Peninsula pupil. Anomaly unique to Newfoundland and Labrador?

Forty cases of an unusual form of iris atrophy that results in a characteristically oval pupil have been seen in Newfoundland and Labrador. The anomaly is an atrophy of part of the sphincter pupillae, is confined to the iris, and is not associated with any systemic disorder. The great majority of those affected are male, and all have blue eyes. We suggest that it may be an inherited trait.

Case of cerebrotendinous xanthomatosis. I: Unusual ophthalmic features.

A case of cerebrotendinous xanthomatosis is reported. In addition to the classical ophthalmic and systemic features the patient presented with unilateral proptosis. This feature has never previously been reported. The results of investigations are described and illustrated.

A case of cerebrotendinous xanthomatosis. II: The sterol content of a cataractous lens.

The cholestanol content of a cataractous lens nucleus from a patient with cerebrotendinous xanthomatosis (CTX) was quantified by gas chromatography-mass spectrometry and found to be 0.27 micrograms per mg freeze-dried lens tissue. The cholestanol-cholesterol ratio of 1.7% in the lens nucleus was similar to that in the serum of the CTX patient. The cholestanol content and cholestanol-cholesterol ratio in the CTX lens were approximately four-fold and six-fold greater respectively than the mean levels found in three senile cataractous lens nuclei analysed simultaneously for comparative purposes.

Spherophakia in a Newfoundland family: 8 years' experience.

In a family with eight siblings, five siblings have had spherophakia. One patient has died, but the other four have been followed up for 8 years. Two have undergone peripheral iridectomy because of steadily rising intraocular pressure. The operations were only partially successful in controlling the pressure. Whether associated with the Weill-Marchesani syndrome or not, spherophakia is difficult to manage. The lenticular myopia must be corrected (sometimes an additional reading correction is needed), and the intraocular pressure and visual field must be carefully monitored. The ability of the retinal circulation to withstand a high intraocular pressure for long periods may not be matched by a corresponding resilience of the drainage mechanism. Therefore, early peripheral iridectomy is probably advisable.

General practitioner registrars' opinions of general practice training in ophthalmology: a questionnaire survey in the northern region.

PURPOSE: Approximately 6% of general practitioners have worked in ophthalmology but to our knowledge the relevance of this training has not previously been evaluated. METHODS: We sent an anonymous questionnaire to all doctors who had held general practitioner registrar (vocational training) posts in ophthalmology in the Northern Region during a 5-year period (1989-1994). RESULTS: Twenty-six of 48 (54%) questionnaires were returned. Twenty-five of 26 respondents (96%) thought the training was useful, with 22 (91.7%) continuing to use some ophthalmic practical skills and 17 (65.4%) said they had received adequate and relevant clinical exposure. Twenty-one (87.5%) of those in general practice felt that they were more confident with eye problems than their peers and 12 (50%) said their referral patterns differed. Eleven (46%) had provided advice for colleagues. However, 9 (34.6%) commented on the large service commitment and 5 (19%) felt that supervision had been inadequate. Only 9 (34.6%) had received relevant teaching and 18 (69%) thought more was necessary. CONCLUSION: We conclude that general practitioner registrar posts in ophthalmology are useful and rewarding but that there is scope for improvement.

Intraocular caterpillar hairs (setae): clinical course and management.

Ophthalmia nodosa is a well-documented condition. We present a case in which a live caterpillar was rubbed into a patient's eye and, after relentless penetration of the hairs into the globe, vitrectomy was required. We discuss the differing clinical features of these injuries, the mode of penetration and the treatment options.