of the control burns. The number of mitotic figures was 25 per cent less in the ointment-treated eyes, an effect similar to that obtained with the ointment containing butacaine sulfate, 2 per cent, and metaphen. 14. Michaelis, M., and Quastel, J. H.: The Site of Action of Narcotics in Respiratory Processes , Biochem. J. 35:518, 1941. 15. Herrmann, H.; Moses, S. G., and Friedenwald, J. S.: Influence of Pontocaine Hydrochloride and Chlorobutanol on Respiration and Glycolysis of Cornea , Arch. Ophth. 28:652 ( (Oct.) ) 1942.

HARDY, Le GRAND H.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190278002pmid: 21009149

Abstract THE PROBLEM What is wrong with the present color-testing procedures? Why do examiners often fail to expose persons with defective color vision? Does the fault lie in the tests, the methods of administering them or the conditions under which they are administered? IMPORTANCE OF THE PROBLEM In the Army. —An officer is shot because a cadet pilot fails to recognize a colored signal and fires an extra round. A bomber is shot down because a returning pilot fails to respond to a prearranged color signal code. Data of the Civil Aeronautics Administration show that a pilot who failed to pass the Ishihara test on the first attempt has a 50 per cent chance of passing a retest. In the Navy. —Tests conducted by members of the Committee on Color Blindness of the Inter-Society Color Council show that all the commonly used tests for color blindness are unreliable and largely ineffective References 1. Gage, H. P., and Macbeth, N.: Filters for Artificial Daylighting: Their Grading and Use , Tr. Ilium. Engin. Soc. 31:995, 1936. 2. Dimmick, F. L.: Methodology in Test Preparation , Am. J. Optom. 20:430, 1943.Crossref 3. Hardy, A. C.: Handbook of Colorimetry , Cambridge, Mass., Massachusetts Institute of Technology, 1936. 4. Macbeth, N.: Color Temperature Classification of Natural and Artificial Illuminants , Tr. Illum. Engin. Soc. , 23:302, 1928. 5. Smith, T., and Guild, J. : The C. I. E. Colorimetric Standards and Their Use , Tr. Am. Optic. Soc. 33:5, 1931-1932. 6. Judd, D. B.: The 1931 I. C. I. Standard Observer and Coordinate System for Colorimetry , J. Optic. Soc. America 23:359, 1933.Crossref 7. The filters may be obtained from Corning Glass Works; the lamp and filter combinations, from the Macbeth Daylighting Company. 8. Reed, J. D.: The Effect of Illumination in Changing the Stimuli in Pseudo-Isochromatic Plates , J. Optic. Soc. America 34:350, 1944.

ROPER, KENNETH L.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190283003pmid: 21009150

Abstract The recent literature describes two new lesions of the sclera—one primarily necrotic in origin and the other primarily degenerative in character. Within a period of six months I have observed 5 cases of the latter type. The condition is one of symmetric hyaline degeneration of the sclera, occurring in advanced age and characterized by the presence of slate gray plaques, situated about 3 mm. from the limbus and 1.5 to 2 mm. anterior to the insertions of the rectus muscles, to which they bear a definite relationship. Clinically, these hyaline areas probably escape notice because the patient rarely draws the physician's attention to their presence. I believe that they would be found much more frequently if ophthalmologists paid more attention to such conditions during their routine clinical examinations. It is surprising that so few contributions to the literature on the subject have been made. REVIEW OF LITERATURE I have made References 1. Parsons, J. H.: The Pathology of the Eye , London, Hodder & Stoughton, 1904, vol. 1, pt. 1, p. 279. 2. Salzmann, M.: Anatomie und Histologie des menschlichen Augapfels in Normalzustande, seine Entwicklung und sein Altern , Vienna, F. Deuticke, 1912. 3. Rolandi, S.: Sulla presenza di speciali chiazza nella sclera di probabile natura cartilaginea , Ann. di ottal. 44:843-857, 1915. 4. Krekeler, F.: Die Struktur der Sklera in den verschiedenen Lebensaltern , Arch. f. Augenh. 93:144-159, 1923. 5. Pillat, A.: Ueber eine eigenartige senile Entartung der Lederhaut an den Ansatzstellen der geraden Augenmuskeln , Ztschr. f. Augenh. 82:113-123 ( (Dec.) ) 1933. 6. Fischer, F. P.: Experimentelle Untersuchungen an der Lederhaut , Arch. f. Augenh. 97:467-492 ( (Dec.) ) 1926. 7. Kiss, J.: Fall von seniler Skleraverdünnung , Klin. Monatsbl. f. Augenh. 92:121-122 ( (Jan.) ) 1934. 8. Kreibig, W., in discussion on Kiss,7 p. 122. 9. Graves, B., in Berens, C.: The Eye and Its Diseases , Philadelphia, W. B. Saunders Company, 1936, p. 468. 10. Graves, B.: Bilateral Mesial Superficial Deficiency of the Sclera , Brit. J. Ophth. 21:534-538 ( (Oct.) ) 1937.Crossref 11. Graves, B.: Bilateral Mesial Superficial "Deficiency" of the Sclera (Scleral Plaques) , Brit. J. Ophth. 23:191-204 ( (March) ) 1939.Crossref 12. Culler, A. M.: The Pathology of Scleral Plaques: Report of Five Cases of Degenerative Plaques in the Sclera Mesially, One Studied Histologically , Brit. J. Ophth. 23:44-50 ( (Jan.) ) 1939.Crossref 13. Graves, B.: Bilateral (Mesial) Deficiency of the Sclera: Scleral Plaques , Brit. J. Ophth. 25:35-38 ( (Jan.) ) 1941.Crossref 14. Urrets Zavalia, A.; Maldonado Allende, I., and Obregón Oliva, R.: Scleromalacia Observed During the Course of a Chronic Porphyrinuria , Arch. de oftal. de Buenos Aires 12:115-137 ( (March) ) 1937. 15. van der Hoeve, J.: Scleromalacia Perforans , Arch. Ophth. 11:111-118 ( (Jan.) ) 1934.Crossref 16. Gasteiger, H.: Ueber senile Entartung der Lederhaut an den Ansatzstellen der Augenmuskeln , Klin. Monatsbl. f. Augenh. 98:767-772 ( (June) ) 1937. 17. Rones, B.: Senile Changes and Degenerations of the Human Eye , Am. J. Ophth. 21:239-255 ( (March) ) 1938. 18. Kyrieleis, W.: Ueber umschriebenen Lederhautschwund (Skleromalazie) in höherem Lebensalter , Klin. Monatsbl. f. Augenh. 103:441-452 ( (Oct.-Nov.) ) 1939. 19. Duke-Elder, W. S.: Text-Book of Ophthalmology , St. Louis, C. V. Mosby Company, 1940, vol. 2, p. 2065. 20. von Bürki, E.: Cornea, Episklera, Sklera, Ophthalmologica 103:405-420, 1942. 21. Graves (footnotes 9, 10, 11 and 13). 22. Boshoff, P. H.: Hyaline Scleral Plaques , Arch. Ophth. 28:503-506 ( (Sept.) ) 1942.Crossref 23. Ascher, K. W.: Personal communication to the author. 24. Verhoeff, F. H., and King, M. J.: Scleromalacia Perforans: Report of a Case in Which the Eye Was Examined Microscopically , Arch. Ophth. 20:1013-1035 ( (Dec.) ) 1938.Crossref 25. Verhoeff, F. H.: Brawny Scleritis , Ophthalmoscope 11:2-10, 1913.

BARLOW, AARON;WEINER, HERMAN L.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190294004pmid: 21009151

Abstract A direct blow on the eye will sometimes cause a detachment of the root of the iris from its ciliary insertion—traumatic iridodialysis. When the separation is small, it is of no concern either from a visual or a cosmetic viewpoint. Frequent instillations of atropine and protection from light by dark glasses or a bandage may result in a reattachment, according to some authors. However, when the separation is large, it may cause monocular diplopia, owing to a double pupil. But of even graver concern in some cases is the unsightly cosmetic effect produced by the distortion of the normal contour of the iris and pupil. When the victim of the accident is a little girl, as in the following case, one has a strong desire to do something to correct the deformity. REPORT OF CASE A girl aged 6 was struck in the left eye with a BB shot while References 1. Wiener, M., and Alvis, B. Y.: Surgery of the Eye , Philadelphia, W. B. Saunders Company, 1939. 2. Jameson, P. C.: Reattachment in Iridodialysis: A Method Which Does Not Incarcerate the Iris , Arch. Ophth. 38:391, 1909. 3. Bulson, A. E., Jr.: Correction of Iridodialysis by Operation , Am. J. Ophth. 3:357, 1920. 4. Goldfeder, A. E.: Ueber die operative Behandlung der Iridodialyse , Klin. Monatsbl. f. Augenh. 89: 229, 1932. 5. Key, B. W.: Iridodialysis as a Clinical Entity , Am. J. Ophth. 17:301, 1934. 6. Spaeth, E. B.: Principles and Practice of Ophthalmic Surgery , ed. 3, Philadelphia, Lea & Febiger, 1944. 7. Wheeler, J. M.: Principles of Modern Surgery in Ophthalmology , Am. J. Ophth. 17: 683, 1934.

HARDY, Le GRAND H.;RAND, GERTRUDE;RITTLER, M. CATHERINE

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190297005pmid: 21009152

Abstract Because of their great convenience and apparent simplicity of administration, polychromatic charts for the detection of defective color vision have been widely used in military and industrial fields for many years. Much dissatisfaction has been reported, and both the statistics of the Civil Aeronautics Administration and the results obtained by the Color Blindness Committee (Army Air Forces, United States Navy, Civil Aeronautics Administration and Inter-Society Color Council) indicate that, as they are used at present, polychromatic test plates are only about 50 per cent effective in screening out persons with defective color vision by the criterion of the test itself. In an endeavor to discover the reason for this failure, extensive investigations have been undertaken at the Knapp Memorial Laboratories utilizing a large battery of tests on all types of subjects, ranging from persons with normal to those with extremely defective color vision. Our results indicate that while defects in References 1. Ishihara, S.: Tests for Colour-Blindness , Handaya, Tokyo, Hongo Harukicho, 1917. 2. Dr. Janet Howell Clark, professor of biophysics and dean of women of the University of Rochester, and Dr. Anna M. Baetjer, associate in physiological hygiene, School of Hygiene and Public Health, Johns Hopkins University, gave us access to this edition. The book is a complimentary copy belonging to the late Dr. W. H. Howell, former professor of physiology and director of the School of Hygiene and Public Health, Johns Hopkins University. 3. Clark, J. H.: The Ishihara Test for Color Blindness , Am. J. Physiol. Optics 5:269-276 ( (July) ) 1924. 4. Mr. R. Koller, of C. H. Stoelting Co., Chicago, gave us access to the sixth, eighth and ninth (Japanese) editions. 5. Ishihara,1 ed. 5, Tokyo, Kanehara, 1925. 6. von Kries, J.: Ueber Farbensysteme , Ztschr. f. Psychol. u. Physiol. d. Sinnesorgane 13:241-324, 1897. 7. Rabkin, E.: Polychromatic Plates for Testing Colour Vision , ed. 2, Kharkov, State Medical Publishing House of the USSR, 1939. 8. American Optical Company: Pseudo-Isochromatic Plates for Testing Color Perception , Philadelphia and New York, Beck Engraving Co., 1940. 9. Farnsworth, D.: Farnsworth-Munsell 100-Hue and Dichotomous Tests , J. Optic. Soc. America 33:568-578 ( (Oct.) ) 1943.Crossref 10. Hardy, L. H.: Single Judgment Test for Red-Green Discrimination , J. Optic. Soc. America 33:512-514 ( (Sept.) ) 1943.Crossref 11. Nagel, W. A.: Zwei Apparate für die augenärztliche Funktionsprüfung. Adaptometer und kleines Spektralphotometer (Anomaloskop) , Ztschr. f. Augenh. 17:201-222, 1907. 12. A test for color blindness may be a simple diagnostic or screening medium, in which case the purpose is merely to screen out the subjects with defective color vision from those with normal color vision; or it may be a differential classifying medium, in which case it is designed to determine both the type and the extent of the defect. It is our belief that the ideal tests for color blindness should serve both functions. 1. For some purposes the simple screening test is adequate, and its simplicity of operation and interpretation is an advantage. 2. For such purposes as industrial employment, vocational guidance and other means of adapting the environment of the person with defective color vision so that it may best serve his practical and esthetic needs, it is important to know how much defect is present and how color stimuli appear to him. There are many vocations, such as automotive wiring, which are open to anomalous trichromats but which cannot be handled by dichromats. Even in this field distinctions must be made. For example, the anomalous trichromat who can distinguish the difference in color between new-coded wires viewed under good illumination is able to work on new motors; but he cannot distinguish this difference under flashlight illumination or when the wires have become soiled by use and is, therefore, unable to do repair work on the motors. It is often necessary, also to know the type of defect and whether or not there is distortion of the brightness value of color stimuli. It would seem that a deuteranope, who has little, if any, distortion of the brightness aspect of the colors, would be useful in certain types of heterochromatic photometry, while the protanope, who sees the long wave end of the spectrum as darker and the short wave end as lighter than normal, could not do this work. Again, a deuteranope is less likely to distinguish between the customary red, green and amber traffic signals than the protanope, who sees the green signal as bright and the red one as dim. On the other hand, the protanope may find it difficult to see a red traffic signal during night driving. 13. Hardy, L. H., and Rand, G.: Recent Developments in Color Vision Testing, Graduate Lecture, American Academy of Ophthalmology Outlines of Instructional Courses, Continuous Course No. 6 and 7, 1944. 14. Hardy, L. H.; Rand, G., and Rittler, M. C.: Color Vision and Recent Developments in Color Vision Testing, Arch. Ophth., to be published. 15. To persons not familiar with the classic terminology of color blindness and those to whom our article 13 is not available, the following simple explanation of terms may be of value. In the Young-Helmholtz theory there are three factors in the color vision process: (1) the red primary, proto, or first, process; (2) the green primary, deutero, or second, process, and (3) the blue primary, trito, or third, process. Hence one would expect to find three types of color vision: (1) trichromatic, in which all three processes function; (2) dichromatic, in which only two processes function, and (3) monochromatic, in which there is only one differentiated physiologic process. Trichromatic color vision means that all three processes are functioning, but since one or more of the processes may function aberrantly, there will be as a result three types of trichromatic color vision: (1) normal; (2) anomalous, in which one or more of the processes is weak, and (3) low discrimination, in which apparently all processes are weak. Anomalous trichromasy is designated according to the process which is weak as (1) protanomaly, or predominantly red weak; (2) deuteranomaly, or predominantly green weak, and (3) tritanomaly, or predominantly blue-yellow weak. Dichromatic color vision means that only two of the processes are functioning and hence is similarly divided into three types : (1) protanopia, formerly called red blindness; (2) deuteranopia, formerly called green blindness, and (3) tritanopia, formerly called blue-yellow blindness. As a mnemonic, we might point out the recurrent triad: There are three kinds of abnormal color vision: (1) anomalous trichromasy (three types—protanomaly, deuteranomaly and tritanomaly) ; (2) dichromasy (also three types—protanopia, deuteranopia and tritanopia), and (3) monochromasy. Protanopia exhibits a shortened red end of the spectrum, a neutral area at about 493 millimicrons (in the blue-green), a second neutral band in the red (at 493 c) and a brightness peak, which is shifted toward the violet. Deuteranopia shows a neutral region in the green (at about 497 millimicrons), a second neutral band in the red-purple (at 497 c) and no shift in the luminosity peak. Tritanopia shows a shortened blue end of the spectrum and a neutral band in the yellow-green. The luminosity peak is not shifted. These types, as well as corresponding anomalous trichromatic types, are best detected and classified by anomaloscopic tests. 16. The Macbeth Daylighting Company has designed an excellent table lamp and book rest to provide convenient, standard conditions for tests of the polychromatic plate type. The color temperature of the illumination supplied is 6800° K; the amount of illumination on the test material is about 40 foot candles; the illumination is even and falls on the test material at an angle of approximately 45 degrees, and the test material is supported so that it is viewed at an angle of 90 degrees. The complete unit, which is called the Macbeth Easel Lamp, provides ideal lighting conditions for the administration of color tests of this type. It is supplied by the Macbeth Daylighting Company, 227 West Seventeenth Street, New York.

OGLE, KENNETH N.;ELLERBROCK, VINCENT J.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190305006pmid: 21009153

Abstract Recent experimental work has shown that the space eikonometer is a suitable instrument for the measurement of aniseikonic errors.1 This instrument2 differs from the standard eikonometer in that the measurement depends on binocular (stereoscopic) perception rather than on a direct comparison of image sizes. In the space eikonometer all empiric clues which might affect the apparent relative positions of selected test elements are eliminated, and their apparent orientation can be perceived only by binocular (stereoscopic) space perception. If an aniseikonic error exists between the two eyes, these test objects will appear incorrectly oriented to the subject, according to the nature of the error present. By means of suitable size lenses the relative sizes of the images in the two eyes can be changed until the test objects appear correctly oriented.3 The magnifications introduced to achieve this measure the aniseikonic error. To complete the study of the visual References 1. Ogle, K. N.: Association Between Aniseikonia and Anomalous Binocular Space Perception , Arch. Ophth. 30:54-64 ( (July) ) 1943.Crossref 2. Burian, H. M., and Ogle, K. N.: Meridional Aniseikonia at Oblique Axes , Arch. Ophth. 33:293-310 ( (April) ) 1945.Crossref 3. Ogle, K. N., and Madigan, L. F.: Astigmatism at Oblique Axes and Binocular Stereoscopic Spatial Localization , Arch. Ophth. 33:116-127 ( (Feb.) ) 1945.Crossref 4. Ames, A., Jr.: The Space-Eikonometer Test for Aniseikonia , Am. J. Ophth. 28:248, 1945. 5. Ogle, K. N.: Theory of the Space Eikonometer, Arch. Ophth., to be published. 6. Ogle and associates.1 Ames.2 7. Ogle, K. N.: An Optical Unit for Obtaining Variable Magnification in Ophthalmic Use , J. Optic. Soc. America 32:143-146 ( (March) ) 1942.Crossref 8. Ogle, K. N., and Ames, A., Jr.: Ophthalmic Lens Testing Instrument , J. Optic. Soc. America 33:137-142 [ (March) ] 1943Crossref 9. Guilford, J. P.: Psychometric Methods , New York, McGraw-Hill Book Company, Inc., 1936, p. 166. 10. Fisher, R. A., and Yates, F.: Statistical Tables for Biological , Agricultural and Medical Research, London, Oliver & Boyd, 1938, table 33, p. 82. 11. Here, a three category experiment was used. The number of doubtful responses was small, and for each stimulus these were distributed in the "nearer" and the "farther" category in proportion to the number of judgments in those categories. This procedure is today considered the proper way to treat doubtful responses (Guilford8). 12. The curve is the integral of the probability function, expressed by the equation y= [1/σ √2 π] exp (—x2/2σ2). 13. Woodworth, R. S.: Experimental Psychology , New York, Henry Holt & Company, Inc., 1938, p. 408-419 14. Ames, A., Jr., and Ogle, K. N.: Size and Shape of Ocular Images: III. Visual Sensitivity to Differences in the Relative Size of the Ocular Images in the Two Eyes , Arch. Ophth. 7:904-924 ( (June) ) 1932.Crossref 15. The relation between these data and visual acuity will be discussed in another paper. 16. Polaroid vectographs of the test elements were also substituted for the actual threads and the sensitivities determined for both distant and near vision. In general, the sensitivities found were of the same order as those given above.

BEDELL, ARTHUR J.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190313007pmid: 21009154

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract This paper is the summation of the study and correlation of many cases of sudden blindness caused by the abrupt closure of the central retinal artery, or a branch of the same. The conclusions have not been collected haphazardly but are presented after repeated examinations of the photographs and clinical histories. Textbooks, those proverbial exponents of repetitions, ancient and modern, rarely guide the student through the maze of generalizations to the correct diagnosis of changes in the retinal vessels. This is not said to disparage, for the compilation of any good textbook is an engaging, time-consuming task, but, rather, to ask the reader to start with an open mind for the reception of a new clinical differentiation between embolism of the central retinal artery and endarteritis. However, before the clearly defined groups are separated, it is essential to remember that there are cases of combined lesions, as, for instance, those

AVERY, JOHN WAITE;WARREN, J. W.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190320008pmid: 21009155

Abstract In a previous issue of the Archives, we made a preliminary report on the case of Mrs. M. W., then aged 50, in whom the disease involved the lymphatics of the bulbar conjunctiva of both globes, as well as various somatic glandular structures. A lump in the cheek was first noticed by the patient in 1935 and was soon followed by flat, reddish growths on the eyeballs. They were not tender and did not respond to medical treatment. About one year after their appearance they were excised, but in six months they again appeared on both globes in the same locations. Invasion of other glands was increasing, the patient was weak and losing weight; vision was poor and painful, and she had pronounced nasal occlusion. The patient came under the care of one of us (J. W. A.) in April 1940 and was referred to the Malignancy Committee of the References 1. Avery, J. W., and Warren, J. W.: An Unusual Case of Hodgkin's Disease: A Preliminary Report , Arch. Ophth. 27:1019 ( (Dec.) ) 1941.Crossref

Pascal, Joseph I.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190321009pmid: 21009156

Abstract The eye, like every compound optical system, has six important reference points (and planes)—the so-called cardinal points. These are the two principal focal points, designated as F1 and F2 ; the two principal points, P1 and P2, and the two nodal points, N1 and N2. Once these six points are located (in fact, even the first four suffice), calculations and constructions for image position, image magnification, etc., are easily made. A scheme for remembering the relative distances between these cardinal points was previously published.1 This method utilizes the well known benzene ring, on which the cardinal points are placed, as in A of the figure. Any two opposite sides which are parallel are equal. Thus if the distance between any two points is represented by the two corresponding letters, P1F1=N2F2; P2F2=N1 References 1. Pascal, J. I.: A Memory Scheme for the Cardinal Points , Arch. Ophth. 22:448 ( (Sept.) ) 1939.Crossref

KOCH, FERDINAND L. P.

1945 Archives of Ophthalmology

doi: 10.1001/archopht.1945.00890190323010pmid: 21009157

Abstract Variations in the diameters of retinal vessels observable ophthalmoscopically in the eyes of normal and of hypertensive persons have drawn the attention of numerous workers since the first report of retinitis in nephritis was published by von Graefe,1 in 1855 ; however, Liebreich,2 in 1859, in his detailed description of "albuminuric retinitis," was the first to mention the existence of narrowed arterial vessels. Frequent attempts have been made since the initial published method by Ruete,3 in 1852, to obtain absolute measurements of the delineable ophthalmoscopically visible retinal structures in the living human eye (table 1). The basic goal has been the attainment of unquestionable accuracy by practical means. Numerous ingenious instruments and methods have been devised, all of which, however, in some manner combine a grid, graticule or micrometer scale with an ophthalmoscopic apparatus. The application of retinal photography, as advocated by Tengroth4 and by Nordenson,5 References 1. von Graefe, A. : Ueber eine Krebsablägerung im Innern des Auges, deren ursprünglicher Sitz zwischen Sclera und Chorioidea war , Arch. f. Ophth. 2 ( (pt. 1) ): 214-224, 1855. 2. Liebreich, R.: Ophthalmoskopischer Befund bei Morbus Brightii , Arch. f. Ophth. 5 ( (pt. 2) ) :265-286, 1859. 3. Ruete, C. G. T. : Der Augenspiegel und das Optometer für practische Aertze , Göttingen, Dieterich, 1852. 4. Tengroth, S. : Demonstration av mätningar av ögonbottnen , Hygiea 92:828-829, 1930. 5. Nordenson, J. W. : Ueber Messungen am Augenhintergrunde , Ztschr. f. ophth. Optik. 19:1-3, 1931. 6. Haessler, F. H., and Squier, T. L. : Measurements of Retinal Vessels in Early Hypertension , Tr. Am. Ophth. Soc. 29:254-262, 1931. 7. Puntenney, I. : Effect of Certain Chemical Stimuli on Caliber of Retinal Blood Vessels , Arch. Ophth. 21: 581-597 ( (April) ) 1939.Crossref 8. Lambert, R. 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