Frank B. Walsh

The tilted disk syndrome.

We noted occasional diagnostic confusion with papilledema and chiasmal compression when its true congential nature was not recognized in 12 patients with a benign ocular syndrome. Retinoscopy, fluorescein angiography, ocular ultrasonography, and histopathology suggested that associated visual field defects were related to a localized staphylomatous ectasia of the posterior globe.

THIRD NERVE REGENERATION A CLINICAL EVALUATION

MY first and most pleasant duty is to thank the members of the Irish Ophthalmological Society for inviting me to deliver the Montgomery Lecture for 1957 at this joint meeting with the Society of British Neurological Surgeons. It is an honour that I appreciate deeply and shall always consider as a highlight in my professional life. The selection of a topic has given me much concern. I am deeply disappointed that I am unable to present something new, but new information is hard to come by. All that I am about to say has been said before; possibly it has not received quite the attention it merits from those of us who, as clinicians, try to utilize basic investigations. My interest in regeneration of the third nerve as an explanation for abnormal eyelid and eyeball movements was stimulated by studies made with Doctor Walter Dandy on saccular aneurysms. This paper deals with acquired third nerve paralysis, and brief mention is made of differential diagnosis.

Peripheral Corneal Degeneration and Occlusive Vasculitis in Wegener's Granulomatosis

A 61-year-old white woman, who had progressive arthritis over a two-year period, developed bilateral peripheral corneal degeneration. The superior cornea thinned to a thickness of approximately two thirds of normal. She died suddenly in the hospital and a primary occlusive vasculitis of the anterior ciliary arteries within the superior rectus muscles was found. There was necrotizing arteritis in the lungs, kidneys, adrenal caps, spleen, fallopian tubes, and skeletal muscle. The observation of an occlusive vasculitis of the anterior ciliary arteries in this patient supports the belief that ischemia may play a major role in peripheral marginal degeneration of the cornea.

IDIOPATHIC HYPOPARATHYROIDISM; A REPORT OF 2 CASES

Excerpt Hypoparathyroidism is a condition which the internist meets fairly commonly. It generally results from the inadvertent removal of one or more parathyroid glands in the process of thyroid op...

PATHOGENESIS OF INTERMITTENT EXOPHTHALMOS

Intermittent exophthalmos is a rare, but striking and unmistakable, syndrome. It is characterized by pronounced and rapid—almost instantaneous—protrusion of one eye when venous stasis is induced by bending the head forward ; by lowering the head ; by turning the head forcibly ; by hyperextension of the neck ; by coughing ; by forced expiration, with or without compression of the nostrils, and by pressure on the jugular veins. The ocular protrusion disappears immediately when the head is erect and when artificially induced venous congestion is relieved. Usually, but not invariably, there is enophthalmos when venous congestion does not obtain. There may or apparently may not (to judge from cases reported in the literature) be pulsation of the eyeball. Vision may or may not be affected. The condition is progressive and may be productive of unbearable pain and troublesome diplopia. The appearance is unsightly, but life is not at stake. The case here reported—the only

Myasthenia Gravis and Its Ocular Signs: A Review.

The primary purpose of this paper is to evaluate our present state of knowledge regarding the ocular signs of myasthenia gravis. However, it is quite impossible to appreciate the ocular symptomatology without having a general knowledge of the disease and of its treatment, for this is one disease in which diagnosis and treatment are largely dependent upon the use of a single drug, prostigmine.

Familial Corneal Scarring: A New Dystrophy?

A 34-year-old white man with skin manifestations of the epidermal nevus syndrome was found to have anesthetic corneas, dry eyes, and localized opaque nodular elevations of both corneas. Similar corneal lesions, unassociated with corneal anesthesia, were found in four family members. Histology of corneal biopsies from the proband revealed superficial stromal scarring. The possible relationship between this familial condition and Salzmanns nodular corneal dystrophy, Goldenhar syndrome, and epidermal nevus syndrome is discussed.

A Case of Corneal Calcification (Band-Shaped Keratitis) with Conjunctival Changes

This case occurred in a white youth, the child of a consanguineous marriage. The pearly, thickened conjunctiva extending down upon the cornea is a feature which a search of the literature proved to be unique. From the Wilmer Ophthalmological Institute of the Johns Hopkins University and Hospital.