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• A 10% viscous solution of phenylephrine hydrochloride was more effective than a 2.5% aqueous solution of phenylephrine hydrochloride in maintaining mydriasis during extracapsular cataract surgery. The pupil area after nucleus expression was 57% larger with the stronger phenylephrine concentration. The difference in pupil area was greater in darkly pigmented irides (114%) than in moderately pigmented (70%) or lightly pigmented irides (12%). Mean BP elevations following phenylephrine administration were not higher in the group receiving the 10% solution than in the group receiving the 2.5% solution. In darkly pigmented irides, a 10% viscous solution of phenylephrine hydrochloride is more effective than a 2.5% concentration in maintaining mydriasis during cataract surgery.

• A disciform macular lesion in the hyperpigmented eye of a patient with melanosis oculi demonstrated slowly progressive increase in size during eight years. Clinical observation and serial fundus photography indicated increase in anteroposterior thickness of the lesion to 2.0 mm and in greatest diameter from 3.5 to 6.0 mm. Subsequent echography revealed an overall anteroposterior dimension of 3.4 mm and an increase to 5.5 mm in 20 months. Enucleation of the affected eye with the intact extraocular tumor mass and a local tenonectomy demonstrated a choroidal malignant melanoma of the epithelioid cell type with extraocular extension, peripapillary scleral infiltration, focal invasion of the juxtalaminar optic nerve, and tumor cells in the subarachnoid space. This experience emphasizes the importance of echography in the periodic evaluation of small choroidal malignant melanomas to detect growth not apparent by ophthalmoscopy.

This stereotaxic micromanipulator is composed of a baseplate with head stabilization mechanism, a Flieringa ring and support column for fixation of the eye, a three dimensional stereotaxic system, a system for mechanically assisted intraocular micromanipulation, and a collet for a series of interchangeable intraocular tools. Calibrations aid the manipulation of intraocular tools when cloudy or opaque media impair visualization, but visual monitoring of intraocular movements with contact-lens surgical microscopy or indirect ophthalmoscopy is employed whenever possible. This stereotaxic micromanipulator is designed to augment present forms of intraocular surgery and to facilitate the performance of new procedures for the management of posterior segment intraocular disease.

CALENDAR OF EVENTS CONTINUING EDUCATION IN OPHTHALMOLOGY OPHTHALMOLOGY BASIC AND CLINICAL SCIENCE COURSE 1972-1973 1972-1973 Presented by the American Academy of Ophthalmology and Otolaryngology as a continuing education program, the Ophthalmology Basic and Clinical Science Course encompasses the essential core of ophthalmic knowledge in eight sections. Each section contains related aspects of basic and clinical science, considers the material as a closely integrated unit, and includes a self-assessment procedure. This format emphasizes overall concepts, facilitates important correlations, and provides the multiple interrelationships that stimulate learning and retention. As noted hereafter, the sections reflect this organization of basic and clinical science.Designed for achievement in a two- or three-month period, each section consists of (1) a general introduction, (2) the section curriculum, (3) specific and supplementary reading lists, (4) discussion topics, (5) library resource information, (6) selected additional educational material, and (7) a self-assement examination. The latter, to be taken upon

CALENDAR OF EVENTS CONTINUING EDUCATION IN OPHTHALMOLOGY. —BASIC AND CLINICAL SCIENCE COURSE. —The American Academy of Ophthalmology and Otolaryngology announces an expanded program of continuing education, which includes the Ophthalmology Basic and Clinical Science Course. This course presents the essential core of ophthalmic knowledge in eight sections, each section covering related aspects of basic and clinical science as a closely integrated unit that associates fundamental scientific knowledge with patients, disease processes, structures, and symptoms. This format emphasizes overall concepts, facilitates important correlations, and provides the multiple interrelationships that stimulate learning and retention. As noted hereafter, the Sections reflect this organization of basic and clinical science. PART I SECTION 1 BASIC SCIENCE. —Optics Clinical Science.—Physical and physiological optics, visual acuity, refraction, lenses, contact lenses, low vision aids, optical diagnostic instruments, and optical therapeutic instruments SECTION 2 BASIC SCIENCE. —Embryology, anatomy, and genetics CLINICAL SCIENCE. —Congenital and developmental abnormalities SECTION 3 BASIC

CALENDAR OF COMING EVENTS FLORIDA MIDWINTER SEMINAR IN OPHTHALMOLOGY AND OTOLARYNGOLOGY. —The Florida Midwinter Seminar will be held from Feb 1-8, 1970, at the Americana Hotel, Miami Beach, Fla. For information write Secretary-Treasurer: K. S. Whitmer, MD, 550 Brickell Ave, Miami, Fla 33130. WILLS EYE ANNUAL CLINICAL CONFERENCE. —The 22nd Annual Clinical Conference of the Wills Eye Hospital will be held on Feb 5-7, 1970, at the Bellevue Stratford Hotel, Broad and Walnut streets, Philadelphia. The Arthur J. Bedell Lecture will be given by David G. Cogan, MD, Boston. Symposia will be held on "Congenital Motor Anomalies" and on "Ocular and Orbital Trauma" and a workshop on "Macular Disorders— Diagnosis and Treatment." Inquiries should be addressed to Robert D. Mulberger, MD, Chairman, Annual Clinical Conference Committee, Wills Eye Hospital, 1601 Spring Garden St, Philadelphia 19130. STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER, COURSE IN MICROSURGERY.—OPHTHALMIC MICROSURGERY. —An

In the clinicopathologic analysis of seven cases of circumscribed malignant melanoma of the ciliary body, the earliest and most consistent symptom was a progressive decrease in vision, not correctable with lenses and without apparent clinical cause. This symptom was related to refractive aberrations caused by tumor-induced alterations in the noncataractous lens. Mechanisms responsible for these optical effects included localized changes in lens shape, caused by asymmetric zonular tension or by direct compression, and changes in lens position related to decentration or tilting. Other important findings included segmentally prominent episcleral vessels, slight ocular hypotony, and significant changes in the anterior chamber depth.

ITEMS FOR PUBLICATION. —To comply with the publication schedule of the Archives of Ophthalmology, items submitted for this department must be received by the "News and Comment" Editor three months prior to the requested date of publication. CALENDAR OF COMING EVENTS COURSES AND MEETINGS UNIVERSITY OF CALIFORNIA SAN FRANCISCO SCHOOL OF MEDICINE TO HOLD POSTGRADUATE PROGRAM ON PEDIATRIC OPHTHALMOLOGY. —The University of California San Francisco Medical Center will conduct a symposium on Pediatric Ophthalmology Feb 9-11, 1967. Registration fee is $65.00. Conference Chairmen: Michael J. Hogan, MD, professor and chairman, Department of Ophthalmology, University of California School of Medicine, San Francisco and Earl L. Stern, MD, assistant clinical professor of ophthalmology, University of California School of Medicine, San Francisco; Chief, Elks' Children's Eye Clinic. WILLS EYE HOSPITAL TO HOLD 19TH ANNUAL CLINICAL CONFERENCE. —The 19th Annual Clinical Conference of the Wills Eye Hospital will be held Feb 9-11, 1967, at

ITEMS FOR PUBLICATION. —To comply with the publication schedule of the Archives of Ophthalmology, items submitted for this department must be received by the "News and Comment" Editor three months prior to the requested date of publication. CALENDAR OF COMING EVENTS COURSES AND MEETINGS ASSOCIATION FOR RESEARCH IN OPHTHALMOLOGY WESTERN SECTION MEETING. —The 1966 meeting of the Western Section of the Association for Research in Ophthalmology will be held at the Bayshore Inn, Vancouver, BC, Sept 15-17, 1966. In conjunction with this meeting there will be a symposium on "Recent Advances in Ocular Therapeutics and Toxicology." Chairman for this symposium is Dr. Stephen Drance. Chairman of the Vancouver, BC meeting is Dr. A.J. Elliot. Information regarding accommodations at the Bayshore Inn and reservation forms will be mailed to all members prior to the meeting, along with additional details of the symposium. WAYNE STATE UNIVERSITY TO CONDUCT POSTGRADUATE COURSE IN OPHTHALMOLOGY.

ITEMS FOR PUBLICATION. —To comply with the publication schedule of the Archives of Ophthalmology, items submitted for this department must be received by the "News and Comment" Editor three months prior to the requested date of publication. CALENDAR OF COMING EVENTS COURSES AND MEETINGS STATE UNIVERSITY OF NEW YORK, UPSTATE MEDICAL CENTER, ANNUAL POSTGRADUATE COURSE IN OPHTHALMOLOGY. —The Department of Ophthalmology, State University of New York, Upstate Medical Center, Syracuse, NY, will present its 16th Annual Postgraduate Course in Ophthalmology at the Hotel Syracuse, Dec 3-4, 1965. The following lecturers will participate: Dr. Goodwin M. Breinin, Dr. Robert M. Ellsworth, and Dr. John M. McLean, NY. Tuition fee is $30.00, payable to the State University of New York, Upstate Medical Center, 766 Irving Avenue, Syracuse, NY 13210. This fee includes luncheon for both days and dinner on Friday night, Dec 3. The course is limited to 70 members. These will

CALENDAR OF COMING EVENTS CALENDAR OF COMING EVENTS—CONTINUED ROBERT S. JAMPEL, MD, APPOINTED CHAIRMAN OF OPHTHALMOLOGY. —Dr. Robert S. Jampel of the Institute of Ophthalmology at Columbia Presbyterian Medical Center has been named Chairman of the Department of Ophthalmology at the Wayne State University School of Medicine and Director of the Kresge Eye Institute of Wayne State University, it was announced by Dr. Ernest Gardner, Dean of the Wayne State University School of Medicine. Dr. Jampel succeeds Albert D. Ruedemann, Sr., MD, who retired after 21 years as Wayne State University Chairman of Ophthalmology. CLINICAL OPHTHALMOLOGY FELLOWSHIP. —Georgetown University Hospital is offering a one-year postresidency at fourth year level, featuring clinical investigations, pathology, and teaching. A two-year MSc degree program is also available. Stipends are $8, 000 and $9,000 respectively, plus dependency allowances. Write to Program Director, Division of Ophthalmology, 3800 Reservoir Rd NW, Washington, DC 20007. COL ROLAND

It has long been known that the eye is often involved in leukemia and allied disorders. In some reported series clinical observations have been corroborated by biopsy, generally of lids or conjunctiva, and less commonly the globe has been examined. By and large, the exact nature, the extent, and the sites of involvement of the eye by the various reticuloendothelial neoplastic processes remain to be defined.Intraocular leukemic disease has been noted as a discrete tumor mass by Wiener,1 McGavic,2,3 Reese,4 and others; specific consideration has been given to fundus changes associated with leukemia by Borgeson and Wagener,5 Goldstein and Wexler,6 Gibson,7 and Dawson.8 Involvement of the orbit and adnexa has been well documented,2,3,9-11 and conjunctival disease has been recorded in many detailed reports.12,13,14-16Within the past 2 years we have had the opportunity to examine the globes of 76 patients

Electrocoagulation is widely used in glaucoma operations, such as cyclodiathermy, and in the surgical treatment of retinal degeneration, cysts, tears, and detachment. The success of these surgical procedures is dependent upon electrocoagulation for the production of a controlled tissue insult which serves as the stimulus for a restricted inflammatory response.Retinal disease is treated by formation of an inflammatory adhesion between the sensory retina and the external tissues of the eye. This adhesion must be firm enough to resist vitreous traction and uniform enough to produce a water-tight seal. Deficient electrocoagulation yields an inadequate adhesion and excessive cautery can produce widespread scleral, choroidal, and retinal necrosis, cause an extensive choroidal exudation, or result in vitreous shrinkage.1 Despite the importance of precise, quantitative control of electrocautery, its use is regulated by the gross appearance of the treated surface and the general features of clinical experience.Studies of basic aspects of

The relative inaccessibility of the ciliary body to clinical examination explains in large part why the anatomical and pathological features of this region of the eye have remained comparatively unexplored. Only in recent years has it become urgent because of improved techniques in ophthalmoscopy to make a careful study of this portion of the eye in both health and disease.Among the most common lesions affecting the posterior ciliary body are cysts of the pars plana. Such lesions are now, and will continue to be important in differential diagnosis. Since Kuhnt12 described ciliary body cysts in 1881, numerous reports have appeared describing 2 major groups of cystic lesions: those occurring the pars plana retinae and those occurring in the ciliary processes.The "pars ciliaris retinae" is described by Wolf22 as the forward continuation of the outer pigmented epithelium and inner nonpigmented retinal layers, extending from the ora serrata

No feature of hereditary ochronosis is more prominent than the pigmentation that occurs in the eye. Nonetheless, the pathology of affected eyes has received only slight attention. A review of the literature revealed only a single report11 describing the gross examination of an enucleated ochronotic globe, 2 recorded biopsies of involved conjunctiva and cornea,18,20 and 1 account of the histological examination of an ochronotic globe.19This report describes the findings of hereditary ochronosis, including gross and microscopic features of the eyes, in an 83-year-old man, who died of myocardial infarction. The ochronotic lesions demonstrate the destructive features of the disease and emphasize the diverse and widespread pigment deposition. REPORT OF CASE An 83-year-old retired architect entered the University of California Medical Center for evaluation of abdominal pains and nausea of 6 months' duration.For most of his life this patient had noted that his urine was yellow

Meibomian gland tumors have been the subject of an uncommon degree of controversy concerning the question of their actual existence, the types of neoplasm that may develop, and the degree of malignancy that they may possess. Much of this controversy stemmed from the rarity of these tumors, which led to opinions on histology and clinical behavior based on single cases or very small series. Generalizations on incidence, classification, and malignancy have been of necessity based on compilations of previous reports, with the inherent limitations of this technique.In spite of, or perhaps because of, the diversity of thought surrounding Meibomian tumors, numerous reports appeared in the medical literature following the original description of a Meibomian tumor by Baldauf1 in 1870. Various authors considered all Meibomian tumors as adenomas,2 while others stressed their malignant nature.3 The existence of both adenomas and carcinomas was suggested by significant differences in

The relationship between enclosed or partially-enclosed ora bays and retinal tears was studied in 1,000 consecutive autopsy eyes. Enclosed ora bay was present in 4.0% and partially-enclosed ora bay in 0.6% of eyes. Retinal tear was associated with 16.7% of either type of ora bay, and occurred posterior to and meridionally aligned with such bays. All such tears occurred at the posterior border of the vitreous base and were a consequence of posterior vitreous detachment. Retinal tears associated with enclosed or partially-enclosed ora bays were present in 0.5% of the 1,000 eyes examined.

THE SECTION on Ophthalmology, initially combined with otology and laryngology, was established in 1878 and held its first scientific assembly the following year.1 Meeting virtually annually thereafter, the Section has convened under a total of 86 previous chairmen, ranging chronologically from Herman Knapp, MD, the first chairman, to A. Edward Maumenee, MD, the most recent.In the planning and conduct of the Section meetings, each elected presiding officer has undoubtedly had most adequate cooperation from the officers and members. I am confident, however, that none could have exceeded my good fortune in the privilege of association with Robison D. Harley, MD, Vice-Chairman; Goodwin M. Breinin, MD, and Ronald E. Carr, MD, the Secretary and the Acting Secretary; Harold F. Falls, MD, and George S. Tyner, MD, Section Delegate and Alternate Delegate; and Frederick C. Blodi, MD, Representative to the Scientific Exhibits. To these colleagues and to the membership

Direct extension into the orbital portion of the optic nerve by glioma originating within the cranial cavity has long been recognized as a serious and difficult problem.1,3,5,9,14 Such tumors, as might be expected, originate most commonly from the prechiasmal portions of the optic nerves, from the optic chiasm, and from the neighboring regions of the frontal lobes of the brain. Thus, the diagnosis and management of these lesions usually require the attention of the ophthalmologist, the neurologist, and the neurosurgeon. Some reports in the past decade have indicated the frequency of orbital optic nerve involvement by such lesions and difficulties encountered in diagnosis and treatment.4,5,7,15The case reported here is illustrative of many well recognized clinical features of this condition. It is recorded primarily to illustrate an unusual degree of arachnoidal meningeal proliferation which by clinical symptoms and signs, and appearance at surgical operation, closely resembled tumor invasion

Astrocytomas are among the rarest of the neoplasms which occur within the eye. Except those intraocular tumors which have occurred in association with neurofibromatosis or with tuberous sclerosis, and those optic nerve gliomas which have invaded the optic papilla, there are apparently only four reported cases1,3,10,12 in which previous reporters1,8,10 deemed documentation adequate. There are two additional case reports of intraocular gliomas unassociated with phakomatoses. One of these was considered as derived from Müller's cells13 and one was believed to be oligodendroglioma.8Intraocular extension of primary optic nerve gliomas has been described by many observers.2,11,18,20,21 In most instances such tumors have infiltrated only into the optic nerve head but they may also involve the adjacent retina.21The present report of astrocytoma of the optic nerve head was unassociated with neurofibromatosis or tuberous sclerosis. It is recorded in order to illustrate some of the special

INTRODUCTION Benign melanomas (nevi) of the eye, especially those of the choroid, have been of great interest to the ophthalmologist, for he is faced with the problem, often urgent, of distinguishing between such a lesion and malignant melanoma. Such lesions have also been viewed with considerable suspicion because many observers consider them as having significant malignant potential. The purpose of this report is to define the incidence and general nature of benign melanomas of the choroid and ciliary body as determined by investigation of autopsy eye specimens from adults.Previous investigations of benign melanomas of the eye appear either to have been by clinical observation or by examination of accidentally discovered lesions in eyes enucleated for other reasons.Moore9 summarized his clinical observations of several benign choroidal melanomas as follows: "in size they varied from about one half the area of the optic disc to about 4 times its

Of importance in the evaluation of the peripheral fundus is a distinctive and fairly common disease process termed paving-stone degeneration of the retina. In its typical form, this condition is located between the ora serrata and the equator and is characterized by small, discrete, rounded areas of depigmentation and retinal thinning. These lesions are yellow-white in color, frequently reveal prominent underlying choroidal vessels, and often possess a pigmented margin. Occurring singly or in groups, the lesions of paving-stone degeneration not uncommonly become confluent and may even coalesce to form bands.The prominent distinguishing features of this condition undoubtedly contributed to its initial recognition by Donders more than 100 years ago.2 A number of subsequent reports, including a meticulous analysis by Rehsteiner,9 noted the clinical features of paving-stone degeneration and, quite recently, Wolter and Wilson11 and Okun8 recorded pertinent observations on its histopathology.During the past century,