[Visual information and road safety]. / Information visuelle et sécurité routière.

The French authorities have recently decided that an eye-sight examination should be required for the delivery of a driving licence and also at a later date for confirmed drivers. This appeared to be necessary, because the impairment of driver's visual capacity is sometimes the cause, either directly or indirectly, of accidents. The visual information relies on the visual acuity but also on contrast sensitivity, the spatial perception, the color vision, the depth appreciation and the visual recovery after a glare. During twilight and during normal night driving with dipped-beam headlights, the luminance of the roadway is very low and reduces the efficiency of the functions indicated above. Other factors also appear to be unfavorable such as: old age, being tired and unreasonable drinking and use of drugs. The visual information of the drivers depends on the technical equipment of the road and more precisely on the general lighting of the most dangerous spots of heavy traffic roads. In order to reduce both the frequency and gravity of accidents, standards covering the minimal efficiency of each eye function are required, such as the choice of the specifications covering the eye examinations.

[A glaucoma follow-up of 1500 persons over 20 years]. / Le suivi glaucomateux de 1,500 personnes durant 20 ans.

The parameters of glaucoma risk have been compiled and computer processed on 1,571 patients during 20 years at the C.P.E.M.P.N. (Medical Evaluation Center for the Aeronautic Staff) of Paris. The goal of this study is to follow in real time the évolution of these parameters and to determine their physiological variations across time in terms of age and professional categories. An average intra-ocular pressure of 15.1 mmHg as well as hypertonia and glaucoma percentages respectively of 3.88% and 0.6% have been recorded in this study. These results were below the results of other previous surveys due to the greater age range of our study the youngest being 15 years old. There was no significant difference among pilots and non pilots. The optic disc examination was not decisive for diagnostic screening.

[Drug-induced dyschromatopsias]. / Les dyschromatopsies pharmacogènes.

PIP: Drug-induced dyschromatopsias are defined as functional or objective alterations of color sense following drug treatment. Drug induced chromatopsias are characterized by a perception of white surfaces as colored and occur following modifications of normally transparent structures or alterations of the chorioretina or higher centers. Digitalic intoxication is responsible for incorrect perception of yellow or blue; the retinal origin of the disorder is confirmed by electroretinograms and histologic modifications in the photoreceptor synapses. Santonin in doses exceeding 1 cg is associated with various color misperceptions due to injury to a peripheral neuron or problems of rhodopsin formation. Some sulfas and antibiotics may cause misperception of yellow, and the anticonvulsant drug Tridione may cause an almost complete disappearance of some colors. Chromotopsias of central origin due to direct action on cerebral neurons are rare but may follow use of phenacetine or atropine. Drug induced dyschromatopsias are more common and may be the initial symptoms of various kinds of drug intoxication. Various simple and reliable tests enable the practicing clinician to detect such disorders at an early stage. Synthetic antimalarial drugs derived from chloroquine and used in longterm treatment of rheumatism or during antimalarial prophylaxis, indomethacine, and the phenotiazins may cause dyschromatopsias due to retinal intoxication. Oral contraceptives diminish the chromatic perception in 20% of cases according to 1 author, and often cause deficits of blue-yellow perception. Disulfiram, certain antibiotics such as chloramphenicol, nystatin, isoniazide, and other drugs may cause dyschromatopsias due to alterations in the optical fibers. Ethambutol is the most harmful to color perception; its effects are usually but not always reversible on discontinuation of the drug. Systematic tests of color perception should be administered prior to and during treatment with any drug known to affect the color sense.^ieng

[Reliability of electrophysiologic examinations for cataract surgery in cases of suspected retinal detachment]. / Fiabilité des examens électrophysiologiques pour la chirurgie de la cataracte en cas de suspicion de décollement rétinien.

Justification for cataract surgery obviously depends on retinal efficiency. The study of light projections makes it sometimes possible to suspect a retinal detachment. We are, therefore, trying to check for retinal detachment by means of the various exploration processes now available. Results of echography, electroretinography, electro-oculography, and visual evoked potentials are discussed according to the exper-ence gained.