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Remembrance of things past

“Aware that his family would be apprehensive concerning his cataract operation, he wrote reassuringly that he could now distinguish light and dark in his left eye, but it would take several weeks to determine whether the vision would return enough to be useful. The removal of a cataract in those days was a primitive procedure, and as he said quite a bad ordeal. ‘I suffered very severely for the first few days after the operation, and they had to give me typhoid fever injections to combat the inflammation in the eye—it seems an artificial fever will accelerate absorption. The injections gave me high fever and chills that nearly shook me to pieces.’ ” (Lye Leveriech. Tom: the Unknown Tennessee Williams. New York: W W Norton & Co, 1995:400.)

Face-brain development requires vitamin A

Ophthalmologists are commonly members of the cranial facial anomaly teams. In evaluating patients with complex facial cranial bone and intracranial anomalies, it has been felt that it was the underlying intracranial anomalies (central nervous system) that determine the abnormal facial growth. Recent work, however, suggests that similar chemicals and proteins shape both the face and the brain and it is this commonality of important chemical transducers that results in patients acquiring abnormal facial and intracranial abnormalities. At least in some circumstances retinoic acid or vitamin A appears to be important in sending signals to genes that are essential for normal forebrain and facial …

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