424 CORRESPONDENCE

A N AID I N MINOR SURGERY

How many times does a patient under­going minor surgery in your office say, "Doc­tor, this doesn't hurt but that light is too bright. '" Or, "Doctor, I would be comfortable if only I could not see what is going on." Because of these laments by anxious or un­comfortable patients I took, upon a patient's suggestion, a contact lens 9.8 mm. in diam­eter, 43-degrees radius back surface and piano power and sprayed the front surface with a can of black household enamel spray paint. The lens was thus rendered opaque. During minor surgery in the hospital and office procedures, this lens is soaked in Storz solution (1:1000*) along with the instru­ments and is placed upon the cornea before the illuminating light is fixed upon the cor­nea. Since the patient's conjunctival sac and cornea have been anesthetized with Tetra-caine, there is no sensation and the lens is well tolerated. The lens has an additional advantage of protecting the cornea. I t has a disadvantage of occasionally being dis­placed during surgery and having to be re­placed upon the cornea.

(Signed) J. William Rosenthal, 1505 Antonine Street,

New Orleans, Louisana.

COLORADO RESOLUTION

Editor, American Journal of Ophthalmology:

Enclosed is a copy of a letter recently forwarded to the executive secretary of the National Medical Foundation For Eye Care. I believe that the letter is quite self-explana­tory. As you will note in the letter, these copies are being forwarded to you as a result of a resolution passed by the Colorado Oph-thalmological Society instructing me to do so. If you would care to publish the letter in T H E A M E R I C A N JOURNAL OF O P H T H A L ­

MOLOGY for whatever help it might provide to other ophthalmological societies by citing our experience, please feel free to do so. I t

* C.R,L Germicide (Clay Adams Company).

is our feeling that the National Medical Foundation For Eye Care rendered a real service to our society and that whatever can be done to strengthen the effectiveness of that group will be beneficial to all ethical medical eye societies.

(Signed) Max Kaplan, M.D., secretary, Colorado Ophthalmological Society.

* * *

Mr. James E. Bryan, Executive Secretary National Medical Foundation For Eye Care 2S0 West 57th Street New York 19, New York Dear Mr. Bryan:

On behalf of the Colorado Ophthalmological So­ciety, I should like to commend and thank the Na­tional Medical Foundation For Eye Care for the excellent guidance and assistance which the Foun­dation recently provided to our Society. As y.:u know, the optometrists of Colorado have recently presented a new bill to the state legislature. The Colorado State Medical Society and the Colorado Ophthalmological Society became actively inter­ested in the proposed bill and sought the assistance of the National Medical Foundation For Eye Care. The help which your organization provided, both in the area of analysis of the proposed bill and in providing material for educational purposes, was very helpful, and played a significant role in the ultimate conclusions and actions of the State Medi­cal Society and the Colorado Ophthalmological So­ciety.

Our experience in this matter has provided evi­dence that the support and strengthening of the Na­tional Medical Foundation For Eye Care are essen­tial to the activities of ethical medical groups and to the protection of the public interest in the entire area of eye care. In order that the medical pro­fession might be made aware of our experience, the Colorado Ophthalmological Society at its last meet­ing passed a resolution that copies of this letter of commendation and appreciation be forwarded to the editors of the AMA Archives of Ophthalmology and T H E AMERICAN JOURNAL OF OPHTHALMOLOGY.

(Signed) Max Kaplan, M.D., secretary, Colorado Ophthalmological Society.

TERMINOLOGY I N OPERATIONS ON IRIS

Editor, American Journal of Ophthalmology:

In the February, 1961, issue of T H E A M E R I C A N JOURNAL OF OPHTHALMOLOGY

was a paper by Ar thur H . Keeney, M.D., on "Classification and surgical techniques in iridectomy" in which he very rightly ob­jects to the incorrect terminology employed

BOOK REVIEWS 425

in ophthalmic texts and papers. He makes a magnificent classification and adds that many authors (except Blaskovics and Kirby) refer incorrectly to the partial iridectomy (that is, of one sector of the iris) performed in the operation for cataract in which a sector of the iris is extirpated, as complete or total iridectomy.

I should like to point out that in 1940 in a paper presented before the II Argentina Congress of Ophthalmology and published on page 119 of the minutes of that meeting, I discussed incorrect terminology employed in referring to operations on the iris and stated the following:

"With regard to the term 'total iridectomy' (in cataract operations), this is wrongly used; nobody has ever performed total iri­dectomy because this means, in the strict interpretation, extirpation of the whole iris, a thing that is never done. What ought to be said is 'partial iridectomy' of a fragment of the iris which may be the adherent edge or the loose edge."

(Signed) Francisco Paez Allende, Pellegrini 3090,

Santa Fe, Argentina.

BOOK REVIEWS P O S T O P E R A T I V E - C A T A R A C T SPECTACLE

LENSES. By Robert C. Welsh, M.D. Miami, The Miami Educational Press, Inc., 1961, 123 pages. Price: $15.00. A needed addition to the ophthalmic litera­

ture is this monograph on the optical correc­tion of aphakia. Cataract surgery may be successfully performed but all too often to the chagrin of the surgeon, the patient proves to be most unhappy with his aphakic state. While there has been considerable advance in the designing of correcting spectacle lenses, the author demonstrates that there is still much left to be desired.

Using as a base the editorial appearing in T H E AMERICAN JOURNAL OF OPHTHALMOL­OGY in 1952 on the "Adjustment to aphakia" which had been written by an eminent anony­mous ophthalmologist who therein related

his personal observations and experiences, Dr. Welsh has attempted to explain the rea­sons for the phenomena and to make sug­gestions which may aid in the prescribing and proper fitting of correcting lenses. He avoids the use of complicated formulas of physiologic optics but much of his text is as valuable to the dispensing optician as to the prescribing ophthalmologist. Certainly much of what he says is controversial but there is a great deal to be learned from his observations and research over a period of years.

Emphasis is placed on the "jack-in-the-box" phenomenon resulting from the "roving scotoma" inherent in strong convex lenses which gives the impression of "no side vision." The author does not favor lenses with a deep base curve but urges his own described type of light-weight lens which he terms the "minimal effective diameter" cata­ract lens. The faults of various lenses, in­cluding aspheric lenses, are described in de­tail and specific suggestions are made as to the type best suited for various corrections, as well as preferences for aphakics with a round pupil and those with a "keyhole" iri­dectomy. He feels that round-pupil surgery gives the most satisfactory result, especially when contact lenses are used. The latter are conceded to be the most satisfactory method of aphakic correction and there is some detail as to the types of cataract contact lenses and to the method of fitting.

It is impossible in a brief review to de­scribe in any inclusive manner the various diagrams presented and opinions offered. Those who have a responsibility to the aphakic patient, whether as surgeons, refrac-tionists, or dispensing or laboratory opti­cians (and especially manufacturing opti­cians) will have to read the book in its en­tirety to digest and enjoy the full flavor of this endeavor. Since it does have an impor­tant place, it is unfortunate that it has been necessary to charge $15.00 for a work which seems to have been prepared by the offset process rather than by standard printing.

William A. Mann.