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Nephroblastoma and neuroblastoma in children.

found to have these organisms in the conjunctival sac. Nevertheless, the examination of scrapings taken directly from the ulcer suggested that the lesion is a non-infective inflammation. The authors also found that a quarter of their patients had recently had or were suffering from an upper respiratory tract infection. Three methods of treatment were tried. Carbolization of the ulcer meant that the eye had to be bandaged for at least two days, and since this treatment in no way shortened the course of ulceration Chignell and his colleagues concluded that it should be abandoned. The other two methods were compared in a controlled study. Prednisolone eye drops were found to be highly effective whereas neomycin eye drops had no appreciable effect on the course ofthe ulcer. Thus most patients were cured using prednisolone drops every two hours for three to four days, without the inconvenience of either using mydriatics or having the eye bandaged. The response to steroids supports the belief that the ulcer is not infective in nature, though in some cases it may be due to hypersensitivity or a toxic response to pathogenic staphylococci. The introduction of eye drops containing broad-spectrum antibiotics and steroids has proved of great value in the treatment of local eye disease. However, they are often used with little or no regard to the underlying condition, and unless a careful inspection and history are taken serious mistakes may occur. It is still quite common to find acute closed-angle glaucoma treated as conjunctivitis, when a simple test of the patient's vision and an inspection of the cornea, quite apart from feeling the tension digitally, would indicate the correct diagnosis. The use of combined antibiotic and steroid drops in the treatment of herpes simplex keratitis may lead to a disastrous extension of the ulcer. In these cases the association with oral herpes and the use of fluorescein should indicate the true nature of the lesion. If there is any suspicion of a herpetic ulcer local steroids must not be administered. This recent paper emphasizes once again the value of simple inspection of the eye, which in the case of simple marginal ulceration ofthe cornea can lead to a correct diagnosis and easy and successful treatment.