Clinical Classification of Degree of Deficiency in Color Defectiveness: Simulations by Changing the Total Number of Caps or Saturation of Farnsworth Dichotomous Test D-15.

Purpose: For the purpose of classification for social adaptability of color vision defectiveness, the Farnsworth Dichotomous Test D-15(Test D-15)was applied to distinguish a severe group from other cases. Following this, the Ichikawa Lantern was employed to separate a moderate from a mild group. Majima's classification has provided a convenient framework for identifying color vision defectiveness for the past several decades. However because of the discontinuity in the employment of Ichikawa's Lantern, the introduction of alternative methods is vital. New classification methods subdividing the "moderate/mild" group into separate groups were established by using simulations. Subjects and methods: Simulations of hue discrimination using the color caps of Test D-15 were carried out. Adding color caps one by one between each of the 15 color test caps of Test D-15 to a total of 30, or subtracting caps from Test D-15 to nine (P-1-3-5-7-9-11-13-15)or six(P-2-5-8-11-14) were employed to simulate the compressing of the hue circles along the color confusion lines. Simulations changing the saturation of color caps were conducted simultaneously. Results: The fewer the number of caps, the more errors occurred. Subtracting the number of caps of Test D-15 made it possible to subdivide the "moderate/mild" group into three groups. Changing the saturation of color caps of Test D-15 had no effect on the results of the Test D-15. Conclusion: Using Test D-15 and reducing the number of caps to nine or six allows for the identification of different levels of color defectiveness and the assigning of patients into separate groups.

Conjunctival mucoepithelial hyperplasia of the elderly.

The ocular surface is exposed to many chronic inflammatory stimuli, and goblet cell hyperplasia of the conjunctiva occurs in many situations. We report two cases of epithelial goblet cell hyperplasia with nonspecific chronic inflammation which occurred on the internal canthus of elderly people. These cases shared the same clinicopathological features that mimicked neoplastic lesion macroscopically, but are composed of nonspecific inflammatory changes pathologically. Immunostaining of the tissue showed few IgG4+ plasma cells, and no neoplastic changes were observed. Both cases arose in elderly patients over the age of 80 years. Pathogenesis and clinical significance of the lesion is unclear, but it might be age related. Recognition of this diagnosis might help us avoid overdiagnosis of malignancy and to reach the correct diagnosis.

Incidence of intraoperative floppy iris syndrome in patients on either systemic or topical alpha(1)-adrenoceptor antagonist.

PURPOSE: To evaluate the incidence of Intraoperative Floppy Iris syndrome (IFIS) in relation to the usage of alpha(1)-adrenoceptor antagonists. DESIGN: Prospective, interventional case series. METHODS: In 2,643 consecutive eyes of 1,968 patients undergoing cataract surgery, occurrence of IFIS and use of alpha(1) antagonists were recorded. RESULTS: IFIS was observed in 29 eyes (1.1%) of 25 male patients, all of whom were receiving alpha(1) antagonists. In those receiving systemic tamsulosin, alpha(1A) selective antagonist, IFIS developed in 25 (43.1%) of 58 eyes. In those receiving systemic naftopidil, alpha(1A) and alpha(1D) antagonists, IFIS was found in 4 (19.0%) of 21 eyes. There was no case of IFIS in patients who received other systemic alpha(1) antagonists and in eyes treated with bunazosin eyedrops, a nonselective alpha(1) antagonist. CONCLUSIONS: IFIS occurred in 1.1% of cases treated with systemic alpha(1A)-adrenoceptor antagonists for benign prostatic hypertrophy. Topical nonselective alpha(1) antagonist did not induce IFIS.

Characteristics of hyperacuity sensitivity in normal and cyclovertical deviation subjects.

PURPOSE: To compare the sensitivity of hyperacuity of patients with cyclovertical deviation with that of subjects with normal vision. METHODS: The sensitivity of hyperacuity was measured in 42 volunteers with normal vision and in 12 patients with cyclovertical deviation, using a newly developed computerized device that randomly presents two opposing targets at vertical or at horizontal directions on the cathode ray tube display. RESULTS: In subjects with normal vision, higher sensitivity was obtained when the targets were aligned in either a vertical or a horizontal direction. These highly sensitive ranges were defined as "the neutral zone of hyperacuity." An anisotropy of the sensitivity of hyperacuity was observed in these subjects, ie, better sensitivity was obtained when the displacement was away from the neutral zone, whereas worse sensitivity was obtained when the displacement was close to the neutral zones. In the patients with cyclovertical deviation, the sensitivity of hyperacuity was low around the neutral zones, which may confirm the dysfunction of the central nervous system. CONCLUSION: This analytical method may be useful to investigate the pathophysiology of patients with cyclovertical deviations.