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New York Eye and Ear Infirmary
SOCIETY PROCEEDINGS Edited by D R . H .R O M M E L
HILDRETH
NEW YORK E Y EAND EAR INFIRMARY
that Lindsey Johnson did some work on animal eyes at t h e London Zoo about 30 years ago, and asked Dr. K n a p p if he was O P H T H A L M O L O G I C A L CLINICAL familiar with this work. CONFERENCE Dr. Loren Guy asked if rabbits have March 27, 1939 glaucomatous cupping of the eye nor D R . S I G M U N D AGATSTON, chairman mally, a n d D r . K n a p p replied that they have a deep cupping. D r . Guy disagreed U N U S U A L CASE OF NUCLEAR SCLEROSIS, with this statement, and said that he had E A C H EYE examined many rabbits' eyes and did D R . D . B L A I R S U L O U F F presented an not see this deep cupping. unusual case of this condition. T h e p a Dr. D . Blair Sulouff asked if the ring tient was a heroin addict, a n d h a d been tail monkey's eye resembles the human taking the drug (80 grs. daily) for about eye most closely, a n d D r . K n a p p replied 18 years. I t w a s suggested that a n opti that it did. cal iridectomy be performed, b u t D r . John S. Cregar suggested that a broad- C A S E OF PARTIAL OCCLUSION OF T H E T E M PORAL ARTERY based iridectomy above would be the bet ter procedure. D R . R. G. T H O R N B U R G H presented a Discussion. D r . Isaac Hartshorne thought Dr. Cregar was right in suggest ing a broad-based iridectomy rather than an optical iridectomy. H e felt that the cataract would develop further. H e told of a patient with a similar condition whom he h a d treated IS years ago. D r . H a r t s h o r n e did a preliminary iridectomy on each eye, and eight years later re moved the cataracts. Dr. Sigmund Agatston said that he had performed a preliminary iridectomy in a similar case. H e said that the pupil should be dilated first to see if vision can be im proved. Dr. Sulouff said that since this m a n had been taking heroin for 18 years the dilator fibers had not had much exer cise. T h e cumulative effect of the heroin did not permit the homatropine to act. ANIMAL-EYE
FUNDI
DRAWINGS
D R . A R T H U R A . K N A P P showed d r a w
ings of numerous animal-eye fundi. Discussion. D r . Isaac H a r t s h o r n e said
case of partial occlusion of t h e temporal artery in a man, aged 24 years. E x a m i n a tion showed t h e lower temporal branch of t h e artery to be occluded, a n d sur rounding this w a s an area of ischemia that reached u p to the fovea. N o foci of infection were found. Discussion. D r . Sigmund Agatston said he saw t h e patient when he first came to the clinic. T h e elevation was out of pro portion to the occlusion of a vessel of this size. T h e patient was admitted to the hospital a n d showed improvement t w o days later, but then suffered a loss of vision again. T h e r e w a s some process going on that was recurrent, and the patient had some sort of allergic mani festation. H e had an ischemia that was undoubtedly of vascular origin. D r . Agatston thought this condition was due to some toxin. CORNEAL
TRANSPLANT
D R . DONALD H A L L reported a case of
corneal transplant in a 60-year-old male.
695
SOCIETY PROCEEDINGS The patient h a d seen only hand move ments with the right eye, but after a suc cessful transplant, his vision was now 20/70 in that eye. Discussion. D r . Donald Bogart said that the question sometimes comes u p before operation as to the condition of the anterior chamber. W e have a means of prognosticating this condition through the infrared rays by taking serial pictures of each cornea at different levels, using a red filter and infrared ray. This process is still in its infancy, but will have a bear ing in selecting cases for corneal trans plant in the future. TUBEROUS SCLEROSIS DR.
BIRNA
NYSTROM
of
Grasslands
Hospital reported a case of tuberous sclerosis. A t the age of t w o years the patient began to have seizures that r e curred until he was five. A t nine these seizures began again a n d increased in severity. T h e r e is a numbness in the left wrist before onset of the seizure. H e becomes tonic, and turns his head to the left. Psychometric examination showed an I.Q. of 7 1 . E y e examination showed a vision of 20/20 O . U . ; fields normal to f o r m ; external examination negative; the cornea, pupil, and anterior chamber normal. T h e pupils did not hold contrac tion well, but reacted to light. Ophthalmoscopic examination showed t h e left eye to be normal. T h e right eye showed the disc in fairly sharp outline, slightly elongated vertically. T h e macula was clear, but just above it w a s a lesion. A second large lesion was found at the periphery in the temporal field—irregular, raised, grayish mulberrylike patches. There was a third lesion below the level of the disc. Over the disc was a smaller tumor containing a single cyst, and a small flat tumor fairly sharply defined. J U V E N I L E GLAUCOMA
D R . A R T H U R C H A N D L E R reported a case
of juvenile glaucoma which had been presented at t h e previous meeting. A n extracapsular extraction of the lens of the right eye had been performed, giving vision of 20/50. N E W TANGENT-SCREEN RULE
D R . LOREN G U Y presented a tangentscreen rule that he h a d designed. T h e triangular rule has three surfaces marked in tangents of degrees—one for one meter, one for t w o meters, and one for three meters. T h e entire device can be made for about one dollar and greatly facilitates making field studies at differ ent distances using an unmarked screen, the rule then being rotated about the fixation point to relate the pins to the tangents of degrees for the given dis tances marked. Donald W . Bogart, Secretary.
COLLEGE O F PHYSICIANS OF PHILADELPHIA S E C T I O N QN OPHTHALMOLOGY
M a r c h 16, 1939 D R . A L E X A N D E R G. F E W E L L ,
chairman
RECOVERY OF NORMAL VISION FOLLOWING A RUPTURE OF T H E CORNEA DR.
MARY
BUCHANAN
presented
the
case of a 19-year-old colored girl who had been in an automobile accident and sustained a transverse wound of the left cornea, the temporal extremity of which contained some prolapsed iris. T h e rest of the iris h a d disappeared. There was blood in the anterior chamber and deep ciliary injection. T h e tension was minus. Treatment consisted of cold compresses, atropine, metaphen and boric irrigations, following which the eye healed and a vision of 6/7.5 was obtained.
HILDRETH
NEW YORK E Y EAND EAR INFIRMARY
that Lindsey Johnson did some work on animal eyes at t h e London Zoo about 30 years ago, and asked Dr. K n a p p if he was O P H T H A L M O L O G I C A L CLINICAL familiar with this work. CONFERENCE Dr. Loren Guy asked if rabbits have March 27, 1939 glaucomatous cupping of the eye nor D R . S I G M U N D AGATSTON, chairman mally, a n d D r . K n a p p replied that they have a deep cupping. D r . Guy disagreed U N U S U A L CASE OF NUCLEAR SCLEROSIS, with this statement, and said that he had E A C H EYE examined many rabbits' eyes and did D R . D . B L A I R S U L O U F F presented an not see this deep cupping. unusual case of this condition. T h e p a Dr. D . Blair Sulouff asked if the ring tient was a heroin addict, a n d h a d been tail monkey's eye resembles the human taking the drug (80 grs. daily) for about eye most closely, a n d D r . K n a p p replied 18 years. I t w a s suggested that a n opti that it did. cal iridectomy be performed, b u t D r . John S. Cregar suggested that a broad- C A S E OF PARTIAL OCCLUSION OF T H E T E M PORAL ARTERY based iridectomy above would be the bet ter procedure. D R . R. G. T H O R N B U R G H presented a Discussion. D r . Isaac Hartshorne thought Dr. Cregar was right in suggest ing a broad-based iridectomy rather than an optical iridectomy. H e felt that the cataract would develop further. H e told of a patient with a similar condition whom he h a d treated IS years ago. D r . H a r t s h o r n e did a preliminary iridectomy on each eye, and eight years later re moved the cataracts. Dr. Sigmund Agatston said that he had performed a preliminary iridectomy in a similar case. H e said that the pupil should be dilated first to see if vision can be im proved. Dr. Sulouff said that since this m a n had been taking heroin for 18 years the dilator fibers had not had much exer cise. T h e cumulative effect of the heroin did not permit the homatropine to act. ANIMAL-EYE
FUNDI
DRAWINGS
D R . A R T H U R A . K N A P P showed d r a w
ings of numerous animal-eye fundi. Discussion. D r . Isaac H a r t s h o r n e said
case of partial occlusion of t h e temporal artery in a man, aged 24 years. E x a m i n a tion showed t h e lower temporal branch of t h e artery to be occluded, a n d sur rounding this w a s an area of ischemia that reached u p to the fovea. N o foci of infection were found. Discussion. D r . Sigmund Agatston said he saw t h e patient when he first came to the clinic. T h e elevation was out of pro portion to the occlusion of a vessel of this size. T h e patient was admitted to the hospital a n d showed improvement t w o days later, but then suffered a loss of vision again. T h e r e w a s some process going on that was recurrent, and the patient had some sort of allergic mani festation. H e had an ischemia that was undoubtedly of vascular origin. D r . Agatston thought this condition was due to some toxin. CORNEAL
TRANSPLANT
D R . DONALD H A L L reported a case of
corneal transplant in a 60-year-old male.
695
SOCIETY PROCEEDINGS The patient h a d seen only hand move ments with the right eye, but after a suc cessful transplant, his vision was now 20/70 in that eye. Discussion. D r . Donald Bogart said that the question sometimes comes u p before operation as to the condition of the anterior chamber. W e have a means of prognosticating this condition through the infrared rays by taking serial pictures of each cornea at different levels, using a red filter and infrared ray. This process is still in its infancy, but will have a bear ing in selecting cases for corneal trans plant in the future. TUBEROUS SCLEROSIS DR.
BIRNA
NYSTROM
of
Grasslands
Hospital reported a case of tuberous sclerosis. A t the age of t w o years the patient began to have seizures that r e curred until he was five. A t nine these seizures began again a n d increased in severity. T h e r e is a numbness in the left wrist before onset of the seizure. H e becomes tonic, and turns his head to the left. Psychometric examination showed an I.Q. of 7 1 . E y e examination showed a vision of 20/20 O . U . ; fields normal to f o r m ; external examination negative; the cornea, pupil, and anterior chamber normal. T h e pupils did not hold contrac tion well, but reacted to light. Ophthalmoscopic examination showed t h e left eye to be normal. T h e right eye showed the disc in fairly sharp outline, slightly elongated vertically. T h e macula was clear, but just above it w a s a lesion. A second large lesion was found at the periphery in the temporal field—irregular, raised, grayish mulberrylike patches. There was a third lesion below the level of the disc. Over the disc was a smaller tumor containing a single cyst, and a small flat tumor fairly sharply defined. J U V E N I L E GLAUCOMA
D R . A R T H U R C H A N D L E R reported a case
of juvenile glaucoma which had been presented at t h e previous meeting. A n extracapsular extraction of the lens of the right eye had been performed, giving vision of 20/50. N E W TANGENT-SCREEN RULE
D R . LOREN G U Y presented a tangentscreen rule that he h a d designed. T h e triangular rule has three surfaces marked in tangents of degrees—one for one meter, one for t w o meters, and one for three meters. T h e entire device can be made for about one dollar and greatly facilitates making field studies at differ ent distances using an unmarked screen, the rule then being rotated about the fixation point to relate the pins to the tangents of degrees for the given dis tances marked. Donald W . Bogart, Secretary.
COLLEGE O F PHYSICIANS OF PHILADELPHIA S E C T I O N QN OPHTHALMOLOGY
M a r c h 16, 1939 D R . A L E X A N D E R G. F E W E L L ,
chairman
RECOVERY OF NORMAL VISION FOLLOWING A RUPTURE OF T H E CORNEA DR.
MARY
BUCHANAN
presented
the
case of a 19-year-old colored girl who had been in an automobile accident and sustained a transverse wound of the left cornea, the temporal extremity of which contained some prolapsed iris. T h e rest of the iris h a d disappeared. There was blood in the anterior chamber and deep ciliary injection. T h e tension was minus. Treatment consisted of cold compresses, atropine, metaphen and boric irrigations, following which the eye healed and a vision of 6/7.5 was obtained.