Walter R. Parker

SCLEROTREPHINE OPERATION FOR DETACHED RETINA: CLINICAL REPORT OF ELEVEN CASES

After observing the results obtained by Colonel Elliot in treating glaucoma by his corneoscleral trephining operation, it seemed possible that scleral trephining might be utilized in the treatment of detachment of the retina. May 19, 1913, the first operation was performed, and since that time fifteen operations have been made on eleven patients, all of which are included in this report. Two operations were performed in Case 7, also in Case 8, and three in Case 9. In Cases 1 and 2, the sclera was trephined over the site of the detachment without incising the choroid and retina. In all the other cases, in addition to trephining the sclera, an incision with a cataract knife was made in the choroid or the choroid and retina, and the subretinal fluid, and, in most instances, a few drops of vitreous, were allowed to escape. TECHNIC The operation may be described in detail

THE RELATION OF OPHTHALMOLOGY TO DISEASES OF THE NOSE AND ITS ACCESSORY SINUSES

The possibility of involvement of the orbit or its contents in diseases of the nose and accessory sinuses has been so well established from an anatomic point of view as to need no further proof. It is only necessary to study the investigations of Onodi, Birch-Hirschfeld and Loeb to be convinced of this fact. When considered from a clinical point of view, however, the frequency of the association is less constant than the anatomic investigations might lead one to suppose. While in many cases the causal connection is obvious, there are others in which a relation is difficult or indeed impossible to establish. Diseases are excited in the eye through the nose by direct communication, in the orbit through the anatomic relations of the accessory sinuses, through nervous reflex action, and as a result of general toxemia. It is not always easy from subjective symptoms alone to determine whether the