Treatment of a cyclodialysis cleft with argon laser photocoagulation in a patient with a shallow anterior chamber.

A 27-year-old man developed a traumatic cyclodialysis cleft with resulting hypotony. He had a flat peripheral anterior chamber, but the chamber was successfully deepened with the help of a Zeiss four-mirror goniolens, and the cyclodialysis cleft treated with argon laser photocoagulation.

A dose-response study of the effect of levobunolol on ocular hypertension.

We conducted a randomized, double-masked, dose-response study of the ocular hypotensive effect of the beta-adrenergic blocker, levobunolol. A single drop of placebo or levobunolol (at concentrations of 0.03%, 0.3%, 0.6%, 1%, and 2%) was administered to one eye of each of 48 patients with ocular hypertension. The 0.3% and 0.6% concentrations decreased intraocular pressure significantly from baseline levels compared to placebo at one, two, and four hours after treatment. The 1% and 2% concentrations decreased intraocular pressure significantly from baseline compared to placebo at one, two, four, six, eight, and 12 hours after administration. No objective or subjective side effects were noted, and no substantial changes in visual acuity, pupil diameter, pulse rate, or blood pressure were recorded during the study. These results appear to justify long-term studies of levobunolol for the treatment of increased intraocular pressure.

Anaerobic orbital cellulitis.

A 10-year-old boy with orbital cellulitis died seven weeks after admission to the hospital despite intensive surgical intervention and medical therapy. We isolated many anaerobic bacteria from the orbit, frontal sinus, and epidural space. Orbital cellulitis, which often occurs by direct extension from infected paranasal sinuses, commonly affects children and young adults, and is a potentially lethal disease, if left untreated. Heightened awareness of the role of anaerobes in chronic sinusitis and of the possibility of an anaerobic orbital cellulitis may lead to the identification of more cases. Penicillin G appears to be the first drug of choice in cases with suspected anaerobic orbital cellulitis. Chloramphenicol and clindamycin should be considered, if treatment with penicillin fails. Antibiotics alone should not be considered as a panacea, and surgical drainage is often the most compelling consideration.

Herpes simplex type 1 retinitis in an adult with systemic herpes zoster.

A 72-year-old man developed bullous skin lesions two months before he was discovered to have malignant lymphoma. Herpes zoster virus grew from the skin bullae. He developed encephalitis, keratitis in the left eye, and bilateral retinitis 18 months later. Herpes simplex virus type 1 grew from cultures of the eyelid vesicles and corneal scrapings from the left eye. The patient died two years after the diagnosis of malignant lymphoma. Virus particles believed to be herpes simplex virus were demonstrated on electron microscopy in the necrotic retinal cells.

Intraocular lens power formulas.

We have developed a FORTRAN digital computer program to evaluate intraocular lens power for any thin lens and combination of corneal curvature and axial length. Partial derivatives of the power with respect to cornea power, axial length, and lens position allow estimation of error in power of the lens. These derivatives are computed along with power of the lens for six far points which may be changed with the program running. The program is written for remote access so that an ordinary telephone and portable terminal provide the ability to compute lens power.

Slit-lamp examination of the bedridden patient.

Slit-lamp examination of bedridden patients is facilitated by using a stretcher with the patient lying prone and holding the head erect.