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Aims There is increasing evidence that pseudoexfoliation (PXF) not only affects ocular anterior segment structures, but may also be a systemic disease. This study was undertaken to assess the relationship between PXF and sensorineural hearing loss. Methods Patients with PXF were identified from hospital records and underwent complete ocular examination. The sum of pure-tone hearing thresholds measured at 1, 2 and 3 kHz (HTL 1,2,3 ) in each ear was compared with the ISO 7029 standard sexmatched, median age-associated hearing loss summed over the same frequencies (AAHL 1,2,3 ). The proportion of ears with thresholds higher than the ISO 7029 median AAHL 1,2,3 on the same side as eyes without PXF was compared with the proportion of ears ipsilateral to eyes with PXF but without glaucoma and similarly the proportion of ears on the same side as eyes with PXF and glaucoma. Results In total, 69 patients were studied, of whom 39 were male (56.5%). The mean age of the male patients was 75.8 years, while that of the female group was 75.1 years. All patients had PXF affecting at least one eye. Overall 101 ears (73.7%) had a higher HTL 1,2,3 than the ISO 7029 median AAHL 1,2,3 which included 56 ears of 78 in the male group (71.8%) and 45 ears of 59 in the female group (76.3%). There was no significant difference between the proportion of ears with HTL 1,2,3 higher than the ISO 7029 median AAHL 1,2,3 on the same side as eyes without PXF, with PXF but not glaucoma and with PXF and glaucoma, in either the male or female groups. Conclusions A large proportion of patients with PXF have sensorineural hearing loss in comparison to age-matched controls, regardless of whether or not there is associated glaucoma. This finding supports the theory that PXF may be a systemic condition.Eye (2002) 16, 261-266.

Aims-An anatomical study was undertaken to determine the extraneural blood supply to the intracranial oculomotor nerve.Methods-Human tissue blocks containing brainstem, cranial nerves II-VI, body of sphenoid, and associated cavernous sinuses were obtained, injected with contrast material, and dissected using a stereoscopic microscope. Results Gibo,7 noted that the proximal intracranial oculomotor nerve can be penetrated by branches of brainstem arteries. These penetrating arteries can also supply nutrient arterioles to the nerves they penetrate.The present anatomical study was undertaken to demonstrate the extraneural blood supply to the intracranial oculomotor nerve. We wanted to clarify the anatomical details using information from earlier studiesl-8 1012 and our own dissection findings (Fig 1). We also examined the relation between the blood supply to the intracavernous section of the oculomotor nerve and that to the pituitary gland. Materials and methodsSix tissue blocks containing midbrain, pons, cerebellum, cranial nerves II-VI, basilar artery (and branches), body of sphenoid with associated pituitary gland, and cavernous sinuses were removed from postmortem subjects and immediately fixed in a solution of 1O% formalin. To facilitate identification of vessels supplying the intracranial oculomotor nerve and other structures, the basilar and internal carotid arteries were injected with India ink before dissection. The specimens were dis-

Aims-The study was designed to investigate the bacterial flora of the operating field during routine cataract surgery and the source of intraocular lens contamination during the surgery. Methods-The normal flora of the external eye and fornices of 17 patients undergoing selective cataract surgery was determined preoperatively. Swabs taken from the eyelid surface and lashes showed coagulase negative staphylococci (CNS) Material and methods Seventeen patients, nine male and eight female and without an active infectious disease, were entered into the study. Their ages ranged from 22 to 82 (mean 75) years. Preoperatively, three cotton wool swabs moistened in sterile saline were used to sample the skin of the upper lid, the base of the lashes, and the lower fomix of each patient. This was performed in the ward.Ocular preparation in theatre included cleaning of eyelids and lashes with chlorhexidine acetate BP 0.02%, 1/5000 dilution.Lashes were not cut and no prophylactic topical or systemic antibiotics were used. Patients were draped with disposable 3M perforated ophthalmic sheet 1064, and an adhesive barrier (3M steridrape 2035) was used to keep the lashes away from the field of the surgery.Thirty four sterile PMMA IOLs were used in the operating theatre (none of the IOLs were irrigated before use). After draping each patient, the upper lid was pulled up and a sterile IOL was touched onto the upper bulbar conjunctiva using a sterile forceps (total 17). It was then placed in a sterile container and immediately transported to the laboratory.Peroperatively, a control lens was placed on the drape within 2-4 cm of the edge of the steridrape (total 17). It was left in this position for the duration of surgery, 20 to 40 (mean 30 minutes). It was then placed in a sterile container and immediately sent to the laboratory.Two settle plates, one containing Columbia agar with 7% horse blood and the other containing Lab M fastidious anaerobic agar with 7% horse blood and nalidixic acid, were exposed in the operating theatre in each instance to monitor airborne contamination.Swabs and IOLs were cultured without delay, onto Columbia blood agar plates containing 7% horse blood, and onto Lab M fastidious anaerobic agar plates (FAA) containing 7% horse blood and nalidixic acid as a selective agent. Lenses were then dropped into cooked meat medium which was incubated at 370C.