In epithelial basal membrane dystrophy of the cornea Bron's dystrophy plays a prominent role (frequently combined with fingerprint dystrophy). It can be visualized only in retroillumination, and is without doubt the most common corneal dystrophy. It should be distinguished from Cogan's microcysts, which were seen in only 11% of the authors patients. The incidence of map dystrophy is about the same, while subepithelial plaques are least frequently observed.

Of a total of 26 patients with hyperlipidemia, 4 developed flat yellow patches of varying size and shape in the macular area. In a different study a total of 9 subjects with similar flat yellow patches were examined; 6 had increased levels of serum cholesterol and triglycerides. The likelihood that such patients have hyperlipidemia is well over 50%.

In epithelial basal membrane dystrophy of the cornea Bron's dystrophy plays a prominent role (frequently combined with fingerprint dystrophy). It can be visualized only in retroillumination, and is without doubt the most common corneal dystrophy. It should be distinguished from Cogan's microcysts, which were seen in only 11% of the authors patients. The incidence of map dystrophy is about the same, while subepithelial plaques are least frequently observed.

Of a total of 26 patients with hyperlipidemia, 4 developed flat yellow patches of varying size and shape in the macular area. In a different study a total of 9 subjects with similar flat yellow patches were examined; 6 had increased levels of serum cholesterol and triglycerides. The likelihood that such patients have hyperlipidemia is well over 50%.

Loaiasis is a chronic parasitic disease caused by the filaria Loa loa.As soon as the worm reaches the subconjunctival space local irration ensues. This so-called Loa ophthalmia necessitates immediate surgical intervention which can be performed under topical anesthesia, using the slit lamp. The indirect immunofluorescence technique represents a valuable diagnostic test,since it is usually difficult to demonstrate the microfilaria in the peripheral blood.

In contrast to the classical picture of herpes simplex infection involving the lids and lid margin characterized by the presence of a group of vesicles situated on a swollen erythematous base, the latter are usually lacking in the erosive-ulcerative type of herpes simplex blepharitis (Fig. 1, 2). Here the following features are encountered: single or multiple intermarginal erosions, single or multiple skin ulcers situated at the lid margin, or a combination of both. The affected lid portion usually exhibits slight swelling and tenderness upon palpation, moderate conjunctival injection especially adjacent to the lesion may be present, as well as ipsilateral palpable lymph nodes. A total of 42 cases has been observed within a period of 3 years. From the initial 28 patients smears were obtained for immunological proof of our diagnosis, which turned out to be positive in 26 cases, testifying to the reliability of the clinical features, which have been outlined in detail in our previous papers (Klin Monatsbl Augenheilkd 173:407–412 (1978), Arch Ophthalmol (in press)). In about 20% of the cases proven herpes simplex conjunctivitis has been encountered; therefore, local virustatics should be applied to the lesions as well as conjunctiva, especially in view of the fact that these drugs will find ready access to the viruses within the erosions and ulcers.

Histologically, pterygium is characterized, apart from the presence of typical collagen fibers, by the appearance of fibres which take up elastic stain but differ from normal elastic tissue, as was confirmed by electron-microscopic investigations. Thus, "elastoid degeneration" of collagen is characterized by the loss of the characteristic periodic fibril structure and by the appearance of coiled and knotty fibres. Collagen types in pterygium were identified biochemically for the first time. The main bulk of collagenous tissue consists of 80-90% Type I collagen, while only 10-20% Type III collagen was detected. Type IV collagen (basal membrane collagen) was present in low amounts. Digestion with elastase resulted in 20% solubilization of pterygium, while bacterial collagenase digested up to 40% of the tissue dry weight.

A report on 11 cases of maplike dystrophy of the cornea; it is characterized by the presence of fine whitish intraepithelial lines, which may easily be overlooked during biomicroscopic examination: they are most easily descernable in bright oblique illumination. Similarities with Cogan's, fingerprint, and bleblike dystrophy (Bron) are discussed, and the potential weakness of the corneal epithelium found in these patients is pointed out.

In 185 diabetics with proliferative diabetic retinopathy (d.r.) involving both eyes symmetrically we analyzed the indication for photocoagulation in borderline cases in which, despite complications (such as inducement of vitreoretinal retraction), the beneficial effect of photocoagulation outweighs the likelihoood of a spontaneous deleterious course. In stage 2 of proliferative d.r. the risks associated with photocoagulation (i.e., factors likely to cause traction phenomena) were found to be extensive coagulation of intraretinal and preretinal hemorrhages, and coagulation of feeder vessels as well as of fundus areas located behind vitreal hemorrhages. In stage 3, procoagulative risk factors in the morphological picture comprised the existence of several vitreoretinal insertions with tent-shaped traction folds and extensive preretinal and subvitreal hemorrhages.

A 49-year-old man went blind in his left eye during coronary angiography. The following day an occlusion of the inferior temporal and inferior nasal branch of the central retinal artery was detected, associated with a moderate papilledema of the inferior part of the optic disk as well as retinal edema of the inferior fundus. Fluorescein angiography confirmed the clinical diagnosis, perimetry revealed loss of visual field in the superior half. Seven months after the initial examination the patient displayed a partial optic atrophy of the inferior portion of the disk associated with a moderate neovascularization in that area. The visual field loss remained unchanged.

A report on 11 cases of maplike dystrophy of the cornea; it is characterized by the presence of fine whitish intraepithelial lines, which may easily be overlooked during biomicroscopic examination: they are most easily descernable in bright oblique illumination. Similarities with Cogan's, fingerprint, and bleblike dystrophy (Bron) are discussed, and the potential weakness of the corneal epithelium found in these patients is pointed out.

In 28 subjects the diagnosis of an erosive-ulcerative herpes simplex blepharitis was confirmed by laboratory tests. The clinical manifestations were characterized by the presence of erosions of the intermarginal portion of the lid or the presence of skin ulcers located at the lid margin or the combination of both features, and usually by an absence of vesicular eruptions. Erosions of the intermarginal portion of the lid can readily be made visible by staining with fluorescein. The involved lid portion usually exhibits mild swelling and tenderness on palpation. Conjunctival injection usually is not pronounced adjacent to the lid lesion, the regional lymph nodes being swollen. Laboratory confirmation can be achieved readily by the indirect immunofluorescence technique. The treatment modality consists of the combination of antibiotic and virustatic ointments.

: A 49-year-old man went blind in his left eye during coronary angiography. The following day an occlusion of the inferior temporal and inferior nasal branch of the central retinal artery was detected, associated with a moderate papilledema of the inferior part of the optic disk as well as retinal edema of the inferior fundus. Fluorescein angiography confirmed the clinical diagnosis, perimetry revealed loss of visual field in the superior half. Seven months after the initial examination the patient displayed a partial optic atrophy of the inferior portion of the disk associated with a moderate neovascularization in that area. The visual field loss remained unchanged.

Within the past two years we have seen the "bleb-like dystrophy" of Bron and Brown in 30 patients. It is characterized by groups of subepithelial excrescences measuring 15-100 microms. These pathologic changes can only be discerned biomicroscopically by retro-illumination; they do not result in any opacification of the corneal epithelium or stroma. In 21 cases a concomitant Fingerprint dystrophy of the cornea (Guerry) was observed. Both types of dystrophy were prevalent in female patients and in most cases occurred bilaterally. The relatively high incidence of recurrent erosions as well as the pathologic structure of the subepithelial membrane documented in the Fingerprint dystrophy points to a potential weakness of the corneal epithelium in these cases. This fact should be borne in mind especially when fiting contact lenses.

Zusammenfassung An 185 Diahetikern mit symmetrischer proliferativer diabetischer Retinopathie (d. R.) beider Augen wurde der Grenzhereich der Indikation zur Lichtkoagulation analysiert, in dem der glinstige Behandlungseffekt rrotz Kornplikationen, wie der Induktion einer vitreoretinalen Retraktion, die Wahrscheinlichkeiteines spontanen deletiren Verlaufs iibertrifft. Als Risikofaktoren der Lichtkoagulation hinsichtlich der lnduktton von Traktionsphãnomenen wurde im Stadium 2 der proliferativen d. R. die extensive Koagulation intraund präretinaler Blutungen sowie die Koagulation von ,,feeder-vessels" und Fundussektoren hinter vitrealen Blutungen ermittelt. Als hauptsachliche Risikofaktoren einer du rch Lichikoagulation provozierten vitreoretinalen Retraktion wurde das Bestehen von mehreren vitreoretinalen Insertionen mit zeltformigen Traktionsfalten sowie ausgedehnte praretinale und subvitreale Blutungen im Stadium 3 ermittelt.