Mogens Norn

SEMIQUANTITATIVE INTERFERENCE STUDY OF FATTY LAYER OF PRECORNEAL FILM

Reflecting colours from the fatty layer of the precorneal film have been studied using mat filter (grease‐proof paper, parchment paper, tracing paper) in front of the slit lamp mirror, maximally open light slit in a half‐lit room, and magnification × 15. The palpebral fissure was narrowed until occurrence of red interference colour (2000 Å).

Per operative trypan blue vital staining of corneal endothelium. Eight years' follow up.

An 0.1% aqueous trypan blue solution was injected into the anterior chamber during cataract extraction for the purpose of disclosing endothelial cell damage if present.

Meibomian orifices and Marx's line Studied by Triple Vital Staining

Abstract. The ciliary margins of the lower lids have been vital stained by the lipid‐specific Sudan III powder, fluorescein 0.1% and the bottom of the lacrimal river (Marxs line) by lissamine green 1% in 100 cases. The Meibomian orifices are situated in a straight row just in front of the Marxs line in the lipid phase. With increasing age (> 50 years) the orifices are more often displaced and also discharge their lipid in the depth of the aqueous phase. The number averaged 21.5 in the lipid phase and 1.7 in the aqueous phase. Active orifices staining with lipid were found in 45% of all orifices in normals, independent of age, and were increased in conjunctivitis in the lipid phase. Lissamine green‐stained orifices were independent of age, phase and diagnosis. The anterior edge of Marxs line may run an irregular course in elderly normals (> 50 years), significantly more often in conjunctivitis and blepharitis.

ASTIGMATISM AND SURFACE PHENOMENA IN PTERYGIUM

Examination of 39 eyes with pterygium and 17 contralateral eyes revealed increased astigmatism with the rule (> 0.5 D in 46%, ≥ 4 D in 13%) without associated impairment of vision.

Spheroid degeneration, pinguecula, and pterygium among Arabs in the Red Sea territory, Jordan.

Report of an examination of 127 Arabs in the Red Sea City of Aqaba, Jordan. The results are compared with those of the authors examinations, using a similar apparatus, of 659 Eskimos in Western Greenland and 810 Caucasians in Copenhagen. Ultraviolet (u.v.) light is at a maximum in the Red Sea territory, considerable in Greenland, and negligible in Copenhagen. The prevalences of the following degenerative processes are high at the Red Sea, somewhat lower in Greenland, and low in Copenhagen: Climato‐keratopathy gr. III (across the cornea, often with autofluorescent spheroids, always with conjunctival location as well), conjunctival spheroids (39%), and pinguecula (90% at the Red Sea). The prevalence of the conjunctival spheroid degeneration greatly exceeds that of the corneal. No difference is demonstrable between tropical and arctic keratopathy. The investigations performed gave results bearing out the view that u.v. light is responsible for all the above degenerative processes. Pterygium is equally frequent at the Red Sea and in Greenland. Lipid deposits (6%) and scleral plaques are not more prevalent at the Red Sea, a fact which argues against an ultraviolet genesis.

PEROPERATIVE PROTECTION OF CORNEA AND CONJUNCTIVA

In 221 consecutive cataract extractions the peroperative epithelial damage was assessed by vital staining with 1 % lissamine green, using logarithmic grading (grade 5 more than 10 000 stained dots) on cornea and on the superior, medial, lateral, and inferior conjunctiva. Evenly spread dots were seen on the cornea in 63 per cent of the eyes not subjected to protective treatment. In 35 per cent we observed staining caused by taut suturing of cornea and/or conjunctiva, in 10 per cent horisontal lines due to corneal bending during the extraction. The cornea was protected most effectively by healon (1% instilled once). Saline (4 or 5 instillations during the operation sufficed) protected equally well as gelatin sponge, methylcellulose, polyvinyl alcohol, and a soft contact lens. The inferior conjunctiva was protected only by healon, the superior also by saline, gelatin sponge, and polyvinyl alcohol.

Tear pH after instillation of buffer in vivo

Abstract The pH of the conjunctival fluid was measured with a micro‐electrode at the middle of the inferior conjunctival fornix of 160 eyes (86 subjects). After instillation of buffer of pH 5 (in 22 eyes pH 9) the linear course of pH changes was followed until the starting value had been regained. The coefficient of regression K was computed (pH‐units/min.). In normal eyes the K‐value declines with increasing age from 1.0 to 0.5, corresponding to a return to the starting value after 2 to 5 minutes. The K‐value is reduced significantly in keratoconjunctivitis sicca (K = 0.21, pemphigoid (0.36), during local anaesthesia (0.38±0.03 against 1.04±0.10 prior to 0.4% oxibuprocain), in the presence of a cotton plug in the inferior fornix, and in wearers of soft contact lenses. The K‐value is normal in cases of lacrimal occlusion (owing to overflow), in exophthalmos and endothelial dystrophy, following corneal grafting, in conjunctivitis and keratitis, and in wearers of hard contact lenses. In cadaveric eyes we find incomplete, irregular neutralization. Conclusion: Tear dilution is the most important factor in the elimination of buffered eye drops in vivo, compared with the proper buffering capacities of the tears and the tissue.

Foam in the external part of the eye

Abstract Foam in the external part of the eye has been measured at the slit‐lamp on 274 normal subjects. Foam occurred in 78%, most frequently in the outer canthus, on the skin round this, and in the lateral half of the lid margin. The age group of 30–50 years predominated. The foam‐covered areas averaged 1.1 mm2, the largest amount always being found laterally (0.93 mm2). The lateral amount of foam was maximal in the age group of 30–50 years, while the medial maximum was seen in the age group of 60–70 years. The incidence of foam was not correlated to the lipid layer on the precorneal film, expressibility of Meibomian secretion, scales on the lid margin, or greasy hair. A hypothesis has been advanced for the mainly lateral position of the foam: blinking whips up the foam, which possibly has sebum admixed.

VITAL STAINING OF EXTERNAL EYE OF RABBIT. by Fluorescein, Rose bengal, Tetrazolium, and Alcian Blue

Fifty normal albino rabbits (Ssc: CPH) had 1% fluorescein and 1% rose bengal instilled into the right eye and 1% tetrazolium and 0.25% alcian blue into the left eye.

VITAL STAINING PROPERTIES OF NEUTRAL RED: Vital Staining of Cornea and Conjunctiva

Vital staining by instillation in the conjunctival sac of 1% neutral red in 54 normal and 153 differently affected eyes was studied by slit lamp examination. Of these, 134 eyes were after‐stained by a mixture of 1% tetrazolium and 1/4% alcian blue and 73 eyes were after‐stained by a mixture of 1% rose bengal and 1% fluorescein.