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Show LITERATURE ABSTRACTS 139 patients treated for hemifacial spasm. Reported contact with 1,676 patients with hemifacial spasm showed that 881 were scanned, usually with computerized tomography, and 9 were found to have tumor or other pathology presumably causing the spasm ( glomus jugulare, Paget's disease, parotid adenocarcinoma, acoustic neuroma, presumed lipoma in cases with named pathology). Although the authors conclude that scanning should be done routinely, one questions whether all these lesions would lead to better treatment via surgery ( versus botulism injection) and whether all lesions were truly unsuspected prescan. Lyn A. Sedwick, M. D. The Use of Vertical Offsets with Horizontal Strabismus Surgery. Metz HS. Ophthalmology 1988; 95: 1094- 7 ( Aug). [ Reprint requests to Dr. H. S. Metz, Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642.] The author used " vertical offsets," i. e., moving horizontal muscles slightly up or down at the time of recession or resection surgery, to correct small amounts of preoperative vertical strabismus in 83 patients with horizontal deviations. Although the results were good ( 67% without residual vertical deviation, 80% with 2 prism diopters or less vertical deviation) with moving muscle 1 mm per 1 prism diopter correction desired, presumably all surgery was cosmetic (? all children) because " diplopia was not encountered, since the patients continued to suppress after surgery." Lyn A. Sedwick, M. D. Transient Severe Visual Loss After Panretinal Photocoagulation. Kleiner RC, Elman MJ, Murphy RP, Ferris FL. Am 1 Ophthalmol 1988; 106: 29&- 306 ( Sept). [ Reprint requests to Dr. R. C. Kleiner, 51 N. 39th Street, Philadelphia, PA 19104.] Seven patients are reported who experienced profound visual loss after panretinal photocoagulation ( seeing only hand motions to no light perception in most cases, others between 201200 and 20/ 400). Some attempt was made to assess pupil function and visual fields but, as might be ex-pected with diabetic individuals and this level of visual loss, neither test was terribly helpful. Although several patients did have shallow macular detachments or edema, these findings seemed not sufficient to account for the very poor vision. Most patients improved with time, usually within several months. The authors postulate temporary ischemia of the posterior pole related to changes in choroidal blood flow induced by photocoagulation in these patients who may be particularly sensitive because of preexistent retinal ischemia. Proper counseling to patients about this usually transient outcome of photocoagulation may be in order. Lyn A. Sedwick, M. D. Inferior Rectus Recession for Vertical Tropia After Cataract Surgery. Burns CL, Seigel LA. Ophthalmology 1988; 95: 1120- 4 ( Aug). [ Reprint requests to Dr. C. L. Burns, 14003 Lakeshore Boulevard, Hudson, FL 34667.] In the continuing saga of postoperative cataract surgery strabismus ( see abstracts in lCNO March 1988 issue, and September 1988 issue), these authors not only discuss possible mechanisms but also present their surgical experience with four patients who benefitted from inferior rectus recession in the eye opposite the hypertropia. Lyn A. Sedwick, M. D. Paraneoplastic Night Blindness with Malignant Melanoma. Berson EL, Lessel S. Am 1Ophthalmol 1988; 106: 307- 11 ( Sept). [ Reprint requests to Dr. E. L. Berson, Berman- Gund Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114.] A patient with previously resected cutaneous malignant melanoma developed night blindness and hallucinations of shimmering lights. Electroretinographic findings were similar to congenital stationary night blindness and to a previously described patient with presumed vincristineassociated retinopathy. Metastatic disease was recognized several months later. This patient received no chemotherapy before retinal examinations and hence probably has findings most representative of a paraneoplastic effect of malignant melanoma. Lyn A. Sedwick, M. D. / Clin Neuro · ophlhalmol, Vol. 9, No. 2, 1989 |