Congenital alacrima

A sixteen-year-old black male with congenital alacrima and deficient salivary secretion demonstrated evidence of keratoconjunctivitis sicca. The workup revealed elevated immunoglobulins and histologically normal lacrimal and salivary glands, but there was deposition of amyloid in the conjunctival stroma. The differential diagnosis of the dry eye is discussed.

Chronopharmacology of strychnine and allylglycine in the mouse

1. The response of individually caged mice to the lethal actions of allylglycine and strychnine was evaluated in animals previously conditioned on an LD 12:12 (12 h light-12 h darkness) schedule in a controlled environment. 2. These convulsant agents were most toxic at 18.00 hours (during the light phase), and least toxic in the dark phase of the programmed lighting schedule. The relationship is considered of the circadian fluctuations in levels of inhibitory transmitter substances to the time-linked action of convulsant agents.

The association of rubeosis iridis with endothelialisation of the anterior chamber: report of a clinical case with histopathological review of 16 additional cases

A patient is reported in whom the clinical observation of extension of the corneal endothelium and Descemet's membrane in association with rubeosis iridis was confirmed by histopathological examination. In a study of eyes which had been removed and demonstrated rubeosis iridis and secondary glaucoma in 16 additional eyes revealed extension of the corneal endothelium and Descemet's membrane on to the anterior iris surface. In all instances the transition occurred at the pseudoangle formed by the attachment of peripheral anterior synechiae. The suggestion is made that the fibrovascular membrane of rubeosis iridis is the stimulus which excites the extension of the endothelium on to the iris surface. The association between rubeosis iridis and extension of the corneal endothelium and Descemet's membrane on to the iris has not been previously appreciated.

Radical anterior segment surgery for epithelial invasion of the anterior chamber: report of three cases

Three patients who developed epithelial invasion of the anterior chamber were treated by radical anterior segment surgery. Two adults had typical epithelial downgrowth of the anterior chamber, while the third patient, an 8-year-old child, developed large serous cysts following evacuation of a traumatic hyphema. In all three patients, the invading epithelium involved the iris, cornea, and angle, while the two adults had epithelium on the vitreous face as well. The operation consisted of an en bloc excision of cornea and sclera with contiguous iris, ciliary body, and vitreous when necessary. A free-hand corneoscleral graft was fashioned and sewn into the bed using interrupted 9-0 nylon sutures on the scleral side and continuous 10-0 nylon sutures on the corneal side. The patients all developed transitory glaucoma in the early post-operative period. The glaucoma was controlled with acetazolamide. A mild anterior uveitis usually was present for several months and was suppressed with topical applications of corticosteroids. Histopathologic study of the excised tissue showed complete removal of the epithelium.

Drusen of the optic disc

Although optic disc drusen have been of interest to ophthalmologists for more than 100 years, their etiology and many aspects of their relationship to other clinical conditions remain obscure. They have been clinically observed in 0.3% of the population, although autopsy studies suggest an incidence of 2%. Drusen are seldom accompanied by visual symptoms; however, decreased vision and visual field changes may occur. The historical and epidemiological aspects of drusen are reviewed; clinical and histological features, as well as special diagnostic techniques (ultrasonography and fluorescein angiography) are discussed in detail.

Squamous cell carcinoma of the conjunctiva. Value of exfoliative cytology in diagnosis

Cytologic examination is of potential value to the practicing ophthalmologist in confirming the clinical impression of cancer of the eye. Scrapings of conjunctival lesions can be prepared in the office, stained with Giemsa stain and rapidly examined. Carcinoma in situ and squamous cell carcinoma of the bulbar conjunctiva were presented as illustrations of the usefulness of exfoliative cytology in clinical ophthalmology.

The retina in type 5 hyperlipoproteinemia

Of two patients with type 5 hyperlipoproteinemia, one exhibited lipemia retinalis with multiple retinal hemorrhages and intraretinal lipid extravasations. Postmortem examination showed hemorrhages in the inner retinal layers and lipid deposits largely in the outer plexiform layer. Lipid within the walls of the retinal vessels was demonstrated by light and electron microscopy. The second patient exhibited visual loss due to progressive obstruction of retinal vessels with white material presumed to be lipid. Findings were confined to one eye.

Metastatic carcinoma of the iris

Of three women and one man with metastatic carcinoma of the iris, the average age of the four was 50.2 years. Two of the tumors originated in the breast and two in the lungs. The average survival from time of diagnosis of the iris lesion was less than six months. Each patient presented with characteristic grayish-white translucent nodules on the iris or in the anterior chamber angle. The patients displayed other features of iris metastases such as secondary glaucoma, rubeosis iridis, iris atrophy, anterior uveitis, hypopyon, and hyphema. As an aid in the clinical evaluation, anterior segment fluorescein angiography was performed, revealing vascular details not seen clinically. Leakage of dye was a constant feature of the angiogram.

Sclero-cornea and defective mesodermal migration

A 5-month-old boy with bilateral sclero-cornea, multiple systemic abnormalities, and normal karyotype had his left eye removed after corneal perforation. Histopathological examination of the enucleated eye revealed an irregular corneal epithelium, absent Bowman's membrane, thickened and vascularized stromal lamellae, absent Descemet's membrane and endothelium, no angle structures, hypoplasia of the iris and ciliary body, and total kerato-iridic adhesions. A profound defect in embryogenesis due to defective mesodermal migration during the earliest phase of mesoderm differentiation is postulated as the causative factor in this case.

Gamma-butyrolactone sleep: A 24-hour rhythm paralleling normal sleep in the rat and CNS amine changes

The duration of sleep induced by a fixed dose of gamma-butyrolactone (GBL) (350 mg/kg, IP) FOllows the normal circadian sleep pattern of rats. GBL sleep duration is maximal at 1800 hr and minimal at 0600 hr. CNS amine changes are not extensive, but when normal sleep is anticipated, GBL treatment increases dopamine and serotonin levels and decreases norepinephrine levels.

Chemosis, proptosis and amaurosis in a 19-year-old male

An ectopic pinealoma was excised in 1966 and the patient received radiotherapy postoperatively. The patient developed diabeted insipidus, hypopituitarism, chemosis, proptosis, and loss of vision in the left eye. The left eye was enucleated in 1974 and a large orbital mass was found to contain malignant cells consistent with the diagnosis of germinoma. The orbital mass was in all likelihood a metastasis from the original focus of the tumor.

Drusen of the optic disc. A retrospective study in cadaver eyes

A retrospective study of 737 consecutive necropsies yielded 15 cases of drusen of the optic nerve head, an incidence of 20-4 cases per thousand. This represents the highest incidence yet reported. The histopathological features of drusen of the nerve head included elevation of the nerve head, compression of optic nerve fibres, partial optic atrophy, cytoid bodies, disc haemorrhages, juxtapapillary retinal scarring with haemosiderin deposition, calcification, and iron deposition within drusen.

Drusen of the optic disc. A histopathological study

A retrospective study of autopsy and surgically enucleated eyes yielded eighteen autopsy and four surgically enucleated eyes harbouring drusen of the optic disc. The average age of the patients in this series was 58-6 years. Various histopathological changes were noted in the optic nerve head and adjacent retina; these comprised compression of nerve fibres, partial optic atrophy, elevation of the optic disc, cytoid bodies, disc haemorrhage, sequelae of haemorrhage, and juxtapapillary retinal scarring. All optic disc drusen were calcified and five of the ten disc drusen stained positively for the presence of iron.

Ultrastructure and clinicopathologic correlation of idiopathic preretinal macular fibrosis

Detailed light and electron microscopic examination of early idiopathic preretinal fibrosis lesions showed that the fibrosis consisted of a layer of glial cells on the retinal surface. Two cases supported the clinical observation that a glinting retinal reflex preceded the development of retinal folds and traction lines. In both cases there was a break in the inner limiting lamina through which glial cells migrated and, presumably, proliferated on the retinal surface. There was no evidence for vitreoretinal adhesions. The ultrastructural similarity of the lesion to preretinal glial membranes seen in other disease entities suggested the possibility of a common biochemical stimulus for glial cell migration and proliferation on the retinal surface.

Exogenous Moraxella liquefaciens endophthalmitis

Moraxella species have been generally associated with diseases of the external eye. In this report we present a case of exogenous Moraxella liquefaciens endothalmitis which developed 14 years after an intracapsular cataract extraction.

Uniocular vascular occlusion in a paraplegic hybrid monkey. A clinicopathologic study

One eye of a hybrid monkey showed ophthalmoscopic, fluorescein angiographic, and electroretinographic evidence of ophthalmic artery occlusive disease. Histopathologic examination of that eye revealed widespread atrophy of the choroid, retina and optic nerve. An associated paraplegia was presumed to be the result of vascular occlusive disease as well.

Retinal pigment epithelial degeneration, partial retinal atrophy and macular hole in acute lymphocytic leukemia

A seven year old child with acute lymphocytic leukemia presented at autopsy with a macular hole, and degeneration of the retinal pigment epithelium and its overlying photoreceptors. She had been treated with cobalt 60, methotrexate, vincristine cyclophosphamide and prednisone. A review of the literature of similar findings as well as pigment epithelial degenerations from other causes is presented.