554 Br J Ophthalmol 2000;84:554–557

ophthalmoscope into the at an angle of 45º “Cyclodiode” or after instillation of 2% pilocarpine eye Br J Ophthalmol: first published as 10.1136/bjo.84.5.554d on 1 May 2000. Downloaded from MAILBOX drops). EDITOR,—I read with considerable interest the We have recently reported a case of persist- paper by Spencer and Vernon1 on the results ent pupillary membrane in both of an 8 of a standard protocol for transscleral diode year old male child.2 The brownish mem- laser cyclophotocoagulation (“cyclodiode”). branes were detected by a school teacher. The The particular importance of this paper with Intraocular implants and risk of child confirmed the presence of poor vision in regard to more widespread use of this endophthalmitis bright sunlight after a precise questionnaire lies in the high percentage (64%) of treated concerning this symptom. The visual acuity in eyes with pretreatment Snellen acuity, and EDITOR,—We would like to comment on the our case under ordinary room illumination while a third of these eyes lost 2 or more lines paper by Bainbridge et al.1 was 20/40 in both eyes. Nevertheless, when of Snellen acuity, it appears this was, in most The aim of their study was to investigate the measured while the light of the indirect cases, not directly attributable to the cyclo- possible association between the use of three ophthalmoscope was shone into his eyes at an diode treatment, with particular note being piece foldable silicone polypropylene intra- angle of 45°, visual acuity was surprisingly made of the low rate of cystoid macula ocular lenses and increased risk of endoph- reduced to 20/100 in both eyes. Similarly, oedema.1 thalmitis, and indeed the investigators have Kumar et al 3 also reported two cases (aged 15 The authors report success rates in achiev- met this goal and proved this association in an and 17 years) of hyperplastic pupillary mem- ing IOP control with a standard protocol, but, elegant study. brane presenting with marked decrease of as in most other published series, record find- In addition, the authors have supplied the visual acuity in bright sunlight. In the latter ings after “repeat as necessary” retreatments reader in their article with very important case, these authors recorded a reduction in (in this study up to five in number). While this information (Table 1) that was not discussed. visual acuity from 20/40 to 20/200 after instil- is of obvious interest to clinicians, it may be of All of the seven cases had a medical history of lation of pilocarpine eye drops or projecting almost equal utility to know the eVect of a sin- one or more systematic diseases that may the indirect ophthalmoscope light at a 30° gle treatment. In an earlier paper, also using a aVect the immunological conditions of the angle. standardised treatment protocol for cyclo- patients and contribute to the development of It is widely accepted that asymptomatic diode treatment,2 an attempt was made to eluci- postoperative endophthalmitis.2 In fact, one cases of PPM usually don’t require excision date any dose-eVect relation from a single patient with plastic anaemia was excluded beyond the sensitive period of .4 cyclodiode treatment session. With a single from the statistical analysis. Nevertheless, some cases presenting with treatment totalling 90 J through 360°, a mean Comparing the patients with endoph- significant visual loss in bright sunlight lowering of IOP of 48% was achieved, but the thalmitis with control subjects in a random required surgical2 or Nd:YAG laser3 interven- predictability of outcomes in this series was fashion, even in small series, may reveal addi- hampered by the high number of neovascular tional risk factors such as medical history. The tion. Besides visual acuity concerns, cosmetic (NVG) cases, which are recognised addition of a controlled group of patients ocular disfigurement caused by PPM may also as having highly variable responses.3 It would undergoing the same who did not be considered as a reason for intervention in seem that Spencer and Vernon are uniquely develop endophthalmitis could add a lot to the some patients. placed—with their standard protocol and low strength of the study. SURESH K PANDEY numbers of NVG cases—to provide data per- We believe that endophthalmitis develops Center for Research on Ocular Therapeutics and when several risk factors are present. We are Biodevices, Storm Eye Institute, MUSC, Charleston, taining to any dose-eVect relation from a obliged to take all these factors into consid- SC-29525, USA single treatment, information which may be used to enhance the predictability of the pro- eration before, during, and after surgical JAGAT RAM cedure for individual patients. procedure, especially in debilitated and im- Department of , Postgraduate Institute of munosuppressed patients. In this kind of and Research, Chandigarh-160012, The authors also note that their cohort was patient prophylactic considerations must be India largely free of cases having had previous cyclodestructive procedures: that is by defini- borne in mind, including adequate prepara- LILIANA WERNER http://bjo.bmj.com/ tion not true, however, of all the retreatment tion of the patient and surgical field, antibiot- Center for Research on Ocular Therapeutics and ics, experienced surgeon, safer instruments, Biodevices cases, and the authors appear not only to have and IOLs. been reasonably forthright in their pursuit of AMOD GUPTA an IOP <22 mm Hg, but appear to have HANNA J GARZOZI Department of Ophthalmology, Postgraduate Institute of applied the same laser dose irrespective of the Afula, Medical Education and Research, India number of retreatments, with their retreat- ALON HARRIS DAVID J APPLE ment plan leaving no untreated quadrant. In Indianapolis, USA Center for Research on Ocular Therapeutics and the series noted above, using a half standard- Biodevices ised single treatment (45 J over 180°) for cases on September 27, 2021 by guest. Protected copyright. Correspondence to: Dr Pandey 1 Bainbridge JWB, Teimory M, Tabandeh H, judged clinically to be at risk of hypotony et al. Intraocular lens implants and risk of (which included cases having had previous endophthalmitis. Br J Ophthalmol 1998;82: cyclodestructive procedures) a mean IOP 1312–15. 1 Malla KS. Pupillary abnormality. Br J Ophthal- reduction of 36% was still achieved.2 It would 2 Montan PG, Koranyi G, Setterquist HE, et al. mol 1999;83:1207. Endophthalmitis after surgery: risk 2 Pandey SK, Ram J, Jain A, et al. Surgical therefore be of great interest to know whether factors relating to techniques and events of the management of complete hyperplastic persist- any cases in Spencer and Vernon’s paper were operation and patient history. A prospective ent pupillary membrane. J Pediatr Ophthalmol excluded from retreatment, despite inad- case control study. Ophthalmology 1998;105: 1999;36:221–3. 2171–7. 3 Kumar H, Sakuja N, Sachdev MS. Hyperplastic equate postoperative IOP control, because of pupillary membrane and laser therapy. Ophthal- a concern about possible hypotony; similarly, mic Surg 1994;25:189–90. it would be useful to know whether “all com- 4 Mader TH, Wergeland FL, Chishmire KJ. ers” were treated in the study period, or Pupillary abnormality Enlarged pupillary membranes. J Pediatr Oph- thalmol Strabismus 1988;25:73–5. whether there were specific exclusions from standardised cyclodiode treatment because of EDITOR,—In a recent issue of the BJO, we had the opportunity to read the interesting case this perceived risk. Reply report on pupillary abnormality, by Malla.1 MARK J WALLAND The author reported a gross persistent - Royal Victorian Eye and Ear Hospital, lary membrane (PPM) in both eyes of a 33 EDITOR,—I have just reviewed the patient with Melbourne 3002, Australia year old Nepalese female. The patient was the bilateral persistent pupillary membrane. asymptomatic and near as well as distant Visual acuity both for distance and near visual acuity were normal. Although the remained unchanged (6/6 partly and N5 in 1 Spencer AF, Vernon SA. “Cyclodiode”: results of author mentioned that the membrane bulged each eye) with constricted by shining a standard protocol. Br J Ophthalmol 1999; 83:311–16. forward into the anterior chamber when the the light of an indirect ophthalmoscope at an ° 2 Walland MJ. Diode laser cyclophotocoagulation: pupil constricted to light, it was not clear if the angle of 45 . The patient has no visual dose-standardized therapy in end-stage glau- patient noticed any decrease in vision with complaints and is unaware of any decrease in coma. Aust NZ J Ophthalmol 1998;26:135–9. bright sunlight and if the author attempted to vision in bright light. 3 Schuman JS, Bellows AR, Shingleton BJ, et al. Contact transscleral Nd:YAG laser cyclophoto- record the visual acuity in simulated condi- K S MALLA coagulation. Mid-term results. Ophthalmology tions (by shining the light of an indirect Ga2-696, Bagh Bazar, Kathmandu 2, Nepal 1992;99:1089–95. Mailbox, Book reviews, Notices 555

Reply Is non-arteritic anterior ischaemic optic thrombotic events or a family history of Br J Ophthalmol: first published as 10.1136/bjo.84.5.554d on 1 May 2000. Downloaded from neuropathy related to homocysteine? thrombosis, or if there is no disc at risk in the EDITOR,—We thank Dr Walland for his fellow eye in a younger patient without vascu- interest in our paper1 and for summarising the EDITOR,—We read with interest the paper lar risk factors, an investigation for hereditary results of his study2 which was published recently published by Kawasaki et al.1 They and acquired thrombophilic markers may be following our paper’s submission. It is diYcult suggested that hyperhomocysteinaemia may justifiable. to quantify the dose-eVect from a single treat- have a role in the occurrence of non-arteritic ment in cyclodiode because (a) it would anterior ischaemic This study was supported in part by a departmental depend on the follow up period as the eVect (NAION) in non-diabetic patients younger grant (department of ophthalmology) from Research may diminish with time, and (b) one would than 50 years, and raised the question of the to Prevent Blindness, Inc, New York, New York, by core grant P30-EY06360 (department of ophthal- have to continue all the prelaser antiglaucoma frequency of the methylene tetrahydrofolate mology) from the National Institute of Health, medications (not always desirable) to see the reductase (MTHFR) C677T mutation in this Bethesda, Maryland. Dr Newman is recipient of true eVect. population. Research to Prevent Blindness Lew R Wasserman However, we can analyse the “single dose There have been anecdotal reports of Merit Awards. eVect allowing for a reduction of medications” thrombotic tendencies in patients with VALÉRIE BIOUSSE from our study by examining the results of NAION.2–4 Although NAION is most prob- Departments of Ophthalmology and , Emory only those eyes which had one treatment ably related to local factors compromising the University School of session (32). This subgroup contained seven posterior ciliary artery circulation at the optic JOHN B KERRISON primary open angle glaucoma, five aphakic, nerve head (so called “disc at risk”), it is also Department of Ophthalmology two pseudophakic, seven uveitic, three possible that some systemic factors such as NANCY J NEWMAN corneal/PK, four rubeotic, one silicone oil, hyperhomocysteinaemia and the MTHFR Departments of Ophthalmology, Neurology, and and three trauma cases, thus representing the C677T mutation may enhance local athero- Neurological Surgery whole spectrum of the cohort treated. Al- genesis at the level of the posterior ciliary Correspondence to: Dr Nancy J Newman, Neuro- though this subgroup, by definition, selects arteries, thereby precipitating the develop- ophthalmology Unit, Emory Eye Center, 1365-B out the “best case scenario”, this was achieved ment of NAION in those at risk for the Clifton Rd, NE Atlanta, GA 30322, USA in over 50% of cases treated. With a mean fol- disease.3–6 Kawasaki et al could not demon- low up of 19 months, the IOP of this subgroup strate any clear relation between hyperhomo- 1 Kawasaki A, Purvin VA, Burgett RA. Hyper- decreased from a mean of 31.2 mm Hg to a cysteinaemia and NAION. However, the homocysteinaemia in young patients with non- mean of 16.2 mm Hg, with a 45% mean per- blood sample used to measure the homo- arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol 1999;83:1287–90. centage reduction. This was associated with a cysteine was obtained years after the clinical 2 Hayreh SS. Acute ischemic disorders of the optic reduction in numbers of patients taking aceta- event. Since homocysteinaemia fluctuates, it is nerve. Pathogenesis, clinical manifestations and zolamide from 88% to 6% and a mean medi- possible that the authors may have underesti- management. Ophthalmol Clin N Am 1996;9: 407–42. cation usage from 2.2 to 1.2. None of these mated the frequency of hyperhomocysteinae- 3 Biousse V. Coagulation disorders and their results diVers significantly from those of the mia. We recently investigated prospectively the neuro-ophthalmologic manifestations. Curr whole cohort. presence of hyperhomocysteinaemia and the Opin Ophthalmol 1999;10:382–93. 4 Salomon O, Huna-Baron R, Kurtz S, et al.Analy- In our study no eyes were denied treatment MTHFR C677T mutation in patients with sis of prothrombotic and vascular risk factors in or retreatment because of a perceived risk of acute NAION. patients with nonarteritic anterior ischemic hypotony, and “all comers” were indeed Blood samples from 14 newly diagnosed optic neuropathy. Ophthalmology 1999;196:739– patients with acute NAION presenting to our 42. treated by this modality if enhanced filtering 5 Lee AG. Prothrombotic and vascular risk factors surgery was considered contraindicated. It centre overa1yearperiod(May1998 to May in nonarteritic anterior ischemic optic neu- may be of interest to know that 71% of the 1999) were evaluated for serum creatinine, ropathy. Ophthalmology 1999;12:2231. cases were referred into our service from other serum and red blood cell folate, B12, and total 6 Ischemic Optic Neuropathy Decompression Trial Research Group. Characteristics of pa- consultants throughout our region (popula- plasma homocysteine levels, as well as the tients with nonarteritic ischemic optic neu- tion approximately six million). We cannot C677T polymorphism in the MTFHR gene. ropathy eligible for the Ischemic Optic Neu- state that all eligible cases were treated by us, There were 10 men and four women (13 white ropathy Decompression Trial. Arch Ophthalmol http://bjo.bmj.com/ but we believe our cohort is likely to be and one Asian), ranging in age from 28 to 68 1996;114:1366–74. representative of cases referred to other years (mean aged 42.8 years). All patients had glaucoma specialists with a similar population a disc at risk in the fellow eye. Five patients Reply to that found in the East Midlands of subsequently suVered NAION in their second England. eye. Four patients (28.5%) were heterozygous EDITOR,—We thank Biousse and colleagues We note that, in Walland’s study, the mean and one was homozygous for the C677T for their comments on our article and their post-laser IOP at a mean of 10.4 months was mutation in the MTHFR gene, which does corroborative study. We agree that an exten- not di er from the frequency reported in the 25.8 mm Hg with only 55% <22 mm Hg even V sive hypercoagulable evaluation is not war- on September 27, 2021 by guest. Protected copyright. 3 when a “full” treatment of 90 J was delivered. general population. Only one of these five ranted in patients with NAION who have Although this may be as a result of the large mutation positive patients had bilateral typical risk factors, including older age. The numbers of patients with neovascular glau- NAION. The homocysteine level was within yield from such an evaluation in young coma in this group, it may also be due to the normal range in all 14 patients, as were the patients with NAION, especially those with- time and power output settings used (1.5 sec- creatinine, folate, and B12 levels. Homo- out known risk factors or those who suVer onds and 1.5 W). With our settings of 2 cysteine levels were not higher in the mutation recurrent events, still needs further elucida- seconds and 2 J per shot we were able to con- positive patients than in the mutation negative tion. trol IOP with a 65.7% reduction using a mean patients. Mutation positive and mutation negative patients did not diVer with respect to AKI KAWASAKI of 1.7 treatments in our neovascular sub- VALERIE PURVIN group. Reducing the output per shot, as in clinical data concerning risk factors for RICHARD BURGETT Walland’s study, may result in a reduction in NAION or coexisting vascular disease. treatment eVect overall despite higher total Although this is a small study, these results energies delivered. This could be due to trans- suggest that homocysteine and the C677T Laser pointers: not to be taken lightly mission attenuation in certain eyes, operator MTHFR polymorphism do not have a role in technique variation, probe output diVerences, the occurrence of NAION. Our results are EDITOR,—We recently treated a 16 year old and ciliary process uptake/susceptibility fac- similar to those of Kawasaki et al and the fre- boy whose friends exposed both his eyes to a tors. quency of the MTHFR mutation is not higher laser beam alternately for 20 seconds from a than in the general population. As recently distance of around 1 metre in the course of STEPHEN A VERNON re-emphasised,245 laboratory testing for hy- horseplay with a key chain laser pointer (class ANNE FIONA SPENCER Department of Ophthalmology, University Hospital, percoagulable states in a patient with NAION 3a diode, 670 nm, maximum output 5 mW). Nottingham without past medical history or family history Immediately thereafter, his vision was blurred of a thrombotic event would be unwarranted. bilaterally and he noted a red central However, it is still possible that for a given in each eye. These symptoms resolved sponta- 1 Spencer AF, Vernon SA. “Cyclodiode”: results of individual already at risk for AION, a neously within 2 days. An eye examination a standard protocol. Br J Ophthalmol 1999; thrombogenic predilection may be a trigger performed 3 days later disclosed that his 83:311–16. for an acute ischaemic event of the vision and visual fields were normal, but there 2 Walland MJ. Diode laser cyclophotocoagulation: dose-standardized therapy in end-stage glau- head. If there are clinical findings suggestive of were retinal pigment epithelial disturbances coma. Aust NZ J Ophthalmol 1998;26:135–9. a thrombogenic tendency, such as recurrent which appeared in fluorescein angiography as 556 Mailbox, Book reviews, Notices a window defect type hyperfluorescence in ophthalmology and a reference and update success of aggressive chemotherapy for both eyes close to the fovea. The macular for the more experienced practitioner”. childhood cancer was the result of a deter- Br J Ophthalmol: first published as 10.1136/bjo.84.5.554d on 1 May 2000. Downloaded from burns persisted throughout an 8 month follow Undoubtedly these clear and circumscribed mined but empirical approach of testing up period. The literature describes two cases aims are well met in this beautifully and systematically multiple drugs in combination. of unilateral macular damage from laser even more lavishly illustrated text. In addition The same approach has now been shown to pointers (class 2 diode, 670 nm, maximum to covering all those aspects of ophthalmol- be successful in the treatment of AIDS output 1 mW and class 3a diode and 670 nm, ogy dealt with in previous editions, a new where three or more drugs are more success- maximum output 5 mW),12 and two other chapter on ocular trauma has been added in ful that one. This “success” is not based on cases of bilateral decreased vision due to large addition to descriptions of new surgical tech- scientific knowledge, despite the vast amount retinal photocoagulation scars from class 3a niques and some pruning of outdated mate- that has been discovered about the AIDS laser pointer.3 rial. virus, but simply on a “suck it and see” In his review of the safety of laser pointers, This is and has been an extremely success- approach. 4 Marshall comprehensively described the ful primer text for the trainee ophthalmolo- In contrast, the great promise of the new classification of the lasers according to hazard. gists and one might ask why this book rather genetics or of the social theory of disease has However, no small part of the message of his than the many other texts available. Perhaps not held up according to the author. The 5 paper and that of a letter to the Lancet were the answer lies in part in the approach taken amazing strides in our knowledge derived unmistakably designed to placate the reader with this text which is intuitively “patient ori- from molecular biology led to the rapid into believing that laser pointers are harmless. ented”: one can almost envisage the author acceptance of the possibilities of gene therapy After witnessing the persistent injury to our examining the patient presenting to the but these have emphatically failed to deliver, own patient and reading the reports of four ophthalmic clinic by starting systematically at despite the intellectual satisfaction that these others who were likewise hurt by this device, the front of the eye and working his way pos- smart ideas generate. Similarly, in the wake of we are appalled. The laser pointer is not an teriorly towards the and/or cortex until studies showing a clear epidemiological cor- innocent toy. It damages the eye and should he finds the source of the patient’s com- relation between smoking and lung cancer the not be made freely available to youngsters plaints. There is less emphasis on why the social theory has sought to link almost every whatever its strength, while the label of the patient might have his complaints than disease for which there is not an obvious laser pointer only cautions users not to shine finding out what exactly the problem is and infectious cause to some lifestyle or nutri- the laser pointer light into an eye.6 what the practitioner can do about it. As such tional source mostly blamed on Western soci- Media “hype” underpinning reports in the it works very well because it is concise but popular press and the pernicious avarice of ety. Le Fanu firmly lays these conceptual suYciently detailed and above all immedi- errors at the feet of a few individuals who individuals lurking in wait for opportunities ately accessible. In fact there is a remarkable to claim compensation for spurious injury inveigled themselves into influential amount of detail (see, for instance, the section positions—for instance, in the American seem to have galvanised estimable individuals on corneal dystrophies) while one could to rush to the defence of this instrument. We Medical Association, and with the support of debate occasional diagnoses attached to some the major drug companies have utterly contend that laser pointers which are re- of the fundus photographs (see, for instance, garded as being “safe” carry the risk of changed our lifestyles to the point where the serpiginous choroiditis). There are also some vast majority of healthy individuals are potential damage to the eyes and that more very helpful line diagrams such as those such cases will be detected once worried more about their health than ever included in the and orbit chapters. The before while being encouraged to ingest drugs are alerted to this possibility. We believe that section on neuro-ophthalmology contains the public must be instructed in the safety such as cholesterol lowering agents for which several excellent illustrative radiological there is little evidence that they will actually measures that need to be taken when using scans. Overall this is an excellent starting text. the laser pointer and that they be made aware do for the individual what the statistics tell us If there is any criticism that can be levelled at let alone prevent the individual patient from of the potential hazards associated with this classic text, it is that it leaves this reader improper use. We recommend that use of dying of a heart attack. Le Fanu suggests that thirsting for further information. If a similar laser pointers in public should be controlled it would be possible to rectify this situation eVect is induced in the trainee ophthalmolo- and that these devices should be kept away overnight by closing down all university http://bjo.bmj.com/ gist it will have achieved its aim. I can there- from children. departments of epidemiology. Ophthalmol- fore recommend this book as essential DAVID ISRAELI ogy has not been immune to these problems reading. YAIR HOD (see the revised recommendations concerning ORNA GEYER laser treatment for diabetic patients Carmel Medical Center, 7 Michal Street, with clinically significant macular oedema Haifa 36342, Israel The Rise and Fall of Modern Medicine.By J Le Fanu. Pp 512; £20. London: Little, and 20/20 vision, Arch Ophthalmol 1999; Brown, 1999. ISBN 0316 648 361. 117:675). 1 Zamir E, Kaiserman I, Chower I. Laser pointer This book is not a sustained attack on maculopathy. Am J Ophthalmol 1999;127:928–9. This is an important and thought provoking modern medical practice nor is it written on September 27, 2021 by guest. Protected copyright. 2 Luttrull JK, Hallisey J. Laser pointer-induced book which should be read widely not only purely to debunk all of medicine’s current macular injury. Am J Ophthalmol 1999;127:95–6. 3 Almenbel YI. Laser pointer . Orlando: within the medical profession but also by fashions. It has been written, I think, to call a American Academy Ophthalmology, 1999; interested parties such as health economists halt to the band wagon which produces con- Poster 167. and government oYcials whose responsibility tradictory statistical theories for the cause of 4 Marshall J. The safety of laser pointers: myths disease and to instil a little circumspection in and realities. Br J Ophthalmol 1998,82:1335–8. it is to set budgets for healthcare pro- 5 Mensah E, Vafidis G, Marshall J. Laser pointers: grammes. I think it will also be of great inter- the scientists who undoubtedly are unravel- the facts, media hype, and hysteria [letter]. Lan- est to the lay public. The practice of medicine ling the secrets of life but are a long way from cet 1998;351:1291. is as susceptible to the whims of fashion and translating these into new cures for disease. 6 Mainster MA, Timbarlake GT, Warren KA, et al. Pointers on laser pointer. Ophthalmology 1997; pervasive ideology as any other human activ- The book does contain implicit and some- 104:1213–4. ity. It is therefore interesting to investigate times explicit criticism of medical scientists how these fashions are set. James Le Fanu has who selectively present evidence to fit their a background in medical and scientific current theories and who then promulgate journalism, having spent time on the staV of these in a way that alters people’s lifestyles. In the Daily Telegraph, one of the UK’s broad- particular, the book has much to say about BOOK REVIEWS sheet newspapers. His thesis is that despite the dangerous part played by the major phar- the significant advances in combatting disease maceutical companies in medicine. Many which reached their peak in the post-war who read this book will be able to relax about years, the promise of modern medicine as we their imputed health problems, to feel confi- are at the end of the century has failed to dent about their ability to ward oV many of Clinical Ophthalmology. 4th ed. By J J materialise. In fact, Le Fanu contends that the supposed hidden dangers which face Kanski. Pp 673; £105. Oxford: Butterworth- much of the advances in the first half of the them out there, and to take much of what Heinemann, 1999. ISBN 0 7506 4014 6. 20th century were accidental or at best they hear from the medical pundits with a serendipitous, citing as examples the discov- pinch of salt. The author oVers hope for the The fourth edition of this standard text lives ery of antibiotics, which was never predicted, future and, in particular, calls for a return of up to its enormous reputation. Jack Kanski or the use of chloroquine for rheumatoid the experienced who exercises good sets out “to provide the trainee with a system- arthritis, which was based on clinical observa- clinical judgment, with a dash of common atic and easily assimilated introduction to tions of patients treated for malaria. Even the sense. Mailbox, Book reviews, Notices 557

Indiana 46202-5175, USA. The last day of VIII Tuebingen Angiography course application is 15 June 2000 (tel: (317) The VIII Tuebingen Angiography course with Br J Ophthalmol: first published as 10.1136/bjo.84.5.554d on 1 May 2000. Downloaded from NOTICES 274-1214; fax: (317) 274-1111). wet lab will take place on 9 September 2000 in the auditorium, University Eye Clinic, Sch- 13th Annual Meeting of German leichstrasse 12, 72076 Tuebingen, Germany. Ophthalmic Surgeons Further details: WIT-Wissenstransfer,Univer- Community participation in eye health The 13th annual meeting of German Ophthal- sitat Tubingen (tel: ++49 7071-29 76439; fax: and and the SAFE strategy mic Surgeons will be held on 15–18 June 2000 ++49 7071 29 5051; email: wit@uni- The latest issues of Community Eye Health (nos at the Meistersingerhalle, Nuremberg, Germany. tuebingen.de/wit). 31 and 32) discuss community participation in Further details: MCN Medizinische Congress- eye health (issue 31) and trachoma and the organisation Nuremberg AG, Zerzabelshof- 30th Cambridge Ophthalmological SAFE strategy (issue 32). For further infor- strasse 29, D-90478 Nuremberg, Germany Symposium mation please contact Community Eye Health, (tel: +49-911-3931621; fax +49-911-3931620; The 30th Cambridge Ophthalmological Sym- International Centre for Eye Health, Institute email: doerfl[email protected]). posium entitled “The Ageing Macula” will be of Ophthalmology, 11–43 Bath Street, London held on 13–15 September 2000 at St John’s EC1V 9EL. (Tel: (+44) 171 608 6909/6910/ XXXIV Nordic Congress of College Cambridge. Chairman: Professor 6923; fax: (+44) 171 250 3207; email: Ophthalmology Alan Bird. Further details: COS Secretariat, [email protected]) Annual subscription The XXXIV Nordic Congress of Ophthal- Cambridge Conferences, The Lawn, 33 £25. Free to workers in developing countries. mology will be held in Reykjavik, Iceland, Church Street, Great Shelford, Cambridge 18–21 June 2000. This meeting celebrates the CB2 5EL (tel: 01223 847464; fax: 01223 Residents’ Foreign Exchange Programme 100 year anniversary of the Nordic Ophthal- 847465; email: [email protected]). Any resident interested in spending a period of mology Conference. Further details: Iceland up to one month in departments of ophthal- Incentives Inc, Hamraborg 1–3, Is- European Association for Vision and Eye mology in the Netherlands, Finland, Ireland, Kopavogur, Iceland (tel: +354 554 1400; fax: Research (EVER) Germany, Denmark, France, Austria, or Portu- +354 554 1472; email: [email protected]). The European Association for Vision and Eye gal should apply to: Mr Robert Acheson, Research (EVER) will be meeting on 4–7 Secretary of the Foreign Exchange Committee, III Modern Cataract and Refractive October 2000 in Palma de Mallorca, Spain. European Board of Ophthalmology, Institute of Surgery International Symposium Further details: Secretariat EVER, Postbus Ophthalmology, University College Dublin, 60 The III Modern Cataract and Refractive Sur- 74, B3000 Leuven, Belgium (fax: +32 16 33 Eccles Street, Dublin 7, Ireland. gery International Symposium will be held on 67 85; email: [email protected]). 19–22 June 2000 at Banská Bystrica, Slovakia. VIth Mediterranean Ophthalmological Further details: Eye Clinic FD Roosevelt Fifth Annual Meeting of the Association Society Hospital, Arm Gen L Svobodu Sq, 1, 975 17 for Ocular Pharmacology and The combined meeting of the VIth Mediterra- Banská Bystrica, Slovakia (tel: 00421 88 413 Therapeutics nean Ophthalmological Society and the VIth 4671; fax: 00421 88 413 2047). The Fifth Annual Meeting of the Association Michaelson Symposium on Ocular Circula- for Ocular Pharmacology and Therapeutics tion and Neovascularisation will be held in 6th Congress of the European Glaucoma will be held on 2–5 November 2000 in Jerusalem on 21–26 May 2000. Further Society Birmingham, AL, USA. Further details: Jimmy details: Secretariat, c/o Unitours Israel Ltd, The 6th Congress of the European Glaucoma D Bartlett, OD, Department of Optometry, PO Box 3190, 61031 Tel Aviv, Israel (tel: Society, millennium meeting 2000, will take University of Alabama at Birmingham, 1716 +972-3-5209999; fax: +972-3-5239099; place at the Royal Lancaster Hotel, London University blvd, Birmingham, AL 35294- email: [email protected]). on 26–29 June 2000. Further details: Euro- 0010, USA (tel: 205-934-6764; fax: 205-975- The VIth Michaelson medal and award will congres Conference Management BV, Jan van 7052; email: Jbartlett@ icare.opt.uab.edu). be delivered on 24 May 2000 in Jerusalem. The Goyenkade 11, 1075 HP Amsterdam, Nether- medal and award ($15 000 monetary prize) are lands (tel: +31 20 679 34 11; fax: +31 20 673 http://bjo.bmj.com/ 12th Afro-Asian Congress of sponsored by the Israel Academy of Sciences 73 06; email: [email protected]). Ophthalmology and Humanities and by the Hadassah Hebrew The 12th Afro-Asian Congress of Ophthal- University Hospital and of British Ophthalmic Photographic mology (OYcial Congress for the Afro-Asian Jerusalem, Israel. Nominations are sought from Association Council of Ophthalmology) will be held on Forthcoming meetings of the British Ophthal- the ophthalmic community at large. Sugges- 11–15 November 2000 in Guangzhou (Can- tions and reasons for choice and CV highlights mic Photographic Association are: 8 July 2000 ton), China. The theme is “Advances of should be sent to Professor David BenEzra, at Southampton Eye Unit. Further details: Tim ophthalmology and the 21st century). Further Secretary for the International Nominating Mole (tel: 01703 798747). On 17–18 Novem- details: Professor Lezheng Wu, Zhongshan Eye on September 27, 2021 by guest. Protected copyright. Committee, Pediatric Ophthalmology Unit, ber BOPA annual conference at York. Further Center, SUMS, New Building, Room 919, 54 Hadassah Hebrew University Hospital, PO details: Mike Geall (tel: 0113 3923506). Xianlie Nan Road, Guangzhou 510060, PR Box 12000, Jerusalem 91120, Israel. China (tel: +86-20-8760 2402; fax: +86-20- Joachim Kuhlmann Fellowship for 8777 3370; email; lwuicv@ gzsums.edu.cn). 5th International Vitreoretinal Ophthalmologists 2000 Meeting–IIV 2000 The Joachim Kuhlmann AIDS Foundation, The 5th International Vitreoretinal Meeting– Essen, Germany, is sponsoring two fellow- Singapore National Eye Centre 10th IIV 2000 will be held in Parma, Italy, on ships per year for ophthalmologists at a well Anniversary International Congress 26–27 May 2000. The main topics will known institute, who want to train in CMV The Singapore National Eye Centre 10th include “Hypotony and glaucoma in vitreo- and other HIV related ophthalmologi- Anniversary International Congress will be retinal surgery”, “Internal limiting membrane cal diseases. The fellowships are valued at held in conjunction with 3rd World ”, “Macula oedema”, “Open $US5000 each. Deadline for application is 31 Surgeons Society International Meeting on injuries”, and “News in retinal pigment July. Detailed applications, including CV and 2–4 December 2000 at the Shangri-La Hotel, epithelium”. Further details: C Cantu, MA publication list, should be sent to the Joachim Singapore. Further details: The Organising De Giovanni, or S Tedesco, Scientific Secre- Kuhlmann AIDS Foundation, Bismarck- Secretariat, 11 Third Hospital Avenue, Singa- tariat, Institute of Ophthalmology, University strasse 55, 45128 Essen, Germany (tel: 0201 pore 168751 (tel: (65) 2277255; fax: (65) of Parma, Via Gramsci 14, 43100 Parma, Italy 87910-87; fax: 0201 87910-99; email: jk- 2277290; internet: www.snec.com.sg). (tel: ++39 0521 259106; fax: ++39 0521 [email protected]). 292358; email: [email protected]). The Hong Kong Ophthalmological DR-2000, International Forum on Symposium ’00 International Strabismological Association The Hong Kong Ophthalmological Sympo- The International Strabismological Associ- The International Forum on Diabetic Retin- sium ’00 will be held 4–5 December 2000, in ation (ISA) has established fellowships for opathy will take place on 7–9 September 2000 Hong Kong, China. Further information: training in strabismus and paediatric ophthal- at the Palazzo Reale, Naples, Italy. Further Miss Vicki Wong, Room 802, 8/F Hong Kong mology, supported by $US 10 000 each. Fur- details: Francesco Bandello, Congress Secre- Academy of Medicine, 99 Wong Chuk Hang ther details: Secretary/Treasurer ISA, Derek T tariat, MGR Congressi, Via Servio Tullio, 4, Road, Aberdeen, Hong Kong (tel: (852) 2761 Sprunger, MD, Indiana University School of 20123 Milano, Italy (tel: 39 02 430071; fax: 9128; fax: (852) 2715 0089; email: Medicine, 702 Rotary Circle, Indianapolis, 39 02 48008471; email: [email protected]). [email protected]).