Functional hemianopias on Humphrey visual field analysis.

We report two cases of uniocular hemianopia that we first detected on Humphrey visual field analysis, with one patient having additional constriction of his peripheral visual fields bilaterally. These field defects were confirmed to be functional in nature after characteristic changes on Goldmann perimetry and spontaneous improvement towards normal. This type of functional field loss is rare and the unusual pattern on computerised perimetry should be recognised for managing the patient appropriately.

Relationship between the development of blindness in Churg-Strauss syndrome and anti-myeloperoxidase antibodies.

Occular involvement is infrequent and blindness rare in Churg-Strauss syndrome. We describe a patient with Churg-Strauss syndrome who presented with blindness. This was associated with the appearance of circulating autoantibodies to myeloperoxidase.

Acquired Brown's syndrome in systemic lupus erythematosus.

A 33-yr-old woman with systemic lupus erythematosus (SLE) and concomitant development of Brown's syndrome is described. This rare complication of SLE is discussed.

Bilateral cilio-retinal artery occlusion in classic migraine.

A case of bilateral cilio-retinal artery occlusion in a patient with classic migraine is described. It is unlikely that this hitherto unreported occurrence represents altered tone in the dense adrenergic innervation to the posterior ciliary circulation. We advise the continued use of beta-adrenergic blockers as prophylaxis in ocular migraine.

Atypical band keratopathy following long-term pilocarpine treatment.

Two patients with an atypical form of band keratopathy following long-term pilocarpine treatment are described. The keratopathy is thought to have resulted from the presence of the preservative phenylmercuric nitrate in the pilocarpine drops. Symptoms of reduced acuity, visual haloes, and recurrent epithelial erosions were relieved by removal of the opacities.

Cardiovascular responses to metipranolol and timolol eyedrops in healthy volunteers.

1. Intraocular pressure and cardiovascular responses to metipranolol 0.1% and 0.3% and timolol 0.25% eyedrops were measured in a balanced single dose placebo-controlled crossover study in eight healthy volunteers aged 34-58 years. 2. Timolol 0.25% and metipranolol 0.3% reduced intraocular pressure throughout the 6 h period of observation to a similar extent. Metipranolol 0.1% was marginally less effective, significantly reducing pressure up to 4 h only. 3. No drug treatment significantly altered resting heart rate or blood pressure. Timolol 0.25% significantly reduced exercise tachycardia (P less than 0.05), an effect which was not shown by metipranolol 0.1 or 0.3%. Exertional pain in the legs occurred more frequently after timolol 0.25% and metipranolol 0.3% than after metipranolol 0.1% or placebo eyedrops. 4. Octan-1-ol/pH 7.4 buffer distribution coefficients at 37 degrees C were found to be: metipranolol 5.19, timolol 0.84, indicating that metipranolol has an approximately 6-fold greater lipid solubility. 5. It is concluded that, by comparison with timolol, metipranolol in eyedrop concentrations up to 0.3%, despite its greater lipid solubility, reaches concentrations in the systemic circulation which are less likely to affect the heart.

Iris autonomic function in acute glaucoma.

Iris autonomic function was studied by binocular infrared pupillometry in 12 patients with acute primary angle closure glaucoma (APACG) and 28 control subjects. Light reflex amplitude and resting darkness pupil diameter were reduced and miotic response to pilocarpine 0.125% drops increased in APACG when compared to controls with anterior chamber depths (ACD) greater than 2.5 mm but not when compared to controls with ACD of 2.5 mm or less. These findings suggest relative autonomic dysfunction, predominantly parasympathetic, in the anterior segment of the eye in APACG. Correlation between results of pupil tests and ACD suggested reduced autonomic function in eyes with shallow anterior chambers. Iris autonomic dysfunction in patients with APACG appears to be a reflection of shallow anterior chambers rather than a specific feature of the condition.

Ocular and cardiovascular response to topical carteolol 2% and timolol 0.5% in healthy volunteers.

Ocular and cardiovascular effects of carteolol 2%, timolol 0.5%, and dummy eyedrops have been measured in a single dose double-blind crossover study in six healthy volunteers. Both drugs lowered intraocular pressure and reduced exercise-induced tachycardia. Neither produced a significant change in resting heart rate or blood pressure. The two agents appear comparable as regards ocular hypotensive and cardiovascular effects.

Neodymium-YAG laser iridotomy.

Results of neodymium-YAG laser iridotomy in 34 eyes with narrow drainage angles are reported. Iridotomies appeared patent on slit-lamp examination in 32 (94%) eyes. Complications included failed patency of iridotomy and acute elevation of intraocular pressure.

Cryptophthalmos: surgical treatment of the congenital symblepharon variant.

A case of the congenital symblepharon variant of cryptophthalmos is reported. Surgical treatment is described. The ophthalmic features of cryptophthalmos and its systemic associations are reviewed.

Retinal detachment in patients with proliferative sickle cell retinopathy.

Results and complications of surgical treatment for retinal detachment in thirteen patients with proliferative sickle cell retinopathy are reported. Eleven had maintained or improved visual acuity after treatment. Methods and complications of exchange transfusion in eight patients are described. The pathogenesis and methods of treatment of these retinal detachments and the benefits of exchange transfusion are discussed.