Eye-ground-photos were taken in twenty-eight previously untreated men with mild to moderate essential hypertension. The same eye was evaluated before and after 26 weeks of double-blind treatment with Enalapril or Hydrochlorothiazide. The vascular changes were assessed by using a more elaborate and refined grading than the Keith-Wagener-Barker scale. All photos were examined by the same observer without knowledge of blood pressure, type of treatment or the order in which the photos had been taken. There were significant positive correlations between the vascular alterations in the retina in the untreated state and left ventricular wall thickness (echocardiography), minimal vascular resistance in the calf (plethysmography) and blood pressure respectively. Treatment with Enalapril decreased the reflection of the retinal arterial wall significantly and reduced the narrowing of arteries and arterio-venous crossing phenomena non-significantly. Hydrochlorothiazide did not affect any of the retinal vascular changes. It can be concluded that this relatively simple technique of evaluating eye-ground-photos with a new grading scale, when used in non-malignant hypertension, gives a useful assessment of the degree of hypertensive target organ damage in the retina as well as in other important target organs, i.e. the heart and vascular beds. In addition, Enalapril positively affects hypertensive retinopathy in contrast to Hydrochlorothiazide, reflecting what happens to structural cardiovascular changes in the rest of the body.

Ophthalmomyiasis interna posterior (OIP) means infection of the posterior part of the eye with the larvae of flies. Few cases have been reported in which the larvae have been removed from the eye and the visual acuity preserved. We report four cases of OIP with living larva in the vitreous cavity. The larvae produced severe uveitis and were removed alive with vitrectomy and a procedure for removing foreign bodies. They were identified as first-stage reindeer warble fly larvae (Oedemagena tarandi). We also observed dead larva in the vitreous cavity of a patient who suffered severe uveitis in 1943, and this eye survived with normal visual acuity. Another patient had a blind eye enucleated and the remnants of a larva were found inside the eye. All patients live in Scandinavia.

ABSTRACT.Purpose: To summarize and analyse the results of our experience in treating patients with a ''dropped nucleus''. Methods: The case records of nineteen patients who underwent surgery for a ''dropped nucleus'' at the Ophthalmology Departments of Sahlgren's University Hospital, Gothenburg, and Ö rebro Medical Centre, Ö rebro, Sweden during 1994 were retrospectively reviewed to determine the mode of treatment used and the results of surgery. The frequency of this complication was also calculated for Sweden as a whole with the help of the National Cataract Register. Results: The lens was successfully removed in all eyes. No retinal breaks or detachments were present at vitrectomy or follow-up. One eye was lost to panophthalmitis 11 days after the vitrectomy; the remaining 18 eyes showed a favourable outcome. Conclusion: The loss of a crystalline lens to the vitreous during cataract surgery is a severe complication. We recommend that an experienced vitreoretinal surgeon should be consulted at an early stage.

A population-based series of retinal detachments (RD) collected during a 10-year period (538 patients, 590 'cases', i.e. diseased eyes including new RD after 6 months in the same eye) is reported. The annual incidence was 10.6 per 100,000 population. Bilaterality was observed in 11.2%. In this material preponderance of the right eye was found. In non-traumatic RD there was a small sex difference, with a higher incidence among females. Older persons were at high risk of sustaining RD, as were myopes. In myopic males the risk increased with the degree of myopia and with increasing age. In myopic females the greatest risk was found in the age group 30-59 years. Myopic eyes are probably also more vulnerable to traumatic RD. Lattice degeneration was more common in middle-aged than in older patients and was also more common in myopic eyes than in eyes with other phakic RD. High myopia (greater than -5D) was more frequent in patients with lattice degeneration than in those without. Aphakia was found to be an important predisposing factor for RD. A classification taking into account the above-mentioned factors is proposed.

Liquid silicone was used in the surgical treatment of 46 eyes with complex retinal detachment. Forty-six eyes have been followed up for at least 6 months. In 27 of these eyes (58.7%) the retina was totally or partially attached at the 6-month follow-up. Visual improvement was found in 20 of the 46 eyes (43.5%). These results are encouraging considering the poor prognosis of the operated eyes. There were few severe complications during an observation time of 6 months. Liquid silicone was found to be a valuable help in the surgical treatment of severe forms of retinal detachment.