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Los Angeles Society of Ophthalmology and Otolaryngology
SOCIETY PROCEEDINGS E D I T E D BY D R . R L P H
CHICAGO
OPHTHALMOLOGICAL SOCIETY
November 18, 1940 D R . R I C H A R D C. G A M B L E ,
president
CLINICAL MEETING
(Presented by t h e E y e Department, Children's Memorial Hospital)
H. MILLER
eye was 18 m m . H g (Schiötz). Vision was 15/200, correctable to 0.3. The media were fairly clear. N o glaucomatous cup ping was noted. The fields showed no con traction. The case was presented because of the occurrence of glaucoma following trauma, associated with parasympathetic paralysis of the pupil. SCIENTIFIC
MEETING
D R . R O Y O. R I S E R presented a case of parathyroid-deficiency cataracts in a boy with renal rickets. ( T h i s case will shortly be submitted as a complete case history.) D R . R O Y O. R I S E R presented cases of retinitis pigmentosa in a boy aged 9 years, and his brother, aged 13 years, w h o showed mild atrophy of the retina but no pigment clumping (early retinitis pigmen tosa, sine pigmento). These patients will be observed further before complete r e ports are submitted.
T h e following motion-picture films were shown : Special points in intracapsular cataract extraction by D r . Daniel B. Kirby, N e w Y o r k ; Intracapsular cataract extraction (Verhoeff technique) by D r . H . Gifford, J r . , and D r . William H . Stokes, O m a h a ; Transplantation of the lacrimal sac by D r . William H . Stokes and D r . H . Gifford, J r . ; Intracapsular cataract extraction with a new corneoscleral suture by D r . J o h n M . McLean, Baltimore ; T h e use of e a r cartilage a s a D R . H I R A M J. S M I T H presented a 60transplant by D r . E d m u n d B . Spaeth, year-old man, who was first seen on A u Philadelphia ; and T h e making of ani gust 11, 1940, following an automobile mated movies of the technique in eyeaccident two weeks previously. There was muscle surgery by D r . A. D . Ruedemann, an incised wound over the right brow ex Cleveland. tending to the nasal border of the left Robert Von der Heydt. orbit. No injury to the left eyeball was ob served, but the pupil was widely dilated and did not respond to light. T h e intra LOS ANGELES SOCIETY O F ocular tension was increased, the media OPHTHALMOLOGY AND cloudy. Operation was refused. OTOLARYNGOLOGY O n September 25, 1940, he returned to the hospital. The tension L . E . was 55 mm. H g ; R . E . 25 m m . H g ( S c h i ö t z ) . T h e pupil of the left eye was still widely di lated. There was no response to light nor to miotics. At operation the following day, sclerectomy, cyclodialysis, and iridectomy at the root of the iris were performed. A t t h e time of the report the tension of the left
November 25, 1940 D R . J O H N LORDAN,
president
(Meeting presented by the staff of the W h i t e Memorial Hospital, College of Medical Evangelists) G U N S H O T W O U N D OF T H E EYE DR.
S I D N E Y BROWNSBERGER
presented
two interesting cases. T h e first patient 1
SOCIETY PROCEEDINGS
212
had received a shotgun blast at close range. The X ray localized two metallic foreign bodies in the vitreous near the posterior pole of the eye. As vision was destroyed no attempt at removal was made. When seen about one year later a foreign body was visible in the anterior chamber, lying on the iris at about the 6-o'clock position. Upon X-ray examina tion it was found that one piece had re mained in the vitreous chamber, but that the piece now visible in the anterior cham ber had migrated from its former posi tion near the posterior pole. This foreign body was removed surgically. At the last examination a complete retinal detach ment and retinitis proliferans were pres ent. DR. SIDNEY BROWNSBERGER presented
a second case in which a bullet entered the left temple and emerged at about the bridge of the nose, severing in its course the levator palpebrae superioris muscle. The resulting ptosis was repaired with excellent results by attaching the tendon of the levator to the superior-rectus mus cle. The approach was through the skin of the upper lid, and the superior rectus was exposed, leaving the conjunctival sac intact. The remainder of the meeting was de voted to otolaryngology. Orwyn H. Ellis, Recorder. LOS ANGELES SOCIETY O F OPHTHALMOLOGY AND OTOLARYNGOLOGY December 23, 1940 WILLIAM
A.
BOYCE,
M.D., presiding
(Papers and case reports from the Eye Service of the Los Angeles County General Hospital) PATHOLOGY REPORTS
DR. M. N. BEIGELMAN discussed the
pathology of chalazia, illustrating the find
ings by colored photomicrographs which clearly demonstrated the lesions. A gross specimen of an eye removed for malignant melanoma of the choroid distinctly showed the changes seen in stage three of the tumor. The tumor had extended into the vitreous chamber and had also perforated the sciera. The extraocular extention was in the region of the optic nerve and the posterior ciliary arteries. Dr. Beigelman gave two reasons for perforation at this place: (a) the sciera is very thin in this region, and (b) the arteries enter almost perpen dicularly to the globe and hence the chan nels are shortest in this area. A second specimen was presented. This was the eye of a female infant, four-anda-half months old, who had had a persist ent fibrovascular sheath in each eye. The thick membrane was seen to contain many blood vessels and was situated just pos terior to the lens. A through-and-through discission had been made, and the mem brane opened wide. Unfortunately this was followed by a septic endophthalmitis. The specimen showed a membrane pass ing from the posterior pole of the eye to the posterior pole of the lens. The ques tion of pseudotumor was raised and Dr. Beigelman replied that the patient had been under observation for approximately two months, and that no gross changes had taken place. The final pathologic report was not yet available, but in the preliminary examination no malignant changes were found. CONGENITAL
LENTICULO-FIBROBLASTIC
MEMBRANES DR.
WARREN
A. WILSON
discussed
congenital membranes, and presented the clinical aspects of the last case demon strated by Dr. Beigelman. Retinoblastoma and pseudotumor were considered, but when the child was examined under the slitlamp and corneal microscope the final
CHICAGO
OPHTHALMOLOGICAL SOCIETY
November 18, 1940 D R . R I C H A R D C. G A M B L E ,
president
CLINICAL MEETING
(Presented by t h e E y e Department, Children's Memorial Hospital)
H. MILLER
eye was 18 m m . H g (Schiötz). Vision was 15/200, correctable to 0.3. The media were fairly clear. N o glaucomatous cup ping was noted. The fields showed no con traction. The case was presented because of the occurrence of glaucoma following trauma, associated with parasympathetic paralysis of the pupil. SCIENTIFIC
MEETING
D R . R O Y O. R I S E R presented a case of parathyroid-deficiency cataracts in a boy with renal rickets. ( T h i s case will shortly be submitted as a complete case history.) D R . R O Y O. R I S E R presented cases of retinitis pigmentosa in a boy aged 9 years, and his brother, aged 13 years, w h o showed mild atrophy of the retina but no pigment clumping (early retinitis pigmen tosa, sine pigmento). These patients will be observed further before complete r e ports are submitted.
T h e following motion-picture films were shown : Special points in intracapsular cataract extraction by D r . Daniel B. Kirby, N e w Y o r k ; Intracapsular cataract extraction (Verhoeff technique) by D r . H . Gifford, J r . , and D r . William H . Stokes, O m a h a ; Transplantation of the lacrimal sac by D r . William H . Stokes and D r . H . Gifford, J r . ; Intracapsular cataract extraction with a new corneoscleral suture by D r . J o h n M . McLean, Baltimore ; T h e use of e a r cartilage a s a D R . H I R A M J. S M I T H presented a 60transplant by D r . E d m u n d B . Spaeth, year-old man, who was first seen on A u Philadelphia ; and T h e making of ani gust 11, 1940, following an automobile mated movies of the technique in eyeaccident two weeks previously. There was muscle surgery by D r . A. D . Ruedemann, an incised wound over the right brow ex Cleveland. tending to the nasal border of the left Robert Von der Heydt. orbit. No injury to the left eyeball was ob served, but the pupil was widely dilated and did not respond to light. T h e intra LOS ANGELES SOCIETY O F ocular tension was increased, the media OPHTHALMOLOGY AND cloudy. Operation was refused. OTOLARYNGOLOGY O n September 25, 1940, he returned to the hospital. The tension L . E . was 55 mm. H g ; R . E . 25 m m . H g ( S c h i ö t z ) . T h e pupil of the left eye was still widely di lated. There was no response to light nor to miotics. At operation the following day, sclerectomy, cyclodialysis, and iridectomy at the root of the iris were performed. A t t h e time of the report the tension of the left
November 25, 1940 D R . J O H N LORDAN,
president
(Meeting presented by the staff of the W h i t e Memorial Hospital, College of Medical Evangelists) G U N S H O T W O U N D OF T H E EYE DR.
S I D N E Y BROWNSBERGER
presented
two interesting cases. T h e first patient 1
SOCIETY PROCEEDINGS
212
had received a shotgun blast at close range. The X ray localized two metallic foreign bodies in the vitreous near the posterior pole of the eye. As vision was destroyed no attempt at removal was made. When seen about one year later a foreign body was visible in the anterior chamber, lying on the iris at about the 6-o'clock position. Upon X-ray examina tion it was found that one piece had re mained in the vitreous chamber, but that the piece now visible in the anterior cham ber had migrated from its former posi tion near the posterior pole. This foreign body was removed surgically. At the last examination a complete retinal detach ment and retinitis proliferans were pres ent. DR. SIDNEY BROWNSBERGER presented
a second case in which a bullet entered the left temple and emerged at about the bridge of the nose, severing in its course the levator palpebrae superioris muscle. The resulting ptosis was repaired with excellent results by attaching the tendon of the levator to the superior-rectus mus cle. The approach was through the skin of the upper lid, and the superior rectus was exposed, leaving the conjunctival sac intact. The remainder of the meeting was de voted to otolaryngology. Orwyn H. Ellis, Recorder. LOS ANGELES SOCIETY O F OPHTHALMOLOGY AND OTOLARYNGOLOGY December 23, 1940 WILLIAM
A.
BOYCE,
M.D., presiding
(Papers and case reports from the Eye Service of the Los Angeles County General Hospital) PATHOLOGY REPORTS
DR. M. N. BEIGELMAN discussed the
pathology of chalazia, illustrating the find
ings by colored photomicrographs which clearly demonstrated the lesions. A gross specimen of an eye removed for malignant melanoma of the choroid distinctly showed the changes seen in stage three of the tumor. The tumor had extended into the vitreous chamber and had also perforated the sciera. The extraocular extention was in the region of the optic nerve and the posterior ciliary arteries. Dr. Beigelman gave two reasons for perforation at this place: (a) the sciera is very thin in this region, and (b) the arteries enter almost perpen dicularly to the globe and hence the chan nels are shortest in this area. A second specimen was presented. This was the eye of a female infant, four-anda-half months old, who had had a persist ent fibrovascular sheath in each eye. The thick membrane was seen to contain many blood vessels and was situated just pos terior to the lens. A through-and-through discission had been made, and the mem brane opened wide. Unfortunately this was followed by a septic endophthalmitis. The specimen showed a membrane pass ing from the posterior pole of the eye to the posterior pole of the lens. The ques tion of pseudotumor was raised and Dr. Beigelman replied that the patient had been under observation for approximately two months, and that no gross changes had taken place. The final pathologic report was not yet available, but in the preliminary examination no malignant changes were found. CONGENITAL
LENTICULO-FIBROBLASTIC
MEMBRANES DR.
WARREN
A. WILSON
discussed
congenital membranes, and presented the clinical aspects of the last case demon strated by Dr. Beigelman. Retinoblastoma and pseudotumor were considered, but when the child was examined under the slitlamp and corneal microscope the final