Herman Grönvall

Metastatic involvement of the eyelids in a case of carcinoma simplex mammae.

Six cases of remote metatases in the eyelids from malignant tumours have been reported ( O l f m a n s 1930, Jaensch 1933, Fleishanderll936 2 cases -, Ascher 1938 and Vrabec 1951) . There are four women and two men, one aged 35, the others between 59 and 85 years old. The primary tumour has heen respectively: a carcinoma of the trachea, a sarcoma or an atypical carcinoma (clinical diagnosis) of the hilus of the lung, a squamous epithelial cancer of a bronchus, an occult tumour, a malignant melanoma of the skin of the back and a malignant tumour of the parotis (the metastasis was a carcinoma). The metastases of the eyelids have in all cases been unilateral and located on the upper eyelid. The size has varied from that of a pea to that of a cherry. In two patients no further metastases could be observed. Microscopic examinations of the primary tumour as well as of the metastasis of the eyelid were made in two, possibly three cases.

Dysostosis mandibulo-facialis; report of a case.

The patient was a 35-year-old, unmarried farm labourer, the second of three siblings. Physical examination and hearing tests of the other two siblings and their four children, two each, revealed nothing of interest. The patients hearing had always been impaired, he had always been a little backward but had attended an elementary school. At the age of 17 he was submitted to operation for complete atresia of the right choana. One year later, when cutting stone, he sustained an accident with resultant cataract and macular injury of the right eye. Except for the head the physical development seemed to be normal. The palpebral fissures were anti-mongoloid (Fig. 1). In the temporal region of either lower eyelid was a coloboma (Fig. 2). Along the medial two-thirds of the eyelids the lashes were missing, and apparently the Meibomian glands were missing, too. No puncta lacrymalia inferiores could be detected. The absence of a normal bony support had resulted in a sinking of the skin below the temporal part of either eye. The sockets seemed to be flattened anterolaterally. The pupillary distance was 70 mm. and the width of the base of the

MALIGNANT MELANOMA OF THE EYE AND ITS ACCESSORY ORGANS. AN ANALYSIS OF A SWEDISH HOSPITAL MATERIAL.

This paper is concerned with an analysis of the clinical symptoms, pathologic findings and the prognosis of malignant melanoma of the eye and ocular adnexa in a Swedish hospital material. The series emanates from the department of ophthalmology, Central hospital, Kristianstad, and covers a 23 year period from April 1, 1940, when the department was opened up, until April 1, 1963. This department serves the entire district of Kristianstad (Kristianstads lan) with a population of about 250,000. The material, which also includes 6 cases from other districts, consists of 58 cases of malignant melanoma of the uvea, 1 of the cornea, 3 of the conjunctiva, 2 of the cutis of the eyelid and 1 seemingly primary melanoma of the orbit.

STATISTICS RELATING TO THE OCCURRENCE AND LOCATION OF 1693 CHALAZIA

Reports have been published on the occurrence and location of chalazia, but I have not found any statistical analysis of a large material in the literature available to me. Kohlmos (1893) had 181 cases, 114 of which male and 67 female. Whtzold (1912) held it probable that both sexes were attacked equally often, even though males occurred in the ratio of 13 to 9 females in his series of unstated size. Of Minamis 285 cases (1939), 55.8 % were males and 44.2 % females. The distribution between the right and left eye was 7 : 4 in Watzolds series. Kohlmos found the lower eyelid affected in 65 76, while Wdtzold found the upper and lower lidt involved equally often and Tassman (1946) states the upper more frequently than the lower. nLe chalazion peut occuper tous Ies points du territoire palpCbraIe, rnais il se trouve Ie plus ordinairement au niveau de la partie moyenne ou externe. Le chalazion situd au niveau de la commissure interne, autour ou au niveau mCme des points lacrymaux, est une variCtC intdrrdsiante et plus rare<< (Terson, 1906). Wdtzold registered the greatest number of chalazia in the middle of the eyelid, horizontally viewed, and then always in the half lying towards the free margin. The disease occurs in all ages (Kohlmos, Bossis 1902). A histologically verified case was observed by Minami in a 142-days-old child, though chalazia are very rare in the infantile age and less common in

ON THE TOPOGRAPHY OF CORNEAL FOREIGN BODIES

The purpose of the present work is to study the topography of foreign bodies on the cornea by means of a statistical analysis of a relatively large material. So far as we have been able to find, modern statistical methods have not been applied by earlier investigators in this field (certain works from Japan, Latin America and Russia have, however, not been available in Scandinavian libraries). An investigation has therefore been considered justified and of practical value, since injuries due to foreign bodies are most common among corneal lesions, which in their turn constitute two-thirds of all eye injuries (Chordas) . The data in Table 1 show that as a rule no great difference has been observed in the frequency of foreign bodies on the right and left cornea. In Prann’s series of 702 cases, however, the incidence was greater on the left eye, as it also was in Giraudeau’s collection of only 107 cases. KO, 1939, states that the left eye is affected somewhat more frequently in lefthanded patients. Generally it is reported (Prann, lschreyt, Lafou, Bussaca, K O ) that the lower corneal half is more attacked by corpora aliena, as it is less protected by the upper eyelid (Prann) . Among 702 cases Prann (quoted from lschreyt) found the nasal half of the cornea more often attacked than the temporal. The inner lower quadrant of the left eye was particularly involved, with an incidence figure of 34.1 %, the inner lower quadrant of the right eye coming next with 22.8 %. Not fully

ON ARGYROSIS AND CONCRETION IN THE LACRYMAL SAC

This essay is an account of two cases of argyrosis or silver impregnation in the tear-sac. Before the cases are described, a short survey will be given of the literature on the genesis of argyrosis, its presence in the lacrymal ducts, and the microscopic appearance of the argyrotic tissue. The latter part of the essay deals with a concretion, a dacryolite, encountered in one of the argyrotic tear-sacs. A r g y r o s i s can be set up in the skin, and also in certain mucosae and organs. It may arise at the place where a preparation containing silver has been applied. After absorption mainly by the skin and respiratory and digestive canals, silver can be supplied to other tissues also via blood or lymph channels. The occupations specially threated by argyrosis are those that have to do with the preparation and packing of AgNO,, with galvanization, and with the silvering of glass beads; further, mirror-silverers, silver-smiths, and -formerly more than now-photographers (cit. Blind, Gabrielides and others). It is also worthy of mention that argyrosis has been seen to set in after treatment with salvarsan silver ( A s c h e r ) , and after doses of pills containing AgNO, ( Pastore) . Ophthalmiatrics use, particularly in cases of conjunctivitis, a number of medicaments containing silver, such as solutions of AgNO, and preparations where the metal has

Intracranial tumours at Centrallasarettet, Kristianstad 1940-1954.

The material consisted of 164 cases, of which the diagnosis was verified microscopically in 117 and macroscopially in a further 10. Males were slightly preponderant (91 as against 73 females). The various types of tumours are given in decreasing order of frequency in Table I. Gliomas were most common, but meningiomas and hypophyseal tumours also represented fairly large groups. It is, of course, debatable whether a case of Sturge-Webers disease should be classified as a vascular tumour or as a malformation. The 2 neoplasms classified as clival tumours possibly consisted of meningiomas, but owing to the absence of anatomico-pathological data, they were classified here as a special group. Finally, 1 hygroma and 2 brain

Studies in xanthelasma palpebrarum. II.

Location of Xanthelasmata palpebrarum in 369 individuals. At the eye department of the central hospital o€ Kristianstad 369 cases of xanthelasma palpebrarum were seen during the years 1943-51. The centre of every single xanthelasma was marked with a dot in Fig. 1. The figure illustrates the well known fact that on comparison of the two eyes the xanthelasmata are on the whole symmetrically distributed, and that they show a predilection for the inner corner of the eye, and

XI: CONTRIBUTIONS TO THE KNOWLEDGE OF THE CITRIC ACID CONTENT OF THE EYE FLUIDS UNDER VARYING CONDITIONS AND OF THE DEHYDROGENASES IN THE RETINA

Intersections are most frequent in the upper temporal quadrant, where blood-vessels are most plentiful1 and more subject to variations in their course than elsewhere. In the papilla this proportion of intersections is G4/3r on the right side and 55/3s on the left. In 70% of all the crossings the artery lies in front of the vein, which may possibly be explained by the fact that the central vein divides before the central artery, i. e., farther back in the optic nerve, giving the arterial system an anteposition already in the first bifurcation.

ZUR KENNTNIS DES KONGLOMERATTUBERKELS IN DER CHORIOIDEA

Einleitung. Der konglobierte Chorioidaltuberkel wird als eine seltcne Krankheit bezeichnet (PetroviC (l)),***) was nicht Erstaunen ers regen kann, da laut Gronholm (2) unter 300 Augenpatienten nur ein Fall von okularer Tbc. uberhaupt vorkommt, wenn die Phlyks taenen ausgeschlossen werden; und von den tuberkulosen Affeks tionen in der Chorioidea selbst, die relativ selten sind (nur 1 1 ’ Falle von 460 an Tuberkulose erkrankten Augen, laut Tadaoki Sudzuki (3)), kommt nur ein geringer Teil auf das Tuberkulom. In Ginsbergs (4) Literaturiibersicht, 1928, werden auch nur etwa fiinfzig Falle angefuhrt, und nach Szabo (5) sind wahrend der letzten 26 Jahre (1933) nur 35 Tumorformen von Chorioidaltbc. eingehend histologisch untersucht worden. Schon diese Ums stande an sich konnten also in gewissem Grade eine nahere klinische und pathol.sanatomische Schilderung eines solchen Krankheitsfalles motivieren. der in der Universitatsaugenklinik in Lund behandelt warden ist. Hierzu kommt indessen, dass dieser Fall sein besonderes Interesse hat, da die Beobachtungss zeit fur denselben ungewohnlich lang ist. Schon im Jahre 1912 demonstrierte Ahlstrorn (6) diesen Patienten unter der Diagnose Chorioidaltuberkulose in der Lunder Arztegesellschaft mit dem -~ *>