Acute myocardial infarction after fluorescein angiography.

A 68-year-old man with a history of previous myocardial infarction and peripheral vascular disease had an acute myocardial infarction 30 minutes after the injection of intravenous fluorescein for fundus angiography. The situational stress or phenylephrine dilating drops could have contributed to the complication.

Direct and indirect ophthalmoscopy for a more accurate baseline evaluation in aircrew members.

The currently required Federal Aviation Agency visual evaluation for commercial and airline pilots often does not detect quiescent retinal disease, unless there is a specific history or a current change in visual acuity which dictates the need for a dilated ophthalmoscopic evaluation. Statistics indicate that there may be a significant number of undetected retinal changes which can cause sudden and irreversible alterations in visual acuity during an airman's career. The requirements for an ophthalmoscopic examination should include, at the time of entry as an aircrew member into the aviation industry, a dilated fundus examination by the binocular indirect and direct ophthalmoscopic methods. In addition, documentary photography, visual fields, and other specific studies as indicated for these patients would be accomplished. These studies should be required by both the Federal Aviation Agency and the military services just as baseline ECG's chest films, SMA 12, and other laboratory studies are utilized.