[Simulated hemeralopia; relation of hemeralopia to mental deficiency].
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An elderly male was referred for evaluation of hemeralopia when cataract extraction did not alleviate his symptom of difficulty seeing in bright illumination. Visual acuity was 20/40 OU. Funduscopic examination revealed marked arteriolar attenuation, disc pallor, and retinal pigment epithelial changes. Visual fields demonstrated relative paracentral scotomata. An ERG was consistent with widespread photoreceptor degeneration. A diagnosis of visual paraneoplastic syndrome was made and an extensive systemic evaluation revealed a squamous cell carcinoma of the lung. The presentation and evaluation of acquired photoreceptor dysfunction in adulthood is discussed.
Electrophysiological and fluorescenceangiographical examinations were carried out in a case of fundus albipunctatus cum hemeralopia congenita. In the ERG a diminished scotopic b-wave was conspicuous, which reached the normal size after longer dark adaptation. It was possible to distinguish between albipunctatus-dots and druses by fluorescenceangiography. While the latter became clearly visible in the phase of choroidic-fluorescence the ophthalmoscopically perceptible albipunctatus-dots lost their visibility.
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