Biomedical subjects
Publications and source records attributed to A Arruga.
Ninety years ago, Paul Stoewer introduced the vacuum method for cataract surgery. It is felt that it is about time to acknowledge his authorship which has been so far almost ignored in ophthalmic literature.
Direction in drawing depends mainly on handedness. In certain cases writing habit also has an influence, yet curiously it is less common in Western culture. Knowledge of sidedness may be important in certain squint and nystagmus cases. Kinsbourne's test is easy, innocuous and, in the author's opinion, highly reliable.
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A case of sebaceous gland carcinoma presenting as a dry-eye-syndrome is documented. In spite of total removal of the primary tumor, as confirmed histopathologically, the patient developed metastases to the neck lymph nodes several months after orbital exenteration. The importance of early diagnosis is stressed.
A simple home-made addition to the tangent-screen allows determination by a test which, although subjective, is anatomical and not sensorial. It is felt that comparison with sensory tests is important since these are often fallacious.
A case is reported of a 41/2-year-old girl with generalized fibrosis, no active or passive eye movements, anisohyperopia, craniofacial asymmetry and hypoplasia of a toe. There was no ptosis, nor backward head tilt and only a moderate exotropia. Study of the fixation and of the binocular relationship met with unusual difficulties owing to the absence of eye movements. Mesodermal abnormalities were noted in the anterior chamber. A normal female karyotype was reported and family history was noncontributory.
Study of the incidence and characteristics of motility alterations following various operations for retinal detachment. Diplopia and asthenopia following retinal surgery are rare, despite relatively frequent muscular imbalance, because of: (a) suppresion (which war frequently found even in orthophorics with good postoperative vision in both eyes); (b) compensation owing to fusional power, and (c) probable role of the sensory factor for the compensation of the subjective experience of cyclotropia. However, asthenopia and diplopia may occur and may be hard to deal with. It is felt that these disorders could be avoided in many cases since they are frequently the result of technical errors.
Forward displacement of the superior oblique insertions, associated with partial anterior myectomies of the inferior obliques, compensated a cyclotropia which was not accompanied by other significant deviations.
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In cases of surgery in retinal detachment, borrowing of techniques employed in strabismus surgery is recommended. The opening of the conjunctiva and Tenon's capsule and careful placement of the final suture as published by Cüppers avoids or at least diminishes postoperative cicatrization, retraction, and resulting disturbances of motility and double images. In case where one are several muscles have to be cut, the exact strabismic muscle surgery helps this treatment. In these cases, statistical results are mentioned. Furthermore in cases of high myopia and especially those combined with nystagmus, the so called Cüpper's "Fadenoperation" gives excellent results. Three cases operated on by this technique, in which no other method succeeded, are demonstrated.
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