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Show Journal of Cli" ical Neuro- ophthalmology 9( 2): 137- 140, 1989. Literature Abstracts Double Vision, Visual Loss, and an Enhancing Orbital Apex. Burde RM, with comments by Gittinger JW Jr, Keltner JL, Miller NR. Surv Ophthalmol 1988; 33: 55- 61 Ouly- Aug). [ No reprints available.] A 70- year- old male physician experienced mild retrobulbar discomfort, double vision, and visual loss in his left eye. The discussants do a nice job reviewing his workup ( two computerized tomographic scans and an erythrocyte sedimentation rate) and differential diagnosis. The discussants do disagree slightly with each other about minor points, i. e., whether temporal arteritis really needed to be considered, and surprisingly none mention the possibility of a carotid cavernous fistula, albeit this would be an atypical presentation, but all agree on a trial of corticosteroids for presumed nonspecific orbital inflammation. This is the therapy that was used and he did improve. Lyn A. Sedwick, M. D. Acute Idiopathic Blind Spot Enlargement Without Optic Disc Edema. Hamed LA, Schatz NJ, Glaser JS, Gass JDM. Arch Ophthalmol 1988; 106: 1030- 1 ( Aug). [ No reprint information given.] The authors of this letter to the editor draw a comparison between the recently reported acute idiopathic blind spot enlargement ( AIBSE) that was abstracted for this journal in the September 1988, issue and multiple evanescent white dot syndrome ( MEWDS). They postulate that AIBSE is a " subset" of MEWDS. Lyn A. Sedwick, M. D. The Optic Neuritis Treatment Trial. Beck RW. Arch Ophthalmol 1988; 106: 1051- 3 ( Aug). [ Reprint requests to Dr. R. W. Beck, University of South Florida, Department of Ophthalmology, 12901 N. Bruce B. Downs Blvd., Tampa, FL 33612.] Dr. Beck describes this important prospective study, which attempts to discover whether oral 137 © 1989 Raven Press, Ltd., New York and/ or intravenous corticosteroid therapy reduces permanent optic nerve damage or speeds recovery from optic neuritis and whether complications of therapy are insignificant compared to beneficial effect. Participating centers are located throughout the United States and listed at the end of Dr. Beck's editorial. He encourages your support of this well- conceived, timely study. Lyn A. Sedwick, M. D. The California Syndrome: A Threat to All. Keltner JL. Arch OphthalmoI1988; 106: 1053- 4 ( Aug). [ No reprint information given.] Every physician who sees patients he suspects are " functional," i. e., consciously or unconsciously feigning visual disability, will enjoy Dr. Keltner's editorial about " The California Syndrome" or " feigning for gain." He estimates the scandalous amounts of money paid for such fraudulent claims in California alone but also cautions against a direct confrontation of these patients because physical harm to the physician can result. Dr. Keltner briefly discusses how to deal with these patients without placing yourself in harm's way legally or physically. Lyn A. Sedwick, M. D. Pseudoretraction of the Eyelid in ThyroidAssociated Orbitopathy. Gonnering RS. Arch Ophthalmol 1988; 106: 1078- 80 ( Aug). [ Reprint requests to Dr. R. S. Gonnering, 2600 N. Mayfair Rd., Milwaukee, WI 53226.] Two patients with Graves' disease are described who complained of a sudden worsening in lid retraction of one eye. One patient reported repeated " black eyes" from trauma and the other had a surgically induced levator disinsertion in the opposite eye for previous asymmetric bilateral lid retraction. A raised eyebrow in the opposite eye and a phenylephrine test resulting in equal measures from |
