Letters to the editor. Book reviews. Obituary 255 treatment in this acute situation consists of derivative - would accumulate in corneal reports - especially with regard to rarer con- systemic steroids to suppress the reaction. tissues to a significant degree. ditions such as malignant glaucoma.

High doses of clofazamine and thalidomide W J POWER The book is subtitled 'A comprehensive Br J Ophthalmol: first published as 10.1136/bjo.76.4.255-b on 1 April 1992. Downloaded from S P TRAVERS have been tried in cases where steroids are D J MOONEY review of primary and secondary angle-closure unobtainable or contraindicated but their Royal Victoria Eye and Ear Hospital, glaucoma' and certainly the interested reader action is too slow and they are generally Dublin 2, will find much useful information which does ineffective. Ireland not appear in standard texts, for example the One other error in the article, which escaped chapters on 'Prevalence' and 'Biometrics.' both our notice, was the statement that paraly- 1 Potts AM. The concentration of phenothiazines in Most chapter headings are enlivened with the eye of experimental animals. Invest sis of the maxillary branch of the facial nerve Ophthalmol 1962; 1: 522-30. relevant quotations from historical writings causes lagophthalmos. This should of course which show the astuteness and common sense have read 'the zygomatic branch', and I am ofour predecessors. The author helps to clarify grateful for this opportunity to rectify this. the nomenclature and hence classification of T J FFYTCHE glaucomas associated with narrow and closed St Thomas' Hospital, angles, and should be applauded for his efforts London SEI 7EH BOOK as accuracy in definition is of such importance. His message on another confused area, that of REVIEWS the role of provocative tests was not quite so Fluphenazine induced welding arc clear, however, and the reader is given a rather maculopathy? ambivalent message about their use. In discuss- ing laser iridotomy the author should have SIR,-Powers et al have presented the case of a made a clear distinction between argon and Vascular Disorders ofthe Ocular Fundus. By Nd:YAG laser iridotomy as the reader other- 45-year-old male welding trainee who incurred Rodney Grey. Pp 118. £47-50. Butterworth: bilateral maculopathy supposedly due to un- wise gains the impression that the complica- London, 1990. tions attributed to 'laser iridotomy' are equally protected exposure of less than 2 minutes' The purpose of this book is to demonstrate in duration to a manual metal arc welding unit.' common with both lasers. colour the photographic appearances of a The lack of illustrations, clinical photo- They believe that fluphenazine, which had variety of retinal conditions not all, it has to be accumulated in his retinal pigment epithelium graphs and diagrams, makes this book appear admitted, strictly 'vascular' in origin although, rather stark and this will detract from its (due to 10 years' treatment for depression), in the retina, vessels of some sort are rarely far rendered him particularly susceptible to retinal appeal, as the modern reader has come to away. expect the understanding and reinforcement of damage. The book is a great success. After pre- The authors further state that 'one of the ideas that good illustrations give to a text's liminary general observations on normal message. However, the readability of this book unusual features of this case is that though the anatomy and pathology, methods of examina- patient was only welding for two minutes he and its important content make it a useful tion, principally fluorescence angiography, and addition to an ophthalmic library. developed a bilateral maculopathy without any the effects oftreatment with photocoagulation, evidence of a keratitis'. In the early part of the the book then covers each condition separately. PETER K WISHART paper they mention that 'there was no accurate A fairly brief but very much to the point record of the exact duration ofexposure'. description is accompanied by well chosen and Is it not possible then, that: (1) the exposure beautifully reproduced illustrations. The might have been actually longer than 2 minutes; writing is lucid and therefore a pleasure to read. (2) fluphenazine may have accumulated in Afficionados of retinal disease might perhaps corneal tissues but rendered them more resis- question some parts in detail but the average OBITUARY tant to photic damage thus explaining the lack general ophthalmologist, and certainly all post- of keratitis in the presence ofmaculopathy? graduate students, will find the simplicity and http://bjo.bmj.com/ This paper inspires one to conduct an clarity of the text most enlightening. experimental study on animals put on long It is traditional to find a few faults. There are SATISH KUMAR BHARGAVA, term fluphenazine. Noting any accumulation a few minor proof reading errors, such as the MB, BS, DO, FRCSE, FCOphth ofthe drug in corneal tissues and the thresholds rather jolly mis-spelling of Dr Dollery's name for photic keratopathy seems in order. A S NEKI on pp 6, 12 and 18 and possibly a transposition Satish Bhargava was born in Lahore in 1939 Mahatma Gandhi Institute ofMedical Sciences, of two photographs on p 66. but moved to Delhi with his family in 1947 on Sevagram, Wardha, Maharashtra, India In summary this book is highly recom- Partition. He was one of the first intake of

mended. students at the All India Institute of Medical on September 25, 2021 by guest. Protected copyright. 1 Power WJ, Travers SP, Mooney DJ. Welding arc REDMOND SMITH Sciences from which he qualified in 1962. After maculopathy and fluphenazine. BrJ Ophthalmol an internship there he came to England to take 1991; 75: 433-5. up a casualty officer post at Lister Hospital, Hitchin, where he met his future wife. Angle-Closure Glaucoma. By Stanley Hyams. He started training in.ophthalmology at the Reply Pp 186. Dfl 90.00. Kugler: Amsterdam, 1990. West of England Eye Infirmary, Exeter in 1963, continued at the Glasgow Eye Infirmary SIR,-In reply to Dr Neki's letter we would This small book covers the subject of angle- in 1965, and returned to Exeter as Registrar in like to make the following points: closure glaucoma in an original and informative 1968. He became senior registrar to the pro- (1) Although there was not an exact record of manner with special attention paid to the fessorial unit at Manchester Royal Eye Hospi- the involved exposure time both the patient bibliography on which the current understand- tal in 1971 where he became interested in and the instructor were quite sure that the ing of angle-closure glaucoma is based. The retinal pathophysiology. exposure duration was no longer than 2 major difference between this book and stan- On appointment to the consultant staff there minutes. dard texts on the subject is that each chapter is in 1975 he developed an electrophysiological (2) Dr Neki suggests that fluphenazine may composed of approximately equal portions of diagnostic service and a referral clinic for the have accumulated in the patient's cornea and text and the author's own abstracts of the management of inherited retinal disorders. may therefore have rendered it more resistant papers from which this knowledge has been Both on his own and in collaboration with the to photic damage. He further suggests that this drawn. This original style of presentation will Department of Optometry and Vision Science may then explain the lack of keratitis in the appeal more to the reader with a specific at the University of Manchester Institute of presence of maculopathy. However the litera- interest in angle-closure glaucoma than Science and Technology he was responsible for ture would suggest otherwise. In a study on the perhaps an ophthalmologist in training who a steady stream of publications in this field, as concentration of phenothiazines in the eye of wishes to gain a rapid and easily remembered well as on colour vision and toxic amblyopia. experimental animals Potts' has shown that the understanding of the subject. However, this In addition to running a very busy unit at concentration of prochlorperazine in rabbit style does allow the reader to cover a very wide MREH, where he was chairman of the medical cornea is less than 100th that of the concentra- range of references quickly without a visit to committee twice (1981-3 and 1987-9), he also tion in choroid. He found similar results when the library, and makes very interesting read- developed a close relationship with the Man- he looked at the ocular distribution of pheno- ing. It is salutary to find out just how much of chester department and School of Orthoptics, thiazine in hamsters. It would seem unlikely, our knowledge and accepted teachings are ofwhich he was medical director from 1986-9. therefore, that fluphenazine - a phenothiazine based on small series of patients and case He frequently examined for the Orthoptic 256 Obituary. Notes

Society as well as for the Royal College of lymphoma. (J. P. Crawford, San Francisco, - Iatrogenic lysosomal storage disease of the Surgeons of Edinburgh, the British Optical USA) cornea. (J. Libert, Brussels, Belgium)

Association, and the Ophthalmic Nursing - Inherited systemic metabolic disease with - Giant cell astrocytoma of the retina. (T. A. Br J Ophthalmol: first published as 10.1136/bjo.76.4.255-b on 1 April 1992. Downloaded from Board. corneal involvement. (J. G. Cunha-Vaz, Makley, Columbus, USA) He was a founder member of the Rotary Coimbra, Portugal) - Not-predictable melanoma reaction on Club of Stockport Lamplighter, where he - Merkel cell tumour of the eyelid. (V. T. empirical radiation doses. (W. A. Manchot, served with distinction on the international Curtin, Miami, USA) Rotterdam, The Netherlands) committee. He indulged his interest in the - Malignant transformation of a choroidal - Lineage and ubiquitination in optic nerve restoration of sight and in children's education naevus. A 46 year case history. (B. C. Daicker, gliomas. (A. C. E. McCartney, London, UK) by promoting aid for eye camps in India and by Basel, Switzerland) - Primary histiocytoid carcinoma ofthe eyelid. sponsoring the education of two African and - Ciliary body and iris metastasis of cutaneous (I. W. McLean, Washington DC, USA) two Indian children, projects which continue melanoma in a patient with dysplastic naevus - Ocular findings in cerebro-ocular dysplasia- to be supported by the club. syndrome. (D. de Wolff-Rouendaal, Leiden, muscular dystrophy (COD-MD) syndrome. He was highly respected by his colleagues The Netherlands) (C. M. Mooy, Rotterdam, The Netherlands) and patients and was a hard-working, - Melanocytomalytic glaucoma. (R. C. Eagle, - Conjunctival nodule with testicular tumour. unassuming, conscientious doctor and fine Philadelphia, USA) (J. Mullaney, Dublin, Ireland) surgeon who was always helpful to his patients - Intraocular involvement with subretinal pig- - Proton beam treated malignant melanoma. and colleagues. He bore his final illness with ment epithelium infiltrates by mycosis (P. Naeser, Uppsala, Sweden) characteristic quiet fortitude and lack of com- fungoides. (P. R. Egbert, Stanford, USA) - Fibrous histiocytoma of the corneal limbus. plaint and, on his death in 1991, is survived by - Clinically atypical granular dystrophy with (G. 0. H. Naumann, Erlangen, Germany) his wife, Sandra, and two children, his son histologic features of lattice dystrophy - Castleman's disease in one orbit. having just entered medical school. (Avellino dystrophy): new perspectives. (J. U. Prause, Copenhagen, Denmark) (R. Folberg, Iowa City, USA) - Torulopsis candida (Candida famata) en- A E A RIDGWAY - Recurrent well differentiated orbital lipo- dophthalmitis simulating P. acnes syndrome. sarcoma with myxoid areas occurring in a (N. A. Rao, Los Angeles, USA) teenager. (R. L. Font, Houston) - Atypical Schnyder's dystrophy. (M. M. - Choroidal pneumocystosis. (R. Y. Foos, Los Rodriques, Baltimore, USA) Angeles, USA) - Massive gliosis of the retina. (A. M. Roth, NOTES - Granulomatous conjunctivitis. (W. C. Sacramento, USA) Frayer, Philadelphia, USA) - Vitreous metastasis from cutaneous - Fibrous histiocytoma of the lacrimal sac. melanoma. (J. Sahel, Strasbourg, France) (A. H. Friedman, New York, USA) - Fungus in epiretinal membrane. (M. E. 20th Meeting European Strabismological - Lacrimal gland myoepithelioma. (A. Garner, Smith, St Louis, USA) Association (ESA) London, UK) - A posterior form of macular corneal dys- - Peutz-Jeghers-like pigmentation, the pre- trophy - type 2 (keratan sulphate positive). (W. A symposium on the management of inter- senting manifestation of bilaterial diffuse H. Spencer, San Francisco, USA) mittent exotropia is to be held in Brussels on melanocytic proliferation of the uveal track; - Conjunctival malignant melanoma. 22-24 May 1992. There will be free paper cancer associated melanocytopathy (CAM). (I. Suveges, Szeged, Hungary) sessions and discussions on various topics along (G. J. Gass, Miami, USA) - Supernumerary eye in multicystic cranio- with poster exhibits. Further information - Kimura's disease of the orbit. (G. J. Goder, cervical abnormality: unilateral diploph- from: Dr M Spiritus, Department of Ophthal- Berlin-Buch, Germany) thalmus associated with ipsilateral temporo- mology UCL, Hippocrate Avenue 10, B-1200 - Epikeratoplasty for keratoconus. (W. R. parietal porencephaly additional tooth and Brussels, Belgium. (Fax: 32-2-764 29 88.) Green, Baltimore, USA) cervical cyst. (F. Stefani, Munich, - Corneal changes in Peters's anomaly. Germany) (R. Haddad, Vienna, Austria) - An atypical case of tumour of the eyebrow: http://bjo.bmj.com/ European Ophthalmic Pathology Society - Pathology of familial (dominant) exudative melanoma or sarcoma? (M. Sterkers, Paris, vitreoretinopathy) (FEVR) in a newborn and in France) The 30th Annual Meeting of the European an infant. (A. Hamburg, Bussum, The Nether- - Abnormal scleral collagen in nanophthalmos. Ophthalmic Pathology Society was held lands) (B. W. Streeten, Syracuse, USA) together with the Verhoeff Society in Nurem- - Walker-Warburg syndrome. (M. Hanssens, - Malignant fibrous histiocytoma of the orbit berg, Germany, 8-12 May 1991 at the invita- Gent, Belgium) with spontaneous resolution. (A. Tarkkanen, tion of the Organising Secretary EOPS Pro- - Posterior polymorphous dystrophy of the Helsinki, Finland) fessor Dr G. 0. H. Naumann. Thirty three cornea. (A. S. Henriquez, Barcelona, Spain) - Malignant medulloepithelioma and hydroxy- on September 25, 2021 by guest. Protected copyright. members of the EOPS and 31 members of the - Congenital malignant rhabdoid tumour of apatite orbital implant. (M. 0. M. Tso, Verhoeff Society attended the meeting. The the eye and orbit. (A. A. Hidayat, Washington Chicago, USA) following papers were presented at the scientific DC, USA) - Microphthalmos with orbital cyst. (M. H. sessions: - Ocular inflammatory disease of unknown Vogel, Gottingen, Germany) - Hepatoblastoma metastatic to the eye. aetiology. (E. L. Howes, San Francisco, USA) - Honeycomb-shaped corneal dystrophy (D. M. Albert, Boston, USA) - Adult extrarenal rhabdoid tumour of the Thiel-Behnke. (H. E. Volcker, Heidelberg, - Another eye tumour in a Riesenschnauzer lacrimal gland. (F. A. Jakobiec, Boston, USA) Germany) dog. (K. Arnesen, Oslo, Norway) - Alagille's syndrome (arteriohepatic dys- - Iridocyclectomy for malignant melanoma of - Pathologic study of hydrogel implant in plasia), hepatocellular carcinoma associated the ciliary body; risk factors affecting success corneal stroma of cat. (P. Bec, Toulouse, with the syndrome in a 4-year-old girl. (O. A. and failure. (F. C. Winter, Stanford, USA) France) Jensen, Copenhagen, Denmark) - Leber's congenital amaurosis. (H. Witschel, - Unusual bluish tumours of the eyelid and - Chondroma of the orbit. (E. Kock, Stock- Freiburg, Germany) conjunctiva. (Angioleiomyoma and gloman- holm, Sweden) - Pseudo-Scheie syndrome; congenital heredi- gioma. (M. Boniuk, Houston, USA) - Optic nerve astrocytoma with angiogenesis. tary endothelial dystrophy (CHED). - A case ofcryptophthalmos syndrome in a 15- (G. K. Klintworth, Durham, USA) (M. Yanoff, Philadelphia, USA) week-old fetus. (A. Brini, Strasbourg, France) - Pseudophakia lipomatosa (PHPV). - Optic atrophy following retrobulbar haemor- - Discoid lupus erythematosus of the eyelid (E. Landolt, Zurich, Switzerland) rhage. (L. Zimmerman, Washington DC, margin. (J. D. Cameron, Minneapolis, USA) - Orbital carcinoma of unknown origin. USA) - Retinal pigment epitheliopathy in the ALS/ (Z. Latkovic, Belgrade, Yugoslavia) The next meeting ofthe EOPS will be held in PD complex of Guam. (R. J. Campbell, - Malignant fibrous histiocytoma of orbit: in- Strasbourg (France), June 1992. Professors Rochester, USA) farction of the optic nerve. (W. R. Lee, A. Brini and J. Sahel will act as Organising - Spindle cell tumour of eyelid in patient with Glasgow, Scotland, UK) Secretaries.