Tuberous sclerosis classically presents a triad of mental deficiency, seizures and adenoma sebaceum. Among the ocular manifestations are astrocytic hamartomas in the retina. This paper describes the case of a 24-year-old man with tuberous sclerosis who had recurrent vitreous hemorrhage from a large epipapillary astrocytic hamartoma in the left eye. Pars plana vitrectomy cleared the vitreous and bimanual bipolar coagulation of tumor bleeding points was done. Fragments of the friable tumor were obtained with the vitrectomy instrument and were prepared for tissue culture, histology, and electron microscopy. Although pars plana vitrectomy offers certain advantages over other methods of biopsy, it does present a danger of extraocular seeding of malignant cells; therefore, it is not recommended in cases with probable intraocular malignancy.

Adolescent↗

PubMedDate not supplied

Optic nerve hypoplasia with diabetes insipidus.

Two patients with the combination of bilateral optic nerve hypoplasia and diabetes insipidus are reported. One patient also had absence of the septum pellucidum (septo-optic dysplasia), which previously has been associated primarily with abnormalities of anterior pituitary function.

Child↗

PubMedDate not supplied

The natural course of congenital obstruction of the nasolacrimal duct.

In order to establish the rate of spontaneous resolution of congenital obstruction of the nasolacrimal duct, 50 infants, referred from a local pediatric group practice over a period of five years, were followed from the time of first symptoms until 8 to 13 months of age. Among the 50 infants, 65 nasolacrimal ducts were blocked and 58 ducts in 44 patients opened spontaneously. Only seven ducts in six patients required probing for relief of the obstruction. During the same period another seven patients from various referral sources were seen because of noninflammatory swelling of the lacrimal sac at birth. These patients were also found to have nasolacrimal duct obstruction, but early surgical intervention was required in six of the seven patients to relieve the distention of the sac.

Anti-Bacterial Agents↗

PubMedDate not supplied

Aicardi's syndrome: a report of four cases and review of the literature.

Four patients with Aicardi's syndrome (infantile flexion spasms, agenesis of the corpus callosum, and ocular anomalies) are reported, along with photographs of their characteristic fundus abnormalities. The etiology of the syndrome is unclear, but its occurrence exclusively in female patients suggests the possibility of a genetic factor. The ocular abnormalities of Aicardi's Syndrome are distinguishable from, but may be confused with, those of congenital toxoplasmosis and cytomegalic inclusion disease. The syndrome can be identified clinically with a high degree of certainty. Ophthalmologists who are familiar with the syndrome may be helpful in the differential diagnosis.

Adult↗

PubMedDate not supplied

The effect of bilateral superior oblique tenotomy on horizontal deviation in A-pattern strabismus.

In order to determine the horizontal effects of bilateral superior oblique tenotomy, all cases of superior oblique tenotomy performed at the Children's Hospital Medical Center and also in a private practice setting over the past ten years were analyzed retrospectively. A total of 18 patients underwent isolated bilateral oblique tenotomy. An average primary position exo-shift of 2 prism diopters was found; in upgaze a significant exo-shift of 11 prism diopters and in downgaze a significant eso-shift of 21 prism diopters were noted. Analysis of data in the literature on the effects of superior oblique tenotomy suggests that the results of others have, in fact, been consistent with our findings, despite the common misconception that an eso-shift in the primary position was to be expected.

Esotropia↗

PubMedDate not supplied

Increase in retinal surface area during infancy and childhood.

Retinal surface area was calculated from measurements made on the eyes of 33 patients ranging in age from six-months of gestation to six-postnatal years. Retinal surface area increased dramatically during the last months of gestation and more gradually in the first two postnatal years. Thereafter the rate of increase was small. These data provide a background against which regional shifts in the cell density of the retina and retinal pigmented epithelium can be studied.

Biometry↗