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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 |
