SUMMARYIntroduction. Following laboratory studies on new potential chemotherapy for Acanthamoeba keratitis,

Aims-To estimate the incidence of corneal melting or necrotising keratitis in association with systemic disease in the Yorkshire Region and to determine the type and duration of the systemic association. Methods-In a prospective study, vigorous attempts were made to identify all patients presenting with newly diagnosed corneal melting over a 3 year period. Results-27 patients were identified during the study period. Rheumatoid arthritis and Wegener's granulomatosis were the most common disease associations. Corneal melting was a late complication of rheumatoid arthritis, but usually occurred during early and overt systemic disease in patients with Wegener's granulomatosis. Conclusion-The annual incidence of corneal melting in the Yorkshire Region is 3.01/million/year (95% CI = 0.7-9.6). (Br J Ophthalmol 1999;83:941-943) Corneal ulceration with rapidly progressive stromal thinning or melting occurs most commonly in association with a systemic vasculitis.

Ninety-six cases of anterior globe perforation in children less than 16 years old, requiring surgical repair, were reviewed. Seventy-three patients were male and 23 female, with a mean age of 9 years 4 months. Perforation involving just the cornea was associated with a good visual prognosis unless: it involved the visual axis, resulting in corneal scarring and/or significant astigmatism (> 3.0 DS); it involved greater than one-quarter of corneal diameter; or there was non-compliance with spectacles/patching in patients younger than 8 years old. Injuries involving the lens in those younger than 8 years were associated with a far worse prognosis due to the problems of correcting aphakia. Surgical delay and method of injury did not affect prognosis. Some patients fail to re-attend and greater patient/parent education prior to discharge is recommended.

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