1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010013001
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010014002
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010017004pmid: 2910275
Abstract To the Editor. —In response to your recent correspondence on container confusion between eye drops and other substances1,2 and your case report on treatment for inadvertent cyanoacrylate tarsorrhaphy,3 I refer you to my case report of 1984.4 An ophthalmic ointment instilled through any small defect in the adhesive tarsorrhaphy will hasten separation of the adhesive shell and its atraumatic removal. In fact, if patience is exercised, the rapid turnover of the ocular epithelia will see to it that the adhesive separates quickly in any case. To give a general anesthetic for such a case would surely be exposing the patient to unnecessary risks. References 1. Fraunfelder FT: Drug-packing standards for eye drop medications . Arch Ophthalmol 1988;106:1029.Crossref 2. Silverman CM: Corneal abrasion from accidental instillation of cyanoacrylate into the eye . Arch Ophthalmol 1988;106:1029-1030.Crossref 3. Raynor LA: Treatment for inadvertent cyanoacrylate tarsorrhaphy . Arch Ophthalmol 1988;106:1033.Crossref 4. Morgan SJ, Astbury NJ: Inadvertent self administration of superglue: A consumer hazard . Br Med J 1984;289:226-227.Crossref
Vrabec, Michael P.;Florakis, George J.;Krachmer, Jay H.
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010017003pmid: 2910274
Abstract To the Editor. —Polycyanoacrylates have been shown to be useful in various corneal diseases, including traumatic perforations and peripheral melting conditions. Many articles discuss its use in already-perforated eyes. However, it is known that glue is a useful adjunct that can aid in corneal healing before perforation occurs.1 It can be difficult, however, to apply very small amounts of glue to a precise location on the cornea. A new method of controlled glue application is presented by illustrating its use in a patient in whom melting of a corneal transplant threatened perforation. Report of a Case. —A 40-year-old man with keratoconus and pellucid marginal degeneration underwent corneal transplantation in the left eye. His postoperative course was marked by persistent epithelial defects. He then developed a noninfected 90% loss of stroma at the graft-host interface despite patching and discontinuation of steroid treatment. We elected to glue the area in an References 1. Fogle JA, Kenyon KR, Foster CS: tissue adhesive arrests stromal melting in the human cornea . Am J Ophthalmol 1980;89:795-802. 2. Hirst LW, Stark WJ, Jensen AD: Tissue adhesives: New prospectives in corneal perforations . Ophthalmic Surg 1979;58-64. 3. Mandelbaum S, Udell IJ: Noninfected corneal perforation , in Abbott RL (ed): Surgical Intervention in Corneal and External Diseases . New York, Grune & Stratton Inc, 1987, pp 87-106.
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010018007pmid: 2910278
Abstract To the Editor. —The Wall Street Journal's "Heard on the Street" column appears to have been usurped in the June 1988 issue of the Archives. However, the high standards normally required for acceptance by both publications do not seem to be met by two letters.1,2The photographs used in the first letter1 were provided by the manufacturer. These are the same photographs that appear in a promotional brochure prepared by the manufacturer. Such a source is normally considered suspect and unacceptable in a clinical study. An added point—minor but indicative of poor preparation—is that Fig 2 is a reversed printing of the photograph as it appears in the manufacturer's brochure.In their letter, Polack and Goodman1 suggest reliance on subjective responses from patients that apparently were not substantiated by objective observations by the authors.In the second letter, Leibowitz and Capino2 suspect that the formulation References 1. Polack FM, Goodman DF: Experience with a new detergent lid scrub in the management of chronic blepharitis . Arch Ophthalmol 1988;106:719-720.Crossref 2. Leibowitz HM, Capino D: Treatment of chronic blepharitis . Arch Ophthalmol 1988;106:720.Crossref
Safran, Avinoam B.;de Weisse, Catherine
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010018005pmid: 2910277
Abstract To the Editor. —In clinical practice, dystrophic lesions of the anterior visual pathways may be misdiagnosed as acquired lesions, and vice versa.1 In acquired defects, transient changes in visual function often occur,2 whereas they rarely occur in dystrophic disorders of these neural pathways.OCTOPUS (Interzeag AG, Schlieren, Switzerland) automated perimeter programs offer two modes of evaluating transient changes in visual function, according to the program selected: (1) the so-called root mean square fluctuation, or (2) the "short-term fluctuation" (SF), both of which require a time interval of less than 15 minutes between threshold testings. However, there are indications that the SF index is the more accurate means of measuring these transient changes in visual function.3We therefore analyzed SF values (computed by the G1 program) obtained (1) from 41 examinations evaluating defects in optic neuritis or anterior visual pathway compression, and compared these values with those obtained References 1. Keane JR: Suprasellar tumors and incidental optic disc anomalies . Arch Ophthalmol 1977;95:2180-2183.Crossref 2. Enoch JM, Campos EC, Bedell HE: Visual resolution in a patient exhibiting a visual fatigue or saturation-like effect . Arch Ophthalmol 1979;97:76-79.Crossref 3. Flammer J: The concept of visual field indices . Graefes Arch Clin Exp Ophthalmol 1986;224:389-392.Crossref
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010018006pmid: 2910276
Abstract To the Editor. —In their article in the March 1988 Archives, Hunter and colleagues1 state that "Attempts to elucidate the pathogeneses of these [genetic] subtypes have been confounded by studies that have considered all patients with RP [retinitis pigmentosa] as a single group," after which two RP studies of which I was one of the authors are referenced.It appears that a careful reading was not given to our articles, as Table 1 in the article on autoimmunity in hereditary retinal degeneration2 illustrates the great effort the UCLA Retinitis Pigmentosa Center takes to subdivide patients with RP on a hereditary and test rationale, while our study correlating the fluorescein angiographic findings with the presence or absence of antiretinal antibodies3 also looked at differences between patients with typical rod-cone vs cone-rod degeneration (type I vs type II RP, Baltimore classification). Hunter et al appear to be critical of References 1. Hunter DG, Fishman GA, Kretzer FL: Abnormal axonemes in X-linked retinitis pigmentosa . Arch Ophthalmol 1988;106:362-368.Crossref 2. Chant SM, Heckenlively J, Meyers-Elliott RH: Autoimmunity in hereditary retinal degeneration: I. Basic studies . Br J Ophthalmol 1985;69:19-24.Crossref 3. Heckenlively JR, Solish Am, Chant SM, et al: Autoimmunity in hereditary retinal degeneration: II. Clinical studies: Anitretinal antibodies and fluorescein angiogram findings . Br J Ophthalmol 1985;69:758-764.Crossref
Leibowitz, Howard M.;Capino, Diosdado
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010018008
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 Reply. —Dr Caccamise's letter raises some rather cogent issues. Regrettably, he does so in an accusatory fashion.Our motivation for writing a letter to the editor was straightforward. One of us (H.M.L.) had edited a textbook that recommended a therapeutic regimen for chronic blepharitis. Clinically that regimen had ceased to be effective, and the change in effect seemed to be related to the product being used to scrub the eyelids, namely, Johnson's Baby Shampoo (Johnson & Johnson Baby Product Co, Skillman, NJ). The manufacturer of this product was at the time advertising widely that "conditioners" had been added to the product and was promoting it for use as an adult shampoo. Several patients called our attention to the fact that they discerned physical differences in the product, and our discussions with a number of pharmacists confirmed this observation. We commented on this in the original text of the letter,
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010018009
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 Reply. —As president of Spectra Pharmaceutical Services Inc, I appreciate the opportunity to respond to Dr Caccamise's letter.Spectra was founded in 1985 on the credo that it would be dedicated to the development of innovative products for the ophthalmic patient and practitioner.Since our inception, we have been true to this credo. We have focused our attention on external surface ocular pathologic conditions, most notably blepharitis. The introduction of I-Scrub in early 1987 represented a scientific approach to the hygienic management of those anatomic structures associated with blepharitis. Since introduction of I-Scrub, approximately 100 ophthalmologists have personally called us to report on its excellent results and favorable patient compliance.Worldwide recognized experts in the area of external ocular disease, namely Drs Leibowitz, Capino, Polack, and Goodman, have independently evaluated I-Scrub and published their clinical impressions as letters in the Archives.Clinical impressions of leading clinicians in all medical
Bengtsson, Bo;Krakau, C. E. Torsten
1989 Archives of Ophthalmology
doi: 10.1001/archopht.1989.01070010020011pmid: 2910279
Abstract To the Editor. —An important objective of most examinations of the optic nerve head is to estimate the mass of nerve tissue, which is assumed to reflect the number of retinal ganglion cell axons leaving the eye.Current clinical estimates in the living eye are based on measurements of the cup/disc ratio or the rim area and suffer from a strong dependence on the size of the optic nerve head.The association between the rim area and the disc size has been noticed in several recent articles. Britton et al1 first confirmed our finding2 that the rim width is uncorrelated with the disc diameter. This leads, on a pure geometric basis, to a strong correlation (r =.75) between the rim and disc areas. Large discs, therefore, have large rim areas as well as large cups. Caprioli and Miller,3 who obtained similar results, rejected the hypothesis that eyes with References 1. Britton RJ, Drance SM, Schulzer M, et al: The area of the neuroretinal rim of the optic nerve in normal eyes . Am J Ophthalmol 1987;103:497-504. 2. Bengtsson B: The variation and covariation of cup and disc diameters . Acta Ophthalmol 1976;54:804-818.Crossref 3. Caprioli J, Miller JM: Optic disc rim area is related to disc size in normal subjects . Arch Ophthalmol 1987;105:1683-1685.Crossref 4. Siebert M, Gramer E, Leydhecker W: Papillenparameter bei Gesunden: Quantifiziert mit dem Optic Nerve Head Analyser . Klin Monatsbl Augenheilkd 1988;192:302-310.Crossref 5. Bynke H, Holmdahl G: Megalopapilla: A differential diagnosis in suspected optic atrophy . Neuro-ophthalmology 1981;2:53-57.Crossref
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