Purpose: To evaluate the minimally invasive strabismus surgery (MISS) technique in combined unilateral horizontal rectus muscle operations for esotropia. Methods: This study included 61 patients operated by one surgeon with MISS medial rectus muscle recession and lateral rectus muscle plication. Alignment, binocular vision, conjunctival injection and swelling as well as complications during the first 6 postoperative months were recorded prospectively. Conjunctival swelling and injection on postoperative day 1 were scored retrospectively and compared to a study, which included patients operated with a limbal approach. Results: Conjunctival swelling and injection were less pronounced than following surgery with limbal approach (comparison of swelling and injection: p < 0.001 for MISS vs. limbal opening plication and p < 0.001 for MISS vs. limbal opening resection). A conversion to a limbal opening was necessary in 2.4% of muscles. No scleral perforation or other serious complication was observed. Conclusions: This study indicates that MISS induces less conjunctival swelling and injection compared to the usual limbal approach.

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When compared with KCl-induced contractions, contractions evoked by U 46619 or L-NAME are proportionally higher in porcine vortex veins than in ciliary arteries.

Aim: The authors described and tested a simple bedside procedure to detect non-organic visual-field loss. Methods: Prospective comparative observational case series of 16 patients with non-organic visual-field loss and 15 patients with organic visual-field loss were examined. Saccade patterns provoked by a stimulus outside the claimed visual field were assessed by a masked observer. Results: Whereas, in organic visual-field defects, eye movements as noted by the observer were in small and erratic searching patterns towards the visual-field defect in all patients (15/15), most patients with non-organic visual-field loss (14/16) were able to jump directly to the presented red cap in one directional large saccade, although the stimulus was outside their stated visual field. The sensitivity of the saccade test in detection of nonorganic visual-field loss by a masked observer was 87% (95% CI 60% to 97%) and the specificity was 100% (95% CI 75% to 100%). The positive predictive value for nonorganic visual-field loss of the saccade test was 100%, and the negative predictive value was 90%. Conclusions: The saccade test is a quick and reproducible examination to use and is largely independent of the patient's willingness for cooperation. The authors believe that the test will be of value to clinicians on bedside evaluation when non-organic visual-field loss is suspected.

Objective: To investigate the influence of the stimulus parameters on perimetry at various distances and draw conclusions for the clinical exploration of nonorganic visual loss. Methods: Visual field testing using Goldmann kinetic perimetry was performed on 15 healthy volunteers. The I/1e isopter at 33 cm was compared to the I/1e, II/1e and I/2e isopters at 66 cm. The 0/1e isopter at 33 cm was compared to the 0/1e, I/1e and 0/2e isopters at 66 cm. Results: Doubling the examination distance without adjusting the stimulus parameters resulted in significant perimetric visual field constriction. Doubling the stimulus diameter resulted in perimetric visual field expansion by a factor of 2.26 and 3.32 for I/1e and 0/1e, respectively. Increasing stimulus luminance by a factor of 3.17 caused expansion by a factor of 2.15 and 2.32 for I/1e and 0/1e, respectively. Conclusions: To avoid falsely diagnosing visual field constriction, stimulus parameters need to be adjusted when visual field testing is performed at double distance. Increasing stimulus luminance was more appropriate than augmenting stimulus size.