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Cavernous sinus thrombosis (CST) rarely causes blindness. It is sometimes difficult to differentiate clinically from a severe orbital cellulitis. We studied a case of CST that evolved from osteomyelitis and orbital cellulitis in a patient who had a rapid loss of vision to the level of no light perception. Detailed clinical and electrophysiologic tests were performed to pinpoint the cause of blindness.

Two mechanisms by which patients compensate for congenital nystagmus are assumption of a head position that places the eyes in a "null zone" of least nystagmus, known as nystagmus compensation syndrome (NCS), and convergence to dampen nystagmus, known as nystagmus blockage syndrome (NBS). We followed five patients in two groups who combine these mechanisms. The first group presented with spontaneous alternation between nystagmus and a head turn with orthotropia (NCS), and a large-angle esotropia with a variable head position that persisted even when patched (NBS). The second group of patients presented with a constant large-angle esotropia that lessened their nystagmus and variable head posture (NBS). Following recession of both medial rectus muscles with or without placement of posterior fixation sutures, they developed an abnormal head posture with orthotropia (NCS). The presence of mild amblyopia may contribute to the alternation between the two compensatory mechanisms.

When operating on bilateral pediatric cataracts, surgeons have performed retinoscopy and contact-lens fitting for the second eye during a third anesthesia or in the office. We evaluated the concordance between eyes for retinoscopy, intraocular pressure, corneal diameter, and base curve in 13 cases. The correlation coefficient was significant (P less than .01), which justifies ordering contact lenses for both eyes after an evaluation of the first eye. Bilateral contact lenses will hasten the treatment or prevention of amblyopia and usually will eliminate the need for a third anesthesia.