Biomedical subjects
Publications and source records attributed to J S Speakman.
The uninvolved lens was removed from a patient with unilateral lens exfoliation, and electron microscopic examination of the lens confirmed the absence of exfoliation. Five years later white granules appeared on the vitreous face, and when the eye was removed at autopsy a further 4 years later typical exfoliation fibres were found in close association with the epithelium of the iris and the ciliary body and in clumps in the vitreous.
A long-term study of primary pigmentary dispersion has shown that the condition is commoner in males than females and appears most frequently in the third decade. After 10 years there may be a significant reduction in the amount of pigment deposited on the cornea, and the condition of several patients receiving treatment for glaucoma has remained under control when treatment has been stopped.
Conjunctival biopsy specimens from both eyes of a series of seven patients with evidence of unilateral senile exfoliation of the lens were examined by electron microscopy. Exfoliation fibers were found in both eyes of each patient. This evidence suggests that the conjunctiva is an independent source of exfoliation that precedes the development of exfoliation in the lens.
Among Inuit less than 30 years old the prevalence of myopia is far in excess of that of their elders. This is especially true for females. There seems to be little, if any, genetic contribution to this "epidemic" of myopia in the young. The age and sex distribution indicates the likelihood of an environmental factor, probably cultural, being responsible for the current pattern. Other data implicate school attendance as a possible etiologic factor.
At variable times after anterior segment surgery spontaneous bleeding may occur into the anterior chamber from a gap in the scleral wound. The patient complains of blurred vision in the morning and examination reveals blood in the anterior chamber. Gonioscopy reveals a bleeding point in the scleral would. In the majority of patients the condition is benign and does not require special treatment.
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Pituitary ablation was performed on 26 patients with advanced diabetic retinopathy by pituitary stalk section (nine patients) or transphenoidal hypophysectomy (17 patients). After a latent period varying from six to 12 months, retinal hemorrhages disappeared, vitreous hemorrhages stopped and new vessels regressed. Eight of 10 patients followed up for more than a year had a complete remission, although in one of two patients whose ablation was incomplete the retinopathy remained active. Preoperative visual acuity levels were preserved in 47 of 50 eyes of patients followed up for a mean period of 12 months. Three patients have died, two from causes related to their operation. Twenty of the survivors have continued in their usual occupation. Pituitary ablation is effective in preventing the progressive visual deterioration usually associated with advanced diabetic retinopathy.
Three patients with hemoglobin S-C disease, all with ocular lesions, were studied and contrasted with four other patients who had predominantly either hemoglobin S or C but no ocular lesions. Attention is drawn to the diagnostic value of hemoglobin electrophoresis in such cases. With this technique a diagnosis of hemoglobin S-C disease was made in a patient previously thought to the "Eales' disease"; one sister was found to have asymptomatic hemoglobin S-C disease and unsuspected early ocular lesions. The number of persons in Canada with hemoglobinopathies is increasing. Awareness of an association between abnormal hemoglobins and ocular disease may lead to the recognition of an unsuspected blood disorder or of an unsuspected retinopathy.
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