VOL. 88, NO. 5
CORRESPONDENCE
3. Edelhauser, H. F., Van Horn, D. L., Schultz, R. O., and Hyndiuk, R. A.: Comparative toxicity of intraocular irrigating solutions on the corneal endothelium. Am. J. Ophthaimol., 81:473, 1976. 4. Edelhauser, H. F., Hine, J. E., Pederson, H., Van Horn, D. L., and Schultz, R. O.: The effect of phenylephrine on the cornea. Arch. Ophthaimol. 97:937, 1979.
Vitteliform Macular Degeneration Editor: My patient, whose photograph ap peared as Figure 6, Case 5, in the Ameri can Journal of Ophthalmology, 84:526531, 1977, has the appearance of a vitelliform macular degeneration. This particular patient was exposed to four atomic bomb tests between 1946 and 1948, and to one hydrogen bomb test at a distance of ten to 12 miles in 1952. My patient and I wonder if any other ophthalmologist has seen clinical mani festations of ocular disease, of any sort, in patients who were exposed to nuclear bomb testing. Please reply to James D. Kingham, M.D. University of Arizona Health Sciences Center 1501 N. Campbell Ave. Tucson, AZ 85724
Figure (Kingham). Highl and li-ll i w s nl n.iliont.' epithelium. The electro-oculogram was normal.
955
Vitamin A-Reponsive Punctate Keratopathy in Xerophthalmia Editor: In the article, "Vitamin-A responsive punctate keratopathy in xerophthalmia" (Am. J. Ophthaimol. 87:330, 1979), A. Sommer, N. Emran, and T. Tamba studied the early punctate staining of the cornea in xerophthalmia using fluorescein for vital staining. Fluorescein staining shows epithelial defects. 1 The drying of the epi thelium could be demonstrated by rose bengal and better yet by lissamine green 1,2 as proven by Sauter in Kenya 3 and Kusin and his co-workers 4 in Suma tra, Indonesia. Lissamine green is a safe, sensitive, specific, simple, inexpensive method for the early detection of xerophthalmia. It can be performed by assistants without a slit lamp. Sommers and his co-workers state that tear film drying as a result of loss of conjunctival mucus-producing goblet cells seems unlikely. Nonethe less in Sauter's cases of xerophthalmia, break-up time, and mucus production were normal a few weeks after sufficient vitamin A therapy as judged by the
yellowish lesion is at the level of the retinal pigment
CORRESPONDENCE
3. Edelhauser, H. F., Van Horn, D. L., Schultz, R. O., and Hyndiuk, R. A.: Comparative toxicity of intraocular irrigating solutions on the corneal endothelium. Am. J. Ophthaimol., 81:473, 1976. 4. Edelhauser, H. F., Hine, J. E., Pederson, H., Van Horn, D. L., and Schultz, R. O.: The effect of phenylephrine on the cornea. Arch. Ophthaimol. 97:937, 1979.
Vitteliform Macular Degeneration Editor: My patient, whose photograph ap peared as Figure 6, Case 5, in the Ameri can Journal of Ophthalmology, 84:526531, 1977, has the appearance of a vitelliform macular degeneration. This particular patient was exposed to four atomic bomb tests between 1946 and 1948, and to one hydrogen bomb test at a distance of ten to 12 miles in 1952. My patient and I wonder if any other ophthalmologist has seen clinical mani festations of ocular disease, of any sort, in patients who were exposed to nuclear bomb testing. Please reply to James D. Kingham, M.D. University of Arizona Health Sciences Center 1501 N. Campbell Ave. Tucson, AZ 85724
Figure (Kingham). Highl and li-ll i w s nl n.iliont.' epithelium. The electro-oculogram was normal.
955
Vitamin A-Reponsive Punctate Keratopathy in Xerophthalmia Editor: In the article, "Vitamin-A responsive punctate keratopathy in xerophthalmia" (Am. J. Ophthaimol. 87:330, 1979), A. Sommer, N. Emran, and T. Tamba studied the early punctate staining of the cornea in xerophthalmia using fluorescein for vital staining. Fluorescein staining shows epithelial defects. 1 The drying of the epi thelium could be demonstrated by rose bengal and better yet by lissamine green 1,2 as proven by Sauter in Kenya 3 and Kusin and his co-workers 4 in Suma tra, Indonesia. Lissamine green is a safe, sensitive, specific, simple, inexpensive method for the early detection of xerophthalmia. It can be performed by assistants without a slit lamp. Sommers and his co-workers state that tear film drying as a result of loss of conjunctival mucus-producing goblet cells seems unlikely. Nonethe less in Sauter's cases of xerophthalmia, break-up time, and mucus production were normal a few weeks after sufficient vitamin A therapy as judged by the
yellowish lesion is at the level of the retinal pigment
