SUMMARYThe retinal function of patients with high refractive error was studied eletroretinographically. Thirty-one hypermetropic patients, 7 myopic patients, and 7 patients with either unilateral or bilateral aphakia participated in the study. The ERG responses were measured in the light-and dark-adapted states. It was found that myopic eyes were characterised by subnormal amplitude but normal pattern, expressed by normal relationship between the b-wave amplitude and the a-wave amplitude. In aphakia the ERG responses were of normal amplitude and pattern. However, the hypermetropic patients could be divided into 3 groups. One group included subjects with a subnormal b-wave to a-wave relationship. The second group was characterised by a normal b-to a-wave relationship, while patients belonging to the third group exhibited supernormal b-wave to a-wave relationship. This classification of hypermetropic subjects did not correlate with the axial length of the eye or the refraction of the ocular media.The electrical response of the eye (ERG) to a flash of light is commonly used to evaluate the functional integrity of the retina.12 The a wave of the electroretinogram reflects light absorption by the photoreceptors and their functional integrity.2-5 The b wave is generated in the proximal retina,2-5 and therefore its amplitude depends on that of the a wave and on signal transmission in the retina.6 Thus the relationship between the b-wave amplitude and that of the a wave depends on the functional integrity of the retina. Any extraretinal parameter, such as opacities in the ocular media, resistance of ocular and extraocular tissues, or resistance between the recording electrodes, may affect the size of the electroretinogram but not the b-wave to a-wave relationship. Therefore the b-wave to a-wave relationship may serve as a useful index for the assessment of retinal function.6It has been previously reported that the amplitude of the b wave was proportional to the refraction of the eye, being smallest for high myopia and largest for hypermetropia.7 An inverse relationship was found between the b wave and the axial length of the eye, which was attributed to the increase in the ocular Correspondence to Ido Perlman, PhD,

The prevalence of pseudoexfoliation among patients of Sephardic origin was more than twice the expected when compared with the ethnic distribution of the population consulting the Rambam Medical Center eye clinic. A strong association between brown irises and pseudoexfoliation was noted. No uniform scanning electron microscope pattern was seen of the pseudoexfoliation.

SUMMARY Twenty-seven patients with vernal conjunctivitis who remained symptomatic following treatment with corticosteroid drops and/or Opticrom drops (sodium cromoglycate 2%, benzalkonium chloride 0.01%) were treated with aspirin. Aspirin produced marked improvement in all patients apart from three. The possible mechanism of the efficacy of aspirin in vernal conjunctivitis is discussed.Vernal conjunctivitis is a severe perennial form of allergic conjunctivitis involving the conjunctiva and often also the cornea. The condition is found predominantly in children or young adults. The main symptoms are those of severe itching, photophobia, and the production of a tenacious, stringy, mucous discharge. The disease generally affects the upper tarsal conjunctiva with papillary hypertrophy and cobblestone appearance. In severe cases the limbal conjunctiva may also be affected, causing localised oedema and hyperaemia or fleshy isolated vegetations. Punctate keratitis and indolent corneal ulceration may also occur.The topical application of corticosteroids may be of considerable benefit. But control is not complete in all cases, and its long term use can produce glaucoma. The efficacy of sodium cromoglycate 2% (Opticrom) remains controversial. ' Aspirin therapy in mastocytosis was found to be beneficial, and, since the pathophysiology of both mastocytosis and vernal conjunctivitis involves mast cell abnormalities, the use of aspirin in treating the latter was tried in three patients.4We report here the effect of aspirin therapy on 27 patients with vernal conjunctivitis. Material and methodsTwenty-seven patients aged 4-18 years were treated with aspirin; 24 were males and three were females.

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A therapeutic trial of 1% indomethacin (Indoptic) eye drops was carried out in 21 children. Looking for possible mediators of inflammation in vernal conjunctivitis, prostaglandin E2 (PGE2) and leukotriene B4 (LTB4 levels in the tears of 9 patients were measured and the effect of the treatment on them examined. A control group of 10 unaffected children was added. Out of 42 eyes in which indomethacin treatment was instilled, only 17 remained in treatment through a 6-week follow-up period. In a few of them a moderate improvement was obtained. The mean level of PGE2 in the patients before treatment was found to be slightly lower than that in the control group, and it dropped even lower during treatment. The average LTB4 level found in patients before treatment was significantly higher than the control group; it decreased somewhat following treatment, but not significantly. This is the first report of elevated LTB4 levels in vernal conjunctivitis, previously not recorded in the literature, it points to the possible role of LTB4 in the pathogenesis of the disease. A constant relationship was observed between low PGE2 levels and high LTB4 content in the patients' tears during highly inflamed states of the eye. We conclude that: (a) indomethacin did not prove to be a highly effective topical treatment for vernal conjunctivitis; (b) PGE2 does not seem to be a dominant mediator of inflammation in this disease; and (c) LTB4, on the other hand, apparently has a role in the mechanism of inflammation of the disease, thus raising hopes for future addition to therapy.