New heterocentric, aplanatic surgical contact lenses for the anterior eye segment

A heterocentric arrangement of optical radii in surgical contact lenses and the extremely eccentric mirror placement which this makes possible guarantee a wide field angle for the observer and the therapeutic laser beam, and thus represent an optimized optical system with minimal optical aberration. The monobloc glass lens systems were developed in cooperation with Dr. Schirmer specifically for glaucoma surgery in the anterior chamber angle. A mirrored chamber angle contact lens and an iridotomy lens for use in argon laser trabeculoplasty, YAG laser iridotomy, YAG laser capsulotomy, and YAG goniosynechiectomy are designed to facilitate therapy with greatly reduced laser energy and optimized image conditions. The lenses have been evaluated, with positive results, at university eye hospitals in Montreal (Dr. Schirmer), Tübingen (Dr. Jean), Berlin (Dr. Seiler), and Munich (Dr. Fabian).     

Histoire du trachome au Canada

The author retraces the history of trachoma in Canada. The numerous articles in Canadian medical journals from the middle of the 18th to the middle of the 19th century show the remarkable contribution of Canadian ophthalmologists. The clinical symptoms and signs followed by the etiology and the different modes of treatment are reviewed. The presence and prevention of trachoma in Canada, ranging from Montreal to Toronto, also in Halifax with the arrival of the transatlantic immigrants, as well as those reaching the western provinces of Canada are described. How the Canadian Department of Health belatedly introduced a prevention campaign only after a widespread dissemination of trachoma across the country is also examined.     

Pioneering surgery for retinal detachment in Australasia: a review

In the 1930s there was excitement worldwide with the realization that Jules Gonin's observation that closing the retinal break was the key to successful retinal re‐attachment surgery. Australians and New Zealanders kept pace with these developments despite the limitations of travel and communication in the 1930s. Dr J. Bruce Hamilton of Tasmania was training at Moorfields Eye Hospital in 1930 and was exposed to the surgical technique espoused by Gonin in its first year of being adopted in Britain. Walter Lockhart Gibson was the first in Australasia to report a successful retinal re‐attachment operation in 1931. In the 1960s Australians made two significant contributions to retinal surgery: the Schultz‐Crock portable indirect ophthalmoscope and the first instrument for closed pars plana vitrectomy. The latter was developed at the Royal Victorian Eye and Ear Hospital by Dr Jean‐Marie Parel and Professor Gerard Crock, in association with Dr Robert Machemer, and it was used by Machemer when he carried out the world's first closed pars plana vitrectomy in 1971.     

The risk of other primary cancer in patients with uveal melanoma: a retrospective cohort study of a Canadian population

BACKGROUND: The incidence of second primary malignant tumours has doubled during the last 2 decades.These tumours now represent the sixth most common group of cancers. Many authors have described the presence of multiple primary cancers in patients with uveal melanoma. However, no studies have been performed using Canadian data.The purpose of this study was to describe the occurrence of other primary cancers diagnosed before or after uveal melanoma and to calculate the incidence of subsequent primary cancer in a Canadian cohort with uveal melanoma. METHODS: We conducted a retrospective study of a cohort of patients with uveal melanoma diagnosed between 1990 and 2002 at a university-affiliated centre in Montreal. We reviewed medical records to identify patients in whom other, unrelated primary malignant disease had been diagnosed. We used the standardized incidence ratio to calculate the risk of development of a second, unrelated cancer following the diagnosis of uveal melanoma. RESULTS: A total of 129 cases of uveal melanoma were diagnosed. Eighteen patients (14%) also had a diagnosis of an unrelated primary cancer. In nine patients the other cancer had been diagnosed first, and in nine patients the other tumour had been diagnosed after the uveal melanoma.There was no increased risk of development of any particular form of cancer studied for females or males. INTERPRETATION: In our Canadian cohort, statistical analysis showed no increased risk of a second cancer, overall or by organ site, in male or female patients with uveal melanoma. As uveal melanoma is a rare type of cancer, analyses of a much larger cohort may be needed to accurately estimate the risk of development of a second primary cancer in patients with uveal melanoma.     

Lest we forget: notes on reading Verhoeff's early correspondence

Dr. Verhoeff's life and work are reexamined by the author in the light of his early correspondence. The letters remind us of the significant contributions of Dr. Verhoeff to ophthalmic pathology in America. His personal qualities, such as candor, ingenuity and intellectual honesty are recalled by his successor in the Howe Laboratory.     

Some aspects of Dr Kinoshita's contributions to lens protein chemistry

A review of some of Dr Kinoshita's contributions to our understanding of lens protein and glutathione biochemistry is presented. Particular emphasis is placed on Dr Kinoshita's work involved with the relationship of carbohydrate metabolism and the maintenance of reduced glutathione, the question of the biological function of glutathione in the lens, the effect of oxidative stress provided by diamide and azoester on glutathione, membrane pump function and protein and also ascorbate and H2O2 effects on Na+, K(+)-ATPase. The importance of oxidative stress was recognized early by Dr Kinoshita and he has continued to make significant contributions in this area as illustrated by his work with Dr Zigler on posterior subcapsular cataracts and with Drs Garland and Zigler on mixed function oxidation. It is concluded that Dr Kinoshita's overall contributions in the areas mentioned above have been broad and of considerable importance.     

Etude clinique du sens chromatique „central” dans l'amblyopie fonctionnelle

R'esumé sens chromatique a été examiné chez 103 sujets présentant une amblyopie fonctionnelle à l'aide de trois types de tests cliniques. Dans les conditions de vision monoculaire on ne trouva pas de modification du sens chromatique liée directement au mécanisme physio-pathologique de l' amblyopie fonctionnelle.

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Summary The colour sense of 103 persons with functional amblyopia was examined with 3 different clinical tests. In monocular vision no change of the colour sense connected with the amblyopia was observed.

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Zusammenfassung Der Farbensinn wurde bei 103 Personen mit funktionneller Amblyopie untersucht, und dies mit Hilfe von drei verschiedenen klinischen Testen. Bei monokularem Sehen fand sich keine Veränderung des Farbensinnes die in direktem Zusammenhang mit dem physio-pathologischen Mechanismus der funktionellen Amblyopie steht.

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Travail de la Clinique Ophtalmologique de Strasbourg. (Directeur Prof. Dr. Jean Nordmann).     

Book Reviews

Book reviewed in this article: The Cranial Nerves Dominique Doyon, Kathlyn Marsot‐Dupuch, Jean‐Paul Francke Medical Contact Lens Practice Elisabeth AW Millis Manual of Eye Emergencies Lennox A Webb     

The Use of Amsler Grids in Early Chloroquin Retinopathy

A survey of Canadian ophthalmologists and rheumatologists suggests that there is a significant incidence of definite chloroquine retinopathy in their patients. As hydroxychloroquine and chloroquine appear to be better tolerated and less toxic than some other drugs used in the treatment of rheumatoid arthritis and systemic lupus erythematosus, there is a need for a simple, patient-administered test for early diagnosis of chloroquine retinopathy. The Amsler grid and smaller Yannuzzi modified Amsler grid are simple, inexpensive, and correlate well with scotomas found with static and kinetic perimetry.     

The Protocol for the Early vs. Late Infantile Strabismus Surgery Study

The Early vs. Late Infantile Strabismus Surgery Study Group is a group of strabismologists and orthoptists who investigate whether early or late surgery is preferable in infantile strabismus, in a non-randomized, prospective, multi-centre trial. Infants between 6 and 18 months of age will receive a standardized entry examination and then be operated either before their second anniversary in clinics A, or between their 32nd and 60th month of age in clinics B. The children will be evaluated at age six. After completion of the study, the two groups can then be compared regarding degree of binocular vision, angle of strabismus and visual acuity of the worse eye relative to the better. Zentrum zur methodischen Betreuung von Therapiestudien, Mrs H. Dinkel, Universit?t Heidelberg, Im Neuenheimer Feld 305, W-69120 Heidelberg. 49.6221.565500. fax: 564195 Germany PD Dr. H.J. Simonsz, Orthoptics & Neuroophthalmology, Afdeling Oogheelkunde, University Hospital Dijkzigt, Dr. Molewaterplein 40, NL 3015 GD Rotterdam. 3 i. 10.4639222, ask for beeper 3394 fax: 4635105 The Netherlands PD Dr. med. G.H. Rolling, Schule für Orthoptik, Universit?ts-Augenklinik, Im Neuenheimer Feld 400, W-69047 Heidelberg. 49.6221.566627/34/39 fax: 565422 Germany Dipl.-Inform. Med. U. Haag, Universit?t Heidelberg, Zentrum zur methodischen Betreuung von Therapiestudien, Im Neuenheimer Feld 305, W-69120 Heidelberg. 49.6221.564192 fax: 564195 Germany Dr. A. Deák, Augenklinik, Korányi Fasor, U-6720 Szeged. 36.62.12321/10822 fax: 22826 Hungary Mr P. Fells, F.R.C.S., F.C. Ophth., Lower Corridor Suite, Moorfields Eye Hospital, City Road, ECIV 2PD London. 44.71.2533411 fax: 2534696 (lower corridor suite) England Prof. R. Frosini, Istituto di Clinica Oculista dell' Universita di Firenze, Insegnamento di Ottica Fisiopatologica, Viale Morgagni 85,1-50134 Florence. Dr. R. Gomez de Lia?o, Nu?ez de Balboa 81, E-28006 Madrid. 34.1.5763229/72318 Spain Dr. O. Haugen, Orthoptic Department, Department of Ophthalmology, University of Bergen, N-3021 Bergen. Norway Dr. med. G. Klainguti, Clinique Ophtalmique, 15 Av. de France, CH-1004 Lausanne. 41.21.9637696/250211 Switzerland Prof.Dr. K. Krzystkowa, Ophthal. Clinic Medical Acad., 38 Copernika Str, P-31501 Krakow. 4812.223272/215210/210460/214577/220411 Poland M.C.M.E. van Lammeren, Afdeling Orthoptie, Dienst Oogziekten, U.Z. St. Rafa?l, Kapucijnenvoer 33, B-3000 Leuven. Prof. G. Lennerstrand, Institutionen for Oftalmiatrik, Huddinge sjukhus, S-14186 Huddinge. 46.8.7461000/3854/3418 Sweden Dr. med. H. Luka, Abt. f. Schielen, Schwachsichtigkeit und Bewegungsst?rungen des Auges, Allgem. ?ffentl. Krankenhaus der Landeshauptstadt St. P?lten, A-3100 St. P?lten. 43.512.85597/5040 43.2742.62521 (Klappe 2869) Dr. V. Paris, Rue de Luxembourg, 48, B-6900 Marche-en-Famenne. 32.84314749 Belgium Dr. L.J.J.M. Prick-Wenniger, Afdeling Oogheelkunde, A.M.C., Meibergdreef 9, NL 1105 AZ Amsterdam. 31.20.5663881/6715637 The Netherlands Prof. M.A. Quéré, 19, Rue Voltaire, F-44000 Nantes. 33.40.738370/083406 fax: 084649 France Dr. F. Reich-d'Almeida, Rua Castilho, No 65.z:Dto, P-1200 Lissabon. 351.1520619 Dr. med. R. Weidlich, Universit?ts-Augenklinik, Leninallee 8, O-4020 Halle. 37.4684.9878/81 Germany.     

The Physiologist Ewald Hering (1834–1918): Curriculum vitae

The Early vs. Late Infantile Strabismus Surgery Study Group is a group of strabismologists and orthoptists who investigate whether early or late surgery is preferable in infantile strabismus, in a non-randomized, prospective, multi-centre trial. Infants between 6 and 18 months of age will receive a standardized entry examination and then be operated either before their second anniversary in clinics A, or between their 32nd and 60th month of age in clinics B. The children will be evaluated at age six. After completion of the study, the two groups can then be compared regarding degree of binocular vision, angle of strabismus and visual acuity of the worse eye relative to the better.

Zentrum zur methodischen Betreuung von Therapiestudien, Mrs H. Dinkel, Universität Heidelberg, Im Neuenheimer Feld 305, W-69120 Heidelberg. 49.6221.565500. fax: 564195 Germany

PD Dr. H.J. Simonsz, Orthoptics &; Neuroophthalmology, Afdeling Oogheelkunde, University Hospital Dijkzigt, Dr. Molewaterplein 40, NL 3015 GD Rotterdam. 3 i. 10.4639222, ask for beeper 3394 fax: 4635105 The Netherlands PD Dr. med. G.H. Rolling, Schule für Orthoptik, Universitäts-Augenklinik, Im Neuenheimer Feld 400, W-69047 Heidelberg. 49.6221.566627/34/39 fax: 565422 Germany

Dipl.-Inform. Med. U. Haag, Universität Heidelberg, Zentrum zur methodischen Betreuung von Therapiestudien, Im Neuenheimer Feld 305, W-69120 Heidelberg. 49.6221.564192 fax: 564195 Germany

Dr. A. Deák, Augenklinik, Korányi Fasor, U-6720 Szeged. 36.62.12321/10822 fax: 22826 Hungary

Mr P. Fells, F.R.C.S., F.C. Ophth., Lower Corridor Suite, Moorfields Eye Hospital, City Road, ECIV 2PD London. 44.71.2533411 fax: 2534696 (lower corridor suite) England

Prof. R. Frosini, Istituto di Clinica Oculista dell' Universita di Firenze, Insegnamento di Ottica Fisiopatologica, Viale Morgagni 85,1–50134 Florence.

Dr. R. Gomez de Liaño, Nuñez de Balboa 81, E-28006 Madrid. 34.1.5763229/72318 Spain

Dr. O. Haugen, Orthoptic Department, Department of Ophthalmology, University of Bergen, N-3021 Bergen. Norway

Dr. med. G. Klainguti, Clinique Ophtalmique, 15 Av. de France, CH-1004 Lausanne. 41.21.9637696/250211 Switzerland

Prof.Dr. K. Krzystkowa, Ophthal. Clinic Medical Acad., 38 Copernika Str, P-31501 Krakow. 4812.223272/215210/210460/214577/220411 Poland

M.C.M.E. van Lammeren, Afdeling Orthoptie, Dienst Oogziekten, U.Z. St. Rafaël, Kapucijnenvoer 33, B-3000 Leuven.

Prof. G. Lennerstrand, Institutionen for Oftalmiatrik, Huddinge sjukhus, S-14186 Huddinge. 46.8.7461000/3854/3418 Sweden

Dr. med. H. Luka, Abt. f. Schielen, Schwachsichtigkeit und Bewegungsstörungen des Auges, Allgem. öffentl. Krankenhaus der Landeshauptstadt St. Pölten, A-3100 St. Pölten. 43.512.85597/5040 43.2742.62521 (Klappe 2869)

Dr. V. Paris, Rue de Luxembourg, 48, B-6900 Marche-en-Famenne. 32.84314749 Belgium

Dr. L.J.J.M. Prick-Wenniger, Afdeling Oogheelkunde, A.M.C., Meibergdreef 9, NL 1105 AZ Amsterdam. 31.20.5663881/6715637 The Netherlands

Prof. M.A. Quéré, 19, Rue Voltaire, F-44000 Nantes. 33.40.738370/083406 fax: 084649 France

Dr. F. Reich-d'Almeida, Rua Castilho, No 65.z:Dto, P-1200 Lissabon. 351.1520619

Dr. med. R. Weidlich, Universitäts-Augenklinik, Leninallee 8, O-4020 Halle. 37.4684.9878/81 Germany     

A common disease haplotype for the Q368STOP mutation of the myocilin gene in Australian and Canadian glaucoma families

PURPOSE: To ascertain whether there is a common disease haplotype for the Q368STOP mutation of the myocilin gene in Australian and Canadian families with primary open-angle glaucoma (POAG). DESIGN: Family pedigree study. METHODS: A disease haplotype for the Q368STOP mutation of the myocilin gene has previously been identified in 15 Tasmanian families with POAG. The four microsatellite markers that constitute this 0.14-megabase (Mb) disease haplotype were genotyped in individuals from a large French Canadian family with POAG (family CT) and two unrelated French Canadian individuals with ocular hypertension. RESULTS: The Tasmanian Q368STOP disease haplotype was identified in affected individuals from family CT, and the same alleles were shared at the four microsatellite markers in the two unrelated French Canadian individuals. CONCLUSION: The same disease haplotype for the Q368STOP mutation of the myocilin gene was found in both the Tasmanian and French Canadian populations, supporting the view that this mutation arose from a common Caucasian founder.     

A thirty year journey in the polyol pathway

The development of the concept that aldose reductase (AR) is involved in diabetic complications is presented from its early beginning when Dr Van Heyningen first found polyols in sugar cataracts in 1959. The involvement of the polyol theory of sugar cataract is described. The prevention of sugar cataract formation by aldose reductase inhibitors dramatically demonstrates the role of this enzyme in sugar-induced cataracts. The possibility of AR involvement of other diabetic complications was an obvious extension of the polyol theory. The use of AR inhibitors in preventing diabetic changes in nerve and retina in animals strongly suggest that AR may play a role in the development of other diabetic complications.     

Samuel Theobald M.D.

Although ophthalmology today at the Johns Hopkins Hospital is synonymous with the name of Wilmer, it should be remembered that the Wilmer Ophthalmological Institute was not founded until 1925. Thus, to appreciate fully the ophthalmic heritage of Johns Hopkins we must look back to the beginnings of the medical institutions. When the Johns Hopkins Hospital opened in 1889 and the medical school followed in 1893, Samuel Theobald, M.D., was appointed ophthalmic and aural surgeon, and later clinical professor of ophthalmology and otology. Dr. Theobald, a native Baltimorean, was a member of the prestigious Smith family, which distinguished itself in early American medicine. He was raised in the home of his grandfather, Dr. Nathan Ryno Smith who directed his education. Dr. Theobald studied ophthalmology and otology abroad before opening a practice in Baltimore in 1871. Before his appointment at Johns Hopkins he was one of the founders of the Baltimore Eye, Ear and Throat Charity Hospital in 1882. In addition to his teaching at the medical school and his work in the dispensary, he contributed for his development of ‘Theobald lacrimal probes’, the introduction of boric acid as a collyrium, and his text bookPrevalent Diseases of the Eye. He was a member of the American Ophthalmological Society for 50 years and its 14th President. In 1925 at the age of 79 years, he retired and became emeritus. Read at the annual meeting of the Cogan Ophthalmic History Society, The National Library of Medicine, Bethesda, Maryland, March 15 and 16, 1996.     

Eye banking: 1944 to the present

Through the efforts of Dr. Townley Paton, eye banks were founded in New York in the early 1940s. Since that time there has been steady growth in both the supply of and demand for donor material. A number of factors have contributed to the success of eye banks in the U.S.A., including improvements in eye banking techniques and administration, increase in corneal surgery, legislation facilitating corneal donations, and growing confidence of patients and ophthalmologists in the success of corneal tissue transplantation.     

A Canadian glaucoma strategy

BACKGROUND: To develop Canadian guidelines for the management of primary open-angle glaucoma and provide a quick and practical reference for physicians in the office setting. METHODS: A Canadian Glaucoma Strategy began with a review of the literature and existing guidelines, as well as consultation with glaucoma specialists and general ophthalmologists across Canada. The resulting information was assessed by a panel of glaucoma experts and general ophthalmologists at the Canadian Glaucoma Strategy Forum to distill what was learned and construct the algorithms of care. RESULTS: A Canadian Glaucoma Strategy was developed in 4 algorithms. First, patients are diagnosed on the basis of risk assessment and clinical findings. The staging algorithm is designed to determine the disease stage, while the treatment and follow-up algorithms focus on control of intraocular pressure and continuing patient follow-up. INTERPRETATION: A Canadian Glaucoma Strategy is a practical series of algorithms that can be at hand in the office setting, providing the general ophthalmologist with an up-to-date guide for the management of patients with glaucoma concerns.     

Eye banking: 1944 to the present

Through the efforts of Dr. Townley Paton, eye banks were founded in New York in the early 1940s. Since that time there has been steady growth in both the supply of and demand for donor material. A number of factors have contributed to the success of eye banks in the U.S.A., including improvements in eye banking techniques and administration, increase in corneal surgery, legislation facilitating corneal donations, and growing confidence of patients and ophthalmologists in the success of corneal tissue transplantation.     

Analysis of the publication volume of Canadian ophthalmology departments from 2005 to 2009: a systematic review of the literature

Objective: To assess the publication volume of Canadian ophthalmology departments over a 5-year period, 2005–2009.Design: Systematic review of the literature.Methods: MEDLINE was searched for papers published from 2005 to 2009 where the designated affiliation corresponded to a Canadian ophthalmology department. The papers were sorted by year, university, and study design. A total impact score (the impact factor of the journal multiplied by the number of papers published in that journal per year) was also calculated for each university.Results: In the 5-year period there was an increasing trend in the total number of published ophthalmology papers. The University of Toronto had the highest number of published papers (224), followed by the University of British Columbia (143) and McGill University (120). The Canadian Journal of Ophthalmology published the most papers, followed by Investigative Ophthalmology and Visual Science. The mos1 frequent study design category was basic science research and a total of 11 different randomized controlled trials were retrieved.Conclusions: The publication volume of Canadian ophthalmology researchers increased significantly from 2005 to 2009 with larger institutions accounting for the majority of published papers. Like researchers in other countries, Canadian ophthalmology researchers preferred to publish in domestic journals.     

From a forester''s boy to a university professor

Austrian ophthalmologist, Dr. Karl B. Hruby, is well known for his preset lens, which allows slit-lamp examination of the vitreous and fundus. He is also known as one of the first to use microsurgical methods for intraocular operations and scleral buckling for retinal detachments. In this memoir, Dr. Hruby shares the fascinating personal account of his experiences as a prisoner and physician during World War II, and as an outstanding teacher and clinician thereafter. The article is followed by the editorial comment of Dr. Fred Blodi, who invited Dr. Hruby to contribute this article.     

The incidence of secondary hemorrhage after traumatic hyphema

A retrospective study was undertaken to determine the incidence of secondary hemorrhage after traumatic hyphema in a medium-sized Canadian city. This was found to be 10%, which is similar to the incidence reported in other Canadian and northern European cities but much lower than that reported in some large American cities. The different racial mix of the sample populations is the most likely reason for these differences.