ABSTRACT
One hundred and eighty-four cases of malignant melanoma of the lids and epibulbar region were seen in the Radiotherapy Department of the Royal Marsden Hospital during the period 1943-74. Some of these tumours were radiosensitive and could thus be treated by radiotherapy without loss of the affected eye. Their clinical and histological features are described. The treatment policy adopted was based on radiotherapy first, and surgery reserved for the failures. A policy of observation is advised for precancerous melanosis, and active treatment should be undertaken only if malignancy supervenes. The contraindications for radiotherapy, the factors governing radiosensitivity, and the incidence and site of metastases are reported, and the possible effect on the metastatic and survival rates of leaving the eye are discussed. Active treatment of the node-free neck is not advised. Results are given according to site, histology, and treatment method, and the frequency with which the eye was lost is shown, since the sole advantage of radiotherapy over surgery is the possibility of saving the eye without worsening the prognosis for survival.
Subject(s)
Conjunctival Neoplasms/radiotherapy , Eyelid Neoplasms/radiotherapy , Melanoma/radiotherapy , Precancerous Conditions/radiotherapy , Adult , Aged , Conjunctival Neoplasms/surgery , Female , Humans , Male , Melanoma/surgery , Melanosis/radiotherapy , Middle Aged , Precancerous Conditions/surgery , PrognosisABSTRACT
In sixth nerve palsy the role of a muscle-transposing procedure, as compared with a recession-resection procedure, is discussed, and reference is made to the special problems when the palsy is the result of hydrocephalus with frequently an associated A phenomenon. In Duane's retraction syndrome, surgical treatment should be limited as a general rule to a restoration of binocular function in the primary position with elimination of the compensatory head posture, because of an understanding of the underlying anomaly of innervation.
Subject(s)
Abducens Nerve , Ophthalmoplegia/surgery , Strabismus/surgery , Duane Retraction Syndrome/surgery , Esotropia/etiology , Esotropia/surgery , Humans , Hydrocephalus/complications , Methods , Oculomotor Muscles/surgery , Ophthalmoplegia/etiology , Strabismus/etiologyABSTRACT
A retrospective study was made of 30 children with Leber's amaurosis (congenital retinal blindness). 24 presented with severe visual impairment, typical ophalmological findings, and absent electroretinograms. 6 other children, though presenting with marked visual loss and absent electroetinograms were later shown to be less severely affected. Some of the more severely affected children had associated neurodevelopmental or renal abnormalities.
