Squash rackets is a game played at a fast pace, popular in over fifty countries, with an estimated half million players in Great Britain alone. It is played between two, or occasionally four, players in an enclosed court of specified dimensions, using rackets similar to but smaller than a tennis racket, and with a hollow black rubber ball I} in. in diameter and i oz. in weight. There has been a spectacular increase in the popularity of squash rackets during the last 20 years, and information suggests that it is now the country's fastest-growing sport (Spink, I972). It is estimated that male players outnumber female players by five to one (Horry, I972). It was our impression that ocular injury is a not uncommon occurrence amongst squash players, although a search of the literature revealed only passing references to the subject (Colson and Armour, I96I; Blonstein, I964). It was hoped that our study would clarify this impression and also elucidate the various factors which might predispose to, or lessen the risk of, such injury. FindingsWe have examined twenty patients who sustained ocular injuries as a result of playing squash rackets, and also the case notes of one further patient, making a total of 2i, all men.A detailed ocular history was obtained from each of the patients examined. Enquiry was also made into the circumstances of the injury on the court, whether spectacles were worn, and whether the patients were right-or left-handed. A complete ocular examination was carried out, including assessment of the visual acuity, spectacle correction, slit-lamp microscopy, applanation tonometry, gonioscopy, fundus examination, and visual fields of each patient. An assessment of the severity of the injuries was made and expressed on a four-point scale (minor + tosevere ++++). As far as could be ascertained, all had 'normal' corrected visual acuity in both eyes before injury.Case reports Table I records for each of the 2I patients their age, date of injury, duration of playing before injury, whether right-or left-handed, which eye was injured, and a brief summary of the nature of the injury and its severity.
Nearly a century ago Lang (i 885) described the occurrence of retinal detachment in a brother and his sister. Since that time many pedigrees have been presented to illustrate the hereditary nature of some cases of simple (syn. serous, idiopathic, rhegmatogenous, perforated) retinal detachment. Most of the earlier authors related the occurrence of the detachment to the presence and degree of co-existing myopia. Braendstrup (i94I) and Cuendet, Streiff, and Dufour (1958) have described a myopic family of five generations in which dominant transmission of retinal detachment was apparent. The hereditary nature of certain cases of detachment is evident from those pedigrees in which a detachment occurs in non-myopic individuals of a myopic sibship (Millikin, I896; Edmund, I96I). Fransois (I968) has described retinal detachment occurring in an emmetropic family in which dominant transmission occurred. Although this is the usual mode of inheritance in familial cases, recessive and sex-linked (Vogt, I 936) inheritance have also been observed.Vogt (I924) indicated that it is the predisposing retinal or vitreoretinal degeneration rather than the retinal detachment which is transmitted, and in recent years family studies of certain types of retinal degenerative disorders, especially lattice degeneration, have been reported.Recently two brothers with retinal detachments received treatment at the High Holborn branch of Moorfields Eye Hospital, and as their mother and other close relatives were also known to have developed a retinal detachment it was decided to examine as many members of the family as possible in order to detect the presence of any asymptomatic predisposing retinal degenerative lesions which might benefit from prophylactic therapy. MethodsA family tree comprising I IO members was constructed. The progenitors married in I889 and there is good reason for assuming that they were cousins. An attempt was made to contact as many surviving members of the family as possible. Most were aware of the family history of retinal detachment and welcomed the opportunity to be examined; a small number declined the offer or lived too far away to attend. In the latter case, the local ophthalmologist was informed and asked to examine the patients. Children under the age of 5 years were excluded from the survey. 59 patients were examined either at Moorfields Eye Hospital, or at the Eye Department of the Kent and Sussex Hospital, Tunbridge Wells. An ophthalmic and general medical history were obtained. Routine ophthalmic examination included direct and indirect ophthalmoscopy, and the Goldmann 3-mirror gonioscope was used whenever possible.Information regarding a further six patients was obtained by studying case sheets of patients examined and treated elsewhere.
(i 964a, b) reported data suggesting significant associations between taster status and glaucoma. In particular they found, in both Caucasian and Negro samples in St. Louis, U.S.A., that there were significantly more non-tasters among patients with "primary open-angle" glaucoma and significantly fewer among those with "primary angle-closure" glaucoma. In addition, they reported an increased prevalence of non-tasters among "primary open-angle" glaucoma suspects without loss of visual field. Small samples of glaucoma patients have since been investigated in Japan in respect of taster status, and the results either supported these findings (Takahashi, I969) or were inconclusive (Suzuki, Takeuchi, and Kitazawa, I966).The purpose of this study was to see whether any association between taster status and glaucoma could be demonstrated in a sample of London glaucoma patients. MethodsPhenylthiocarbamide tests by the method of Harris and Kalmus (I949) were performed over several months on patients attending the Glaucoma Clinic of Moorfields Eye Hospital, High Holborn Branch; the controls were other patients attending the same hospital and a previously reported group of normal Londoners (Harris and Kalmus, 1949). The diagnosis was based on full glaucoma assessment, including repeated measurements of intraocular pressure, gonioscopy, appearance of the optic discs, and central visual field findings. Altogether 569 patients were investigated in the Glaucoma Clinic, of whom 436 had some overt form of glaucoma and 72 were found to have ocular hypertension (above 24 mm. Hg on repeated occasions without field-loss).Patients with pseudoexfoliate and pigmentary glaucoma have been classified separately. The rest were non-glaucomatous and were included with the controls. There were twenty non-Caucasians among the sample, and these were excluded from the analysis leaving a total of 418 glaucomatous and seventy hypertensive patients. These were classified as shown in Table I (overleaf).In Table I it was attempted to classify the patients in the same way as those of Becker and Morton (i 964a, b), but a separate class had to be formed for those whose type of glaucoma could not be positively determined.
Optokinetic nystagmus is the term applied to the nystagmus evoked by a succession of moving objects passing before the eyes (Brain, 1962). It has proved useful as a diagnostic tool in the examination of patients with neurological disease (
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