The levels of total protein in tears from healthy donors, conjunctivitis vernalis patients, and conjunctivitis follicularis patients, were 625, 1370 and 1160 mg% respectively. Serum albumin accounted for 3.3%, 43% and 67% of the total protein of tears from these groups, and the level of proteins probably synthesized by the lacrimal gland, was in tears from conjunctivitis follicularis patients only half the level in normal tears. By crossed immunoelectrophoresis with intermediate gel, 10 antigenic species could be recognized in normal tears, and of these the following were identified: Lysozyme, IgA, lactoferrin and serum albumin. In tears from patients with conjunctivitis vernalis three more immunoprecipitates were observed, of which one was due to IgG. No lysozyme could be demonstrated in tears from a case of conjunctivitis sicca by immunoelectrophoresis. In tears from healthy donors the mean level of IgA was 20 mg%, of IgG 3 mg%, and IgM could not be demonstrated. Rabbit anti-tear immunoglobulin did not precipitate a standard of human IgM in double immunodiffusion. In cases of conjunctivitis vernalis and follicularis the mean levels were increased to 80 and 114 mg% IgG, and 11 and 14 mg% IgM, but IgA was increased only to 32 and 41 mg%. It is assumed that the level of IgA in normal tears is almost entirely due to local synthesis, while serum albumin and other immunoglobulins may have escaped from the circulation by molecular sieving. The increased levels of immunoglobulins in inflammatory diseases is probably due to transudation. However, in blepharoconjunctivitis patients several tear samples with a high IgM and a low or zero level of IgG could be demonstrated. Possible explanations for this phenomenon are discussed.

Background: It has been established that lack of circumcision increases the risk of urinary tract infection in infants. During the first six months, the presence of foreskin is associated with a greater quantity and a higher concentration of uropathogens in the periurethral area. Very

We report a case of endogenous endophthalmitis due to a sporodochial-forming species of Phialemonium curvatum. The infection led to the enucleation of the affected eye, but there was no evidence of systemic dissemination. The isolated P. curvatum produced aggregates of phialides, many occurring on coils or in verticils, which eventually develop into sporodochia. The initial and post-enucleation isolates revealed they were identical to strains of P. curvatum from Israel causing disseminated disease in patients practicing intracavernous autoinjections for the treatment of erectile dysfunction. The reported case had unusual clinical and microbiological features. Despite the route of acquisition and the lack of systemic antifungal therapy, the infection did not spread beyond the eye. The morphology of the phialides aggregates was also unique, and the distinction between Volutella and Acremonium is discussed. This case expands the spectrum of infections due to Phialemonium species, and reveals a novel way of developing fungal endophthalmitis.

Tears and sera of 53 patients of vernal conjunctivitis were examined for antibodies of the IgE type to a panel of 18 allergens. In 18 of the patients (34.0%) allergen-specific IgE was demonstrated in both tears and serum, in 3 (5.7%) in tears only, and in 4 (7.5%) in serum only. The antigen-specific reactions with tear fluid were found in patients with the highest total IgE levels, not only in tears but also in serum. This is evidence for a specific, local allergic reaction in these patients. Most positive reactions were to perennial allergens, particularly house dust mites, cat epithelium and Bermuda grass. This fact is in harmony with the lack of season-linked symptoms in most patients in this geographical area.