James Wardrop (1782-1869): from Whitburn to Windsor Castle.

The medical career of a Scottish doctor, James Wardrop, in the 19th century is described. An early interest in the developing science of Pathology in the Royal College of Surgeons of Edinburgh was expanded further when he moved to London, due to financial needs. Despite being outside the London teaching hospital scene, he continued to publish and teach in the private schools of the time. His interest in ophthalmology led him to describe what we now know as retinoblastoma, with recommendation for treatment. He also described sympathetic ophthalmitis and performed paracentesis in acute angle-closure glaucoma. He became surgeon to the Prince of Wales, later King George IV, but his criticism of other medical men at court led to his exclusion from the King at the scene of his death. He owned a notable collection of pictures and presented two of them to the National Gallery of Scotland on its foundation in 1850. In recent years, his work has been recognised by leading ophthalmologists, particularly in the USA. The Library of the Royal College of Surgeons of Edinburgh contains several of his works, and his portrait hangs in the College.

Visual handicap in south-east Scotland.

A study of 288 cases was made of those registered blind and partially sighted patients in Lothian Health Board area. The purpose of this study was to identify the trend of the main cause of visual handicap in a general population. The registration rates were analysed by age, sex and causes. It was found that the leading causes for blindness were age-related macular degeneration (ARMD) (58.8%), chronic open angle glaucoma (COAG) (12.8%), proliferative diabetic retinopathy (PDR) (4.9%), while for partial sight (PS) the main causes were age-related macular degeneration (ARMD) (57.1%), chronic open angle glaucoma (COAG) (8.8%) and congenital (4.7%). For both men and women the incidence rate of blindness remains low until the age of 65, followed by a considerable increase, especially after the age of 75. The male to female ratio for blindness was 1:2.06 and for partial sight 1:2.58.

An audit of the 1995 Royal College of Ophthalmologists guidelines for screening for retinopathy of prematurity applied retrospectively in one regional neonatal intensive care unit.

To test the effectiveness of the 1995 Royal College of Ophthalmologists (RCO) guidelines for screening for retinopathy of prematurity (ROP) in one regional neonatal intensive care unit, an analysis was carried out of screening examination results over a 4 year period, retrospectively applying the rules of the 1995 RCO guidelines. Four hundred and forty-eight examinations would have been performed in 258 infants, significantly fewer than the 764 examinations which had been performed using our existing screening protocol. Threshold ROP developed in 36 infants, and would have been detected promptly in every case. No case of threshold ROP developed in infants of birth weight greater than 1250 g. The 1995 RCO guidelines for ROP screening provide an effective and efficient means of detecting treatable ROP. The need to include infants of birth weight > 1250 g should be reviewed at a future date, following a period of further national data collection.