| OCR Text |
Show LITERATURE ABSTRACTS 219 sion disruption with " bobbing" of the image seen by the aphakic eye, and no patient had a pretrauma history of strabismus. The authors note that they cannot judge the incidence of this problem as their cases were all referred post facto. They do caution that intractable diplopia can follow surgery and optical correction of a longstanding traumatic cataract, and that contact lens correction may be preferable to intraocular lens implant until one knows whether intractable postoperative diplopia will be a problem. LYll A. Sedwick, M. D. Editor's Note: Some of the " bobbing" of the image here reminds me of the monocular vertical oscillations of amblyopia, also known as the HeimannBielschowsky phenomenon. A reference to this is J Clin Neuro- ophthalmol. 2: 85- 91, 1982. j. Lawton Smith, M. D. Errors in the Three- step Test in the Diagnosis of Vertical Strabismus. Kushner BJ. Ophthalmology 1989; 96: 127- 32 Gan). [ Reprint requests to Dr. B. J. Kushner, F4/ 336, Clinical Science Center, 600 Highland Avenue, Madison, WI 53792.] Seven cases are presented in which three- step testing taken in isolation would confirm a single cyclovertical muscle palsy. When the history and other parts of the examination are reviewed ( ductions, cover testing, etc.), in most cases another cause for the strabismus was evident such as blowout fracture with entrapment, dissociated vertical deviation, previous superior oblique surgery, and myasthenia gravis. He has one case each of hypertropia associated with a large esotropia in a child and hypertropia following an episode of dizzyness that he believes to be " nonparalytic vertical deviation associated with horizontal strabismus" and skew deviation, respectively. The last paragraph of the article summarizes its lessons into six steps that one can use to avoid trouble when applying the three- step test. Lyn A. Sedwick, M. D. Scleritis as the Presenting Manifestation of Procainamide- induced Lupus. Turgeon PW, Slamovits TL. Ophthalmology 1989; 96: 68- 71 Gan). [ Reprint requests to Dr. T. L. Slamovits, Department of Ophthalmology, Montefiore Medical Center, 111 E. 210 Street, Bronx, NY 10467.] A 66- year- old woman who had used procainamide for 10 months presented with anterior and posterior scleritis in one eye. Laboratory studies were consistent with systemic lUpus erythematosis and she responded to prednisone. With cessation of procainamide, her laboratory abnormalities gradually improved. Good- quality computerized tomographic, magnetic resonance, ultrasound, and clinical photographs are presented. LYll A. Sedwick, M. D. The Effect of Age on Normal Human Optic Nerve Fiber Number and Diameter. Repka MX, Quigley HA. Ophthalmology 1989; 96: 26-- 32 Gan). [ Reprint requests to Dr. M. X. Repka, The Wilmer Institute, BI- 35, The Johns Hopkins Hospital, Baltimore, MD 21205.] One optic nerve from 19 persons ( cadaveric eyes) was studied to determine axonal number, distribution of fiber diameter, and total neural area. Fiber count was quite variable, from - 520,000 to 900,000, with an average of 693,316, and there was no correlation with age. Older patients did have more small than large fibers in the nerve in a modestly statistically significant fashion. The article is discussed by Dr. Sadun, who applauds the authors for their fully automated counting technique. LYll A. Sedwick, M. D. Malignant Glioma of the Optic Chiasm Eight Years after Radiotherapy for Prolactinoma. Hufnagel TJ, Kim JH, Lesser R, Miller JM, Abrahams JJ, Piepmeier J, Manuelidis EE. Arch Ophtha/ 1110/ 1988; 106: 1701- 5 ( Dec). [ Reprint requests to Dr. T. J. Hufnagel, Section of Neuropathology, Yale University School of Medicine, 333 Cedar St., P. O. Box 3333, New Haven, CT 06510.] A 41- year- old man who had undergone transsphenoidal removal of a prolactin- secreting pitu- JClin Nt'uro · ophthalmol. Vol. 9. No. 3. 1989 220 LITERATURE ABSTRACTS itary adenoma followed by radiation therapy in 1979 presented in 1987 with visual loss found to be secondary to a biopsy- proven suprasellar anaplastic astrocytoma. The authors discuss the literature regarding intracranial gliomas arising after irradiation of pituitary adenoma. Lyn A. Sedwick, M. D. Recurrent Blepharoptosis Secondary to a Pituitary Tumor. Small KW, Buckley EG. Am J Ophthalmol 1988; 106: 760- 1 ( Dec). [ Inquiries to Dr. E. G. Buckley, P. O. Box 3802, Department of Ophthalmology, Duke University Medical Center, Durham, NC 27710.] An ll- year- old girl had ptosis without ocular motility or pupil abnormalities that promptly resolved following resection of a pituitary adenoma with suprasellar extension, but without cavernous sinus extension. The authors discuss possible mechanism for what they feel represents a partial third nerve palsy. Lyn A. Sedwick, M. D. Successful Treatment of Postherpetic Neuralgia with Capsaicin. Bucci FA Jr, Gabriels CF, Krohel GB. Am J Ophthalmol 1988; 106: 758- 9 ( Dec). [ Inquiries to Dr. G. B. Krohel, Samaritan Hospital, Troy, NY 12180.] Two patients with chronic postherpetic neuralgia were treated with topical capsaicin ( Zostrix) with excellent relief of pain. Lyn A. Sedwick, M. D. Ocular Ischemic Syndrome Secondary to Carotid Artery Dissection. Duker JS, Belmont JB. Am J Ophthalmol 1988; 106: 750- 2 ( Dec). [ Inquiries to Dr. ]. B. Belmont, Retina Service, Wills Eye Hospital, Ninth and Walnut Sts., Philadelphia, PA 19107.] A 64- year- old man with a complaint of amaurosis fugax was found to have iris neovascularity and retinal hemorrhages consistent with ocular ischemic syndrome. Arteriography demonstrated a carotid artery dissection and the patient did well J Clin Neuro- ophthalmol, Vol. 9, No. 3, 1989 with medical treatment and pametinal photocoagulation. Lyn A. Sedwick, M. D. Correlation of Afferent Pupillary Defect with Visual Field Loss on Automated Perimetry. Johnson LN, Hill RA, Bartholomew MJ. Ophthalmology 1988; 95: 1649- 55 ( Dec). [ Reprint requests to Dr. L. N. Johnson, Neuro- Ophthalmology Unit, The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA 17033.] The authors compared the strength of an afferent pupillary defect to differences between the 30° visual fields of each eye. They found a fairly linear relationship between log afferent pupillary defect and visual field differences on Humphrey automated perimetry ( Program 30- 1). Four patients with a weak afferent pupillary defect were found to have normal 30° visual field testing, indicating the exquisitely sensitive nature of the pupil response. One conclusion that the authors made was that interocular difference of > 8.7 dB on 30° visual field testing without an afferent pupillary defect was indicative of a functional visual field loss with 95% confidence limit. Lyn A. Sedwick, M. D. Bumpy Muscles. Slamovits TL, Burde RM, with comments by Sedwick L, Newman S, Katz B. Surv OphthalmoI1988; 33: 189- 98 ( Nov- Dec). [ No reprints available. ] You should read this article not because yours truly wrote some of the comments, but rather because the case discussed is so unusual- an otherwise healthy 63- year- old man who developed a restrictive ocular myopathy and " bumpy"- looking extraocular muscles on computerized tomographiC scanning. The diagnostic possibilities seem endless, and the waterfront is more than adequately covered by the discussants, but the answer was metastases to extraocular muscles biopsied by fineneedle aspiration. Lyn A. Sedwick, M. D. |
