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CASES of intra-ocular Cysticercus usually affect only one eye, and bilateral cases such as that reported below are very rare.Case Report A man aged 55 years attended the hospital complaining of gradual loss of vision in both eyes for one year. He was not a vegetarian and was accustomed to eating pork.Examination.-The anterior segments of the eyes were normal. The visual acuity in the right eye was perception of light in all quadrants; in the left eye counting fingers I m.The right fundus showed extensive chorio-retinitis proliferans in the upper quadrants. A vitreous cyst occupied the lower temporal quadrant between 6 and 9 o'clock and covered the macular region. The shortest distance between the edge of the cyst and the optic disc was 5 disc diameters. It appeared to be bilobulate with a sharp luminous border, and a thin transparent wall. No movement of the cyst was detected though it was watched by many surgeons; a doubtful undulating movement of the portion of the wall nearest to the optic disc was occasionally noticed by the writer, but this was dismissed as being due to imagination.The left fundus also showed extensive chorio-retinitis proliferans around the optic disc, and a sub-retinal cyst occupied the area between 7 and 9 o'clock in the lower nasal quadrant. The shortest distance between the edge of the cyst and the optic disc was 6 disc diameters. The cyst was transparent with retinal vessels running over it and a clear luminous border. In the centre was a whitish circumscribed area, suggesting the scolex. No movement of the cyst was noticed, and perhaps none was possible because of its sub-retinal situation.There was no evidence of the presence of Cysticercus in any other part of the body. The motions were examined repeatedly but no tapeworm segment was detected.X-ray examination of the skull was normal. The liver and spleen were not enlarged. There were no subcutaneous nodules. The total white blood cell count was 8,000 per cmm. and the differential count showed 18 per cent. eosinophilia. Blood tests for venereal disease were negative. The urine was normal.Operation.-Because of the typical appearance of the cyst the case was diagnosed as one of bilateral Cysticercus, and the worse (right) eye was operated on first to confirm the diagnosis. After two unsuccessful attempts a third operation was performed under local anaesthesia. A 5-mm. meridianal incision was made at 8 o'clock, 17 mm. from the limbus. The wound was retracted with two double hooks in the hope that the cyst would extrude, but as this did not happen it was assumed that the organism was dead and a lens spoon was gently inserted to scoop it out. As the spoon was inserted there was much bleeding from the choroid, so that the spoon had to be withdrawn and the wound mopped up. Suddenly the edge of a white mass presented itself, and this was gently pulled out with Arruga's forceps (Fig. 1, opposite). After the application of surface diathermy, the wound was closed.

IT is not uncommon to find infections of the cornea with varied organisms of the soil in South India, where agriculture is the main occupation of the people, and mycotic keratitis is often encountered in ophthalmic practice. Case Report A farmer aged 50 years was admitted to the Government Ophthalmic Hospital, Madras, on September 26, 1960, with pain and loss of vision of 3 days' duration in the right eye. Examination Right Eye: Corneal hypopyon ulcer. Visual acuity perception of light. Lacrimal passage free. Left Eye: Visual acuity 6/6. Anterior segment and fundus normal. The following routine treatment was given for one week: subconjunctival injections of crystalline penicillin 100,000 units, local atropine, terramycin ointment and bandage, and sulphadiazine 4 g. daily in divided doses with alkalis. There was no improvement. The case was then reviewed by the author and the followingclinical picture was observed: Right Eye: Corneal ulcer 6-5 mm. diameter, faintly yellow with an irregular round border (Fig. 1). The centre of the ulcer was necrosed but the surrounding cornea was clear. FIG. 1.-Appearance of comeal ulcer in right eye.

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