Mardi Gras eye injury survey, 1998-1999.

BACKGROUND: We studied the nature of associated ocular trauma during the 1998 and 1999 New Orleans parade seasons and whether trends were observable from previous surveys. METHODS: A prospective survey and retrospective analysis included 18 emergency rooms (ERs) in the New Orleans area. RESULTS: Sixteen surveys representing eight ERs were completed between February 19 and 24, 1998, and 32 surveys representing five ERs were completed between February 5 and 17, 1999. In both years, the most common ocular complaints were pain, blur, foreign body sensation, tearing, and photophobia. The most common slit lamp findings in 1998 were within normal limits, corneal abrasion, and conjunctival hyperemia. In 1999, the most common findings were subconjunctival hemorrhage, corneal abrasion, cell and flare, and lid laceration. CONCLUSIONS: Projectile injuries of the eyes are common during Mardi Gras due to the nature of interaction between paradegoers and float riders. We found no identifiable trend in the number or type of injuries reported in 1986, 1987, and 1998 Mardi Gras surveys.

Exophthalmometry: a comparative study of the Naugle and Hertel instruments.

Exophthalmometry is frequently used as a tool in the evaluation of proptosis. The purpose of this study was to compare the clinical usefulness of the newly developed Naugle superior and inferior orbital rim-based exophthalmometer with that of the Hertel exophthalmometer, as well as to obtain normal values and analysis of possible race and sex differences. In the first part of this study, we measured 135 patients in a double-blind study in order to evaluate the repeatability of serial measurements using each instrument. Comfort was also evaluated in this series of patients. In the second part, a single observer measured 205 patients in order to obtain information for a multifaceted analysis. In the first part of the study, we found the Hertel measurement to be more variable in terms of coefficients of variation. We further found the Hertel base measurements to vary more between observers than those of the Naugle instrument. In the second part, we found that the mean values of globe position were not statistically different (mean Naugle, 17.23; mean Hertel, 18.61; p = 0.909). A significant difference was noted between black and white patients when using the Naugle instrument. A difference between white and black women was noted with the Hertel instrument. The results of this analysis strongly suggest that the values obtained from the Naugle exophthalmometer are more repeatable in serial measurements compared with the Hertel values. However, single measurements of globe position from all patients were statistically similar. We conclude that the Naugle instrument is comparable in accuracy to the Hertel instrument for measuring ocular position, as well as being more comfortable for the patient. The Naugle instrument has the advantage of measuring hyperophthalmos and hypoophthalmos with a vertical gradient scale.

Management of large filtering blebs with the argon laser.

Complications attributable to large conjunctival blebs after glaucoma filtering surgery range from annoying foreign-body sensation to devastating endophthalmitis. We used the argon laser to shrink large complicated blebs in four eyes of four patients who had previously undergone glaucoma filtering surgery. The eye is first anesthetized with a topical agent. The bleb surface is lightly abraded with a sterile cotton swab and then "painted" with a tissue-staining dye. Diffuse laser burns applied over the surface resulted in sufficient shrinkage to allow resolution of the respective symptoms or secondary complications in all four cases. The first two patients developed small leaks that we attribute to delivering laser burns to extremely thin areas of conjunctiva. In both cases the leaks gradually sealed over several weeks. None of the eyes developed increases in intraocular pressure or anterior segment inflammation. In each case, filtering capability was maintained.

Unscheduled DNA synthesis in cultured ataxia telangiectasia fibroblast-like cells.

The capacity of cultured fibroblast-like cells from 5 ataxia telangiectasia (AT) patients to repair gamma-ray-induced damage formed in DNA under aerobic conditions was measured by unscheduled DNA synthesis (UDS). The AT cultures exhibited generally reduced UDS compared to the normal cultures for gamma-ray doses of 4--12 kR. Reduced UDS in the AT cultures was observed for repair-incubation periods at which UDS was not saturated (0.5 and 1 h), and for periods characterized by maximal amounts of UDS in both the normal and AT cultures (2 and 4 h). The results suggest a class of lesions repairable in the normal cells by UDS within 1 h may persist in the AT cells for 4 h or longer.