On the nature and the role of the subsurface vesicles in the outer epithelial cells of the conjunctiva.

The layer of the tear film in contact with the conjunctiva is mucus. This mucus comes from two sources, the conjunctival goblet cells and the subsurface vesicles. These vesicles are found just below the surface of the conjunctival cells. They contain long chain mucus glycoprotein molecules that are joined to the vesicle membrane. The vesicles fuse with the surface membrane of the conjunctival cells and expose their mucus glycoprotein chains to the overlying mucus. Chemical and physical bonds between the two types of mucus help to bind the mucus layer to the conjunctiva. The vesicle membrane becomes incorporated in the cell membrane and supplies the membranes for the microvilli that cover the exposed surface.     

Determination of the location of the fovea on the fundus

PURPOSE: To evaluate whether the distance between optic nerve head and fovea in healthy eyes determined by scanning laser ophthalmoscope may facilitate estimation of the location of the fovea relative to the optic disc in patients with macular disease. METHODS: The angular distance was measured, in horizontal and vertical directions, between the center of the optic nerve head and the fovea in 104 eyes of 104 healthy probands. For additional evaluation of intraindividual variation in 70 of these persons the contralateral eye was measured as well. RESULTS: The distance between the optic disc and the fovea differed vertically more than horizontally (-1.5 +/- 0.9 degrees [-3.65 to +0.65 degrees ] vs. 15.5 +/- 1.1 degrees [13.0-17.9 degrees ]). There was a mean angle between the fovea and the center of the optic disc versus the horizon of -5.6 +/- 3.3 degrees. The intraindividual difference between right and left eyes was markedly lower, with average angles being 0.2 +/- 1.3 degrees vertically and 0.0 +/- 1.1 degrees horizontally. CONCLUSIONS: The distance between the optic nerve head and the fovea does not allow for a meaningful determination of the location of the fovea in eyes in which morphologic changes have occurred. The angle of rotation of the fovea relatively to the center of the optic nerve head is relatively stable. Therefore, the size of a central scotoma can be determined by movement of the blind spot according to the change of the preferred retinal locus (PRL). In addition, the knowledge of the location of the fovea enables determination of the position in the contralateral eye of the same patient.     

On the relevance of the long-time follow-up of the cyclocryotherapy

In spite of the availability of cyclocryodestructive laser therapy there still appears to be an indication for cyclocryotherapy in different kinds of glaucoma. PURPOSE: Cyclocryotherapy very often appears to be the operation of choice in cases of progressive functional visual loss if a patient is not sufficiently helped with the maximum tolerated medical therapy. We investigated long-term IOP effects and possible complications in our group of patients undergoing cyclocryotherapy. PATIENTS: Cyclocryotherapy was performed on 109 eyes of 97 patients from 1988 to 1994. Cyclocryotherapy was performed as follows: 67 of 109 eyes were controlled for IOP for an average of 10 months (3-41 months). We applied cryotherapy six times 3-4 mm behind the limbus for an average duration of 50 to 60 s over half of the circumference. RESULTS: We achieved satisfactory IOP control (IOP K 22 mm Hg) in 40 eyes, however, with 30 additional operations. One eye developed phthisis bulbi, and 3 other eyes became blind because of complications in neovascular glaucomas. Neovascular glaucoma cases responded the least. CONCLUSIONS: Cyclocryotherapy produced a statistically significant IOP reduction in eyes with primary open-angle glaucoma or secondary glaucoma. Close long-term follow-up appears advisable in order to check the eyes for possible increase in IOP or complications of surgery.     

On the relevance of the long-time follow-up of the cyclocryotherapy

In spite of the availability of cyclocryodestructive laser therapy there still appears to be an indication for cyclocryotherapy in different kinds of glaucoma.