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Show J. Clin. Neuro-ophthamol. 5:277-280, 1985 © 1985 Raven Press, New York Literature Abstracts The California Syndrome: Functional Visual Complaints with Potential Economic Impact. Keltner, J. L., May, W. N., Johnson, C. A., and Post, R. B. Ophthalmology 92(3): 427-435, 1985. (Reprint requests to J. L. Keltner, M.D., Dept. of Ophthalmology, School of Medicine, Davis, CA 95616.) This article should be required reading for optometrists and ophthalmologists everywhere. Dr. Keltner and colleagues review the cases of 84 patients with functional visual loss and give detailed descriptions of their complaints and examinations. They discuss useful examination techniques to document the functional nature of the visual loss and describe several cases in detail. If one has time to read only two paragraphs in this paper, they should be the one immediately preceding and the one immediately following the heading "economic impact" on the last page: To paraphrase-don't accuse patients of malingering or you may be open to charges of libel, don't sign disability papers or you will permit economic recovery, and keep in mind that an estimated $300 million was paid in 1982 by Workers' Compensation Programs in California in compensation for fraudulent claims. Lyn A. Sedwick, M.D. • • • Oassification and Treatment of Bilateral Superior Oblique Palsy. Pollard, Z. F. Ann. Ophthalmol. 17 (2): 127-131, 1985. (Reprint requests to Z. F. Pollard, M.D., 2004 Peachtree Road, N.W., Atlanta, GA 30367.) Dr. Pollard presents a succinct classification and treatment system for superior oblique bilateral palsy. A series of 21 patients is analyzed based on such characteristics as small hyper/large hyper/no hyper in primary position, amount and position of greatest excyclotorsion, and "v" esotropia as major complaint. The last class, V, includes patients whose bilateral superior oblique palsy is appreciated only after corrective surgery for presumed unilateral superior oblique paresis. Treatment suggestions vary, depending on what characteristics are present (bilateral recession of the inferior obliques, bilateral tucks of the superior obliques, bilateral Harada-Ito, etc.). This is a clearly written and authoritative paper that is reminiscent of Dr. Knapp's excellent classification of superior oblique palsy in the American Journal of Orthoptics in 1974. Lyn A. Sedwick, M.D. • • • December 1985 Neuroretinitis in Acquired Syphilis. Arruga, J., Valentines, J., Mauri, F., Roca, G., Salom, R., and Rufi, G. Ophthalmology 92: 262-270, 1985. [Reprint requests to J. Arruga, M.D., Paseo Manuel Girona 57, 3° 2", Barcelona 08034, Spain.) Dr. Aruga and associates report on four cases of syphilitic neuroretinitis and review 19 other cases from the literature. By their definition, all the cases represent "syphilitic disease of the retina and! or optic nerve head without choroidal involvement" and they exclude cases of optic atrophy or chorioretinitis. Their four patients were in their late 40s; three had secondary syphilis and one could not be accurately classified. Two had evidence of neurosyphilis and all had improvement in visual function following appropriate treatment. According to the authors, the paper was written to "establish the clinical characteristics of this condition, to assess its current occurrence in the context of syphilitic disease and to judge its response to treatment." Although these objectives are met, one finds some of the numerous conclusions advanced in the discussion section to be trivial or inappropriate, given the limited series of new case reports presented. Lyn A. Sedwick, M.D. • • • Orbital Fine-Needle Aspiration Biopsy. Kennerdell, J. S., Slamovits, T. L., Dekker, A., and Johnson, B. L. Am. J. Ophthalmol. 99: 547-551, 1985. [Reprint requests to John S. Kennerdell, M.D., Eye and Ear Hospital, 230 Lothrop St., Pittsburgh, PA 15213.) Inaccuracy of Fine Needle Aspiration Biopsy. Krohel, G. B., Tobin, D. R., and Chavis, R. M. Ophthalmology 92(5): 666-670, 1985. [Reprint requests to Gregory B. Krohel, M.D., Dept. of Ophthalmology, Albany Medical College, Albany, NY 12208.) Dr. Kennerdell and associates have popularized the technique of orbital fine-needle aspiration biopsy in the last 5 years. In this article they review their cumulative experience with 156 patients. Positive identification-defined as agreement among aspirate, clinical presentation, and CT or other imaging- was achieved in 80% of cases. Negative identification- inadequate specimen for interpretation- occurred in 18% of cases, and 3 (2%) patients had "false results." Of the 125 successful aspirates, 28% were carcinoma, 19% were inflammations, 17% were lymphoid tumors, 6% were neural tumors, 6% other neoplasms, and 3% miscellaneous. Although Kennerdell et al. report no complications, they mention Liu's survey of 98 orbital surgeons (in press, 277 |
