ABSTRACT.Purpose: To investigate the use of a digital non-mydriatic camera for determining the ETDRS clinical level of diabetic retinopathy, and to evaluate its use in a screening setting to appropriately determine the need for referral to an ophthalmologist (ETDRS level ‡ 35). Methods: A total of 83 patients with diabetes were photographed with and without pharmacological pupil dilation at an ophthalmology department using a digital nonmydriatic camera, obtaining two sets of five non-stereoscopic, 45 degree field images of each eye. ETDRS seven standard field, 35-mm stereoscopic colour fundus photographs were also obtained. A subgroup of 59 patients was photographed at an optician's shop using the digital non-mydriatic camera without pupil dilation. Results: There was substantial agreement between the clinical level of diabetic retinopathy assessed from the 35-mm photographs and the digital images: the ophthalmology department (k = 0.76) with pupil dilation and (k = 0.66) without pupil dilation, respectively, and at the optician's (k = 0.60 without pupil dilation). With respect to the need for referral to an ophthalmologist, there was almost perfect agreement in the ophthalmology department (k= 0.88) with pupil dilation and (k = 0.84) without pupil dilation, respectively, and those taken at the optician's (k = 0.87 without pupil dilation). Conclusion: A digital non-mydriatic camera may be used in a screening situation to appropriately determine the need for referral to an ophthalmologist (ETDRS level ‡ 35).

The orbit differs from the rest of the organism, excluding the central nervous system, as concerns lymph drainage. This may possible explain some of the peculiar features in lymphoid orbital lesions. The lymphoid tumours of the orbit are discussed on the basis of the classification most widely applied. An illustrative case is reported and it is concluded that even if local therapy may prove successful, patients in whom orbital lymphoid tumours have been diagnosed should be kept under constant observation with a view to prompt institution of treatment upon evidence of generalized disease.

The incidence, survival rate and causes of death of patients with orbital lymphomas and other lymphoid lesions of the orbit in Denmark, during the period 1943-62 inclusive, were studied by means of a clinico-pathological analysis. In the period examined, the incidence of histologically verified primary orbital tumours was 0.06%. The incidence of primary orbital lymphomas and lymphoid lesions was at least 0.012%. These can be histologically divided into 3 categories: benign, indeterminate (intermediary) and malignant. The present study confirms the relevance of this classification, as there is a definite relationship between the histological diagnosis and the clinical survival rate. For the patients in question, the chances of dying of a universal malignant disease were approximately 10(3) times greater than in the normal Danish population.

A clinical and histopathological study was made in 19 cases of pilomatrixoma (epithelioma calcificans Malherbe). Clinically the analysis confirmed that pilomatrixoma is often found in young females, usually above the palpebral fissure. Pilomatrixoma is a solid tumour adherent to the skin but not to the underlying tissue. The histological picture shows epithelial strands and islands of characteristic “shadow cells”. The stroma is characterized by granulation tissue with foreign body giant cells. Calcifications almost always occur. The tumour is benign. Malherbe stated that the lesion was developed from the sebaceous glands, but to‐day the tumour is believed to originate from hair matrix cells. The name pilomatrixoma was therefore suggested as a better term. In none of the present cases was the correct diagnosis made clinically. In view of the difficulty in diagnosis it is emphasised that every tumour removed should be referred for histological examination.

A histopathological series of 45 children with intraocular pseudotumours in Denmark from 1942 to 1966 was studied. The number of eyes examined was 50. The average population was 4.1 million. A clinical and histopathological correlation between these cases and a previously published series of 69 patients with retinoblastomas was undertaken.I n about two-thirds of the total material, the clinical diagnosis was retinoblastoma, and in the remainder a pseudotumour. In the first of these groups, just under half were cases of Coats's disease, which was also the most frequent lesion in the total material. Next in frequency were inflammatory lesions and malformations. Various clinical and histopathological aspects such as sex and age, location, past history, general condition, signs and symptoms are analysed indicative of the benign lesions or the malignant tumour. It is concluded that it is the sum of many parameters and the experience of the clinician which may determine the correct diagnosis, and that it is always wise to enucleate a useless eye. The omnibus item, pseudotumour, should be replaced to the greatest possible extent by a pathogenetical diagnosis.