Current Concepts in Ophthalmology

Current Concepts in Ophthalmology

526 AMERICAN JOURNAL OF OPHTHALMOLOGY amines in the human eye. Arch. Ophthalmol. 81:622, 1969. 2. Thompson, H. S., and Mensher, J. H. : Adrenergic m...

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amines in the human eye. Arch. Ophthalmol. 81:622, 1969. 2. Thompson, H. S., and Mensher, J. H. : Adrenergic mydriasis in Homer's syndrome. The hydroxyamphetamine test for diagnosis of postganglionic defects. Am. J. Ophthalmol. 72 :472, 1971. 3. Falter, R. T., and Thompson, H. S.: Mecha­ nisms of guanethidine's sympatholytic action: a pupillograph demonstration. In Biodi, F. C. (ed.) : Current Concepts in Ophthalmology, 4th ed. St. Louis, C. V. Mosby Co., 1974, pp. 65-71. 4. Riley, F. C, and Moyer, N. J. : Oculosympathetic paresis associated with cluster headaches. Am. J. Ophthalmol. 72:763, 1971. 5. Holland, M. G. : Autonomie drugs in ophthal­ mology. Some problems and promises. 3. Sympathomimetic drugs. Ann. Ophthalmol. 6:884, 1974. REPLY

Editor: Dr. Mindel's point of view and mine are very close. In the instances that are clearly either preganglionic or postganghonic lesions, there is no need for drug testing. In ambigu­ ous cases, drug testing is often, unfortunate­ ly, ambiguous. However, in surgical experi­ mental sympathetic denervation (total postganglionic) of the rabbit eye topical amphetamines do not produce mydriasis. Therefore, both Thompson and Mensher and Mindel are proper in their reasoning, but the verification of their hypotheses has not been established. MARVIN L. SEARS,

self provided some interesting epidemiologie features of the disease. ALFRED SOMMER,


Editor: In their interesting article, "Fundus albi­ punctatus and vitamin A deficiency" (Am. J. Ophthalmol. 78:926, 1974), N. S. Levy and P. P. Toskes fail to mention that this classical fundus picture has long been as­ sociated with vitamin A deficiency. Teng Khoen Hing credits Mikamo (1915) and Wright (1922) with the earliest reports, al­ though little attention was paid to the syn­ drome until Dr. Uyemura's paper in 1928. Since that time numerous reports have ap­ peared by such luminaries as Fuchs, Pillât, and Bietti among others. Dr. Teng 1 has him-


Baltimore, Maryland REFERENCE

1. Teng, K. H. : Further contributions to the fundus xerophthalmicus. Ophthalmologica 150:219, 1965. REPLY

Editor: Our observation of fundus albipunctatus occurred after intestinal surgery and chronic steatorrhea due to the bacterial overgrowth syndrome. This association is unusual and may account for the fact that the diagnosis was not made for eight years. The marked improvement in adaptation thresholds seen following vitamin A therapy, despite the presence of morphologic albipunctate areas, makes recognition of this association clini­ cally important. NORMAN S. LEVY,




Gainesville, Florida



New Haven, Connecticut

MARCH, 1975





vol. 4. Edited by Frederick C. Biodi. St. Louis, C. V. Mosby, 1974. Clothbound, 452 pages, table of contents, index, 371 black and white figures. $45 This second volume from the staff of the Department of Ophthalmology of the Uni­ versity of Iowa, which comes only two years after the first, is greatly expanded and con­ tains only a few of the original chapters. The text, a potpourri ranging from comparative anatomy to ophthalmic holography, contains basic research reports as well as clinical re­ views. The reader benefits from the most recent thinking and work of a large and pro­ ductive ophthalmic group. There are five papers devoted to external

VOL. 79, NO. 3



disease. A clinical study of corneal changes following scierai buckling revealed that sponge expiants may induce large astigmatic errors. The dry eye and corneal erosions and aseptic ulcérations are reviewed. Included is a short discussion of the dreaded ocular mycoses with the latest methods of therapy. Finally, there is a well-referenced review of corneal cryopreservation. Glaucoma is reviewed with a complete dis­ cussion of the classic arguments concerning the etiology of congenital glaucoma. The anatomy of the ciliary body and an assess­ ment of cyclocryotherapy are detailed. It is evident that long-term information concern­ ing the benefits of cyclocryotherapy is yet to be obtained. Choroidal tumors are discussed at length with emphasis on their prognosis and diag­ nosis by fluorescein angiography, echography, and radioactive phosphorus uptake testing. Recent material on the immunology of melanomas is also included. Many other subjects are covered both in review and with specific research reports. Dr. Blodi's chapter on orbital inflammations alone makes the text a valuable addition to the ophthalmologist's library. J. TERRY ERNEST


By G. Bechac and G. Bechac. Paris, Doin, 1974. Paperbound, 118 pages, table of contents, 7 color plates. $11.80 This small paperbound publication con­ tains a brief account of the ophthalmoscopic manifestations of the various disturbances of the blood. Although the text is written in French even those not skilled in this language will find it a good source of information. There are 42 fundus photographs, reproduced in color, and one black and white photograph. Although the illustrations are reduced some­ what from optimal size, the pathologic de­ tails are clearly visible and supplement ade­ quately the text. The colored photographs are situated inside the back cover of the book,

on triple-sheet foldout pages that enable the reader to read the text and follow illustra­ tions concurrently. There are 83 pages of text, in large type, except for the 43 case reports set in reduced italic type ; and there are 16 pages listing 215 references. The text is divided into four categories: diseases of the red and white blood cells; diseases of the hematopoietic organs; the dysproteinemias ; and hemorrhagic diatheses and disorders of hemostasis. Included in diseases of the erythrocytes are a general statement of anemic retinopathy and the modifications in the retinopathy produced by the various forms of macrocytic, microcytic hypochromic and normocytic normochromic anemias ; primary and secondary polycythemias are included in this section. Leukocytic diseases illustrated are: leucemia, agranulocytosis, and infectious mononucleosus. In the second chapter, on diseases of the hematopoietic organs, only one case report is given, that of Hodgkins' disease, and the single photograph shows the ophthalmoscopic picture of dysproteinemia. There are two similar fundus photographs in the following chapter on the dysproteinemias. The last chapter presents the ophthalmo­ scopic findings in the following disorders: increased capillary fragility, idiopathic and secondary thrombocytopenic purpura, thrombocythemia, defective thromboplastin, prothrombin abnormalities, and diseases of the formation of fibrin. This booklet does a service in bringing to­ gether the findings in the broad spectrum of diseases of the blood. ROBERT W .







Edited by William F. Hughes. Chicago, Year Book Medical Publishers, 1974. Clothbound, 424 pages, table of contents, index, 86 black and white figures. $19.75 It is always a joy to receive the Year Book of Ophthalmology and to see the material