Between the years I960 and i965, 226

(4) elevated mounds lifting the retina and causing striae radiating from the mounds towards the macula and beyond; (5) pigmentary disturbance of the macula or a wider area of papillo-macular bundle after the resolution of acute stages which, while often clinically severe, is compatible with recovery of normal or near normal vision. It is proposed that the syndrome be designated the 'optic disc drusen retinopathy.'

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IN 1945-46 one of us (EGM) became aware that approximately 20 years in ophthalmology had not taught how or why the classical von Graefe iridectomy deserved its pride of place in the surgical treatment of acute (congestive) glaucoma; nor did any authority pretend to this knowledge. The operative results were not outstandingly commendable and congestive glaucoma remained a condition of serious prognosis for vision. On the contrary a considerable experience of Holth iridencleisis in " chronic" glaucoma had shown far better results which might be due either to the character of the operation or, more probably, to the state of the eye at the time of surgical intervention.Numerous attempts to systematize various types of glaucoma from the surgical point of view and to draw logical conclusions as to the rational operative procedure in each particular case did not seem to yield unequivocal directives for the surgeon confronted with his patient. The surgical approach to glaucoma was first suggested by von Graefe (1859) as an empirical measure, and it is on this empirical basis that we still stand to-day. The " theoretical " objections to the mere idea of an operation on a congested eye were very strong, and more than 40 years after von Graefe's publication de Wecker (1901) thought it important to devote a great part of his lecture on iridectomy in glaucoma to opposing the prejudice against it.When the mechanism of the rise in ocular tension is clinically obvious, the choice of treatment is also obvious: iridectomy in secondary glaucoma with seclusio pupillae, Barkan's goniotomy in congenital malformations of the angle of the anterior chamber, and so on. In cases of primary idiopathic glaucoma-be it narrow or wide angle or of the over-secretive or impededdrainage type-the choice of procedure is usually determined by the surgeon's experience with various techniques or his operative routine.In congestive glaucoma it is less possible than in any other form to decide the choice of operation from the clinical picture, and in most clinics a routine operation is performed unless contraindicated.