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Pattern reversal Visual Evoked Potentials (VEPs) were elicited from 68 normal subjects (31 males, 37 females) in the age range 40-80 years. With VEP latency, a significant age effect, increasing values with age, was demonstrated, but none in relation to gender. The converse held true for VEP amplitude however, no age effect being observed, but some gender effect in that lower values were elicited from males as compared to females.

We have documented the initial clinical features of 100 patients with primary Sjögren's syndrome (SS) together with the results of their baseline investigations. The evolution of the disease in these patients has been followed for a median of 34 months (range 3-84 months). The majority of patients were females aged 40-60 years, and common clinical features included eye symptoms (100%), xerostomia (100%), polyarthralgia (94%), Raynaud's phenomenon (81%) and salivary gland swelling (47%). Thyroid disease was relatively common (14%) while other endocrine disease was rare. Four patients died during follow-up, and three cases of lymphoma were detected. Other serious complications included pericarditis (10%), pleuroparenchymal lung disease (9%), renal tubular acidosis (3%) and cerebrovascular accidents (2%). The presence of anti-Ro antibodies identifies patients with more severe systemic disease. Spontaneous improvement occurred in 12 patients, while steroids were required for specific complications in 18. Overall, although lymphoma was found to excess in our group, the high mortality reported with primary SS elsewhere was not seen.

Retinal migraine is not uncommon, but permanent sequelae in the anterior visual pathway are rare. We describe the case ofa young woman in whom blindness developed over a six-year period due to recurrent episodes of migrainerelated occlusions of a branch retinal artery.Migraine occurs in 10-25% of the population' and is more common in women than in men. ' Eight months later, following an increase in the frequency of her migraine, she developed an occlusion of a macular branch of the right superotemporal arteriole which resulted in a permanent scotoma and a reduction of visual acuity on the right to 6/9.At the age of 20, again following an increase in the frequency of her migraine, she suddenly developed further loss of vision in the right eye due to an inferotemporal BRAO affecting the macula (Fig 1). On this occasion she was treated with the calcium channel blocker nimodipine and intravenous methyl prednisolone 1 g daily for three days. No visual recovery occurred.The patient had not been taking an oral contraceptive agent and had never been prescribed ergot derivatives. Her father, brother, and niece also suffer from migraine. EXAMINATIONA general medical examination revealed no significant abnormalities. In particular she was normotensive, the heart was clinically normal, and there were no carotid or orbital bruits. Slitlamp examination revealed normal anterior segments, and the intraocular pressures were 14 mm Hg in both eyes. After the most recent BRAO her visual acuity was counting fingers in the right eye and hand movements in the left. There was loss of the central and superotemporal visual field of the right eye and loss of all but the superotemporal quadrant of the left. Funduscopy showed an acute occlusion of the inferotemporal arteriole on the right and optic atrophy plus attenuation of the superior and inferior temporal arterioles on the left. A fluorescein angiogram, performed on the right eye two days after the inferior temporal BRAO (Fig 2) showed occlusion of the inferotemporal arteriole and evidence of the previous superior macular branch arteriolar occlusion. INVESTIGATIONSThe following investigations gave normal or negative results: full blood count, erythrocyte sedimentation rate, routine biochemical screen-

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