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Br J Ophthalmol. 2007 September; 91(9): 1256.
PMCID: PMC1954929

From the Library

“They eventually landed in Trieste, and there for the next decade or so, he worked as a language teacher and completed Dubliners and A Portrait of the Artist as a Young Man. With the publication of Portrait, in 1916, he acquired rich patrons, but until then—that is, throughout his children's early years—the Joyces were very poor. Some days they went without dinner. Their first child, Giorgio, was born in 1905, a bonny, easy baby, and furthermore, a boy. Nora adored him until the day she died. Two years after Giorgio came Lucia, a sickly, difficult child, and a girl, with strabismus—that is, she was cross‐eyed. Nora, too, had strabismus, but hers was far less noticeable.” Acocella, J. Twenty‐Eight Artists and Two Saints. New York: Pantheon Books; 2007:4.

The case against cigarette smoking and its effect on age‐related macular degeneration (AMD) continues to be built. In the EUREYE study of nearly 5 000 patients from seven study centres across Europe investigators estimated that the attributable fraction of AMD related to smoking was 27%. Most alarmingly they found that compared with people with unilateral macular degeneration those with bilateral were much more likely to have a history of heavy smoking in the previous 25 years. The need for public education about the relationship between smoking and AMD seems self‐evident. (Ophthalmology 2007;114:1157–63)

Considerable controversy surrounds the issue of whether or not visual training for patients with visual field defects related to brain damage is effective in expanding the useful visual field (Br J Ophthalmol 2005;89:30–5). In a meta‐analysis of relevant publications on the topic, scientists from The Netherlands concluded that it remains unclear whether there is a benefit from restoration therapy. No studies have given a satisfactory answer. They conclude that strategies to improve scanning techniques seem more effective and simple than those aimed at visual restoration. The need for further validation or refutation of the effectiveness, or lack thereof, of visual restoration therapy was emphasised by the authors. (J Neurol Neurosurg Psychiatry 2007;78:555–64)

“In Buenos Aires after WWII, there were two literary voices of incontestable international stature. The main difference between them was that only one of them was known to possess it. The whole world heard about Borges. But to get the point about Sabato you had to go to Argentina. Both inhabitants of a beautiful but haunted city, both great writers, and both blind in their later lives, Borges and Sabato were linked by destiny but separated in spirit.” James, C. Cultural Amnesia. Necessary Memories from History and the Arts. New York: WW Norton & Co; 2007:68.

The use of anabolic steroids is now relatively widespread in many competitive athletic activities. Yet the adverse effects of these hormones cannot be denied. A study from Italian investigators demonstrated that anabolic steroid use was associated with lower diastolic peak velocities and impaired systolic deformation indices of the left ventricular lateral wall and interventricular septum even though the subjects were asymptomatic. The implications for this observation are not known but other studies have suggested a four‐fold rise in mortality in power lifters using anabolic steroids. (Br J Sports Med 2007;41:149–55)

Concerns have been raised that routine blood transfusions may be involved in the transmission of cancer. In a large database from Scandinavia, this fear appears to be unjustified. The authors studied 354 000 people who received blood products between 1968 and 2002. Three percent of these patients later developed cancer but they were no more likely to develop cancer than any other patient group. The authors assert the risk of cancer remains negligible even 20 years after transfusion of blood products. (Lancet 2007;369:1724–30)

Angle closure is an anatomic disorder that accounts for a significant amount of glaucoma morbidity throughout the world. It occurs as a result of iris apposition to the trabecular meshwork. Physicians from New York have demonstrated that there are anatomical reasons for earlier closure of the superior portion of the iridocorneal angle. This appears to be due to differences in iris insertion position on a ciliary body face and from asymmetry of the ciliary body position. (Arch Ophthalmol 2007;125:734–9)

Distinguishing neuropathic causes of eyelid ptosis from myopathic causes is usually not difficult. The association of pupillary anomalies with eyelid ptosis usually points to a neuropathic process. Physicians in Italy have recently reported a small group of patients presenting with upper eyelid ptosis related to sympathetic nerve dysfunction that were mistaken as myopathic in origin. They emphasise that the use of naphazoline nitrate, a sympathomimetic drug may be useful in differentiating neuropathic from myopathic ptosis. Installation into the conjunctiva sac of one or two drops of naphazoline nitrate, an alpha adrenergic eye drop commonly used as a decongestant, caused complete opening of eyelids within 2–3 minutes in the patients described by these authors. (J Neurol Neurosurg Psychiatr 2007;78:632–4)

Branch vein occlusion is a frequent eye disorder in middle‐aged and elderly patients. It is primarily a consequence of arterial disease with a number of documented risk factors including arterial hypertension, diabetes, smoking, etc. One might naturally anticipate, therefore, that the occurrence of branch retinal vein occlusion might be a risk factor for increased mortality in involved patients. Nevertheless in a study from Denmark, physicians did not show an association between branch retinal vein occlusion and cardiovascular or cerebral vascular risk factors. There was no significant difference in mortality between patients with branch retinal vein occlusion and a control population. The authors suggest that these results may be due to the institution of interventions after the diagnosis of branch retinal vein occlusion to address underlying associated medical problems. (Ophthalmology 2007;114:1186–9)

“The mathematics was impressive, but in Hamilton's hands it led to immediate experimental payoff. Hamilton noticed that his method implied the existence of “conical refraction,” in which a single light ray hitting a suitable crystal would emerge as an entire cone of rays. In 1832 this prediction, which was a big surprise to everyone who worked in optics was dramatically confirmed by Humphrey Lloyd using a crystal in the mineral aragonite. Overnight, Hamilton became a house hold name in science.” Stewart, I. Why Beauty is Truth. A History of Symmetry. New York: Basic Books; 2007:142.

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