SUMMARYWe have studied the effects of dermatochalasis on Humphrey automated perimetry of the central 24° visual field. Fifteen visual fields of 9 ocular hypertensive patients (18 eyes) were found to be incongruous with their apparently healthy optic discs. Examination revealed dermatochalasis, which was felt to be respon sible for the field defects. This was confirmed by reversal of the defects on repeating the field test (programme 24-2) with the redundant upper lid skin taped up, or in 2 cases following blepharoplasty. The defects always involved the superior visual field. The deepest and largest defects were sited in the supero temporal quadrant in 13 of the 15 affected fields and the supero-nasal quadrant in 2 fields. The most common pattern was a temporally skewed defect which reflected the tendency of the loose upper lid skin to be greater in extent temporally than nasally. In 7 fields the supero temporal defect extended to fuse with the blind spot, mimicking a superior arcuate scotoma. Temporal extension of the field defects below the horizontal meridian occurred in 5 fields. In cases where visual field testing was repeated without taping up the lid inter-test fluctuation in scotoma size and depth was observed, although the position of scotomas when present within the visual field remained constant. We conclude that dermatochalasis has the potential to confound diag nostic automated visual field testing for glaucoma.

Liverpool SUMMARYPurpose: To investigate the effect of choroidal mela noma on pulsatile ocular blood flow (POBF).Methods: Seventeen patients (10 men and 7 women) with unilateral untreated choroidal melanoma and 22 controls matched for age and sex were studied.Intraocular pressure (lOP), pulse amplitude (PA) and POBF were measured using the OBF Tonograph. In each patient, mean inter-ocular differences were analysed using the paired t-test. The correlation coefficient between tumour thickness and POBF was calculated. To assess the variation of this parameter, the coefficient of variation for three repeated readings was determined for healthy and affected eyes.Results: In the control group, there was no significant difference between eyes in any parameter. In patients with melanoma, there was no significant difference in lOP and P A between affected and unaffected eyes. Mean POBF was significantly higher in affected eyes The aim of this study was to determine whether uveal melanomas cause a measurable change in POBF. METHODSeventeen patients (10 men and 7 women) with newly diagnosed unilateral choroidal melanoma and 22 age-matched controls (13 men and 9 women) were Eye (1997) 11,331-334 © 1997 Royal College of Ophthalmologists

A 17-year-old youth presented with bilateral follicular conjunctivitis and nummular subepithelial corneal infiltrates. Failure of this to settle in an outpatient setting led to corneal scraping with microscopy and culturing for bacteria, fungi, Herpes simplex, adenovirus and Acanthamoeba as an inpatient. Polymerase chain reaction analysis of corneal cells was positive for adenovirus, and culture on live Escherichia coli-coated agar plates was positive for Acanthamoeba by phase contrast microscopy on day two. We conclude that Acanthomoeba infection can complicate adenoviral keratoconjunctivitis. This observation is in keeping with previously reported modes of infection by Acanthamoeba, whereby any epithelial breach seems to allow inoculation of the eye by this opportunistic organism.

After both ECCE + TRAB and phacotrabeculectomy, IOP control was achieved in significantly more eyes on fewer pressure-lowering medications than preoperatively. Phacotrabeculectomy with IOL implantation led to better unaided long-term postoperative IOP control than ECCE + TRAB with IOL implantation.

Background The changes of blood pressure in patients undergoing cataract procedure are not well studied. The blood pressures of cataract patients often become uncontrolled intraoperatively causing the procedure to be postponed. Intraoperative rise in blood pressure has been associated with ocular complications such as suprachoroidal haemorrhage and can be fatal from stroke or even myocardial infarction. We attempt to study the changes in blood pressure of patients undergoing cataract surgery. Aim Prospective study on the variation of blood pressure pre-and intra-operatively. Method The blood pressure readings of patients going for cataract procedures were measured in five stages during the pre-assessment clinic, on arrival at the day surgery, at the anaesthetic room, on the operating table intraoperatively; and postoperatively. The readings were compared to their age, sex, past medical history, and use of antihypertensive medication. Results The rise in systolic blood pressures between intraoperative readings and those at the preassessment and anaesthetic room was highly statistically significant. Being older (465 years of age), taking more than two antihypertensive drugs, being hypertensive, or having a family history of hypertension does not appear to increase the risk. Conclusion Our study showed that there is a significant rise in systolic blood pressures especially in females during topical phacoemulsification. Further studies are needed on the factors that determine this increase and the changes in blood pressures during different stages of the procedure.