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SUMMARY This report documents the long-term clinical and histopathological behaviour of eight intraorbital and 16 intracranial optic nerve gliomas and relates the therapeutic data to the prognosis for both visual acuity and survival. The mean age at onset of symptoms was 8.6 years and at the diagnosis 10O9 years. It is generally held that proptosis is mild in intraorbital glioma, but we encountered marked proptosis ranging from 7 to 12 mm in six of the eight intraorbital gliomas, which contained abundant Alcian-blue-positive mucoid material. Of the patients with intracranial optic nerve gliomas 37.5% survived for a mean of eight years after treatment with radiotherapy or surgery combined with radiotherapy. At follow-up ranging from five months to 11 years only one of the six patients with intracranial gliomas had full visual acuity. Our observations emphasise that, although optic nerve gliomas are benign hamartomas, the prognosis for visual acuity and survival is unfavourable in cases which are diagnosed and treated late. Histopathological and histochemical observations suggest that increase in the amount of mucoid material may contribute to rapid enlargement of intraorbital and intracranial optic gliomas.Since the first description of optic glioma by Scarpa in 1816 much has been written on their natural course and treatment.' Most optic gliomas are low-grade pilocytic astrocytomas, and excision of the tumour results in a benign course. Malignant optic nerve gliomas are rare.2 Death from intracranial optic glioma may be from mechanical pressure on vital structures, mainly owing to enlargement of the tumour.1 Anderson and Spencer' emphasised the accumulation of mucinous material within the tumour as an important cause of its enlargement together with proliferation of neoplastic astrocytes and a reactive proliferation of arachnoidal tissue.The present study reports the clinical findings and the effect of treatment on visual acuity and survival in children with histologically confirmed glioma of the optic nerve or chiasm. In addition, the effect of collateral meningeal hyperplasia and accumulation of mucoid material was studied histopathologically and histochemically as a possible mechanism for Correspondence to Professor S Bilgiq, Hacettepe Universitesi, Hastaneleri, Turkey. enlargement of the tumour causing rapid exophthalmos or progressive deterioration of the patients' health. Material and methodsThe hospital records of 24 patients with histopathologically confirmed optic gliomas seen in the Departments of Ophthalmology and Neurosurgery at Hacettepe University from 1968 through 1982 were reviewed. Eight patients with orbital and 16 patients with intracranial optic gliomas were examined with regard to age, sex, and mode of onset of symptoms and signs. The surviving patients were followed up in an attempt to correlate the therapy with visual acuity and survival. The follow-up periods ranged from 5 months to 11 years, mean 8 years.Sections of tumour blocks were prepared and histological verification of tumour c...

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Ligneous conjunctivitis is one of the rare forms of membraneous conjunctivitis. This chronic, recurrent and somewhat peculiar form of conjunctivitis was first described by Lijo-Pavia in 1924. Morax (1928) made the first anatomo-pathologic investigation and used the term "granuloma". In 1935, Bore1 introduced the term "ligneous conjunctivitis". Duke-Elder (1965) found about 50 cases in opthalmic literature.Ligneous conjunctivitis is rarely unilateral, affecting girls more than boys.It causes severe corneal complications which usually end with perforation and, quite often, the loss of both eyes. The membrane is hard and may be 1 or 2 mm. thick. Haemorrhages occur, when removal is attempted, and they reform within a few days, thicker than before. No specific microorganisms cultivated.Treatment was uneffective and the etiology was unknown (Duke- EZdeK 1965, Hery et al. 1966, Katsourakis and Roussas 1966, Spaeth 1967 till recent publications by FranCois and his co-workers (1966, 1967, 1968), who proposed new etiological ideas and therapeutic possibilities.FranCois and his co-workers (1966) have demonstrated the existence of mucopolysaccharides in the constitution of the lesions by means of special staining methods and histochemical analyses.Mucopolysaccharides are colored using specific staining methods and loose this coloring when the specimens are treated with hyaluronidase, acting as a