THE discovery that retrolental fibroplasia was a cause of blindness in premature infants (Terry, 1942) and of the role of oxygen in the causation of the disease (Ashton, Ward, and Serpell, 1953) has led to regular examination of the eyes of premature babies. In the search for evidence of this condition, the appearance of the immature fundus has become familiar. The pallor of the retina and disc, the thread-like vessels, and the vitreous haziness seen in the more immature are now well known. Careful examination of the eyes of the newborn is not a new idea, for Seissiger (1929) examined the eyes of 500 infants aged from 1 to 8 days and found, for instance, pupillary membrane remnants in 95 per cent. of them. Despite this, there has been little mention of the persistence of remnants of the hyaloid artery (Brit. med. J., 1960). Brown (1960) gives a good account of the eye of the premature infant, and states that the entire length of the hyaloid artery may be visible in a 28-week baby, while a remnant may be seen posteriorly at 32 weeks, which disappears by 38 weeks. Roper-Hall (1960) found complete hyaloid remnants in ten of eleven babies weighing between 2 and 3 lb. at birth; and remnants were seen in 58 per cent. of 55 weighing between 3 and 4 lb. and in 36-5 per cent. weighing between 4 and 5 lb. Forrester (1960) rarely failed to see remnants in babies of less than 3 lb. but found them uncommon in larger infants. Embryology The eye forms from a hollow protrusion from the anterior primary cerebral vesicle. The distal end of this protrusion enlarges to form the optic vesicle, the remainder becoming the optic stalk. The ectoderm of the side of the head overlying the optic vesicle becomes thickened and depressed to form the lens. The distal, swollen part of the optic vesicle is invaginated to form the optic cup, with the embryo lens lying in its mouth. While the cup is being formed the ventral wall of the stalk and vesicle is also invaginated to form a cleft, the choroidal fissure, in which the hyaloid artery is developed. This is enclosed, as the fissure closes in from behind forwards, to become the central retinal artery. Within the optic cup the vitreous body develops. This soon becomes very vascular, and is chiefly supplied by the hyaloid artery traversing the centre of the vitreous, lying in the canal of Cloquet. On reaching the back of the lens the artery divides into many branches to form the tunica vasculosa.
Miconazole nitrate (Micatin cream) is a potent antifungal agent. Few side effects have been reported with topical application. We report on 10 patients who exhibited an intolerance to topical use of this drug. Most of the reactions were irritant in nature but in two instances, an allergic contact dermatitis was observed. Patch tests were positive to the cream base.
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