Bulletin des societes d'ophtalmologie de France最新文献

During ocular treatments by drops of INDOCID are observed 4 superficial punctuate keratitis disappearing when INDOCID is discontinued, and 2 diffuse corneal oedemas. Some possible explanations for such a corneal involvement are suggested.

Contrast visual testing (CVT) is a psychovisual test newly used in the clinical study of neurovisual disorders. Using a micro E (Luer-Essilor) the authors present their technique and discuss the principal indications of CVT in neuro-ophthalmology.

For basic research, measurement used in our medical routine doesn't seem to be self-evident. Classical physics claim and demand that everything should be measured with a maximum of exactness in order to avoid errors principly. Results of measurement and diagnosis are often regarded as on and the same thing. For quantum physics, measuring means rather description, approximation, and even perturbation due to manipulation. In strabismology, zero is the starting point of measurement and defines normality. The examination of 70 patients with asthenopia has reveiled that zero-localisation at the Maddox Wing doesn't imply parallelism of the eyes but an esophoria combined with an ocular-cervical syndrome.

The authors analysed the results of 24 patients who underwent non-freeze refractive surgery with the BKS set. 22 myopic and 6 hypermetropic keratomileusis, and 6 epikeratoplasty are evaluated. The majority of patients had no astigmatism (or some irregular one) on corneoscopy. The final refraction may take up to 6 months to stabilize. The technique is difficult but may have application in the visual rehabilitation of these patients.

The presence of a DVD makes the ocular motility examination complicate but it is a valuable sign for the clinician as it is noticed essentially in infantile early onset strabismus with latent nystagmus. It is fundamental not to confuse it with an hyperaction of the inferior oblique. It requires a surgical treatment: a recession of superior recti.

The occlusion of one eye may trigger two types of deviation: 1) Heterophorias: the occluded eye deviates towards a horizontal, vertical or torsional abnormal position of rest. Fusion keeps the eyes straight during binocular fixation. 2) Dissociated deviations, horizontal (DHD), vertical (DVD), torsional (DTD): they are found in infantile strabismus. The deviation without fixation is always smaller than the deviation of the occluded eye. The more typical cases are the ones where the position of rest without fixation is an orthoposition. Normal binocular vision is lacking. Most of the time, an alternant neutralisation is found: the occlusion deviation is not the return of the occluded eye to an abnormal position of rest. The deviation is caused by a disequilibrium of binocular retinal stimulations. Horizontal and vertical deviations are easy to study. It is not the case in dissociated torsional deviation (DTD) where the incyclotorsion does not exist when fixation is absent. An indirect proof of extorsion is given by the study of horizontal and vertical deviations determined in the cardinal position of gaze. Extorsion of the globus leeds always to abnormal actions of the recti. This give a typical synoptometer chart which is found in any extorsion whatever its origins: paralysis, alphabetic patterns or infantile strabismus. Dissociated extorsions are always associated with a bilateral elevation in the primary position. Dissociated deviations are found in infantile strabismus with the other dissociations phenomenon such as nystagmus, optokinetic nystagmus asymmetry, fixation in adduction preference (and incyclotorsion).

The authors present the results of clinical application of a new invasive real time method for ocular movement recording. There is an optical system which measures the gaze direction from the video signals of five reflected corneal dots and pupil image. Their study is based upon 110 simultaneous P.O.G. - E.O.G. recordings of normal beings or patients having various oculomotor troubles. It appears that the heavy odds of such a new method is obvious. It allows to obtain an absolute measurement of eye positions in relation to the basic line whatever the pattern and axis of the moving may be. A quantitative evaluation of all movement parameters is in progress. It still remains to solve the problem of large deviations and the wearing of optical correction during the examination.

Twenty-eight patients with papilloedema have been observed on twenty-thousand patients. In one third of the cases, they were associated with an hypertensive retinopathy. Another third was symptomatic of an expansive intra-cranial process. Otherwise, we only find a papilloedema in one case of eight with an expansive intra-cranial process. If a lot of them stay idiopathic and can regress without complication, it is necessary to look after them regularly, the secondary discovery of a cerebral tumor is not exceptional at all.

This study reports donor corneas stored at +37 degrees C in organ culture incubation. The follow up is 12 months. The graft survival is 92%. Two grafts are failed before 6 months. The mean control thickness is 0.54 mm and the mean endothelial cell density 1625 cells per mm2. A mean decrease in cell density of 40.6% is recorded. This study demonstrates that banked donor material can be successfully employed for corneal transplantation.