H. Saul Sugar

Ocular Findings Six Years After Intravitreal Silicone Injection

A case of giant retinal tear treated by injection with dimethicone 350 (medical fluid silicone) was observed for six years before enucleation. About four months after the injection, signs of anterior segment ischemia were evident. A year after the injection, an injury resulted in displacement of dimethicone 350 into the anterior chamber. Enucleation was done because of pain.

Oculodentodigital Dysplasia Syndrome with Angle-Closure Glaucoma

A 14-year-old girl with typical oculodentodigital syndrome had been treated for chronic glaucoma for seven years. She had corneas measuring R.E.: 10 mm; L.E.: 9 mm, with narrow angles open on the right, but almost entirely closed on the left. Gonioscopic examination of the right iris revealed that the root was attached forward on the trabecular meshwork, which suggested a congenital anomaly. Peripheral iridectomies were ineffective. In a case previously studied, a 20-year-old woman with typical oculodentodigital syndrome developed typical acute angle-closure glaucoma seven years after the original examination.

The exfoliation syndrome: Source of the fibrillar material on the capsule

A clinical case of unilateral capsular exfoliation syndrome was observed in the previously traumatized eye of a 22-year-old man with a drawn-down pupil. The distribution of material correspond to the folds of the inner surface of contiguous iris. The periphery of the lens appeared free of deposits. These findings contradict previous theories on the source of the fibrillar material from the lens epithelium and indicate that it is derived from the iris pigment epithelium and not from within the lens capsule, although there is no question but that the lens is involved in a similar process, the products of which probably do not reach the lens surface. The unilateral occurrence of the exfoliation syndrome in a traumatized eye of a 22-year-old man is unique and cannot be explained at this time.

Anterior Segment Metastases from an Ovarian Choriocarcinoma

A 28-year old woman with ovarian choriocarcinoma developed a uveitis in her left eye. Subsequently, a mass was observed in the anterior segment of that eye together with a subconjunctival mass that appeared to extend from it. Biopsy of the subconjunctival nodule showed two different cell types consistent with the cytotrophoblastic and syncytiotrophoblastic elements typical and choriocarcinoma. No abnormalities of the posterior segment were found on careful examination. Treatment consisted of systemic chemotherapy with a variety of therapeutic agents, argon laser photocoagulation of tumor seedings in the anterior chamber angle, radiation to the eye, and finally, subconjunctival injections of methotrexate. The eye became blind and painful and was enucleated. Histopathologic examination revealed residual tumor cells in the anterior segment indicating treatment changes, but there were no abnormalities posteriorly. Choriocarcinoma metastatic to the eye has been reported infrequently, and this is the first case in which anterior segment metastases have been observed and the effects of treatment thoroughly documented.

Onset of the Exfoliation Syndrome After Intracapsular Lens Extraction

Two patients who had previously been operated on for cataract and had been carefully observed for evidence of the exfoliation (or pseudoexfoliation) syndrome had continuing formation of exfoliative material on the anterior surface of the hyaloid and the pupil border several years later.

Maximilian Salzmann. Ophthalmic pioneer and artist

Abstract In addition to being an outstanding scientist and ophthalmologist, Maximilian Salzmann was a talented artist. In the early 1900s Salzmann, known as one of the fathers of gonioscopy, made many drawing of the angle. The drawings were presumed to be lost after Salzmanns death in 1954. In this article, the story of the recovery of the first gonioscopic pictures is told, and six of Salzmanns drawings are reproduced.

In appreciation of the contributions of Harry Searls Gradle.

The many contributions of Harry Searls Gradle (1883-1950) to ophthalmology are recalled by an author who was his protégé. A former student of Anton Elschnigs, Gradle taught unique surgical skills to those who worked directly with him. Furthermore, he lent his insights and brilliant organizational talents to the development of institutions and programs for the betterment of ophthalmic education and practice.

Results and complications of limbal trephination and subscleral trephination (trabeculectomy).

Limbal trephinations on 395 eyes were followed postoperatively for six months to 19 years. Excellent results were obtained in patients over the age of 35, particularly those in the 50 and older age group, with chronic open‐angle and chronic angle‐closure glaucoma. Results were poor in younger age groups and in those with secondary glaucoma, particularly where it was associated with inflammatory disease.

The GP and glaucoma.

The warnings against the use of certain drugs in patients with glaucoma are only one of the reasons why knowledge of this disease (which is actually many diseases) is important. Glaucoma has become a matter of public health concern. Inclusion of tonometric testing in multiphasic health screening portends an ever wider use of this simple means of discovering one of the major diseases of man.