SUMMARY We studied 40 patients with a total of 44 retinal arterial macroaneurysms. All

Six double-blind, independently randomized studies evaluated the efficacy and safety of calcium mupirocin ointment in eliminating nasal carriage of Staphylococcus aureus among health care workers. Healthy volunteers with stable nasal carriage of S. aureus (n = 339) received either calcium mupirocin ointment (n = 170) or an identical placebo ointment (n = 169) intranasally for 5 days. Nasal carriage was eliminated 48-96 hours after completion of treatment in 130 (91%) of 143 evaluable volunteers receiving mupirocin but in only 8 (6%) of 142 evaluable volunteers receiving placebo. The 85% crude difference represents a 90% pooled (adjusted) estimate of the risk difference (95% confidence interval, 0.86-0.95) and a risk ratio of 16 (P < .0001). This effect of treatment with mupirocin was observed consistently (risk ratio, 8-32) in all six centers. In addition, 96 of the 130 mupirocin-treated volunteers and 1 of the 8 placebo-treated volunteers who were culture-negative at the end of therapy remained free of S. aureus 4 weeks after treatment. Adverse events in each treatment arm were mild and equally frequent. These data, consistent across six institutions, demonstrate that calcium mupirocin ointment administered intranasally for 5 days is safe and effective in eliminating stable nasal carriage of S. aureus.

London SUMMARYA current review of ophthalmic zoster is presented including its virology, immunology, epidemiology and pathogenesis. We give our findings in 1356 patients referred to the Zoster Clinic at Moorfields Ey e Hospital, London. The treatment of the disease and its ocular com plications is discussed.Ophthalmic herpes zoster is a disease varying in severity from devastating, threatening life and sight, to so mild that it may pass unnoticed. The ophthalmic division of the fifth cranial nerve is affected in 7-17.5% of herpes zoster patients. 1-5 Ocular involvement complicates approxi mately 50% of these cases and very rarely cases of maxil lary herpes zoster,l affecting many of the tissues of the globe and orbit by highly varied types of lesions.

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SUMMARY Seventy-seven new patients suffering from ophthalmic zoster and a selected group of 69 old patients were carefully examined with regard to external ocular movements. An incidence of 31 % of ocular pareses was found in the new patients, and 58 in all were analysed. We were surprised to find several of these were contralateral and bilateral palsies. 28 % of the palsies were asymptomatic, due to diplopia being present only in extremes of gaze and the rapid development of suppression in the affected eye. The theories of aetiology of these pareses are discussed.Herpes zoster ophthalmicus produces widely varying lesions of the eye in 500% of cases (Edgerton, 1945a)

SUMMARY One hundred sterile intraocular lenses were placed on the external eye of 50 patients during cataract surgery. Half of the specimens were cultured for bacteria, the other half were examined under the light microscope after fixing and staining. A bacterial contamination rate of 26% was recorded. This is significantly higher than that found in conjunctival swabs (6%) or irrigation specimens (8%) taken at the same time, and higher than that recorded in a group of control lenses (15-2%) exposed to operating theatre air alone. We propose that intraocular lenses contaminated with viable bacteria may be implanted into the eye and thereby account for some cases of postoperative uveitis in the pseudophakic eye.

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SUMMARY Sixty-three cases of vascularised lipid keratopathy were treated with the argon laser to occlude feeder vessels which had been identified by fluorescein angiography. There was a reduction in extent in 62% and density in 49%. Visual acuity was improved in 48%. Six patients had keratoplasties shortly after treatment, none of which showed graft rejection. Minor complications included temporary haemorrhage into the cornea and iris atrophy. A more serious problem was severe corneal thinning after resorption of lipid. The patients had to be carefully followed up and maintained on a low dose of topical steroid.Most lipid keratopathy is secondary to corneal inflammatory disease and is vascularised. The commonest causes are herpes simplex and herpes zoster disciform keratitis. Treatment involves firstly controlling the primary inflammatory disease and then the lipid deposits. Many attempts have been made to occlude the blood vessels supplying these deposits'-9 in the hope that further lipid deposition can be prevented, some resorption occur, and, in some cases, the host made safer for grafting. More recently the argon laser has been used for this purpose."'-'2 I was pleased with our preliminary results'3 but was struck by the extensive iris atrophy induced.