Neuro-Ophthalmology

Hayreh's work is well known in the ophthalmic community. Charts from 85 patients who had biopsy proven temporal arteritis from 1973 to 1995 were reviewed.

21.2% of patients with GCA and visual loss did not have symptoms of GCA (or they were not documented).

Bottom line: For a patient with ocular symptoms, ESR and C-reactive protein should be performed. If index of suspicion for TA is raised by the presence of one of the above signs, high dose corticosteroids and TA biopsy should be performed.

Raymond Magauran, M.D.
Boston, Massachusetts

Neuro-Ophthalmology

PURPOSE: This study aimed to alert ophthalmologists as to their role in the diagnosis of rabies.

METHODS: A 13-year-old girl was admitted with acute encephalitis of unknown etiology. Bacterial and viral cultures and test results for Lyme disease and tuberculosis were negative. Initial cerebrospinal fluid, serum, skin, and saliva specimens were negative for rabies. A corneal impression test was performed.

RESULTS: Immunofluorescent antibody staining of the epithelial cells on the corneal impression test was positive for rabies. Subsequently, the diagnosis was confirmed by serum serologic analysis and saliva testing.

CONCLUSION: Ophthalmologists can assist in the diagnosis of rabies by using the corneal impression test. Corneal smears should be part of the routine antemortem work-up for presumptive rabies.

Authors' abstract, Ophthalmol
New York Medical College,
Westchester County Medical Center,
Valhalla, NY