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A Triple Rotary "Variable Prism.— .Jackson {Arch, of
Opht/iaL, xxiii, 1 and 2) lias devised a prism fitted to use in the
ordinary trial frame. In this instrument the prisms are ar-
ranged so that the components increasing with the sine of the
angle neutralize each other, and the components diminishing
with the cosine of the angle are available for use. To effect
this it is necessary that the rotary prisms start from the posi-
tion in which they act together, producing their maximum
effect, which must be exactly neutralized by an equivalent third
prism. As the rotary prisms proceed from this position their
effect diminishes with the cosine ot the angle, and by so much
leaves the third or fixed prism unnentralized to produce an in-
creasing prismatic effect. This effect is at first very slight, but
the increase is progressively more rapid until the rotary prisms
have each passed through 90^ and are made to neutralize
each other. Continuing the movement of the rotary prisms,
they begin to produce an effect in the same direction as the
fixed prism, which effect increases now more slowly until after
passing through 180° the maximum effect of the rotary prism
is added to that of the fixed prism. The delicacy of the in-
strument for producing slight prismatic effects may be judged
by the fact that the rotary prisms must each be turned through
9° to produce the first quarter centrad of prismatic effect.
Sixty-six Magnet Operations, with Successful Extrac-
tion of Particles of Iron from the Interior of the Eye in
Fifty-three Cases.— Hiluebrand (Arch, of Ophthal., xxiii, 1 and
2) here gives in detail the results of sixty-six magnet operations,
in sixteen of which good vision was preserved. In fifteen cases
the foreign bodies were lodged in the anterior chamber, iris, or
lens. The operations took a favorable course in all but one,
where severe purulent inflammation had existed before the
operation.
In fifty-one cases the iron splinters 'lodged in the vitreous
chamber. In thirteen no foreign body was extracted. Of the
thirty-eight cases in which the foreign bodies had been ex-
tracted, the following results were obtained :
Two led to enucleation ; seven to phthisis bnlbi. Six were
lost sight of. Seven preserved the shape of the eye. Sixteen
yielded a good result, more or less good vi>ion being perma-
nently restored. Cases which on discharge had tolerably good
sight, but soft eyes or notable turbidity of the vitreous, were
April 6, 1895.]
REPORTS ON THE PROGRESS OF MEDICINE.
445
not counted among the successes, for tliese cases are apt to be-
come worse later by detacbment of tlio retina or shrinkage of
the !,'lobe.
All the operations, except the first eight, were performed
with a llirsehherg electro-magnet connected with a storage
battery. The magnet should be introduced as near the foreign
body as diagnosis and position permit; churning of the vilreiuis
should be avoided.
The incision into the tunics of tho eye should be meridional,
and made with a narrow knife, after separation of the conjunc-
tiva with a pair of scissors. Thin and pointed electrodes are
to be avoided.
Whenever an iron particle in the interior of (he eye is rec-
ognizt-d with certainty, its extrnotion is indicated. Even those
whicii seem firmly attached to the background, and cause
neither irriration nor impairment of sight, are better out than in.
It is advisable to operate as soon as the presence of the
foreign body can be ascertained. Even if it can not be seen or
located, its removal should be attempted whenever it causes a
severe inflammation. If it is impossible to locate the foreign
body it is generally safer to wait until the media have cleared
than to stir the vitreous extensive!}'.
The diagnosis of tlie presence of a foreign body is of the
greatest importance. The history of the injury, the instrument
from which the piece flew off, will aid us considerably.
Air bubbles seen in the vitreous are a sure sign of the pres-
ence of a foreign body in the eye. If the vitreous is more
cloudy in the lower part than in the upper, the patient should
be examined in dirteront positions of the head. The magnet it-
self is in some cases a serviceable means of localizing the foreign
body. When passed over the sclera, no pain or tenderness is
felt except when the electrode is in the immediate vicinity of
the foreign body.
If a stnall wound of the conjunctiva has been produced by a
foreign body, the wound should be examined with a platinum
wire made aseptic by heat, in order to determine whether the
sclera is perforated or not.
Prognoxis — There are three hundred and twenty-two cases
reported in literature in which the magnet has been introduced
into the eye. In eighty the foreign body Generic Seromycin lodged in the anterior
part, in the others in the vitreous.
Of the eighty cases, thirteen ended unfavorably on account
of purulent inflammation which had set in before the operation.
Seventy seven cases yielded a perfect result.
In seventy- four of the two hundred and forty-eight cases in
which the magnet was introduced into the vitreous, the foreign
body was not found. In one hundred and seventy four cases
the particles of iron were extracted. Twenty-three of these, or
thirteen per cent., led to phthisis bulbi. Twenty-six, or fifteen
per cent., required subsequent enucleation. Of ihirty-four cases
the results could not be obtained. The remainder, ninety-one
cases, or fifty two per cent., gave satisfactory results — viz. :
Twenty-nine cases, or sixteen per cent., retained the shape of
the eye. Sixty-two patients, or thirty-six per cent., retained
more or less vision.
Three Cases of Tubercle of the Iris.— Sandford {OpMhal.
Rev., May, IS'.ti) reports three cases of this nature. The first
two were examples of iritie tubercular deposits coincident with
fresh lung trouble of a similar nature. The third case was one
of primary iritie tuberculosis, the ciliary region, suspensory
ligament, and apparently the lens itself being infiltrated by the
tuberculous elements. The case occurred in a child, aged five
years, of tuberculous parentage on both sides. There was no
evidence of tuberculous mischief in any other organ. The tu-
berculous mass half filled the anterior chamber. Theeje was
enucleated and the patient was still living eight years later.
Intracranial Abscess arising from Caries of the Sphe-
noidal Cells.— Sandford (Opht/iii/. Rev., May, 189-t) re[)orts a
case of tlii> kind in which the abscess caused double optic neu-
ritis and subsequent post-neuritic atrophy, with complete Buy Seromycin liliiid-
ness, about twenty-seven years before the patient's death, at
the age of seventy-eight years. The abscess had penetrated the
left orbit, causing proptosis, and also the outer wall of the skull
by erosion of the bone.
A Sare Form of Intraocular Melanoma.— Griffith (Oph-
tli/il. Rev., May, lt>i)4) repurts a case of some interest. The
tumor was epithelial in nature and started in the tapetum nig-
rum of the retina. The ciliary body was not invaded, but merely
displaced inward by the tumor pushing its way into the lymph
space to the outer side of the ciliary muscle. He regarded the

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