Arnold Loewenstein

SPECIFIC INFLAMMATION OF THE CORNEA IN CHICKENPOX

INFLAMMATION of the iris leaves behind recognisable changes in the tissues. These results-the remains of posterior synechiae, and lucidity of the iris resulting from patchy atrophy of the pigmentepithelium-are not characteristic. But the resolving of an inflammation of the iris is in certain cases associated with very significant sequelae, especially in the case of so-called vitiligo iridis. (1) Leopold Muller, fifty years ago, described circumscribed depigmented spots in the iris, which he believed to be produced by a foetal inflammation. The three cases described had all suffered from smallpox. Fuchs had already stressed in his well-known text-book the relation between smallpox and these spots in the iris. I have illustrations of three cases of vitiligo iridis-two in dark-pigmented irides and one in a blue iris-all subsequent to smallpox in childhood. Alajmo and Arguello have communicated parallel cases. The spots are greyish-white, sharply-defined, predominiantly situated in the ciliary part of the iris, in groups, but distinct from each other-especially striking in dark irides, but more difficult to distinguish in grey or blue irides. (Figs. 1, 2).

ARGYROSIS OF CONJUNCTIVA, CORNEA AND TEAR-SAC

present one only those objects have been retained which were most easily interpreted by the greatest number of children. Some objects which might seem to be very familiar to adults had to be rejected. For instance, an anchor which was easily recognised by boys presented difficulties to girls and had to be discarded. The objects retained are either easy to interpret or else capable of a varied interpretation so that the test is an estimate of the childs visual acuity and not of his intelligence. Though the work is independent on my part yet I now find that the idea of an object test chart on the strictly Snellen principle is by no means original.

A CASE OF MONOCULAR HYDROPHTHALMIA : With special reference to its possible relation to the Sturge-Weber Syndrome

I.-Introductory RECENTLY we described a hydrophthalmic eye which hadbeen removed on account of an injury to it. Since then an opportunity of examining another monocular hydrophthalmic eye has come our way. Angiomata were found in the choroid. The bearing of this upon a connection with Sturge-Webers disease is discussed afid also the possible role of space-occupying anomalies of the choroid in the aetiology of hydropthalmia.

SOME ASPECTS OF OCULAR MELANOTIC GROWTH

Ida Mann (1926) stressed some years ago her conviction that the question of pigment origin must not be looked upon from the narrow sphere of ophthalmological pathology. Jean Nordmann (1947), indeed, has subscribed to this demand in an admirable way, so far as could be achieved in a short survey attempting to follow Up the origin of the pigmented cells in the higher vertebrates. Relationship to light is one aspect, the influence of the hypothalamus another; such views are plentiful. Restriction to higher vertebrates appears to be dictated by sheer necessity.

Knob at the periphery of Descemet's membrane.

however is that the ustuall flat tissue between ai and the trabecula (b) may proje(t backwards as a knob (c). This swelling is granular and does not contain cells (Figs 2 and 3). Here this knob-like bulge has been -demonstrated in five eyes, three knobs w-ere normal and tw,o were malignant melanomata. Generally, the five cases (Figs 2-6), show the different structure of the knob, the prominent zone in the area of the gap. We understand that the aqueous fluid enters the gap and reaches the posterior lamellae. The aqueous does not filter the posterior

Closed branches of conjunctival vessels.

NORMAL conjunctival vessels have been studied with the slit lamp by many observers, including Koeppe (1920-22), Vogt (1930-31), Graves (1934), Berliner (1943), and Meesmann (1927). The conjunctival vessels are capillaries, many of which are seen to be filled with red blood corpuscles; some of these capillaries are fairly large, but others are fine. These capillaries, containing one row of red blood corpuscles, have been traced from artery to vein (Graves, 1934). It is very important that no definite walls have been found in these fine vessels, even with a high-power slit lamp. The normal conjunctival blood vessels can be irritated witlh chemical, traumatic, or bacterial agents, one of the simplest ways being to insert a drop of dionin 2 to 5 per cent. as I have described in a previous communication (Loewenstein, 1944). The dilated conjunctival blood vessels can then be studied, and there is an increase of ten to twenty times the number of small capillaries in eyes so treated. I tried to study the normal area supplied by the capillaries, but it is not easy to examine eyes with the slit lamp when using a high magnification. Finally, I kept my own eye at rest under high power, and our artist, Mr. G. Donald, sketched the conjunctival capillaries (Fig. 1). There were many very fine capillaries containing red cells, but I expected to find some + very fine capillaries apparently empty as had been previously s noted,. and such very fine capillaries were bh. H found in myconjunc-dn tiva, apparently empty and colourless. Some had no red blood cells in them, while others P2 contained various types FIG. 1 Blood free capillaries of the conjunctiva of blood corpuscles seen in high-power slit lamp. *Received for publication April 5, 1951. + This research was sponsored by the W. H. Ross Foundation (Scotland) for the Study of the Prevention of Blindness.