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A.M.A. Archives of Ophthalmology

Subject:
Ophthalmology
Publisher:
American Medical Association
American Medical Association
ISSN:
0096-6339
Scimago Journal Rank:
203
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REGISTRY OF INTERESTING CASES

Cogan, David G.

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010519001

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 To many of us, and I dare say most, interesting cases are the spices of our professional lives. But they have to be shared to be appreciated. What many of us do on seeing such a case is confer with a colleague or two from across the hall and let it go at that, feeling that when the time is available we will "look it up." But time passes, and to look further than in the few texts on our personal shelves is no little chore. Hence it comes to be relegated to a variously obscure position in the storehouse of our memories to be called upon at some future time, if at all, with something short of accuracy. Actually many unique cases are undoubtedly lost because there has been no filing system in which they may be conveniently deposited. To report a case has come to mean a review
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EXPERIMENTAL RADIATION CATARACTS: I. Cataracts in the Rabbit Following Single X-Ray Exposure

COGAN, DAVID G.;DONALDSON, DAVID D.

1951 A M A Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010520002

Abstract Radiation cataracts have been of interest as medical and biologic phenomena since the early days of roentgenology, when an unusual type of cataract developed in certain x-ray technicians without necessarily other manifestations of irradiation developing. This apparent predisposition of the lens has intrigued investigators not only because of its practical importance but also because, on a priori grounds, one would not expect a tissue having the slow rate of growth of the lens to be particularly susceptible to radiation. Recent interest in the subject has been accentuated by the occurrence of radiation cataracts in cyclotron workers1 and in some of the persons exposed to radiation from the atomic bomb.2 Accordingly, the Committee on Radiation Cataracts was formed under the auspices of the National Research Council for the purpose of stimulating research in this field, and the work to be reported in this paper was supported by a grant References 1. Radiation Cataracts , editorial, J. A. M. A. 140:1218 ( (Aug. 13) ) 1949. 2. Abelson, P. H., and Kruger, P. G.: Cyclotron Induced Radiation Cataracts , Science 110:655 ( (Dec. 16) ) 1949.Crossref 3. Cogan, D. G.; Martin, S. F., and Kimura, S. J.: Atom Bomb Cataracts , Science 110:654 ( (Dec. 16) ) 1949.Crossref 4. Hunt, H. B.: Cancer of the Eyelid Treated by Radiation, with Consideration of Irradiation Cataract , Am. J. Roentgenol. 57:160, 1947. 5. Desjardins, A. V.: Action of Roentgen Rays and Radium on Eye and Ear: Experimental Data and Clinical Radiotherapy , Am. J. Roentgenol. 26:643, 789 and 921, 1931 6. Leinfelder, P. J., and Kerr, H. D.: Roentgen-Ray Cataract: An Experimental, Clinical and Microscopic Study , Am. J. Ophth. 19:739 [ (Sept.) ] 1936 7. Rohrschneider, W.: (a) Experimentelle Katarakt nach mehrfacher Bestrahlung mit kleinen Röntgenstrahlendosen , Ber. u. d. deutsch. ophth. Gesellsch. 48:241, 1930 8. (b) Untersuchungen über die Morphologie und Entstehung der Röntgenstrahlenkatarakt beim Menschen , Arch. f. Augenh. 106:221, 1932. 9. (c) Mitner, J. G.: Irradiation Cataracts , Brit. J. Ophth. 18:497, 1934.Crossref 10. Footnote deleted. 11. Chalupecký, H.: Über die Wirkung der Röntgenstrahlen auf das Auge und die Haut , Centralbl. f. prakt. Augenh. 21:234, 267, 1897. 12. (a) Peter, L.: Studien zur experimentellen Röntgen- und Radium Katarakt , Arch. f. Ophth. 125:428, 1930. 13. (b) Okusawa, T.: Die experimentelle Untersuchung über die durch Röntgenstrahlen verursachten Veränderungen des Linsenepithels , Acta Soc. ophth. Jap. 37:814, 1933 14. abstracted, Klin. Monatsbl. Augenh. 92:695, 1934. 15. (c) Poppe, E.: Experimental Investigations of the Effects of Roentgen-Rays on the Epithelium of the Crystalline Lens , Acta radiol. 23:354, 1942.Crossref 16. Leinfelder and Kerr.4 Peter.8a Poppe.8c Rohrschneider.5a 17. Peter.8a Poppe.8c 18. (a) Leinfelder and Kerr.4 19. (b) von Sallmann, L.: Report on Studies of the Effect of Roentgen Irradiation on the Rabbits' Lens, United States Atomic Energy Commission Declassified Document no. NYO-1508, April, 1950 20. abstracted, Nuclear Sc. Abstr. 4:631 ( (July 31) ) 1950 21. Experimental Studies on Early Lens Changes After Roentgen Irradiation , Arch. Ophth. 45:149 ( (Feb.) ) 1951.Crossref 22. (c) Gredzielski, J.: Zur Histologie der Röntgenkatarakt , Klin. Monatsbl. f.. Augenh. 95:360 ( (Sept.) ) 1935. 23. Poppe.8c von Sallmann.11b 24. Rugh, R.: Histological Effects on the Embryo Following X-Irradiation , J. Morphol. 85:483, 1949.Crossref 25. Mottram, J. C.: Early Changes in Nucleus of Cells of Tumours Following Exposure to β Radiation , Brit. J. Radiol. 32:61, 1927. 26. In a separate study, not reported here, no difference was found for the susceptibility to cataract in a group of chinchilla and a group of New Zealand white rabbits. 27. Trump, J. G., and Van de Graaff, R. J.: A Compact Pressure-Insulated Electrostatic X-Ray Generator , Physical Rev. 55:1160-1165 ( (June 15) ) 1939.Crossref 28. Verhoeff, F. H., and Bell, L.: Pathological Effects of Radiant Energy on the Eye , Proc. Am. Acad. Arts & Sc. 51:629, 1916. 29. When Zenker's fixation is used, the peripheral cells also show intercellular clefts, giving the appearance of "cracking"; this is not true with Carnoy's fixative. 30. Macklin, C. C.: Binucleate Cells in Tissue Cultures , Contrib. Embryol. 4:69 ( (13) ), 1916. 31. Howard, W. T., and Schultz, O. T.: Studies in the Biology of Tumor Cells, Monograph 2, Rockefeller Institute for Medical Research, 1911. 32. Ludford, R. J.: Pathological Aspects of Cytology , in Bourne, G., editor: Cytology and Cell Physiology , New York, Oxford University Press, 1942, pp. 226-259.
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DISTANCE DISCRIMINATION: VIII. Influence of Rod Brightness and Background Illumination in Howard-Dolman Test

WILNER, BURTON I.;WEYMOUTH, F. W.;HIRSCH, M. J.

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010535003

Abstract Hirsch, Horowitz and Weymouth1c have demonstrated that the apparatus rod size (width) does not affect the threshold but does significantly influence the position of subjective equality in tests of distance discrimination. It is known, in addition, that the apparent size of an object varies with the brightness of the object, this effect being due to irradiation (Duke-Elder2). In the Howard-Dolman apparatus the rods are painted dull black and have a different and weaker source of illumination than the background. Because of this arrangement the rods are seen essentially as silhouettes. Should the contrast between the rods and the background be lessened by decreasing the illumination of the background or by increasing the reflectivity of the rods, the factor of apparent rod size due to irradiation might alter the results obtained in testing with the apparatus, particularly if the reflectivity or brightness of the two rods differed. The purpose References 1. (a) Hirsch, M. J., and Weymouth, F. W.: Distance Discrimination: I. Theoretical Considerations , Arch. Ophth. 39:210-223 ( (Feb.) ) 1948Crossref 2. (b) II. Effect on Threshold of Lateral Separation of the Test Objects , Weymouth Arch. Ophth. 39:224-231 ( (Feb.) ) 1948.Crossref 3. (c) Hirsch, M. J.; Horowitz, M. W., and Weymouth, F. W.: III. Effect of Rod Width on Threshold , Arch. Ophth. 39:325-332 ( (March) ) 1948.Crossref 4. (d) Hirsch, M. J.; Horowitz, M. W.; Walker, E. L., and Weymouth, F. W.: IV. Effect of Aniseikonic Lenses on Distance Discrimination , Arch. Ophth. 39:333-338 ( (March) ) 1948.Crossref 5. (e) Hirsch, M. J., and Weymouth, F. W.: V. Effect of Motion and Distance of Targets on Monocular and Binocular Distance Discrimination , J. Aviation Med. 18:594-600, 1947. 6. (f) VI. Relationship of Visual Acuity to Distance Discrimination , Weymouth J. Aviation Med. 19:56-58, 1948. 7. (g) Wilner, B. I.; Weymouth, F. W., and Hirsch, M. J.: VII. Influence of Initial Position of Rods in Howard-Dolman Test , Arch. Ophth. 44:365-369 ( (Sept.) ) 1950.Crossref 8. Duke-Elder, W. S.: Text-Book of Ophthalmology , St. Louis, C. V. Mosby Company, 1946, vol. 1. 9. Weymouth, F. W., and Hirsch, M. J.: The Reliability of Certain Tests for Determining Distance Discrimination , Am. J. Psychol. 58:379-390, 1945.Crossref 10. Helmholtz, H.: Helmholtz's Treatise on Physiological Optics , edited by J. P. Southall, Ithaca, The Optical Society of America, 1924, vol. 2, pp. 188-189.
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INTRAOCULAR INFECTION WITH THE GAS-FORMING BACILLUS CLOSTRIDIUM WELCHII: Report of a Case

KENNEDY, ROSCOE J.;VOGEL, ADOLPH W.

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010540004pmid: 14829112

Abstract A CASE of panophthalmitis due to the gas-forming organism Clostridium welchii (Clostridium perfringens) was reported in this country by Berry in 1932.1 Since then four cases have been added to the American literature2 and 23 to the foreign.3 The report by Klüver and O'Brien2b gives an adequate review of the foreign literature up to 1936 and of the laboratory identification of the Cl. welchii bacillus. REPORT OF CASE A laborer aged 27 was admitted to the Cleveland Clinic Hospital on Nov. 24, 1950. The personal and medical histories were noncontributory.Twenty-eight hours prior to admission the patient had been struck in the left eye by a small fragment from the inside cement framework of a cellar window on which he was chipping with a hammer and chisel. The window was opened only for coal deliveries. He was not conscious of discomfort until three hours later, when References 1. Berry, E. M.: Intraocular Foreign Body with Bacillus Welchii Infection , Am. J. Ophth. 15:1022 ( (Nov.) ) 1932. 2. (a) Walker, S., Jr.: Bacillus Welchii Panophthalmitis , J. A. M. A. 102:1561 ( (May 12) ) 1934.Crossref 3. (b) Klüver, H. C., and O'Brien, C. S.: Panophthalmitis Due to Clostridium Welchii , Arch. Ophth. 15:1088 ( (June) ) 1936.Crossref 4. (c) Walker, S., Jr.: Prognosis of Bacillus Welchii Panophthalmitis , Arch. Ophth. 19:406 ( (March) ) 1938.Crossref 5. (d) Capus, B.: Clostridium Welchii Panophthalmitis: Report of a Case , Arch. Ophth. 36:226 ( (Aug.) ) 1946.Crossref 6. Cross, A. G.: Gas-Gangrene of the Eye , Lancet 2:515 ( (Nov. 1) ) 1941.Crossref 7. Rieger, H.: Wound Infection of Eye with Irritants of Gas-Gangrene Group , Arch. Ophth. 17:61, 1937. 8. Canon, G.: Gas Bacillus Infection of Human Eye , Klin. Monatsbl. Augenh. 100:394 ( (March) ) 1938. 9. Gledhill, W. C.: Gas-Gangrene: Thirty-Three Cases, with One Death Treated at a Forward General Hospital in Italy , Lancet 2:264 ( (Sept. 1) ) 1945.Crossref 10. Hac, L. R.: Experimental Clostridium Welchii Infection: Penicillin Therapy , J. Infect. Dis. 74:164 ( (March-April) ) 1944.Crossref 11. Hoskins, L. C.: Penicillin Therapy and Experimental Infections of Lens and Vitreous with Clostridium Welchii , Arch. Ophth. 38:301 ( (Sept.) ) 1947.Crossref 12. von Sallmann, L.: Penicillin and Sulfadiazine in Treatment of Experimental Intraocular Infections with Staphylococcus Aureus and Clostridium Welchii , Arch. Ophth. 31:54 ( (Jan.) ) 1944.Crossref 13. Kirz, E.: Gas Gangrene After Amputation Under Refrigeration Anesthesia: Warning , Brit. M. J. 2:662 ( (Nov. 18) ) 1944.Crossref 14. MacLennan, J. D.: Anaerobic Infections of War Wounds in Middle East , Lancet 2:94 ( (July 24) ) 1943.Crossref 15. Wan, F. E.: Gas Bacillus Infection: Review of Its Etiology, Symptomatology, and Treatment , China M. J. 44:97 ( (Feb.) ) 1930. 16. Altemeier, W. A., and Gibbs, E. W.: Bacterial Flora of Fresh Accidental Wounds , Surg., Gynec. & Obst. 78:164 ( (Feb.) ) 1944.
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CORTISONE THERAPY IN CASE OF RHEUMATOID NODULES OF THE EYE IN CHRONIC RHEUMATOID ARTHRITIS

MUNDY, WILLIAM L.;HOWARD, ROYAL M.;STILLMAN, PAUL H.;BEVANS, MARGARET

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010543005pmid: 14829113

Abstract THE VALUE of cortisone in the treatment of various diseases of the eye has been reported by numerous investigators.1 Reports from Merck & Company claim beneficial results in phlyctenular conjunctivitis, keratitis, iritis, iridocyclitis, uveitis and sympathetic ophthalmia.2 Beneficial effects may result when the drug is administered intramuscularly, by instillation of a saline suspension or by subconjunctival injection; and it is expected that the oral route will prove efficacious. The first two modes of therapy were used in the present case. The commonest ocular affections seen in conjunction with disease of joints (especially rheumatoid arthritis) are keratoconjunctivitis sicca (Sjögren's syndrome), episcleritis, primary uveal disease, scleritis and conjunctivitis.3 Various authors have reported rheumatic granulomas of the sclera, external ocular muscles, orbital tissue and uveal tract.4 Nodular formations of other causes are described.5 Episcleral nodular tuberculosis may grossly resemble rheumatoid granulomas.6 Except for the case described by References 1. Woods, A. C.: Clinical and Experimental Observations on the Use of ACTH and Cortisone in Ocular Inflammatory Disease , Am. J. Ophth. 33:1325 ( (Sept.) ) 1950. 2. Thorn, G. W.; Forsham, P. H.; Frawley, T. F.; Hill, S. R., Jr.; Roche, M.; Staehelin, D., and Wilson, D. L.: The Clinical Usefulness of ACTH and Cortisone , New England J. Med. 242:783 ( (May 18) ) 1950.Crossref 3. Therapy with Cortisone—Inflammatory Eye Disease , Cortone, A Syllabus, Rahway, N. J., Merck & Co., Inc. 1950. 4. Henderson, J. W., and Hollenhorst, R. W.: Clinical Observations on the Use of Cortisone in Ophthalmological Diseases: Preliminary Reports , Proc. Staff Meet., Mayo Clin. 25:459 ( (Aug. 2) ) 1950. 5. Stenstam, T.: On the Occurrence of Keratoconjunctivitis Sicca in Cases of Rheumatoid Arthritis , Acta med. scandinav. 127:130, 1947.Crossref 6. Mills, A. J. O.: Rheumatoid Iritis , Am. J. Ophth. 31:2 ( (Feb.) ) 1948. 7. Franceschetti, A.: Les affections oculaires d'origine rhumatismale , Ophthalmologica 111:242 ( (April-May) ) 1946.Crossref 8. Abelsdorff, G.: Skleritis rheumatica mit typisch rheumatischen Veränderungen (Aschoffsche Knötchen) , Klin. Monatsbl. Augenh. 89:836, 1932. 9. Babel, J.: Contribution à l'étude histologique du rhumatisme oculare (À propos d'un cas de scléroténonite , Ophthalmologica 104:243, 1942.Crossref 10. Marchesani, O.: Über rheumatische Entzündungen des Auges , Klin. Monatsbl. Augenh. 106:1 ( (Jan.) ) 1941. 11. Berens, C.: The Eye and Its Diseases , ed. 2, Philadelphia, W. B. Saunders Company, 1949. 12. Pollak, W.: Über isolierte Tuberkulose der Skiera unter dem Bilde eines Tumors , Klin. Monatsbl. Augenh. 88:747 ( (June) ) 1932. 13. Edström, G., and Österlind, G.: A Case of Nodular Rheumatic Episcleritis , Acta ophth. 26:1, 1948.Crossref 14. Ropes, M.: Personal communication to the authors. Heath, P.: Personal communication to the authors. 15. Raven, R. W.; Weber, F. P., and Price, L. W.: The Necrobiotic Nodules of Rheumatoid Arthritis: A Case in Which Scalp, Abdominal Wall (Involving Striped Muscle), Larynx, Pericardium (Involving Myocardium), Pleurae (Involving Lungs), and Peritoneum Were Affected , Ann. Rheumat. Dis. 7:63 ( (June) ) 1948.Crossref 16. Purchased with funds supplied by the United States Public Health Service. 17. Hoefer, P. F. A., and Glaser, G. H.: Effects of Pituitary Adrenocorticotropic Hormone (ACTH) Therapy: Electroencephalographic and Neuropsychiatric Changes in 15 Patients , J. A. M. A. 143:620 ( (June 17) ) 1950.Crossref 18. Sprague, R. G.; Power, M. H.; Mason, H. L.; Albert, A.; Mathieson, D. R.; Hench, P. S.; Kendall, E. C.; Slocumb, C. H., and Polley, H. F.: Observations on the Physiologic Effects of Cortisone and ACTH in Man , Arch. Int. Med. 85:199 ( (Feb.) ) 1950.Crossref 19. Sokoloff, L.: Personal communication to the authors. 20. Ragan, C.; Howes, E. L.; Plotz, C. M.; Meyer, K.; Blunt, J. W., and Lattes, R.: The Effect of ACTH and Cortisone on Connective Tissue , Bull. New York Acad. Med. 26:251 ( (April) ) 1950. 21. Spain, D. M.; Molomut, N., and Haber, A.: Biological Studies on Cortisone in Mice , Science 112:335 ( (Sept. 22) ) 1950.Crossref 22. Creditor, M. C.: Bevans, M.; Mundy, W. L., and Ragan, C.: Effect of ACTH on Wound Healing in Humans , Proc. Soc. Exper. Biol. & Med. 74:245, 1950.
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THE FREE COMPOSITE LID GRAFT

CALLAHAN, ALSTON

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010551006pmid: 14829114

Abstract ALL METHODS of replacing sectors of complete lid thickness loss have been L based either on the principle of advancing flaps constructed in the lid itself or on the principle of transposing required lid tissue from nearby areas or across the palpebral fissure from the opposing lid. The best method of repairing small colobomas of the lid (up to about 4 mm.) is by constructing a pedicle flap of the lateral lid fragment and the skin and subcutaneous tissue of the zygomatic and temporal region and advancing it to the medial lid fragment, the edges being united by the halving repair. Its only disadvantage is that the end of the lid margin remains bare of lashes, a more objectionable feature in the upper than in the lower lid. If the loss is more than 4 to 5 mm., this method is usually contraindicated because the necessary medial advancement of the References 1. Fricke, J. C. G.: Die Bildung neuer Augenlieder (Blepharoplastik) nach Zerstörungen und dadurch hervorgebrachten Auswärtswendungen derselben , Hamburg, Perthes u. Besser, 1829. 2. Sheehan, J. E.: Plastic Surgery of the Orbit , New York, The Macmillan Company, 1927. 3. Callahan, A.: Surgery of the Eye: Injuries , Springfield, Ill., Charles C Thomas, Publisher, 1950. 4. Brown, J. B., and Cannon, B. S.: Composite Free Grafts of Skin and Cartilage from Ear , Surg., Gynec. & Obst. 82:253-255. 1946. 5. Armstrong, C. J., and Garcia, F. A.: The Use of a Composite Graft in Reconstructive Surgery of the Lower Eyelid , Plast. & Reconstruct. Surg. 3:79-83, 1948.
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STUDIES IN EXPERIMENTAL OCULAR TUBERCULOSIS: XV. Effect of Paraaminosalicylic Acid and of Streptomycin plus Paraaminosalicylic Acid in Normal Rabbits

WOODS, ALAN C.;WOOD, RONALD M.;NAQUIN, HOWARD A.

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010558007

Abstract SINCE the first reports by Lehmann1 in 1946 on the use of paraaminosalicylic acid in tuberculosis, there have been an increasing number of reports on its value in experimental and human tuberculosis, both alone and in combination with streptomycin. The subject has recently been reviewed.2 There have been a number of recent reports on the use of paraaminosalicylic acid in experimental ocular tuberculosis, as well as in cases diagnosed as ocular tuberculosis in humans.3 The following studies were undertaken to determine the effect of paraaminosalicylic acid, both alone and in combination with streptomycin, on experimental ocular tuberculosis in the normal rabbit. At the same time, these effects were compared with the effect of streptomycin and thiazolsulfone (promizole®; 4, 2′-diaminophenyl-5′-thiazolylsulfone) on experimental ocular tuberculosis in the normal rabbit. EXPERIMENTAL STUDIES Sixty-four healthy, normal adult rabbits, of mixed sex, averaging approximately 2,500 Gm. in weight, and of the same References 1. Lehmann, J.: Para-Aminosalicylic Acid in the Treatment of Tuberculosis: Preliminary Communication , Lancet 1:15, 1946Crossref 2. Chemotherapy of Tuberculosis: The Bacteriostatic Action of Para-Aminosalicylic Acid and Closely Related Compounds upon the Tubercle Bacillus, Together with Animal Experiments and Clinical Trials with Para-Aminosalicylic Acid , Svenska läk.-tidning 43:2029, 1946. 3. Bogen, E.; Loomis, R. N., and Hill, D. W.: Para-Aminosalicylic Acid Treatment of Tuberculosis , Am. Rev. Tuberc. 61:226, 1950. 4. Tucker, W. B.; Fellows, H. H.; Gale, J. W.; Jenkins, D. E.; Kirby, W. M. M.; Lincoln, E. M.; Schwartz, W. S.; Skavlem, J. H., and Trimble, H. G.: Current Status of Drug Therapy in Tuberculosis , Am. Rev. Tuberc. 61:436, 1950. 5. Lepri, G., and Fornaro, L.: Para-Aminosalicylic Acid in Experimental Ocular Tuberculosis , Arch. ottal. 53:8, 1949 6. The Combination of Streptomycin and Para-Aminosalicylic Acid in Experimental Ocular Tuberculosis , Fornaro Arch. ottal. 53:129, 1949. 7. Witmer, R., and Ragaz, L.: Pharmacologic Basis and First Results of Treatment of Ocular Tuberculosis with Para-Aminosalicylic Acid , Schweiz. med. Wchnschr. 79:452, 1949. 8. Lepri, G., and Capalbi, S.: Studies on the Chemotherapy of Experimental Ocular Tuberculosis , Arch. ottal. 53:289, 1949. 9. Gundersen, T., and Bietti, G. B.: Experimental and Clinical Investigations on Para-Amino-Salicylic Acid (PAS)—Alone or in Association with Streptomycin—in Ocular Tuberculosis , Tr. Am. Ophth. Soc. 47:276, 1949. 10. Bietti, G. B.: Use of Paraaminosalicylic Acid Alone or in Association with Streptomycin in Ocular Tuberculosis: Experimental and Clinical Observations , Arch. Ophth. 43:431 ( (March) ) 1950.Crossref 11. Rees, R. J. W., and Robson, J. M.: Experimental Tuberculous Infections of the Cornea of the Mouse: A Screening Test for Anti-Tuberculous Substance , Brit. J. Pharmacol. 5:77, 1950.
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PATHOGENESIS OF OPHTHALMOPLEGIC MIGRAINE

ALPERS, BERNARD J.;YASKIN, H. EDWARD

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010567008pmid: 14829116

Abstract THE PROBLEM of the origin of the ocular paralyses occurring in the course of migraine, referred to as ophthalmoplegic migraine, remains unsolved. Of the several concepts which have been proposed to explain them, that of cerebral aneurysm has received wide acceptance, though there has been little evidence to support it. In order to test the validity of the concept of cerebral aneurysm as a cause of ophthalmoplegic migraine, two patients with this condition were studied by means of arteriography. In neither instance was an aneurysm demonstrated. REPORT OF CASES Case 1. —M. R. (J. H. no. R-54069). Recurrent pain in left side of head and left eye associated with ptosis of left eyelid, diplopia and partial oculomotor paralysis. Normal left internal carotid arteriogram on two occasions (1948 and 1950). No evidence of aneurysm to account for ophthalmoplegic migraine.The patient, a white woman aged 56, first appeared for relief on Oct. 26, References 1. Marlow, F. W.: Ophthalmoplegic Migraine: Convergence Paralysis , Am. J. Ophth. 11:222, 1928. 2. Donahue, H. C.: Migraine and Its Ocular Manifestations , Arch. Ophth. 43:96 ( (Jan.) ) 1950.Crossref 3. Riley, H. A.: Migraine , Bull. Neurol. Inst. New York 2:429, 1932. 4. Gubler, A.: Des paralysies consecutivés aux maladies aiguës , Gaz. hôp. 33:58, 1860. 5. Saundby, R.: A Case of Megrim, with Paralysis of the Third Nerve , Lancet 2:345, 1882.Crossref 6. Charcot, J. M.: Sur un cas de migraine ophthalmoplégique , Progr. méd., Paris 1:89, 1890. 7. Möbius, P. J.: Die Migraine , Vienna, A. Hölder. 1894. 8. Nothnagel, H.: Handbuch der speciellen Pathologie und Therapie , Leipzig, F. C. W. Vogel, 1899, vol. 12, pt. 2. 9. Riley, H. A., in discussion on Kennedy, F.: A Case of Ophthalmoplegic Migraine, and a Theory for Its Production , J. Nerv. & Ment. Dis. 104:89, 1946. 10. Bürki, E.: Zur Kenntnis der ophthalmoplegischen Migräne , Confinia neurol. 4:54, 1941. 11. Wolff, H.: Headache and Other Head Pain , New York, Oxford University Press, 1948, pp. 390-395. 12. Posey, W. C., and Spiller, W. G.: The Eye and the Nervous System , Philadelphia, J. B. Lippincott Company, 1906. 13. Coutouzis: Nouvelle observation d'un cas de migraine ophthalmoplégique—paralysie du nerf oculo-moteur commun périodique , J. méd. et chir. prat. 68:308, 1897. 14. Hunt, J. R.: A Contribution to the Paralytic and Other Persistent Sequelae of Migraine , Am. J. M. Sc. 150:313, 1915. 15. Chabbert, L.: Sur un cas d'ophthalmoplégie nucléaire transitoire, consécutive à une migraine ophthalmique—ophthalmoplégie migraineuse , Progr. méd. Paris 23:241, 1895. 16. Joachim: Über periodische Oculomotoriuslähmung , Deutsche Arch. klin. Med. 44:185, 1889. 17. Weiss, D.: Ein Fall von periodisch auftretender totaler linkseitiger Oculomotoriuslähmung , Wien. med. Wchnschr. 35:521, 1885. 18. Richter, A.: Ein Fall von typisch recidivirender Oculomotoriuslähmung mit Sectionsbefund , Arch. Psychiat. 18:259, 1887. 19. Karplus, J. P.: Ophthalmoplegic Migraine with Autopsy , Wien. klin. Wchnschr. 8:883, 1895. 20. Shionoya, F.: Ein Fall von rezidivierender Oculomotoriuslähmung (Migraine ophthalmoplegique) mit Autopsie , Deutsche Ztschr. Nervenh. 42:155, 1911. 21. Dassen, R.: Jaqueca oftalmopléjica con parálisis recidivante del III par craneano: Muerte en el segundo ataque; Necropsia , Semana méd. 51:1049, 1931. 22. Bramwell, E.: Upon Leaking Aneurysm of Cerebral Arteries as Cause of Third Nerve Paralysis, with Special Reference to 2 Cases in Which Diagnosis Was Confirmed by Arterial Radiology: Note upon Aetiology of Recurrent and Periodic Ocular Palsy and Ophthalmoplegic Migraine , Tr. Ophth. Soc. U. Kingdom 54:205, 1934. 23. Ehlers, H.: On Pathogenesis of Ophthalmoplegic Migraine , Acta psychiat. et neurol. 3:219, 1928. 24. Daily, R. K.: Ophthalmoplegic Migraine , Texas J. Med. 36:802, 1941. 25. Oppenheim, H.: Lehrbuch der Nervenkrankheiten , Berlin, S. Karger, 1908. 26. Walsh, F. B.: Clinical Neuro-Ophthalmology , Baltimore, Williams & Wilkins Company, 1947, p. 1308.
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PECULIAR MACULAR LESIONS WITH UNACCOUNTABLY GOOD VISION

Friedenwald, Jonas S.;Maumenee, A. Edward

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010579009pmid: 14829117

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 The following three cases show such remarkable similarities that we wish to report them together. Case 1 (seen by J. S. F.). —The patient, a healthy woman aged 42, had never had any serious illness. The trouble with her eyes was first discovered six years ago, when she consulted Dr. Warren C. Phillips, of Harrisburg, Pa. At that time the left eye was found to be entirely normal, while the right eye "showed a large oval orange-yellow lesion at the macula, about 3/4 disk diameter in size." Vision with correction was 20/25 in the right eye and 20/20 in the left.The patient was reexamined by Dr. Phillips in 1949, when the lesion in the right eye had grown to more than 1½ disk diameters and a similar lesion, approximately two-thirds the size of the disk was noted in the left eye. Visual acuity was then 20/50 + in the right
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STELLATE GANGLION BLOCK FOR CEREBROVASCULAR ACCIDENT INVOLVING HOMONYMOUS HEMIANOPSIA

Scott, David H.

1951 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1951.01700010583010pmid: 14829118

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 In view of the current widespread interest in the procedure of stellate ganglion block as a therapeutic procedure in cerebrovascular accidents, it is thought that the following case may be of interest. Mr. G. J., a machinist, aged 56, awoke Feb. 1, 1951 and discovered he had great difficulty in reading. He could see the letters but could not follow them across a line to read even a short word. He had a history of three coronary occlusions during the preceding four years and had had an occlusion of the central retinal vein of the right eye with hemorrhagic glaucoma five years previously. The latter condition had been treated with diathermy to the globe, and he had retained a good field of vision, although the central acuity was reduced to 4/200. The night before his present difficulty began, he had been reading for about an hour and had experienced a
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