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PubMed1982

Single-dose penicillin prophylaxis of neonatal group-B-streptococcal disease.

The efficacy of a single dose of aqueous penicillin G in preventing neonatal group-B streptococcal infections was demonstrated in a randomised study conducted over 41 months. 16 082 infant received a single dose of penicillin within one hour of delivery, and 15 976 infants who received tetracycline ophthalmic ointment served as the control group. Group-B streptococcal systemic infections were significantly less common in the penicillin-treated infants (0.6 vs 1.7 cases per 100 live birth, p = 0.004). The incidence of infection caused by penicillin-resistant pathogen was insignificantly increased in the penicillin group (2.2 vs 1.6 cases per thousand live birth, p = 0.32). this difference was accounted for almost completely by the events of the first 12 months of the study period when, for unexplained reasons, there was a considerable increase in the number of penicillin-resistant infections in the penicillin group (3.6 vs 1.4 cases per 1000 live births, p = 0.09). The mortality associated with penicillin-susceptible pathogens was higher in the control group (0.1 vs 0.4 per 1000 live births, p = 0.18). However, the mortality associated with penicillin-resistant pathogens was increased in the penicillin (0.4 vs 1.0 per 1000 live births, p = 0.06). The combined mortality rates for all pathogens were not significantly different (1.1 vs 0.7 per 1000 liver births, p = 0.27, for the penicillin and control groups, respectively) and were nearly equivalent when the excess number of deaths associated with penicillin-resistant infections in the penicillin group during the first study year was excluded from analysis. The incidence of gonococcal ophthalmia and conjunctivitis was unaffected by the use of intramuscular penicillin at birth.

Clinical Trials as Topic↗
PubMed2002

Efficacy and safety of chlorambucil in intractable noninfectious uveitis: the Massachusetts Eye and Ear Infirmary experience.

PURPOSE: To report our experience with the use of chlorambucil for otherwise treatment-resistant uveitis and to assess its safety and efficacy. DESIGN: Noncomparative interventional case series. PARTICIPANTS: Twenty-eight patients with intractable noninfectious uveitis. METHODS: We reviewed the records of 28 patients (56 eyes) with chronic noninfectious uveitis who were treated with chlorambucil from 1987 to 2000. Diagnoses included Adamantiades-Behçet's disease (ABD) (7 patients), juvenile rheumatoid arthritis (JRA)-associated uveitis (10 patients), pars planitis (2 patients), sympathetic ophthalmia (1 patient), idiopathic uveitis (6 patients), Crohn's disease (1 patient), and HLA-B27-associated uveitis (1 patient). All patients were refractory to other immunomodulatory therapy and systemic steroids. The median duration of treatment with chlorambucil was 12 months (range, 4-50 months), whereas the median daily dosage was 8 mg (range, 4-22 mg). Patients were followed for a median follow-up period of 46 months (range, 4-166 months) after chlorambucil treatment was begun and continued to be followed for relapse after cessation of therapy. MAIN OUTCOME MEASURES: Visual outcome, response to treatment, treatment-related side effects, drug dosage, previous and final treatment, discontinuation of systemic corticosteroids. RESULTS: Chlorambucil was discontinued in seven patients because of side effects: two females had temporary amenorrhea develop, two patients had unacceptable gastrointestinal intolerance, one patient had infection, and 2 patients had progressive leukopenia. Nineteen patients (68%) showed positive clinical response to the treatment, four (14%) initially responded then relapsed after discontinuation of the drug, three patients with ABD had improvement of ocular disease but worsening of systemic symptoms, and two had persistent inflammation. Visual acuity was improved in 24 eyes (43%), stable in 22 (39%), and worsened in 10 eyes (18%). Systemic prednisone was successfully discontinued in 19 of the 28 patients (68%), and 14 patients were free of inflammation at the end of follow-up without any systemic medication. CONCLUSIONS: Chlorambucil can be a safe and effective alternative for preserving vision in patients with otherwise treatment resistant uveitis.

Adolescent↗
PubMed1984

B- and T-lymphocytes in ocular disease.

Ocular inflammatory diseases and ocular adnexal lymphoid tumors have become less obscure and intimidating by virtue of our ability to study the infiltrates in these various diseases for their B-lymphocyte and T-lymphocyte composition. Comparisons are also possible between lymphocytic profiles in the peripheral blood and the precise composition of the in situ infiltrates within the ocular tissue themselves. The availability of monoclonal antibodies, which can determine T-lymphocytic subsets such as T-helper cells and T-suppressor/cytotoxic cells, natural killer cells, and monocytes-histiocytes, has provided a powerful technology for the delineation of the distinctive immune composition of the inflammatory infiltrates, as well as any possible disturbances in T-cell immunoregulation. B-lymphocytes produce immunoglobulins, which may be misdirected as autoantibodies in local or systemic autoimmune diseases. Immunoglobulin-mediated and therefore B-cell derived conditions include vasculitis, progressive cicatricial ocular pemphigoid, Mooren's corneal ulcer, scleritis, and hay fever and vernal conjunctivitis. Other diseases in which B-lymphocytes, their immunoglobulin products or immune complexes formed with presently unknown antigens are potentially at fault are chronic non-specific uveitis; iridocyclitis in Behcet's syndrome; Fuch's heterochromic syndrome, ankylosing spondylitis, and Reiter's syndrome; Graves' disease; and idiopathic inflammatory orbital pseudotumor and myositis. T-cells do not produce immunoglobins, but rather secrete lymphokines or interact directly with receptors or determinants on viruses or target tissues (eg. immunosurveillance against neoplasia); it is possible that some autoimmune diseases are the result of neo-antigens on the surfaces of host tissues that have been coded for by a cryptic inciting virus. T-cell diseases include phlyctenulosis graft rejections, graft versus host disease, and possibly sympathetic ophthalmia and temporal arteritis. Natural killer cells are involved in many of the same diseases as cytotoxic T-cells, except that the former require no period of sensitization (natural immunity), whereas cytotoxic T-cells must undergo an antigen-specific blast transformation (acquired immunity of the delayed hypersensitivity type). In many diseases in which B-cell derived auto-antibodies are at fault, there may be local tissue or systemic T-cell imbalances, with a reduction in T-suppressor cells and a relative augmentation in T-helper cells, thereby facilitating production of misdirected auto-antibodies.(ABSTRACT TRUNCATED AT 400 WORDS)

Antibodies, Monoclonal↗
PubMed1985

Choice of procedure. Enucleation, evisceration, or prosthetic fitting over globes.

Enucleation is more likely to be associated with certain intraoperative and postoperative complications but remains the procedure of choice in cases where detailed histopathologic examination of the globe is required, in many cases of intraocular neoplasm, and in selected cases of ocular trauma with visual loss. In many patients, evisceration results in enhanced cosmesis compared to enucleation and is a technically simpler and faster operation. Evisceration may be indicated in patients with blind and unsightly or painful eyes and in selected instances of ocular trauma following discussion of the risk of sympathetic ophthalmia with the patient. It is contraindicated in patients with possible intraocular malignancy. In appropriate cases, a cosmetic shell or contact lens may constitute an alternative to enucleation or evisceration, and may provide superior cosmesis. Management of patients requiring these procedures should be tailored to the particular clinical situation with consideration of the wishes of the well-informed patient.

Contact Lenses↗
PubMed2001

Incidence of Chlamydia trachomatis and other potential pathogens in neonatal conjunctivitis.

OBJECTIVE: Ocular infection in neonatology is a permanent and important health problem. To improve primary attention, prevention, and control, the study of the potential bacterial etiology of all consecutive cases of conjunctivitis was incorporated as a regular procedure in primary care from July 1995 to December 1998. MATERIALS AND METHODS: Prof. A. Posadas Hospital (Great Buenos Aires) has an average of 4294 births per year. This report analyzes the results obtained in 332 infants (age range, 0-30 d) with conjunctivitis. Clinical conjunctivitis was diagnosed in inpatients and outpatients by the same specialized staff. Isolation and characterization of bacteria were done by conventional microbiologic methods, including specific search for Neisseria gonorrhoeae and Chlamydia trachomatis. Chlamydia trachomatis was studied by antigen immunodetection and polymerase chain reaction, and genotyped by restriction fragment length polymorphism. RESULTS: Conjunctivitis had an incidence (cases per 1000 live births) of 39.6 in 1995, 25.3 in 1996, 15.4 in 1997, and 15.2 in 1998. Microbial growth was detected in 167 (50.3%) of 332 cases. Ocular C. trachomatis infection was detected in 26 cases (7.83%). Five of seven isolates in tissue cultures belonged to type E and two to type G. Bacteria from respiratory ecology were the main isolates: Haemophilus influenzae (16.9%), Streptococcus pneumoniae (12.3%), and Staphylococcus aureus (8.7%). Haemophilus influenzae isolates were not serotyped and 17.2% of them were b-lactamase producers. In 15 cases both H. influenzae and S. pneumoniae were isolated together. Of S. pneumoniae, 4.9% were oxacillin resistant. CONCLUSIONS: There has been a decline in the total number of cases of neonatal conjunctivitis, but the disease is still an important health problem. Chlamydia trachomatis also shows a decreasing profile with an incidence of (cases per 1000 live births) 4.39 in 1995, 1.85 in 1996, 1.01 in 1997, and 0.78 in 1998, and a tendency to show more incidence in spring-summer and significant accumulation of cases in babies between 7 and 9 days of age. Haemophilus influenzae alone (12.3%) or associated with S. pneumoniae (4.5%) appears as a prevalent potential bacterial pathogen. A significant accumulation of H. influenzae and S. pneumoniae cases occurs in winter. In 47.6% of cases, there was no bacterial growth. No significant seasonal differences in percentage of negative cultures or among the three-day age groups were detected. Neisseria gonorrhoeae was not found associated with ophthalmia neonatorum in this series.

Age Factors↗
PubMed1999

Friedrich August von Ammon (1799-1861).

As this year marks the 200th anniversary of the birth of Friedrich August von Ammon (1799-1861), it presents an opportunity to recall and celebrate Ammon's life and his many contributions that helped shape both ophthalmology and plastic surgery into independent specialties. Some 250 years after Georg Bartisch, Ammon reestablished Dresden as a major center of ophthalmology, through the creation of a teaching institute, the publication of influential periodicals, and his personal publication of important monographs and journal articles. Ammon's Zeitschrift für die Ophthalmologie (founded 1830) was only the third journal in history that had been entirely devoted to ophthalmology. His prize-winning treatise, De Iritide (1835), correctly categorized iritis and gave a detailed description of sympathetic ophthalmia. His beautiful color-plate atlas, Klinische Darstellungen (1838-1841), contains landmark descriptions of congenital eye anomalies and has been described by Norman as 'the best summary of the knowledge of diseases of the eye prior to the introduction of the ophthalmoscope.' Ammon made most of his literary contributions in ophthalmology but he also contributed to another emerging field, plastic surgery. His monograph, Die plastische Chirurgie (1842), critically and comprehensively surveyed the entire history and current practice of plastic surgery, one of the very first textbooks to achieve this goal. In his last monograph (1858) Ammon returned to the subject of embryology of the human eye and drew upon his 30 years of study. Before his death, two of his last papers reported ophthalmoscopic observations, demonstrating his exploration of the frontiers of ophthalmology that characterized his entire career.

Germany↗
PubMed1994

Intraocular caterpillar hairs (setae): clinical course and management.

Ophthalmia nodosa is a well-documented condition. We present a case in which a live caterpillar was rubbed into a patient's eye and, after relentless penetration of the hairs into the globe, vitrectomy was required. We discuss the differing clinical features of these injuries, the mode of penetration and the treatment options.

Adolescent↗
PubMed1998

The role of azathioprine in the management of retinal vasculitis.

PURPOSE: Azathioprine is commonly used as a second-line immunosuppressive agent in the management of patients with retinal vasculitis. The aim of this study was to determine the efficacy of azathioprine by evaluating its effect on relapse rate, clinical outcome and maintenance steroid dose. METHODS: A retrospective analysis was performed of 34 patients presenting over 15 years to the Medical Eye Unit at St Thomas Hospital. Relapse rate, steroid dosage, inflammatory score and visual acuity were assessed before and during treatment with azathioprine. RESULTS: Thirty-four patients (23 male) aged 17-70 years (median 41.4, median 38) were enrolled. Fifteen had idiopathic retinal vasculitis, 12 had Behçet's disease, 2 sarcoidosis, 2 sympathetic ophthalmia, 1 birdshot retinochoriodopathy, 1 Still's disease and 1 Harada's disease. The principal indications for azathioprine treatment were uncontrolled disease despite appropriate steroid therapy in 28 patients (82%) or to permit a decrease in steroid dosage in 6 patients (18%). Frequency of relapse was assessed in 10 patients whose pre-treatment and treatment periods with azathioprine were of 1 year or greater. All were found to have a decreased relapse rate. In 60%, reduction of steroid dosage was achieved. Ocular inflammatory score decreased in 56% of eyes and visual acuity was improved or maintained in 64%. In 8 patients treatment had to be stopped due to side effects. CONCLUSION: Within the limitations of a retrospective study, we found azathioprine when used in combination with systemic steroids to be most effective at reducing the relapse rate of retinal vasculitis, but only partially effective in allowing a reduction in steroid dosage.

Adolescent↗
PubMed2003

Sheep-associated malignant catarrhal fever involving 3-5-week-old calves in Saudi Arabia.

Between late December 1999 and late April 2000, three locally bred Friesian calves (ageing 25, 28 and 35 days) in a dairy farm, at Al-Ahsa locality of the eastern region of Saudi Arabia showed dullness and inappetence. Their rectal temperatures ranged between 41 and 41.5 degrees C. One to 2 days later and onwards, the calves showed lacrimation, nasal discharge, salivation, oedema of the head, conjunctivitis, exo-ophthalmia and corneal opacity. One calf showed diarrhoea. The superficial lymph nodes were oedematous and swollen. The calves died after 7, 5 and 8 days, respectively, following the onset of the disease. Calves and rabbits were experimentally infected with materials from the naturally infected calves. The rabbits showed fever, mild conjunctivitis and one rabbit showed wet faeces. The experimentally inoculated calves showed rise in temperature and mild symptoms but none of them died. The virus from the naturally infected calves and from the experimentally infected rabbits was identified as malignant catarrhal fever (MCF) virus using both the complement fixation test and the fluorescent antibody test, employing a reference anti-serum against the WC 11 strain of MCF virus. Serological survey for MCF antibodies in cattle, sheep and goats from the affected farm revealed that 54% of the examined animals were positive. The situation of MCF in Saudi Arabia was discussed in relation to sheep and wild game. This paper constitutes the first report of MCF in Saudi Arabia and the Gulf region.

Animals↗
PubMed2005

Chlamydia trachomatis infections in neonates and young children.

In 1911, Lindner and colleagues identified intracytoplasmic inclusions in infants with a nongonococcal form of ophthalmia neonatorum called inclusion conjunctivitis of the newborn (ICN). Mothers of affected infants were found to have inclusions in their cervical epithelial cells, fathers of such infants had inclusions in their urethral cells, and the epidemiology of sexually transmitted chlamydial infections was revealed. Fifty years later, chlamydial isolation procedures were developed, and studies again demonstrated Chlamydia trachomatis as an etiology of ICN and the female birth canal as the reservoir. In the late 1970s, a report by Beem and Saxon described respiratory tract colonization and a distinct pneumonia syndrome in infected infants. Genital chlamydial infection is recognized as the world's most common sexually transmitted disease, with estimates of greater than 4 million new infections occurring annually in the United States. Although most C. trachomatis infections in men and women are asymptomatic, infection can lead to severe reproductive complications in women. The high prevalence in women of child-bearing age results in exposure of an estimated 100,000 neonates in the United States annually. Many of these infants develop conjunctivitis, pneumonia, or both in the first few months of life. Clinical features, diagnosis, treatment, and approaches to prevention of conjunctivitis and pneumonia in the newborn and young infant are reviewed here. Appropriate testing for chlamydial infection in a pediatric victim of sexual assault and the implications of identifying C. trachomatis in suspected cases of childhood sexual abuse also are reviewed.

Adult↗
PubMed2001

Ocular manifestations of feline herpesvirus.

Feline herpesvirus-1 (FHV-1) infection is ubiquitous in the domestic cat population worldwide. The most common clinical ocular manifestations of infection with FHV-1 are conjunctivitis and keratitis. This paper reviews the pathogenesis of feline herpesvirus-1 and discusses the various clinical ocular manifestations, diagnostic techniques and treatment of FHV-1-induced diseases. Ocular manifestations include: conjunctivitis, keratitis, stromal keratitis, keratoconjunctivitis sicca, ophthalmia neonatorium, symblepharon, corneal sequestrum, eosinophilic keratitis and anterior uveitis. Diagnostic techniques discussed include: virus isolation, fluorescent antibody testing, serum neutralising titers, ELISA and polymerase chain reaction. Various therapies are also discussed.

Animals↗
PubMed2000

[Immunohistochemical detection of humoral autoantibodies in patients with hearing loss in the last hearing ear].

BACKGROUND: An autoimmune etiology similar to the sympathetic ophthalmia has been discussed for sensorineural hearing loss on the last hearing ear following deafness in the first ear. In sympathetic cochleolabyrinthitis inner ear proteins are thought to be released after laterobasal fracture, which may induce an autoimmune process in the last hearing ear. Animal models have failed to clearly demonstrate the location of the target in the labyrinth, attacked by immunologic processes. Furthermore, it is unclear whether the humoral or cellular pathway is initiating this process. METHODS AND PATIENTS: Serum was acquired from 15 patients with traumatic or post-inflammatory unilateral deafness and slowly progressive or sudden sensorineural hearing loss on the last hearing ear. Deparaffinized sections of rat temporal bones were incubated with patient serum and subjected to immunohistochemical examination. RESULTS: A specific but heterogeneous binding pattern of the labyrinth was found in 14 of 15 patients. CONCLUSION: Our results indicate different autoantibodies in the patient serum, which may be the cause of the hearing loss. Therefore, in patients with sensorineural hearing loss on the last hearing ear, we recommend a therapeutic trial with corticosteroids.

Adrenal Cortex Hormones↗
PubMed1999

[Recent experimental and clinical findings retarding an interlabyrinthine connection].

BACKGROUND: In his experiments on the origin and site of formation of perilymph, which he conducted using radioactive substances in 1961. Schreiner also came across a surprising secondary finding, namely that rapid substance exchange takes place between the perilymph spaces of both inner ears. This rapid transition was only demonstrated for real solutions, such as low-molecular radioactive sodium phosphate, whereas it was greatly delayed for C14-labeled amino acids. No patency was demonstrated for particles which approach the limit of visibility under a light microscope, such as cell granules consisting of radioactively labeled mitochondria from rabbits. The graded patency between perilymph spaces in relation to the molecule size of the radioactive substances added indicates a direct connection between the perilymph spaces of both inner ears. This interlabyrinthine connection first postulated by Schreiner was controversial at the time but was soon confirmed by several authors in Germany and abroad and has been known since then as the "Schreiner effect" (1964). CLINICAL FINDINGS: In spite of these publications, the hypothesis of an interlabyrinthine connection was ignored for over 20 years until the American authors Harris et al. took up the topic once again in 1985, because of clinical investigations. They termed this phenomenon "sympathetic cochleo-labyrinthitis" in line with sympathetic ophthalmia. In pathogenetic terms, these authors suspect autoimmunological genesis. It has not been clarified which anatomical and immunological routes are taken to affect the labyrinths. Possibilities being discussed include connections via the perineural lymph sheath, NEW METHODS: In recent times, the perivascular spaces have also been considered, and Maher et al. (1997) attempted to substantiate this theory by demonstration using contrast media. In 1997, W. Zenker, the Zurich anatomist, conducted experiments using ferritin and was the first to demonstrate movement of such molecules within the dura. He believes that the transition of substances from one inner ear to the other is via CSF movements in the subarachnoid space and in the perivascular compartment of numerous small vessels crossing in a median plane such as veins of the clivus and plexus cavernosi but also venules and arterioles.

Animals↗
PubMed1999

[Results after cyclodiathermy: report on 29 eyes].

BACKGROUND: Persisting angle-closure glaucomas with circular anterior synechia and lost anterior chamber are at the moment an unsolved therapeutical problem. Antiglaucomatous anterior cyclodiathermy is a last therapeutical option to serve the eye. PATIENTS AND METHODS: We retrospectively examined the results and the complications of 29 eyes, which were consecutively treated with anterior cyclodiathermy between 1992 and 1998. RESULTS: We found a significant decrease of the intraocular pressure (IOP) during mean follow-up of 10 month, reduction of antiglaucoma medication, no change of visual acuity and no severe complications (no phthisis bulbi, no severe intraocular hemorrhage, no sympathetic ophthalmia). CONCLUSION: Anterior cyclodiathermy is a successful treatment for selected patients with severe forms of glaucoma, if other operation techniques and antiglaucoma medication fail to decrease the IOP.

Adolescent↗
PubMed1995

[Tarantule hairs as corneal foreign bodies].

A 22 year-old-man and owner of several tarantulas visited his ophthalmologist because of red itchy eyes. Additionally to kerato-conjunctivitis epidemica, uncommon hairs were found especially in his left cornea. Corrected visual acuity was 0.8. According to literature these spider hairs can induce granulomas in the meaning of ophthalmia nodosa, and even migrate inside the eye. Therefore we removed as many hairs as possible, but we left two, not to cause iatrogen perforation. The penetration depth was measured by laser tomography. Local steroids successfully prevented further granuloma formation. Regular ophthalmological controls are important to early detect possible changes, and if necessary to remove these hairs even from deeper corneal layers, in case by keratectomy.

Adult↗
PubMed1991

[Complications following cataract incision 1751].

In 1751 the oculist Joseph Hillmer was expelled as charlatan from Petersburg by an expert opinion, which was founded on 125 case reports on his Russian clients, amongst them 60 suffering from cataracts, which had been couched on 80 eyes. Beside 82% of failures these case reports on cataract-couching contain postoperative complications, epicritically symptomatic for today's clinical pictures, which have been etiologically unknown in 1751. At least five eyes suffered postoperatively blindness by supposed detachment of the retina. The experts believed Hillmer's unexact, rough handling of the cataract needle to have been the reason. No less than 18 cases were complicated post operationem by secondary glaucomata, which ended at least twice as absolute glaucoma. We also recognize acute glaucoma, caused by couching the cataract. Secondary glaucomata were associated with severe iridocyclitis. In three cases there are indications of sympathetic ophthalmia. The experts seem to have been well acquainted with that threat to the untreated second eye. We are enabled to recognize a vitreous hemorrhage and an abscess in vitreum. No less than 21 times the couched crystalline lenses had set up again, in one case repeatedly after having been couched a second time.

Cataract Extraction↗
PubMed1989

[Endophthalmitis phakoanaphylactica with anterior uveitis of the partner eye].

Phakoanaphylactic endophthalmitis is a rare but deleterious complication of surgical, traumatic, or spontaneous lens capsule perforation. The authors describe a 79-year-old patient who developed severe endophthalmitis four days after extracapsular cataract extraction and implantation of a posterior chamber lens. The inflammation, which led to phthisis and eventually necessitated enucleation, was characterized by an atypical hypopyon in the form of a conglomerate of fibrin and cellular elements originating at pupillary level. The laboratory workup revealed a chronic lympho-granulomatous inflammation with epitheloid cells and polynuclear giant cells near the lens capsule, confirming the clinical diagnosis of a phakoanaphylactic endophthalmitis. Ten weeks after the cataract extraction a persistent iridocyclitis developed in the fellow eye, which had been free of inflammation up to that point. Hypotonia of the globe, a previous opacification of the first eye, the close chronological relationship with the phakogenic inflammation of the first eye, and clues from the literature suggest a sympathizing phakoanaphylactic endophthalmitis in the fellow eye. Differential diagnosis to rule out other postoperative inflammatory reactions, e.g., bacterial endophthalmitis, toxic lens syndrome, pseudo-phakoanaphylactic endophthalmitis, and sympathetic ophthalmia is described.

Aged↗
PubMed1988

[Change in the course of blindness in childhood].

In the course of the 20th century there have been major changes in the causes of blindness in childhood. This is illustrated by the example of the 1271 children born between 1885 and 1976 who attended the Bavarian State School for the Blind. The following developments became apparent: Until 1940 the most common cause of blindness, accounting for 25% of the cases, was corneal disease, almost exclusively of infectious origin. This cause has been reduced most, to 2%. There has also been a clear reduction in blindness due to anterior uveitis (mainly due to infection) and chorioretinitis. There were fewer such cases -5% and 3%, respectively. Since the 1960s there have been no further cases of blindness due to ocular injury in children, and no case of sympathetic ophthalmia has occurred since 1950. While the incidence of congenital cataract and buphthalmos has remained constant, they now only lead to blindness in a small proportion of those affected, thanks to improvements in therapy. The incidence of blindness caused by retinal detachment, usually associated with myopia, is also unchanged, though rare (2-3%). The same applies to bilateral retinoblastoma, while the frequency of optic nerve atrophy (20%) and tapetoretinal degeneration (16-19%) has remained both constant and high. There has been a drastic increase in ocular malformations and developmental anomalies. These include retrolental fibroplasia, which was responsible for blindness in 38% of the children born between 1967 and 1976. Overall, there has been a major reduction in the number of blind children in the population since the 1960s and especially since the 1970s.

Blindness↗