Alport's syndrome and the eye

Alport's syndrome comprises hereditary deafness, nephritis and ocular abnormalities. The features of Alport's syndrome are illustrated by a family with Alport's syndrome and hereditary oesophageal leiomyomatosis. The evidence that Alport's syndrome is due to a widespread basement membrane disorder is noted. Treatment of anterior lenticonus, the principal ocular abnormality, by lensectomy and intraocular lens insertion is recommended.     

COMBINED HAMARTOMA OF THE RETINA AND RPE: AN UNUSUAL CAUSE OF THE DRAGGED DISC APPEARANCE

Combined hamartoma of the retina and retinal pigment epithelium (RPE) is a rare, benign, congenital fundal lesion which contains a mixture of glial tissue, blood vessels and pigment epithelium. Such turnours are variably pigmented and may be wrongly diagnosed as malignant melanoma or retinoblastoma. We report two cases which were located in the periphery of the fundus and which produced a dragged disc appearance.     

Septic cavernous sinus thrombosis — A case report

This paper reports a case of septic cavernous sinus thrombosis following a chronic ear infection and paranasal sinusitis. The diagnosis and management of this condition are discussed.     

Computer-assisted analysis of the electro-oculogram

A method of acquiring and analysing electrooculogram signals was developed using computeraided techniques. The repetitive nature, characteristic shape and spectral properties of the electro-oculogram are used in the automated analysis, enabling the retinal resting potential to be investigated. Online computer-aided automatic analysis of the electro-oculogram is efficient, reliable and accurate. Automated analysis produced results that have a highly significant degree of correlation ( P < 0.001) with the results obtained manually from strip chart recording of the electro-oculogram signals. The increased accuracy of the automatic analysis system demonstrates a significantly reduced (McNemar's Test) false positive rate in classifying abnormal results on the basis of Arden ratio. The computer-aided analysis system offers a useful clinical means of measuring the electrooculogram for diagnostic and research purposes.     

Spontaneous resolution of primary congenital glaucoma

We report a further four cases of spontaneously resolved primary congenital glaucoma, including one case seen bath prior and subsequent to the resolution. This condition is detected usually in eyes with megalocornea, which are later found to have breaks in Descemets membrane. Two other patients also had this diagnosis made, but later developed active glaucoma, requiring surgical treatment, indicating the need for continued observation of apparently abortive forms of congenital glaucoma.     

A comparison of the efficacy of betaxolol and timolol in ocular hypertension with or without adrenaline

Betaxolol hydrochloride, a selective beta:-adrenergic blocker, is claimed to be less likely to aggravate chronic obstructive airways disease than timolol maleate, a nonselective beta-blocker. It is not clear which drug is more effective in lowering intraocular pressure (IOP) and how each acts in combination with topical adrenaline. To assess this we conducted a randomised clinical trial on ocular hypertensive patients. Both betaxolol and timolol produced a significant fall in IOP though not in all patients. No significant difference was found between betaxolol and timolol. The addition of dipivefrin gave an additional fall in some eyes only. No significant difference was found between the addition of dipivefrin and adrenaline. Some fellow eyes had a fall in IOP when dipivefrin was added to timolol. It is important to assess the response carefully in each individual eye when using betaxolol or timolol or when adding additional medication.     

DERMIS-FAT GRAFT: EVOLUTION OF A LIVING PROSTHESIS

Over the past two years 15 dermis-fat grafts were performed Ten were primary grafts, two were implanted because of migrated implants, two for extruding implants and one to correct deep superior sulcus recession.
Our experience showed dermis-tat grafts to be an effective method of correcting orbital volume deficit, of maintaining satisfactory prosthetic motility and of preventing the development of conjunctival deficiency.
In primary dermis-tat grafts fat atrophy was less than 70%, whilst in secondary implants fat atrophy was less than 30% Complications were minimal in our small series     

PENICILLINASE-PRODUCING NEISSERIA GONORRHOEA AS A CAUSE OF NEONATAL AND ADULT OPHTHALMIA

A retrospective analysis of 80 cases of gonococcal ophthalmia revealed six (7.5%) to be due to penicillinase-producing Neisseria gonorrhoeae (PPNG), five neonatal cases and one adult. All six cases were finally cured, but best results were obtained with topical chloramphenicol and single-dose spectinomycin (40 mg/kg) given intramuscularly. All gonococcal isolates should be tested promptly for penicillinase production, and if this is present systemic treatment, modified to spectinomycin or penicillinase-stable cephalosporin, should be given as single-dose treatment.