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  1. Creig Hoyt, Editor

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    CLINICAL FEATURES OF FUNGUS INFECTION OF THE CORNEA

    Suppurative keratitis is an important cause of monocular blindness worldwide. Although the standard of care is microbiological investigation to identify the cause of this agent, in some situations these facilities are limited. Thomas and co-workers identified clinical features of suppurative keratitis that suggested the infection was caused by fungi. These included serrated margins, raised slough, dry texture, satellite lesions, and coloration other than yellow. In contrast, hypopyon and fibrinous exdate were more frequently seen in bacterial keratitis. See p 1554

    MINIMISING ERRORS IN THE OPERATING THEATRE

    The problems surrounding human error in hospitals have received worldwide attention in the past few years. Mandal and co-workers studied 500 cases of cataract surgery performed in the United Kingdom. Nurses maintained reports concerning abnormal events; 69% of abnormal events were intraoperative whereas 27% were preoperative. The authors suggest that nursing staff are a reliable source for collecting data regarding near misses. Further definition and clarity of what constitutes a near miss or human error in the operating theatre should be a high priority. See p 1565

    THOSE DISTURBING EPIRETINAL MEMBRANES

    Epiretinal membranes are vascular fibrocellular proliferations on the retinal inner surface. They develop either spontaneously, in association with ocular disease, or postoperatively. It is well recognised that they can be visually disturbing even in the presence of normal visual acuity. Ugarte and Williamson report a study of patients with epiretinal membranes using a computerised version of a new aniseikonia test. They demonstrate that this test can be a simple, fast, valid, and reliable method to measure differences in image size perceived by each eye. Significant aniseikonia was measured in the majority of symptomatic patients with epiretinal membranes. See p 1576

    THINGS ARE GETTING SMALLER

    We are entering the age of nanotechnology, which promises to initiate a revolution in surgical techniques and drug delivery systems. Bhisitkul and Keller report a prototype MEMS forceps designed for intraocular surgery. They suggest that MEMS microforceps are not only feasible for conventional vitreoretinal surgery but offer advances in terms of small scale operating precision and construction tolerance. See p 1586

    VARIATION IN RATES OF SEVERE RETINOPATHY OF PREMATURITY

    Retinopathy of prematurity continues to be a major cause of blindness in the developed world and an emerging cause in the developing world. Darlow and co-workers demonstrate that there is significant variation in the rates of severe retinopathy of prematurity among neonatal intensive care units in New Zealand even after adjustment for case mix and sampling variability. The reasons for this variability need to be further investigated in order to identify further risk factors related to the development of severe retinopathy of prematurity. See p 1592

    CARBOPLATIN FOR RETINOBLASTOMA

    Over the past decade primary chemotherapy has been seen as a useful treatment for intraocular retinoblastoma but when used alone it is rarely curative. Abramson and co-workers studied 36 tumours following one treatment with systemic carboplatin. In this study carboplatin caused measurable shrinkage of retinoblastoma tumours. The response was greatest following the initial treatment and decreased with subsequent treatments. The effect appeared to be similar to the treatment effect associated with multiagent chemotherapy. See p 1616

    KNOCKOUT MOUSE MODEL FOR LIPID DEPOSITION IN BRUCH’S MEMBRANE

    In age related maculopathy one of the primary pathological findings is lipid deposition within Bruch’s membrane which exceeds the norm for the age of the patient. The source of this lipid, be it endogenous or exogenous, continues to be controversial. Resolving this issue is important since it might indicate that current medications, which reduce serum lipid levels, could be effective in preventing or modulating age related maculopathy. Rudolf and co-workers studied a knockout mouse model in which the low density lipoprotein receptors were deficient. In this model the mice exhibited an accumulation of lipid particles in Bruch’s membrane which further increased after dietary fatty intake. Further studies of this mouse model may clarify the relation between dietary lipid intake and age related maculopathy. See p 1627

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