Editorial stance on duplicate and salami publication

In this edition of the British Orthoptic Journal the notice to contributors has been amended. The sentence ‘Papers are considered for publication on the understanding that they are not being submitted elsewhere at the same time’ has been extended to address the problem of duplicate publication and now appears under ‘Terms of submission’

Sixty yet still active!

The British Orthoptic Society published the first British Orthoptic Journal in 1939, the second appeared in 1944 then, with the exception of 1946, annually. In the first copy of the British Orthoptic Journal the editorial outlines the events leading up to the formation of the British Orthoptic Society, and this and the subsequent history of the Society is described in the 1987 editorial, the year of the Society’s Golden Jubilee. In the president’s letter published in that first edition, Mary Maddox wrote: ‘This journal will afford a method of recording the progress of orthoptics.

Heroin and diplopia

Aims: To describe the eye misalignments that occur during heroin use and heroin detoxification and to give an overview of the management of persisting diplopia (double vision) which results from eye misalignment. Methods: A literature review using Medline and the search terms strabismus, heroin and substance withdrawal syndrome is presented. General management of cases presenting to the ophthalmologist and orthoptist with acute acquired concomitant esotropia is described. Findings: A tendency towards a divergence of the visual axes appears to be present in heroin users, although when present it may not always lead to diplopia. Following detoxification intermittent esotropia or constant esotropia (convergence of the visual axes) can occur; if intermittent the angle tends to be small and diplopia present when viewing distance objects. Occlusion of one eye to eliminate the second image could encourage the development of a constant deviation. The deviation is not caused by a cranial nerve palsy. Constant deviations of this type are classified as 'acute acquired concomitant esotropia'. Relief from the diplopia may be gained by prismatic correction, and the deviation may then resolve spontaneously. Botulinum toxin or surgical intervention may be necessary in cases that do not resolve. Conclusions: Heroin use may lead to intermittent or constant exotropia and withdrawal may result in intermittent or constant esotropia. Awareness of the mechanism causing this may avoid referral to other specialties (e.g. neurology) and awareness of treatment modalities could encourage patients to seek appropriate help for relief of symptoms

Minimising latency of pitch detection algorithms for live vocals on low-cost hardware

A pitch estimation device was proposed for live vocals to output appropriate pitch data through the musical instrument digital interface (MIDI). The intention was to ideally achieve unnoticeable latency while maintaining estimation accuracy. The projected target platform was low-cost, standalone hardware based around a microcontroller such as the Microchip PIC series. This study investigated, optimised and compared the performance of suitable algorithms for this application. Performance was determined by two key factors: accuracy and latency. Many papers have been published over the past six decades assessing and comparing the accuracy of pitch detection algorithms on various signals, including vocals. However, very little information is available concerning the latency of pitch detection algorithms and methods with which this can be minimised. Real-time audio introduces a further latency challenge that is sparsely studied, minimising the length of sampled audio required by the algorithms in order to reduce overall total latency. Thorough testing was undertaken in order to determine the best-performing algorithm and optimal parameter combination. Software modifications were implemented to facilitate accurate, repeatable, automated testing in order to build a comprehensive set of results encompassing a wide range of test conditions. The results revealed that the infinite-peak-clipping autocorrelation function (IACF) performed better than the other autocorrelation functions tested and also identified ideal parameter values or value ranges to provide the optimal latency/accuracy balance. Although the results were encouraging, testing highlighted some fundamental issues with vocal pitch detection. Potential solutions are proposed for further development

Heroin withdrawal as a possible cause of acute concomitant esotropia in adults

Aim: To report the possible effects of heroin withdrawal on binocular vision. Methods: To present a case series of patients in whom esotropia developed on cessation of heroin use. Results: In each case the esotropia was concomitant and prismatic correction restored binocular single vision. Intermittent spontaneous control occurred in one patient, the deviation resolved in one and one patient was lost to follow-up. Conclusions: Heroin withdrawal should be considered as a cause of acute concomitant esotropia. However, accurate history of other medication is needed to ensure that this is not the cause of decompensation

Class A drug abuse: an ophthalmologist's problem?

[First Paragraph] The 2002/3 British Crime Survey reported that 3% of all 16 to 59 year olds (equating to around one million people) had used a class A drug in the last year. Use of a class A drug in the 16-24 year old age group (8%) has remained similar since 1996. Use of cocaine and crack cocaine are on the increase. For the first time since 1996 the use of ecstasy has decreased. Poly drug use is not uncommon. During the year 2000/1, 118,500 patients were in treatment with drug misuse agencies and general practitioners. Ocular sequelae from illicit drug use are varied, affecting visual acuity, visual perception, ocular posture or motility, the globe itself or its adnexa. Large studies are not available to allow us to quantify the problem, and many of the reports are of single cases or small case series. However, an awareness of possible problems which may arise from the use of class A drugs may alert the clinician to this as the aetiology of a condition presenting to them

Spending Out - Making It Happen

While it may be of interest to a wider audience, this companion guide is focused on the practicalities of spending out and targeted at those foundations that have decided this is the path for them. By sharing the practical experience of those who are well into the process or have already completed it, we hope to make it easier for others wishing to follow in their footsteps