Archives of Ophthalmology

Davis, Matthew D.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010191001pmid: 4853316

Abstract One hundred seventy-six eyes with retinal breaks without detachment or with subclinical detachment were followed up without prophylactic treatment for six months to 16 years. In 31 (18%) progression occurred. The likelihood of progression was greater in the following circumstances: (1) fresh symptomatic horseshoe tears, (2) breaks with subclinical detachment, (3) aphakic eyes. Progression in eyes containing breaks with opercula or round holes without opercula or in phakic eyes containing asymptomatic horseshoe tears was unusual (5% to 10%). In the patient first seen with a fresh clinical retinal detachment in one eye due to a horseshoe tear or hole with operculum and an asymptomatic break of either of these types without detachment in the fellow eye, the eye with the asymptomatic break usually represents the chronologically more-advanced stage of vitreoretinal degeneration. References 1. Gonin J: Le décollement de la rétine: Pathogénie-traitement . Lausanne, Librairie. Payot et cie, 1934. 2. Schepens CL: Progress in detachment surgery . Trans Am Acad Ophthalmol Otolaryngol 55:606-615, 1951. 3. Meyer-Schwickerath G: Light Coagulation . St. Louis, CV Mosby Co, 1960. 4. Schepens CL: Subclinical retinal detachments . Arch Ophthalmol 47:593-606, 1952.Crossref 5. Okun E, Cibis PA: Photocoagulation in "limited" retinal detachment and breaks without detachment , in McPherson A (ed): New and Controversial Aspects of Retinal Detachment . New York, Paul B Hoeber Inc, 1968, pp 164-171. 6. Colyear BH Jr, Pischel DK: Clinical tears in the retina without detachment . Am J Ophthalmol 41:773-792, 1956. 7. Colyear BH Jr, Pischel DK: Preventative treatment of retinal detachment by means of light coagulation . Trans Pac Coast Otoophthalmol Soc 41:193-215, 1960. 8. Halpern JI: Routine screening of the retinal periphery . Am J Ophthalmol 62:99-102, 1966. 9. Rutnin U, Schepens CL: Fundus appearance in normal eyes: IV. Retinal breaks and other findings . Am J Ophthalmol 64:1063-1078, 1967. 10. Byer NE: Clinical study of retinal breaks . Trans Am Acad Ophthalmol Otolaryngol 71:461-473, 1967. 11. Teng CC, Katzin HM: An anatomic study of the periphery of the retina: I. Nonpigmented epithelial cell proliferation and hole formation . Am J Ophthalmol 34:1237-1248, 1951. 12. Okun E: Gross and microscopic pathology in autopsy eyes: III. Retinal breaks without detachment . Am J Ophthalmol 51:369-391, 1961. 13. Boniuk M, Butler FC: An autopsy study of lattice degeneration, retinal breaks and retinal pits , in McPherson A (ed): New and Controversial Aspects of Retinal Detachment . New York, Paul B Hoeber Inc, 1968, pp 59-75. 14. Foos RY, Allen RA: Retinal tears and lesser lesions of the peripheral retina in autopsy eyes . Am J Ophthalmol 64:643-655, 1967. 15. Neumann E, Hyams S: Conservative management of retinal breaks . Br J Ophthalmol 56:482-486, 1972.Crossref 16. Schepens CL, Marden D: Data on the natural history of retinal detachment: Further characterization of certain unilateral nontraumatic cases . Am J Ophthalmol 61:213-226, 1966. 17. Linder B: Acute posterior vitreous detachment and its retinal complications . Acta Ophthalmol , (suppl 87) , pp 1-108, 1966. 18. Straatsma BR, Allen RA, Christensen RE: The prophylaxis of retinal detachment . Trans Pac Coast Otoophthalmol Soc 46:211-236, 1965. 19. Mortimer CB: The prevention of retinal detachment . Can J Ophthalmol 1:206-212, 1966. 20. Colyear BH Jr: A clinical comparison of partially penetrating diathermy and xenon-arc photocoagulation , in McPherson A (ed): New and Controversial Aspects of Retinal Detachment . New York, Paul B Hoeber Inc, 1968, pp 176-185. 21. Söllner F: Über die prophylaktische Behandlung der Ablatio retinae durch Lichtcoagulation . Ber Dtsch Ophthalmol Ges 66:327-336, 1965. 22. Schepens CL: The preventative treatment of idiopathic and secondary retinal detachment , in Acta Concilium Ophthalmologicum , 1958, vol 1, pp 1019-1027. 23. Tasman WS: Posterior vitreous detachment and peripheral retinal breaks . Trans Am Acad Ophthalmol Otolaryngol 72:217-224, 1968. 24. Pischel DK: Detachment of the vitreous as seen with slit-lamp examination . Trans Am Ophthalmol Soc 50:329-346, 1952. 25. Schepens CL, in discussion, Okun and Cibis: Photocoagulation in "limited" retinal detachment and breaks without detachment , in McPherson A (ed): New and Controversial Aspects of Retinal Detachment . New York, Paul B Hoeber Inc, 1968, p 172.

Kaiden, Jeffrey S.;Zimmerman, Thom J.;Worthen, David M.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010203002pmid: 4850540

Abstract A new screening tonometer, the Glauco-Test, has been evaluated by two experienced investigators, three medical students, three physician assistants, and has been used in a small glaucoma screening clinic. The tonometer was found to be simple, quick, and required only a small number of trials before proficiency and confidence were achieved. The level of intraocular pressures screened in this study was 22 mm Hg. There was a definite tendency for overreferral but few cases of elevated intraocular pressure were missed. Because of the simplicity of its use and accuracy at detecting abnormal pressures, this instrument would appear to be a useful screening device for use by physicians in general medical practice and in screening of large groups of patients by medical students and physician assistants if the problem of overreferral is accepted. References 1. Kaufman HE: Pressure measurements: Which tonometer? Invest Ophthalmol 11:80-85, 1972. 2. Kaiden JS, Zimmerman TJ, Worthen DM: Handheld tonometers: An evaluation by medical students . Arch Ophthalmol 89:110-112, 1973.Crossref

Dawson, Chandler R.;Daghfous, Toufique;Messadi, Mohammed;Hoshiwara, Isao;Vastine, David W.;Yoneda, Chieko;Schacter, Julius

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010206003pmid: 4137188

Abstract A controlled chemotherapy trial of trachoma was carried out in a Tunisian oasis where the disease is highly endemic and frequently leads to loss of vision. Children 6 to 9 years of age with clinically active trachoma were divided into three groups. One of the groups was treated with chlortetracycline ophthalmic ointment (48 cases), one with erythromycin ophthalmic ointment (52 cases), and one with boric acid ointment (46 cases). Medications were administered twice daily six days a week for ten consecutive weeks. Both antibiotics were considerably more effective than boric acid in suppressing clinical disease for four weeks and 17 weeks after treatment. Similarly, both antibiotics considerably reduced the prevalence of trachoma agent (in immunofluorescent and Giemsastained smears) at four weeks after treatment, but a noticeable decrease at 17 weeks was found only in the erythromycin group, in which there was much less trachoma agent before treatment than in the other two groups. References 1. Special subject: Trachoma . World Health Statistics Report . 24:274-329, 1971. 2. Tarizzo ML: Chemotherapy of trachoma . WHO Chronicle 26:99-101, 1972. 3. Assaad FA, et al: Clinical evaluation of the Taiwan trachoma control program . Bull WHO 45:491-509, 1971. 4. Bobb AA, Nichols RL: Influence of environment on clinical trachoma in Saudi Arabia . Am J Ophthalmol 67:235-243, 1969. 5. Hoshiwara I, Powers DK, Krutz G: Comprehensive trachoma control program among the southwestern American Indians , in XXI Concilium Ophthalmologicum, Mexico 1970 . Amsterdam, Excerpta Medica, 1971, pp 1935-1939. 6. Reinhards J, Weber A, Maxwell-Lyons F: Collective antibiotic treatment of trachoma. Report on comparison trials leading to more economic methods of treatment . Bull WHO 21:665-702, 1959. 7. Reinhards J, et al: Studies in the epidemiology and control of seasonal conjunctivitis and trachoma in southern Morocco . Bull WHO 39:497-545, 1968. 8. Bietti G, Werner GH: Trachoma prevention and treatment , in Kugelmass IN (ed): Springfield, Ill Charles C Thomas Publisher, 1967, pp 1-227. 9. Dawson CR, Hanna L, Jawetz E: Controlled treatment trials of trachoma in American Indian children . Lancet 2:961-964, 1967.Crossref 10. Dawson CR, et al: Tetracyclines in the treatment of chronic trachoma in American Indians . J Infect Dis 124:255-263, 1971.Crossref 11. Dawson CR, et al: Controlled trials with trisulfapyrimidines in the treatment of chronic trachoma . J Infect Dis 119:581-590, 1969.Crossref 12. Vastine DW, et al: Severe endemic trachoma in Tunisia. I. The effect of topical chemotherapy on conjunctivitis and ocular bacterial. Br J Ophthalmol, to be published. 13. Fourth WHO Scientific Group on Trachoma Research—Report , WHO Tech Rep Ser 330:1-24, 1966. 14. Expert Committee on Trachoma—Third Report . WHO Tech Rep Ser 1962, p 234. 15. Dawson CR, et al: The evaluation of controlled trachoma chemotherapy trials . Rev Int Trach 44:77-85, 1968. 16. Schachter J, et al: Comparison of procedures for laboratory diagnosis of oculogenital infections with inclusion conjunctivitis agents . Am J Epidemiol 85:453, 1967. 17. Schachter J, et al: Evaluation of methods for detecting acute TRIC agent infection . Am J Ophthalmol 70:375-380, 1970. 18. Pagès R: Le rôle des conjonctivites aigues saisonnières dans l'évolution du trachome . Rev Int Trach 28:179-182, 1951. 19. Hanna L: Immunofluorescence in chronic TRIC infections of American Indians and Tunisians: Influence of trauma on results of tests . Proc Soc Exp Biol Med 136( (suppl 2) ):655-659, 1971.Crossref 20. Tarizzo ML, Nabli B, Labonne J: Studies on trachoma. II. Evaluation of laboratory diagnostic methods under field conditions . Bull WHO 38:897-905, 1968. 21. Nichols RL, et al: Immunofluorescent studies of the microbiologic epidemiology of trachoma in Saudi Arabia . Am J Ophthalmol 63( (pt 2) ):1372, 1967. 22. Nichols RL, et al: Studies on trachoma. II. Comparison of fluorescent antibody, Giemsa, and egg isolation methods for the isolation of trachoma virus in human conjunctival scrapings . Am J Trop Med Hyg 12( (suppl 2) ):223-229, 1963.

Morse, Peter H.;Scheie, Harold G.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010212004pmid: 4853908

Abstract Two hundred patients (231 eyes) undergoing prophylactic cryoretinopexy for retinal breaks with a follow-up period from six months to three years were found to have no complications as a result of the treatment. There was no new retinal break formation, macular pucker, or subsequent retinal detachment. Analysis of type of retinal hole and location in 216 patients (223 eyes) with clinical retinal detachment are reviewed to emphasize that all types of breaks in all quadrants of the fundus may lead to retinal detachment. Of particular note, 48% of retinal detachments initially occurred without antecedent symptoms. Prophylactic cryoretinopexy for retinal breaks is advocated. References 1. Cockerham WD, Freeman HM: Molehills, mountains and prophylaxis of retinal detachment . Arch Ophthalmol 79:655-656, 1968.Crossref 2. Teng CC, Katzin HM: An anatomic study of the periphery of the retina: I. Nonpigmented epithelial cell proliferation and hole formation . Am J Ophthalmol 34:1237-1248, 1951. 3. Okun E: Gross and microscopic pathology in autopsy eyes: III. Retinal breaks without detachment . Am J Ophthalmol 51:369-391, 1961. 4. Boniuk M, Butler FC: An autopsy study of lattice degeneration, retinal breaks and retinal pits , in McPherson A (ed): New and Controversial Aspects of Retinal Detachment . New York, Paul B Hoeber Inc, 1968, pp 59-75. 5. Foos RY, Allen RA: Retinal tears and lesser lesions of the peripheral retina in autopsy eyes . Am J Ophthalmol 64:643-655, 1967. 6. Rutnin U, Schepens CL: Fundus appearance in normal eyes: IV. Retinal breaks and other findings . Am J Ophthalmol 64:1063-1078, 1967. 7. Halpern JI: Routine screening of the retinal periphery . Am J Ophthalmol 62:99-102, 1966. 8. Barishak YR, Stein R: Retinal breaks without detachment in autopsy eyes . Acta Ophthalmol 50:147-159, 1972.Crossref 9. Byer NE: Clinical study of retinal breaks . Trans Am Acad Ophthalmol Otolaryngol 71:461-473, 1967. 10. Linder B: Acute posterior vitreous detachment and its retinal complications . Acta Ophthalmol , (suppl 87) , pp 1-108, 1966. 11. Jaffe NS: Complications of acute posterior vitreous detachment . Arch Ophthalmol 79:568-571, 1968.Crossref 12. Tasman WS: Posterior vitreous detachment and peripheral retinal breaks . Trans Am Acad Ophthalmol Otolaryngol 72:217-224, 1968. 13. Morse PH, Scheie HG, Aminlari A: Light flashes as a clue to retinal disease . Arch Ophthalmol 91:179-180, 1974.Crossref 14. Neumann E, Hyams S: Conservative management of retinal breaks . Br J Ophthalmol 56:482-486, 1972.Crossref 15. Colyear BH, Pischel DK: Preventive treatment of retinal detachment by means of light coagulation . Trans Pac Coast Otoophthalmol Soc 41:193-215, 1960. 16. Davis M: The natural history of retinal breaks without detachment. Read before the Retina Society, Atlantic City, NJ, 1969. 17. Okun E, Cibis PA: Photocoagulation in limited retinal detachment and breaks without detachment , in McPherson A (ed): New and Controversial Aspects of Retinal Detachment . New York, Paul B Hoeber Inc, 1968, pp 164-172. 18. Straatsma BR, Allen RA, Christensen RE: The prophylaxis of retinal detachment . Trans Pac Coast Otoophthalmol Soc 46:211-236, 1965. 19. Mortimer CB: The prevention of retinal detachment . Can J Ophthalmol 1:206-212, 1966. 20. Colyear BH: A clinical comparison of partially penetrating diathermy and xenon-arc photocoagulation , in McPherson A (ed): New and Controversial Aspects of Retinal Detachment . New York, Paul B Hoeber Inc, 1968, pp 176-185. 21. Söllner F: Uber die prophylaktische Behandlung der Ablatio retinae durch Lichtcoagulation . Ber Dtsch Ophthalmol Ges 66:327-336, 1965. 22. Schepens CL: The preventative treatment of ideopathic and secondary retinal detachment , in Acta Concilium Ophthalmologicum . Belgium, Imprimerie Medicale et Scientifique, SA, 1958, vol 1, 1019-1027. 23. Robertson DM, Norton EWD: Long-term follow-up of treated retinal breaks . Am J Ophthalmol 75:395-404, 1973. 24. Kreissig I, Sbaiti A: Kryopexie in der Ablatio-Prophylaxe . Klin Monatsbl Augenheilkd 159:588-596, 1971. 25. Böke W, Voigt G: Ergebnisse der prophylaktischen Kryoretinopexie . Klin Monatsbl Augenheilkd 159:12-21, 1971. 26. Ramsay RC, Eifrig DE: Outpatient freezing of retinal breaks . Am J Ophthalmol 76:782-785, 1973. 27. Hosni FA: Management of peripheral retinal breaks . Ophthalmologica 166:265-288, 1973.Crossref 28. Robertson DM, Curtin VT, Norton EWD: Avulsed retinal vessels with retinal breaks: A cause of recurrent vitreous hemorrhage . Arch Ophthalmol 85:669-672, 1971.Crossref

Byer, Norman E.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010216005pmid: 4853892

Abstract Although the causative role of the retinal break in the onset of retinal detachment is well established, guidelines for the understanding of the relative risks of various types of breaks have been largely lacking because of the paucity of prospective clinical studies of retinal breaks. A series of 162 retinal breaks in 125 phakic, non-"fellow" eyes was observed without treatment for from three to nine years. None of the breaks progressed to clinical retinal detachment. One patient did develop a small subclinical retinal detach. ment. It was concluded that the presence or absence of symptoms in association with the onset of the retinal break is the most important prognostic criterion. Prophylactic treatment is rarely indicated in asymptomatic retinal breaks, but should be recommended in cases of symptomatic breaks. References 1. Gonin J: Le décollement de la rétine: Pathogénie. Traitement . Lausanne, Switzerland, Payot, 1934, p 77. 2. Colyear BH, Pischel D: Clinical tears in the retina without detachment . Trans Pac Coast Otoophthalmol Soc , 1955, pp 185-217. 3. Colyear BH, Pischel D: Preventive treatment of retinal detachment by means of light coagulation . Trans Pac Coast Otoophthalmol Soc , 1960, pp 193-215. 4. Davis MD: Natural history of retinal breaks without detachment . Arch Ophthalmol 92:183-194, 1974.Crossref 5. Neumann E, Hyams S: Conservative management of retinal breaks . Br J Ophthalmol 56:482-486, 1972.Crossref

Portney, Gerald L.;Portney, Susan B.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010219006pmid: 4852056

Abstract For five consecutive years, active trachoma has been surveyed and treated in the entire population of the San Xavier Papago Indian Reservation on the premise that only such a major effort would be successful in eradication of this disease. Numerous socioenvironmental factors have been evaluated in detail. During that time, rapid improvement in housing and sanitation standards has occurred. The incidence of active trachoma has been substantially reduced in the children and virtually eliminated in the adults as a result of this wide-scale effort. Nevertheless, the total reservation screening approach does not seem to have been warranted. References 1. Portney G: Analysis of the prevalence of trachomas: Selected environmental and social factors . J Pediatr Ophthalmol 7:233-237, 1970. 2. Portney G, Hoshiwara I: Prevalence of trachoma among southwestern Indian tribe . Am J Ophthalmol 70:843-848, 1970. 3. Portney G, Portney S: Epidemiology of trachoma in the San Xavier Papago Indians . Arch Ophthalmol 86:260-262, 1971.Crossref 4. MacCallan AF: The epidemiology of trachoma . Br J Ophthalmol 15:369-411, 1931.Crossref

Ulrich, Richard A.;Burton, Thomas C.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010221007pmid: 4852420

Abstract Cultures of 638 routine preoperative conjunctival specimens prior to retinal detachment surgery demonstrated bacterial contamination with Staphylococcus epidermidis in 37%, S aureus in 3%, Proteus in 1%, Klebsiella in 1%, and Pseudomonas in 0.2%. Postoperative infection with rejection of the scleral implants occurred in 4% (37) of 878 operations. The risk of a clinical infection was increased statistically when a preoperative culture demonstrated pathogenic bacteria, when episcleral solid silicone was used in surgery, and when the procedure was a reoperation. Age, sex, side of surgery, type of anesthesia, aphakia, preoperative contamination with S epidermidis, drainage of subretinal fluid, disinsertion of muscles, or the use of silicone sponges did not influence the vulnerability of the eyes to postoperative infections. The risk of recurrent detachment following surgical removal of the infected materials was found to be 33%. References 1. Lincoff H, Nadel A, O'Connor P. The changing character of the infected scleral implant . Arch Ophthalmol 84:421-426, 1970.Crossref 2. Huntsberger DV, Leaverton PE: " Frequency Data II: Tests for Statistical Significance " in Statistical Inference in the Biomedical Sciences . Boston, Allyn and Bacon Inc, 1970, pp 89-93. 3. Russo CE, Ruiz RS: Silicone sponge rejection . Arch Ophthalmol 85:647-650, 1971.Crossref 4. Cason L, Winkler CH: Bacteriology of the eye: I. Normal flora . Arch Ophthalmol 51:196-199, 1954.Crossref 5. Smith CH: Bacteriology of healthy conjunctiva . Br J Ophthalmol 38:719-726, 1954.Crossref 6. Polack FM, Locatcher-Khorazo D, Gutierrez E: Bacteriologic study of "donor" eyes . Arch Ophthalmol 78:219-225, 1967.Crossref

Peyman, Gholam A.;Apple, David J.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010224008pmid: 4853026

Abstract Histopathological analysis of a malignant melanoma locally excised by fullthickness eye wall resection revealed the margins and scleral emissaria to be completely free of tumor. This surgical technique, if applied to tumors that are of appropriate size and location, appears promising as a means of retaining vision and cosmesis in the involved eye. Furthermore, histopathologic examination of the excised tumor tissue is possible. This latter feature is an important advantage of this technique over other forms of local therapy of choroidal malignant melanoma. References 1. Peyman GA, Dodich NA: Full-thickness, eye wall resection: An experimental approach for treatment of choroidal melanoma. I. Dacron graft . Invest Ophthalmol 11:115-121, 1972. 2. Peyman GA, et al: Full-thickness eye wall resection: An experimental approach for treatment of choroidal melanoma. II. Homo- and heterograft . Invest Ophthalmol 11:668-674, 1972. 3. Peyman GA, et al: Full-thickness, eye wall resection in various species: An experimental approach in treatment of choroidal melanoma . Albrecht von Graefes Arch Klin Ophthalmol 186:157, 1973.Crossref 4. Peyman GA, et al: Full-thickness eye wall resection in primates: An experimental approach for treatment of choroidal melanoma . Arch Ophthalmol 89:410-412, 1973.Crossref 5. Peyman GA, et al: Full-thickness eye wall resection: Evaluation of preoperative photocoagulation . Invest Ophthalmol 12:262-266, 1973. 6. Peyman GA, Diamond J, Apelrod AJ: Sclero-chorioretinal (S.C.R.) resection in humans. Ann Ophthalmol, to be published.

Wilensky, Jacob T.;Holland, Monte G.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010227009pmid: 4604027

Abstract A 34-year-old woman had a pigmented tumor of the ciliary body which had begun to invade the angle structures. Fluorescein angiography of the iris correctly suggested the benign nature of the lesion. The tumor was locally excised with the retention of good visual function. References 1. Reese AB: Tumors of the Eye , ed 2. New York, Harper & Row, 1963, pp 48-67. 2. Cogan DG, Kuwabara T: Tumors of the ciliary body , in Smith ME (ed): International Ophthalmology Clinics: Ocular Pathology . Boston, Little Brown & Co, 1971, vol 11, pp 27-56. 3. Zimmerman LE: Verhoeff's 'terato-neuroma': A critical reappraisal in light of new observations and current concepts of embryonic tumors . Am J Ophthalmol 72:1039-1057, 1971.

Mumma, John V.

1974 Archives of Ophthalmology

doi: 10.1001/archopht.1974.01010010229010pmid: 4854546

Abstract A 3-year-old boy with congenital esotropia and underaction of both superior obliques developed a marked left head tilt that was not relieved by weakening the right inferior oblique. On attempted right superior oblique tuck, no superior oblique could be found. Alternately, a new procedure for intorsion of the right eye was performed, consisting of a temporal shift of the right superior rectus and a nasal shift of the right inferior rectus. The results are cosmetically acceptable for both the eye position and the head tilt. References 1. Duke-Elder WS: Textbook of Ophthalmology, Vol. IV, The Neurology of Vision, Motor and Optical Anomalies . St. Louis, The CV Mosby Co, Publishers, 1949, p 4068. 2. Knapp P: Symposium on Strabismus , St. Louis, The CV Mosby Co, Publishers, 1971, p 248. 3. Jackson E: Operation on the tendon of the superior rectus for paresis of the superior oblique . Ophthalmol Rev 22:61-70, 1903. 4. Knapp P: Vertically incomitant horizontal strabismus: The so-called "A" and "V" syndromes . Trans Am Ophthalmol Soc 57:666-669, 1959. 5. Goldstein JH: Monocular vertical displacement of horizontal rectus muscles for "A" and "V" patterns . Am J Ophthalmol 64:265-267, 1967. 6. Fink WH: Surgery of the Oblique Muscles of the Eye . St. Louis, The CV Mosby Co, Publishers, 1951, p 54.