116 AMERICAN JOURNAL OF OPHTHALMOLOGY January, 1987

2. Mann, I.: Developmental Anomalies of the Eye. Philadelphia, J. B. Lippincott Co., 1957, pp. 290-291.

3. Francois, J.: Heredity in Ophthalmology. St. Louis, C. V. Mosby Co., 1961, p. 532.

4. Waardenburg, P. J.: Uveal membrane. In Waardenburg, P. J., Franceschetti, A., and Klein, D. (eds.): Genetics and Ophthalmology. Springfield, 111, Charles C Thomas Publisher, 1961, p. 702.

5. Francois, J.: La melanose congenitale et benigne de l'oeil. Arch. Ophtalmol. 51:689; 792, 1934.

The Stenopeic Strip M. F. P. Griffiths, F.R.C.S. Department of Ophthalmology, Queen Elizabeth Military Hospital.

Inquiries to M. F. P. Griffiths, RAMC, F.R.C.S., Depart­ment of Ophthalmology, Queen Elizabeth Military Hospi­tal, Stadium Road, Woolwich, London SE18 4QH, Eng­land.

Stenopeic apertures, such as the "pinhole" and slit, are part of every trial lens set. The pinhole, used as a universal lens can aid refrac­tion in several ways in addition to simple visual acuity testing. Moved from side to side, the movement of the image ("with" or "against") can tell the examiner whether the subject is myopic or hypermetropic. This information can also be obtained if it is known whether minifi-cation or magnification of the perceived image occurs when the pinhole is moved away from the eye.1 Used as a reduced aperture, the pin-hole can markedly improve visual acuity in some cases of media opacity.

The stenopeic slit2 can be useful in astigmatic

SYSTEM O F O P H T H A L M O L O G Y

Figure (Griffiths). The stenopeic strip.

refractions since its action is to pinhole the meridian at right angles. It can also be useful in media opacities where monocular diplopia con­fuses the refraction.

I recently examined a patient who had found that her troublesome monocular diplopia could be cured by holding a thin strip of card in front of one eye. I quickly improved this innovative approach by a thin strip of black adhesive tape stuck to her eyeglasses (Figure).

I have subsequently used this method on several patients with lens or corneal opacities that caused monocular diplopia, while they are awaiting surgery. Those patients accustomed to bifocal lenses tolerate the method best per­haps because they are accustomed to seeing different images through different parts of their corrective lenses.

References

1. Rubin, M. L.: Optics for Clinicians. Gainsville, Florida, Triad, 1974, pp. 185-191.

2. Duke-Elder, S., and Abrams, D.: Ophthalmic Optics and Refraction. In Duke-Elder, S. (ed.): Sys­tem of Ophthalmology, vol. 5. London, H. Kimpton, 1970, p. 434.

Grand Mai Seizure During Argon Laser Panretinal Photocoagulation Richard J. Duffey, M.D. University of South Carolina.

Inquiries to Richard j . Duffey, M.D., University of South Carolina School of Medicine, Department of Ophthalmolo­gy, Four Richland Medical Park Dr., Columbia, SC 29203.

Panretinal photocoagulation has been shown to decrease the incidence of severe visual loss from proliferative diabetic retinopathy. Al­though many complications from this treat­ment have been reported, the argon laser has rarely been implicated in a generalized seizure.

A 63-year-old man with insulin-dependent diabetes mellitus developed bilateral prolifera­tive diabetic retinopathy. He had no other med­ical problems and specifically no history of a seizure disorder. After several minutes of pan­retinal photocoagulation treatment and 192 burns, the patient complained of feeling