Over a nine-month period two hundred and thirteen referrals to the Department of Ophthalmology of the Leicester Royal Infirmary, England, for suspicion of glaucoma were examined by a single ophthalmologist. Ninety-nine percent of referrals resulted from the findings at an optometric visit. Despite this, less than 32% were confirmed as having glaucoma and less than 23% had ocular hypertension. Twenty-nine percent showed no abnormality. Of those with glaucoma 19% showed advanced field loss in their worse eye. The guidelines relating to referral practices as a result of optometric examinations need to be reviewed and agreed upon by ophthalmologists, optometrists and general practitioners.

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Objectives-To estimate demand incidence and episode rates of ophthalmic disease in a defined urban population over one year.Design-Study of patients presenting with eye problems to general practice and eye casualty department.Setting-General practice and ophthalmic services in west Nottingham.Subjects-36 018 people from the combined practice lists of 17 Nottingham general practitioners.Main outcome measures-Ophthalmic disorder, age and sex ofpatient, and where presented.Results-2587 consultations were recorded for ophthalmic problems, 1771 with general practitioners and 816 with eye casualty. Most consultations to general practice were by females (1066 (60%)), whereas men aged 15-44 accounted for most work in eye casualty. These men commonly presented with trauma. Infective conjunctivitis, the commonest condition, had an episode rate of 13-5/1000 populationlyear. Demand incidence for cataracts was 1 9/1000 population/year. Demand incidence for chronic conditions increased with age.Conclusions-As the average age of the population increases demand for ophthalmic services will rise. Planning and provision ofresources to meet this increased demand should be considered now.

Differential diagnosis included Behcet's disease, sarcoidosis, systemic lupus erythematosus, viral retinitis, and Eales disease. He did not have any systemic signs and symptoms such as oral aphtha, genital lesions, and skin lesions. The absence of these systemic symptoms and laboratory results indicative of autoimmune diseases excluded many of the aforementioned diseases, especially Behcet's disease. Viral retinitis will yield more severe exudates than preretinal or vitreous haemorrhage. It is uncommon in Eales disease that anterior uveitis and dense vitritis exist as seen in our case. 4 This patient and his father have HLA-B27, which is possessed only in 0.8% of the Japanese population. 1 His father had a past history of unknown uveitis. It is quite possible that his disease was also related to the haplotype of HLA-B27. Furthermore, HLA-B27 AAU occurs in B27positive members of the patients' families (approximately 10%) more frequently than in B27-positive healthy controls (1-2%). 5 Posterior segment involvement in HLA-B27-associated uveitis occurs somewhere between 4 and 17.4% in Caucasians. 2,6 Benitez del Castillo reported that the blood-aqueous barrier had been broken when HLA-B27-positive acute anterior uveitis was in active stage. 7 However, these cases usually have good responses to corticosteroid or immunosuppressive therapy. HLA-B27-associated uveitis in Japanese have also good visual prognoses. 8 However, there was no report of PVR despite intensive therapy. Our case, thus, verifies the fact that severe and refractory inflammation can happen in HLA-B27associated uveitis that could lead to the development of PVR in a short period.

A line scan imaging system which provides a facility for comprehensive measurement and analysis of eyelid motion in human subjects is described. The device obtains parasagittal line images of the eye and eyelids by focusing an image of the eye onto a linear 256-element CCD array. Line images are acquired and digitized at a rate of 200 per second and stored in a buffer memory. The stored data are subsequently analysed on a PC to give measurements of eyelid displacement and velocity. Measurements of eyelid displacement and velocity during normal blinks in five subjects were comparable with published results from other measurement techniques.