Corneal grafting at St. Luke`s Hospital

A corneal graft is a resection of a part of a diseased and opaque cornea, and its substitution by a clear fragment of equal size taken from a healthy cornea of a person who has just died. This is a report on corneal graft operations carried on at St. Luke's Hospital, Malta in 1969 and 1975. For the first time in Malta, fresh corneal tissue was used from eyes of patients in St. Luke's Hospital. We are very grateful to the relatives of these patients. The case suffering from dendritic ulcer operated upon for the third time is still doing well six months after the operation.peer-reviewe

Muscular reinforcement in convergent strabismus

Between 1966 and 1970, forty-one cases of unilateral convergent strabismus and three cases of divergent strabismus were operated upon by the technique suggested by Malbran. Most of the cases had shown a severe degree of amblyopia and weakness of the External Rectus. In this technique, the muscle is twisted around its longitudinal axis the required amount of turns according to the degree of deviation, and attached again to its original insertion. There is no cutting of the muscle tendon. The results were very satisfactory, showing a marked strengthening of the action of the External Rectus. It is suggested that in order to obtain reinforcement of an ocular muscle, resection should be replaced by a screw-like twisting of the muscle.peer-reviewe

The electrocautery in the treatment of cicatricial entropion and trichiasis

A new technique is described, where in cases of cicatricial entropion of the upper lid, the electrocautery is used instead of the scalpel to excise a wedge-shaped band from the deformed tarsus in order to restore to a normal position the inturned lid border. This technique is considered to be simpler and easier to carry out than paring the deformed tarsus by means of a scalpel. Moreover, the induced fibrous tissue contraction after the application of the electrocautery, is another factor in favour of this technique. Eight cases were operated upon in this way. The results were satisfactory. In one case, a good result was obtained even without the use of sutures.peer-reviewe

A case of oculo-auriculo-vertebral dysplasia

This is a report on a case of Goldenhar syndrome. It shows the usual association of auricular appendages, epibulbar dermoid and vertebral abnormalities. A case of oculo-auriculo-vertebral dysplasia is described: a girl, now aged 12, was reported at birth to have two “supernumerary ears”, two nodular appendages in front of the tragus of the left ear. The two nodules were eventually excised; however, she was operated again for a growth in the canthus of the left eye. Examination showed the presence of a greyish red dermolipoma, occupying the whole extent of the outer canthus for a distance of 5 mm from the angle. There was no impairment of movement of the external Rectus. Apparently, the growth has passed unnoticed for all these years and lately has increased in size.peer-reviewe

The electrocautery sclerocorneal puncture in the treatment of the glaucomas

This paper was read at the 53rd Annual meeting of the Societa` Oftalmologica Italiana held on the 26th-29th September, 1971. A survey covering a ten year period of cases of glaucoma operated upon by means of the sclerocorneal, electrocautery puncture is presented. One hundred and fifteen eyes with chronic open angle glaucoma were operated upon at St. Luke`s Hospital Malta during the period 1960-1970. All these cases presented extensive field losses and deep cupping. Surgery was resorted to because of continuous field loss in spite of medical treatment. A considerable number of cases operated upon for chronic open angle glaucoma and acute glaucoma were suffering from diabetes mellitus. In no case was any sign ever found of proliferative retinopathy. The main advantages of the use of electrocautery are the simplicity of the technique and the absence of any complications. The results were very satisfactory.peer-reviewe

Severance of the optic nerve at the optic foramen caused by lead pellets

This is a report on two cases of sudden and complete loss of sight, following upon a laceration of the optic nerve near the optic foramen by means of a single lead pellet from a shot gun. Such cases are considered to be of interest because they are uncommon, also because of the almost identical clinical findings. The changes in the fundi, seen in these two cases, must have been caused either by a tangential grazing of the sclera by the pellet, or by the concussion waves travelling through the semi-fluid orbital contents.peer-reviewe

Eye diseases in Malta at the turn of the century

This work is based on reports published by three ophthalmologists working between the years 1890-1909, namely (1) on Prof. L. Manche's "Rendiconto degli ammalati ammessi durante il Biennio 1890-91 (per il Dottor Salvatore Cassar) nel Comparto Ottalmico dell`Ospedale Centrale di Malta; (2) on "Le Malattie Oculari in Malta: Appunti Clinici e Statistici 1899" by Dr. Giuseppe Norsa an "oculist" from Rome, and (3) on an "Annual Statistical Report of the Eye Diseases treated at the Ophthalmic Institute of Malta from July 1908 to July 1909" by Dr. C. Manche. These reports show that eye diseases at the turn of the century were being treated by the best means available at that time. The surgeons were very well informed about developments on the Continent and tried to do their best. What was needed was the raising of the standard of living, especially better housing to avoid overcrowding, a good water supply, good sanitation, the establishment of suitable centres for treatment and education of the masses on ocular hygiene and early treatment.peer-reviewe

The first chair of ophtalmology: a biographical sketch of Joseph Barth

This article features a short biography of Professor Joseph Barth (1745-1818), a well known teacher and ophtalmologist in Europe, especially in Vienna where he was asked to occupy the chair of Anatomy and Physiology along with the newly established chair of Ophthalmology at the Imperial University of Vienna. In the year 1787, it is recorded that he performed 300 cataract extractions, which is quite a substantial figure, considering that at that time anaesthesia was not yet introduced. His greatest accomplishment was the establishment of the first University Eye Clinic of Vienna, which is also the first University Eye Clinic in Europe.peer-reviewe

Ocular tetanus following upon an injury to the conjunctiva

Tetanic infection as a result of an injury to the conjunctiva is rather uncommon. A case of ocular tetanus following upon a wound of the lower conjunctival fornix and the entrance of a foreign body in the orbital cavity is reported. In reporting this case, the objective of the author is to comment on some particular features, which indicated that mental symptoms were a prominent factor besides the usual paralytic and spasmodic signs. Additionally, complete recovery followed massive treatment by penicillin, streptomycin and antitetanic serum.peer-reviewe

Mandibulofacial dysostosis : a case report

A case of the mandibulofacial dysostosia at the age of 5 months is reported. All the main features described in the syndrome are present in this case. Though the Mandibulo-Facial Dysostosis is a relatively rare congenital abnormality this case deserved reporting because of the tender age of the patient. Most reported cases were in considerably older patients. Moreover this is presumably the first case to be described in Malta. The syndrome is described as having clearly established hereditary characters. It is inherited as an autosomal dominant trait with variable penetrance. This variability in penetrance of the gene is shown by the fact that the features of the parents of this child do not show any abnormalities.peer-reviewe