Binocular vision after lens implantation.

Orthoptic tests for binocular vision were performed on 107 patients with intraocular lenses 3 to 10 months after surgery. The tests carried out were: cover test, Worth-test, Lang's two-pencil-test, the TNO-test and Lang's stereo-test. The implanted lenses were of the four-loop Binkhorst type. They were all implanted after planned extracapsular surgery. Visual acuity 3 to 10 months after operation was 0.5 or more in 95% of the patients (0.8 or more in 53% of the patients). Refraction in spheric equivalents was -0.7 +/- 1.26 diopters. The calculated optical aniseikonia was 2.2% +/- 1.8%. Orthotropia as disclosed by the unilateral cover-test prevailed in 81% of the patients. Most of the patients were exotrop (14 patients for the near, 6 patients for the near and the far). The results of Lang's two-pencil-test were positive in 89%. The Worth-test (polarized, for distance) showed suppression in 23% of the patients. The random-dot-test (TNO-test) showed positive results in 68% (retinal disparities 1980 arc seconds or less), in 57% (480 arc seconds or less), and the new Lang stereotest in 58% (1200 arc seconds or less) of the patients.

[Centrally caused achromatopsia]. / Zentral bedingte Achromatopsie.

A 65-year-old patient sustained a transient left-sided sensomotoric monoparesis with homonymous hemianopsia. One day later there was an acute deterioration in the patient's vision and he developed achromatopsia, prosopagnosia, disturbance of spatial orientation and a homonymous upper hemianopsia. Six months later the findings are about the same. The CT shows a bioccipital lesion with left-sided accentuation, extending dorsocaudally. The origin of the cerebral infarct is presumably a vertebrobasilar insufficiency due to congestive cardiomyopathy and atrial fibrillation.

[Non-Hodgkin lymphoma with infiltration of the optic nerve (author's transl)]. / Infiltrative Optikusneuropathie bei Non-Hodgkin-Lymphom.

Infiltration of the optic nerve is very rarely found in any form of malignant lymphoma. We report on a 24-year-old male patient suffering from non-Hodgkin lymphoma of the stomach. While recovering after treatment of the primary tumor by chemotherapy he developed papilledema in both eyes and almost total loss of vision. Radiotherapy resulted in restitution of vision within a few days. Later there was a transient acute detachment of pigment epithelium. Malignant cells in the CSF could not be detected until three months after the onset of ophthalmological symptoms. Histopathological sections revealed meningeosis sarcomatosa with infiltrations into the optic chiasm, tracts and nerves.

[A simple ERG-EOG apparatus for clinical use (author's transl)]. / Eine einfache Apparatur zur Abteilung und Registrierung von ERG und EOG in der Klinik.

This paper describes the concept and construction of an ERG-EOG apparatus which satisfies the requirements of clinical routine and which is realizable at a reasonable cost. The instrument comprises a ganzfeld stimulator (Ulbricht sphere), with a filter bank holding up to six filters, a flash lamp, and small stimulus lamps for the EOG. The responses are recorded binocularly. The electronic components are commercially available (high quality industrial electronics). The ERG may be recorded with the patient sitting or supine.

[Fisher syndrome]. / Das Fisher Syndrom.

In 1956, Fisher described a variant of Guillain-Barré syndrome characterized by ophthalmoplegia, ataxia and areflexia. There is spontaneous remission within several weeks or months. Etiology and pathogenesis are not yet clear. A lesion in the brain stem or of peripheral neurons, or a combination of central and peripheral lesions are considered possible causes. A case history is presented as an example of this rare syndrome.

[The function of the retina in malattia leventinese (dominant drusen) (author's transl)]. / Die Netzhautfunktion bei Malattia leventinese (dominant drusen).

Malattia leventinese was studied clinically and by electroretinography in 27 members of an affected family and in two additional cases. Typical changes in the central fundus consist of agglomerations of drusen, varying in size, number and localization. These distinct ophthalmoscopic changes occur in young adults, but characteristically remain asymptomatic for one to five decades. Then, metamorphopsia and diffuse color vision deficiency introduce a rapid decay in visual acuity. These changes in function are observed in parallel with large fields of confluent drusen, atrophy of the pigment epithelium and of the retina and with patchy pigmentations in the central fundus. The electroretinogram (ERG) of the subjects with drusen revealed "low normal" amplitudes of the b-waves of both, the cone- and rod system. These ERG-data suggest discrete but widespread functional abnormalities in the outer and middle layers of the retina well before the onset of the clinical symptomatology. In contrast, subnormal ERGs (b-wave amplitudes below 2 standard deviations of normal controls) were recorded in the advance cases, and reflected the severity of functional and structural changes.