Abstract: DIFFUSE neurofibromatosis in which the eyelids, orbit and surrounding parts are involved, is a well-recognized picture, and a good many examples of it have been fully reported in this country. At different times I have had four cases under my care and the.last one being a good example with, as is usual, several points of interest, it seems worth while to report it in detail, and at the same time to refer, with regard to particular points, to the other three cases.

Abstract: subsequent loss of the eye. The young woman was badly impressed and in a short time developed a sort of fixed idea, that the child, which she was carrying, would have something wrong with its eyes. I heard afterwards from several persons, and from friends of the lady, confirmation of this part of her history: being pregnant, she often expressed apprehensions for the eyes of her future child. In due time she gave birth to a baby who \" had no eyes.\" Under the eyelids, which could be opened well, only \" flesh \" was seen. There were no other deformities. The child died from an acute infection. The same apprehension haunted her during the whole of her second pregnancy, which ended in the birth of the present child. She has had no other children.

Abstract: hole into the sub-retinal space, as it was uninterruptedly doing before the operation was performed. Gonin's operation, therefore, seems to nme to achieve success by excluding \" the hole in the retina, to use the term which we apply to pupillary adhesions, not to \" occlusion.\" In the cured case the position of the retinal hole will correspond with the organized choroidal scar which can be recognized with the ophthalmoscope. It would appear to be necessary to determine as accurately as possible before operating in each case to what part of the choroid the retinal hole will correspond when the sub-retinal fluid flows out, and to puncture with the cautery at this point in the overlying sclerotic; the height of the detachment in the region of the hole will presumably be a factor in determining the spot selected for the puncture; the rather free use of a large cautery would increase the chance of success. A clear apprehension of the modus operandi of Gonin's operation is desirable, and clear thinking may promote further advance in this method of treatment of detachment of retina, which has already achieved so much success. The expression \" sealing the hole \" seems inappropriate and misleading: \" exclusion of the hole \" by ring synechia between retina and choroid is perhaps the phrase which will best convey the state of affairs to the ophthalmic surgeon; in using the term he will not conceive of the annular attachment as merely linear at the extreme margins of the hole; a broader area of the circumference is no doubt adherent to the choroidal scar; the surgeon will not need to be reminded that in the presence of the detachment the direction of the current of fluid is from the intra-ocular to the sub-retinal space.

Abstract: 18. Lindner.-Arch. f. Augenheilk., Vol. LXXVIII, p. 245, 1911; Ibid., Vol. LXXXIV, p. 1, 1913; Klin. Monats. f. Augenheilk., Vol. LXXVII, p. 555, 1926; Zeitschr. f. Augenheilk., Vol. LVII, p. 508, 1926. 19. Aust.-Arch. f. Augenheilk., Vol. CXXIII, p. 93, 1929. 20. Taboriski.-Arch. f. Ophthal., Vol. CXXIV, p. 455, 1930. 21. Bengston.-Amer. Ji. of Ojihthal., p. 637, 1929. 22. Gifford and Lazar.-Arch. of Ophthal., p. 468, October, 1930. 23. von Szily.-Klin. Monats. f. Augenheilk., Vof. XLIX, p. 265, 1911. 2L. Solovieff.-Arch. Institut Pasteur de l'Afrique du Nord, Vol. I, p. 388, 1921. 25. Noguchi.-Jour. Exper. Med., Suppl. No. 2, August, 1928. 26. Finnoff and Thygeson.-Amer. JI. of Oihthal., Vol. XII, p. 651, 1929, and address at Amer. Med. Assoc. Annual Meeting, 1930. 27. Kendall.-Personal communication by Thygeson. 28. Tilden and Tyler.-Science, Vol. LXXI, No. 1833, p. 186, 1930. 29. Olitsky.-Science, p. 263, 1930. 30. Addario.-Revue du Trach., p. 14, January, 1931. 31. Stepanowa and Azarowa.-JI. Microbiol., Vol. VIII, p. 180, 1929 (abst. Arch. of Ophthal., Vol. II, p. 357, 1929.) 32. Weiss.-Personal communication. 33. Lumbroso.-Compte-rendu Acad. Science, Vol. CXC, p. 1026, 1930. 34. Bietti.-Boll. d'Ocul., 9, 10, p. 1170 (abst. Klin. Monats. f. Augenheilk., Vol. LXXXV, p. 734, 1930. 35. Lindner and Rieger.-Zeitschr. f. Augenheilk., Band LXXII, Heft 1/2, p. 116, 1,930. 36. Bengston.-Personal communication by Dr. Proctor. 37. Morax.-Revue du Trach., Vol. VII, p. 2, 1930. 38. BrUckner.-Oftal. Sbornik, Vol. III, p. 1, 1929. 39. Wilson.-Bull. Ofihthal. Soc. of Egypt, p. 36, 1928. 40. Weiss.-Personal communication. 41. Howard.-Personal communication by Dr. Proctor. 42. Olitsky.-Revue du Trach., p. 173, 1930. 43. Lindner.-Arch. f. Obhthal., Vol. CXXII, p. 391, 1929.

Abstract: AT the present time some interest is being taken in cases which present all the symptoms of glaucoma except that of increased tension. In April, 1930, I read a paper (a) dealing with this group of cases, showing that, as far as the tests employed were concerned, there was no difference from glaucoma except that of tension. Prof. F. H. Newman, D.Sc., Professor of Physics in the University College of the South-West, afterwards kindly examined the paper and the charts on which it was founded. He agreed that on the facts as presented to him the deductions were correct. He suggested that a plot of the tension against the size of the optic disc cup be made and that the elasticity of the cup should be investigated. The present paper embodies these results, an enquiry into the origin of the low tension cases, compares the clinical course of the two conditions, and discusses the name to be applied to the condition when it occurs with no rise of intra-ocular tension. The cubic capacity was calculated upon the basis that the transverse diameter of the disc is 1P5 mm., the vertical 1P6 mm. and that a depth of 3 D. equals 1 mm.; the drawings of the discs made in my notes supplying the remaining details. It should be noted that, because of some details being absent, some cases used in the paper (a) had to be rejected, while as many of the cases shown in it as " too advanced for use in charts " as possible were added, as the present paper does not deal with the fields of vision, and they are necessary for a more complete comparison of the clinical course.

Abstract: THERE is probably no subject in the whole of ophthalmology which teems with greater difficulties or has given rise to wider diversity of opinion than the subject of trachoma. Sociological, clinical and aetiological problems alike cry aloud for immediate solution. Opinions and theories without number have been forthcoming but the original problems not only remain but also have become more complicated than ever. Indeed, the difficulties have increased so enormously and the confusion has become so great that at last we are now having to return to the beginning to ask ourselves " What is trachoma ?" To-day, when we compare the definitions of trachoma as given by authorities on the subject, we find that no two agree on all points. This, however, should not confound seekers after truth nor mystify them because experts are, not entirely in accord. It must be remembered and admitted that the essential features of trachoma may become modified to a greater or lesser extent according to the type of patient, his constitution, his social condition, his nationality, the locality in which he lives, the presence of mixed infection, the preponderance of one or more essential coright.

Abstract: been the true explanation in all ? The rapid and early developments in the successful Madras cases may be held to correspond merely with the direct corneal traumatism inflicted in these experiments-scratching and massage. Controls appear to be needed consisting of exactly similar traumatism at an epidemic period, without the use of any epithelial emulsion from diseased eyes, but possibly with the application of emulsions, filtered and unfiltered, taken from healthy eyes.

Abstract: As an ophthalmic and aural surgeon practising in a colliery area, I meet many cases of miners' nystagmus in miners' hospitals, and mnany cases are referred to me by colliery companies and the South Wales Miners' Federation. I feel I have some advantage over some previous investigators, I am both an ophthalmic and an aural surgeon; I have not read any literature which states that the inner ear has previously been investigated in connection with this disease. The following table shows how nystagmus has increased since 1910, and the economic drain it is upon the country

Abstract: I later submitted the specimen to Dr. R. Howard Mole, Pathologist to Birkenhead and Wirral Children's Hospital, etc., who reports as follows:" With regard to section submitted, there is no doubt whatever of its malignancy, and I think the cells are epithelial, of what origin I cannot say. There is abundant evidence of cellular mitosis. There is also some lymphocyte and polymorphonuclear celled infiltration. The tumour is moderately vascular." Thus, apparently, we would be justified in calling this a case of malignancy of the lacrymal gland, notable for its extremely rapid growth of only 40 days up to the inoperable stage shown in the accompanying two photographs.

Abstract: IN his interesting studies concerning xerophthalmia and keratomalacia in China, A. Pillat 12, 13 has called attention to a particular conjunctival pigmentation. He finds this to be one of the most striking symptoms of xerosis, being found with a frequency of about 70 -80 per cent. of the cases. In what concerns the origin of that pigmentation, some authors (Kirkpatrick, Wright) think it to be due to a disturbance in the functions of the liver, and see in it a connection with the icteric state of the conjunctiva, signs of cirrhosis, etc., frequently found in such patients. Opposed to that opinion, Mori and Pillat think that such pigment is melanin accumulated through a mechanism still unknown, as a result of the processes of degeneration going on in a xerophthalmic conjunctiva. In his observations Pillat could not find any notable increase of bilirubinaemia or any liver insufficiency, as verified by the levulose test. We have been interested in this fact because in our limited observations, which we could follow in the Ophthalmological Clinic of Jassy, we had never noticed such particular pigmentation. Pillat mentions not having found this symptom recorded, excepting in such Oriental races as Indians and Chinese. From the literature that we have analysed, only the observations made in Poland by Narog 11 were found to mention it. In one 18

Abstract: paralysis of Papilloedema to dioptres is found, due to of intra-cranial tension. The severe cases are more evidently cases of lead encephalopathy. Explanation given of why soluble lead is available, and why and how it is ingested. Lead is found in the urine. No albumin is found in the urine.)

Abstract: My colleagues will agree witlh mze that in Egypt cataract may be complicated by a great nmany other diseases of the eye. These may affect the globe or the eyelids, but whether thiey be primary or of a cicatricial nature, either may hinder the good progress of the operation or jeopardize a successful issue. It is, therefore, of the greatest importance for the surgeon to be wvell acquainted witli such complications in order that he may be better able to overcome them when they present themselves. After 20 years of careful observation, I have been able to point out to our young Egyptian colleagues the importance of these complications, but at the same time they ouight to be brought to the knowledge even of European surgeons so that, by being better acquainted with tropical ophthalmology, they will not criticize us adversely if we do not follow exactly the ustual technique for cataract extraction. In the first place, it is of interest to compare the frequency of cataract in Egypt with that in other countries, for it might appear that it is a relatively rare condition in Egypt. Abotut a quarter of a century ago, Dr. Osborne, of Alexandria, tried to ascertain the real facts, and in his paper' " Some Characteristic Observations of the Ophtlhalmic Surgeon in Egypt " he compared the statistics of operations performed at the clinique of Duke Charles Theodorel of Bavaria (Munich) with those done at the European Hospital (Alexandria). The figures examined covered the period 18981907X and whilst 3659 per cent. of the operations performed at

Abstract: pupil was dilated a small coloboma of the lens was discovered. There appeared to be a small opacity in the lower part of the lens. The slit-lamp examination with the broad beam showed that the mass had the texture and colour of ordinary uveal tissue, and that there was no vascularization. It merged with the ciliary body without any abrupt edge, and had no irregularity of surface that might be present in a new growth. The vitreous was perfectly normal showing the usual filmns without any trace of infiltration with cells or larger particles. When examined with the narrow beam in optical section, it was seen that the white area seen by focal illumination on the surface of the mass was really a flocculent filamentous deposit on the back of the lens. It extended downwards and was lost in the region of the coloboma. The lens itself, except in the colobomatous area was perfectly clear, and showed the usual sutures and zones of discontinuity. I came to the conclusion that the mass was due to an abnormal development of the ciliary body in the lower sector of the eye, probably a fusion of several processes, and' that there could be no question of sarcomatous growth. Apart from the fact that the lens was obviously implicated in the abnormal picture, the absence of vascularization, the normal aspect of the vitreous, and the normal tension as estimated with the Schiotz tonometer, were evidence against tumour formation. Mrs. D. has now been under observation for six months and no change has taken place in the eye.

Abstract: 6. Iancu, A.-Pigmentation of integuments following administration of irradiated ergosterol per os. Abstract in Cluj. Med., 11, 148, 1930. (Roumanian). 7. Laignel Lavastine.-Pathologie du sympathique. Alcan. 1924, p. 466et seq. 8. L&wenstein -Experimentelle Erzeugung konjunctivaler Pigmenttumoren. XIII Intern. Ophthal. Congr. Abstract in Klin. Monatsbl. f. A ugenheilk., 83, 617, 1929. 9. Lubarsch.-Handbuch der Sp. Pat. Anat. u. Hist., Springer, Berlin, Vol. II, p. 169. 10. Masson.-Diagnostic de laboratoire. II Tumeurs, Maloine, p. 599, 1923. 11. Narog.-Contribution a la pathologie du xerosis conjonctival et cornden et de la keratomala-cie. Arch. d'O_hta1., 45, 25, 1928 12. Pillat, A.-Does Keratomalacia exist in adults ? Arch. of Ofhthal., 2, 256 and 399, 1929. Abstract in Zentralbl f. d. ges. Ophthal., 23, 46, 1929. 13. and King, Gordon.-An inquiry into the origin of the abnormal pigmentation of skin and conjunctiva in cases of keratomalacia in adults. Brit. Jli. of Ophthal., 13, 506, 19S9. 14. Redslob.-Etude sur le pigment de l'epith6lium conjonct. et corn6en. Ann. d'Ocul., 159. In Lubarsch, loc. cit. 15. Steiner.-La pigmentation de l'epith6lium conjonct. et corn6en. Ann. d'Ocul., 160, 137, 1923. 16. van Duyse.-M6lanose de la conjonctive et de la cornbe. Encycl. Fr. d'Ophtal., Vol. Il, p. 373.