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• A 31-year-old woman had bilateral retinoblastoma diagnosed in early childhood. The right eye was enucleated at the age of 1 year, and the left eye was treated with radiation therapy (a total dose of 16,000 rad). Twenty-three years later, in 1975, a subcutaneous mass was noted in the left periorbital region. A biopsy specimen of the mass was taken and a diagnosis of pleomorphic postradiation sarcoma was made. Electron microscopic studies of the periorbital mass confirmed the diagnosis of leiomyosarcoma. After additional radiation therapy, the residual mass was surgically excised. Five years later, a right renal mass, which histologically proved to be a renal cell carcinoma, was discovered. She was treated with nephrectomy, radiation, and chemotherapy. A recent follow-up examination disclosed that the patient is alive and apparently without any evidence of metastatic disease, 30 years after the diagnosis of bilateral retinoblastoma was made. The literature is reviewed regarding postradiation sarcomas and the occurrence of second malignant neoplasms in patients with retinoblastoma.

• Occupational eye injuries are common and preventable. Between 1985 and 1991, there were 635 work-related penetrating eye injuries among the 2939 cases (22%) reported to the National Eye Trauma System Registry by 48 collaborating centers in 28 states and Washington, DC. The median age of the injured workers was 30 years; 75% were younger than 40 years; and 97% were male. The commonest causes of injuries were projectiles (457 cases), sharp objects (166 cases), blunt objects (60 cases), and blasts (22 cases); these terms are not mutually exclusive. Specific objects causing injuries included nails, wire, screwdrivers, and other hand tools. There was evidence of alcohol use by at least 2% of the injured workers. When they were injured, 6% of the workers were wearing safety glasses; 3% were wearing nonsafety eyewear. Posterior segment trauma, which occurred in 63% of the cases, included vitreous hemorrhage (42%), intraocular foreign bodies (35%), and retinal detachment (10%). Hyphema occurred in 35% and traumatic cataract in 32% of the cases. Initial visual acuity after injury was hand motion or worse in 43% of the cases. National Eye Trauma System Registry data are useful to identify strategies to prevent occupational eye injuries such as wider use of safety glasses and improvement in engineerina controls.

• The risk of active trachoma in children appears to be higher in association with flies in the environment. However, a measure of fly density that could consistently be related to an increased risk of trachoma is unknown. In a survey of six villages in a hyperendemic area of Tanzania, a comparison was made between the number of flies on the faces (face-fly scores) of children and the number of household flies around the main door-ways (household-fly scores). The risk of trachoma associated with each measure was evaluated after adjusting for the age and sex of the child. A multiple logistic regression model demonstrated that the presence of files on the face was consistently associated with increased risk of trachoma, and that number of flies on the face is a superior predictor in terms of ease of measurement and strength of association than is number of household flies.