This paper describes the protocol evolved for a double blind prospective trial to determine any possible effect on cortical cataract of the drug Catalin. Riboflavin is the placebo chosen to afford a close colour match. Careful patient selection is necessary to maintain a homogenous population, and indications for excluding would-be volunteers are listed. Different strata are constructed for analyses purposes, based on the amount of cortical cataract present and the age of the patient. Analysis is based on the findings at two-monthly examinations of visual acuity, slit lamp estimation of change in cataract by drawing, and analysis of stereo slit lamp photographs. The conversions used to translate clinical findings into arithmetic values for statistical analyses are given. The results so far obtained have been decoded only as far as the alpha equivalents of the drug. There are statistically significant differences in some parameters between the two groups.
The National Registry of Drug-induced Ocular Side Effects is an international information centre for ocular toxicology. The Registry collects case reports of drug-induced ocular side effects from physicians and other national registries, and surveys the world literature for drug-related ocular events. Possible adverse drug associations can be identified in this system, and cause-and-effect relationships may on occasion be proven. Functions of this Registry include increasing ophthalmic awareness of human ocular toxicology, and promoting continuation of contributions to decrease the delay between recognition of a possible adverse drug reaction and the actual reporting of it in the literature.
AbstractThe association of anterior Uveitis (AU) with the HLA‐B27 histocompatibility antigen is now well established; however, the clinical features of this subgroup of AU patients have not been extensively studied. We investigated 81 consecutive patients with AU over a 12‐month period.Fifty‐one percent of the patients were HLA‐B27‐positive as were all patients with ankylosing spondylitis and Reiter's syndrome. This group of AU patients, when compared to HLA‐B‐27‐negative patients, had more frequent attacks of shorter duration and rarely developed chronic AU.Males with AU, when compared with females, had a higher incidence of HLA‐B27 (31/41; p<0.005) and were more likely to have an associated rheumatic disease such as anky losing spondylitis, Reiter's syndrome or another seronegative arthritis. In contrast, HLA‐B27‐positive AU patients without associated rheumatic disease occurred with equal frequency in males and females. Females in this group had a comparatively later age of onset of AU (47 vs 40 years); had more attacks, each being of longer duration; and had a higher attack rate per year. This study defines the nature, severity and prognosis of AU with respect to the sex, associated rheumatic disease and HLA‐B27 status of patients.
The pattern and the focal electroretinogram (ERG) are both non-invasive, electrophysiological responses recorded from circumscribed retinal areas and are most easily recorded from the macula. This paper describes how our department has incorporated these tests into our clinical protocol, shows how the recording technique and the method of electrode construction may be improved, and describes the normal limits of the macular responses we obtain. The ERG signal-noise ratio we obtained was better than that of the binocular visual evoked potentials (VEPs) recorded simultaneously. Pattern and focal ERGs, using improved methods of recording, show promise of being a valuable addition to the clinical investigation of subtle maculopathies and some forms of optic nerve dysfunction. Three illustrative cases are described. The first demonstrates normal macular ERG responses with abnormal Ganzfeld ERGs due to peripheral retinal damage. The second reveals differential pattern ERG reduction with normal focal ERG in recent optic neuritis. The third case demonstrates reversible simultaneous loss of Ganzfeld ERGs and macular ERGs in vitamin A deficiency.
AbstractEsotropia in the neonatal period is significant if it is prolonged or recurrent, while exotropia is not. Straight eyes for most of the waking hours is the rule rather than the exception in the newborn.Successful surgical management of congenital esotropia depends on equal attention to diagnosis, planning and treatment These are preceded by proper timing of the surgical procedure and followed by careful, comprehensive attention to the needs of the patient. The manifest cosmetic and hoped‐for functional benefit of early surgery, when supported by competent paediatric anaesthesia, makes early surgery the logical choice for treatment of congenital esotropia.
