3
396 NOTES, CASES, INSTRUMENTS though it has occasionally appeared to be equally effective, especially in Negro patients. The production of lid paresis by oculomotor akinesia adds support to the theory that the third nerve in its passage through the orbit sends some communication to the palpebral portion of the orbicularis oculi,* but just where is difficult to determine. Injection of the anesthetic combination in or near the superior rectus produces ptosis and lid akinesia could not be effected by the injection of any other single extraocular muscle. One practical suggestion seems justi- fied ; a separate injection for lid akinesia may be omitted in enucleation and muscle surgery when the procaine-epinephrine-hyaluronidase combination is used as the local anesthetic. 4010 West Madison Street (24). A SPEEDLIGHT UNIT FOR EYE PHOTOGRAPHY* IRVING H. WAGMAN, PH.D., AND DAVID NAIDOFF, M.D. Philadelphia, Pennsylvania The photographic assembly described in this report was designed to provide a rela- tively light, hand-held, and easily operated unit for photography of the eye. Any 35- * Bender, M. B.: The nerve supply to the orbi- cularis muscle and the physiology of movements of the upper eyelid. Arch. Ophth. 15:21-30 (Jan.) 1936. 1" From the Departments of Physiology and Oph- thalmology of the Jefferson Medical College. Sup- ported in part by a grant from the Charles Pfizer Company to Dr. Arno E. Town, chairman, Depart- ment of Ophthalmology, Jefferson Medical Col- lege. mm. or smaller camera may be used. The speed-flash light source (Mighty Midget Speedlight) used is ideally suited for the purpose and is comparatively inexpensive and easily mounted. The plate which carries the camera and light source along with its built-in eye-positioning device can be manu- factured fairly readily. The whole unit may be simply adapted for photography of other portions of the body. All the components of the unit are mounted on a single aluminum plate to which are also attached two upright handles so that the unit can be held comfortably. The com- ponents are so placed that the whole is well balanced and easy to hold in the position necessary for taking a photograph. Figures 1 and 2 show the apparatus in sufficient detail for purposes of description. Apart from the camera,* the two essential features are the device for accurately locat- ing the camera in relation to the eyes to be photographed and the light source with its accessories. The camera is located and supported at exactly the proper position for photography of either one or both eyes by means of two rods secured to the underside of the alumi- num plate. The rods which are maintained * The camera we use is the Kine Exacta V. It is so mounted that it can be moved back from its normal position. In this way, the camera can be unloaded and loaded without being removed from the plate. Fig. 1 (Wagman and Naidoff). Photographs of the eye camera showing it set for photographing (A) the right eye alone, (B) the left eye alone, and (C) both eyes together. Note the presence of the lens extension ring in (A) and (B). Note also (C) the small collar on the right positioning rod. This collar is the stop used to fix the distance from the end of the rods to the eyes when adjustment is made for the shorter picture taking dis- tance as in (A) and (B). A similar stop, hidden by the base plate, is used to fix the longer distance as in (C). See text for description of the other essential details.

A Speedlight Unit for Eye Photography†

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Page 1: A Speedlight Unit for Eye Photography†

396 NOTES, CASES, INSTRUMENTS

though it has occasionally appeared to be equally effective, especially in Negro patients. The production of lid paresis by oculomotor akinesia adds support to the theory that the third nerve in its passage through the orbit sends some communication to the palpebral portion of the orbicularis oculi,* but just where is difficult to determine.

Injection of the anesthetic combination in or near the superior rectus produces ptosis and lid akinesia could not be effected by the injection of any other single extraocular muscle. One practical suggestion seems justi­fied ; a separate injection for lid akinesia may be omitted in enucleation and muscle surgery when the procaine-epinephrine-hyaluronidase combination is used as the local anesthetic.

4010 West Madison Street (24).

A SPEEDLIGHT UNIT FOR EYE PHOTOGRAPHY*

IRVING H. WAGMAN, P H . D . , AND DAVID NAIDOFF, M.D. Philadelphia, Pennsylvania

The photographic assembly described in this report was designed to provide a rela­tively light, hand-held, and easily operated unit for photography of the eye. Any 35-

* Bender, M. B.: The nerve supply to the orbi­cularis muscle and the physiology of movements of the upper eyelid. Arch. Ophth. 15:21-30 (Jan.) 1936.

1" From the Departments of Physiology and Oph­thalmology of the Jefferson Medical College. Sup­ported in part by a grant from the Charles Pfizer Company to Dr. Arno E. Town, chairman, Depart­ment of Ophthalmology, Jefferson Medical Col­lege.

mm. or smaller camera may be used. The speed-flash light source (Mighty Midget Speedlight) used is ideally suited for the purpose and is comparatively inexpensive and easily mounted. The plate which carries the camera and light source along with its built-in eye-positioning device can be manu­factured fairly readily. The whole unit may be simply adapted for photography of other portions of the body.

All the components of the unit are mounted on a single aluminum plate to which are also attached two upright handles so that the unit can be held comfortably. The com­ponents are so placed that the whole is well balanced and easy to hold in the position necessary for taking a photograph.

Figures 1 and 2 show the apparatus in sufficient detail for purposes of description. Apart from the camera,* the two essential features are the device for accurately locat­ing the camera in relation to the eyes to be photographed and the light source with its accessories.

The camera is located and supported at exactly the proper position for photography of either one or both eyes by means of two rods secured to the underside of the alumi­num plate. The rods which are maintained

* The camera we use is the Kine Exacta V. It is so mounted that it can be moved back from its normal position. In this way, the camera can be unloaded and loaded without being removed from the plate.

Fig. 1 (Wagman and Naidoff). Photographs of the eye camera showing it set for photographing (A) the right eye alone, (B) the left eye alone, and (C) both eyes together. Note the presence of the lens extension ring in (A) and (B). Note also (C) the small collar on the right positioning rod. This collar is the stop used to fix the distance from the end of the rods to the eyes when adjustment is made for the shorter picture taking dis­tance as in (A) and (B). A similar stop, hidden by the base plate, is used to fix the longer distance as in (C). See text for description of the other essential details.

Page 2: A Speedlight Unit for Eye Photography†

NOTES, CASES, INSTRUMENTS 397

Fig. 2 (Wagman and Naidoff). Illustrations of the method used for taking pictures of the eye with the unit described. In (A) a picture is being taken of the left eye alone. In (B) a picture is being taken of both eyes together.

parallel and in fixed relationship to each other (64 mm. apart) are mounted in a movable holder underneath the plate.

Both rods together can be moved farther from or closer to the lens and, by means of a stop, fixed so that their front ends are at

a definite distance from the camera lens. In addition, the rods can be moved simply from side to side and held in three positions by means of spring detents.

In one position the right rod is in a line with the camera's optical ax i s ; in the second position the left rod is so aligned; and in the third position the rods are placed sym­metrically in relation to the optical axis.

At the end of each rod is fastened a short upright piece of flat metal covered on its front with soft felt. Each is of such dimen­sions that when it is placed on the cheek bone with its upper edge directly underneath the lower lid, the eye which looks into the lens is centered for the photograph.

In relation to the forward and backward movements of the positioning rods, two stops are provided: one to fix the padded ends of the rods closer to the camera lens and one to fix them farther away.

Fig. 3 (Wagman and Naidoff). Four photographs reproduced from Kodachrome transparencies made with the described photographic unit shown in Figure 1. (A) Staphyloma. (B) Acute dacryocystitis. (C) Pulsating arteriovenous aneurysm. (D) Bell's palsy. In (A) note the circular highlight from the ring light source. It is never disturbing in the photograph and it is often helpful since it is in the center of the pupil when the eye is looking at the lens of the camera. When both open eyes are photographed simultaneously, the highlight in each pupil is considerably smaller and centered therein, if no eye devia­tions exist.

Page 3: A Speedlight Unit for Eye Photography†

398 NOTES, CASES, INSTRUMENTS

In the former position with the end of the rod held up to the cheek bone, one eye is in focus on the film at a magnification of ap­proximately 1.0. In this position an appro­priate lens extension collar is used. When the rods are in the farther of the two posi­tions, both eyes when positioned properly are in focus on the film at a magnification of less than 0.5.* In this position the extension collar is not used.

The light source, which is unusually con­venient, is the Mighty Midget Speedlight close-up ring. It is a light-weight unit with a light output comparable to other and more bulky equipment. In Figure 1 can be seen the cylindrical power pack mounted upright to the right of the camera. In front of it is a small isolation transformer through which connection is made to the 110 v. A.C. line. (Both wet-cell and dry-cell battery packs are available with this speedlight.)

The close-up ring is a circular light tube mounted in a plastic case which is so con­structed that it can be fitted directly onto the lens by means of a Series VI filter adapter mounted on this plastic case. Thus the light is directed, in effect, along the line of the optical axis of the camera lens providing shadowleSs pictures. This light source has proven to be excellent for the close-up color photography necessitated in eye work.*

We have found it convenient to mount the close-up ring separately rather than directly onto the camera lens. It is mounted by means of its incorporated Series VI adapter to a mount fastened onto the aluminum plate. In this way the ring can be moved sufficiently forward to allow for removal or insertion of the lens extension tube without disturbing the camera.

The taking of the photograph is quite

* The stops for the rods are fixed permanently for our purposes. They can be changed easily, how­ever, to bring into focus objects at other distances.

t With daylight Kodachrome, no filters are neces­sary. Although we use color film only, our trials with black and white (Plus X) have been quite successful, even though the results are not as uni-formally excellent as they are with color.

simple. When all adjustments for photo­graphing the specific eye or eyes are made, the operator holds the unit up to the patient as shown in Figure 2 and directs him to look into the lens. The exposure is made by means of the cable release mounted on the left handle as shown in the illustration. No dis­comfort is experienced by the patient. The after-image which persists for several sec­onds is not in the least annoying.

We have mounted the power pack as shown in the illustrations in order to make the unit more flexible. By placing a reflector and a standard flash tube into their normal positions on the cylindrical tube we can use the camera for general photography.

Figure 3 shows four black and white re­productions from Kodachrome transpar­encies made with this unit. The pictures emphasize the exceptional clarity and fine detail that are obtainable with a speedlight whose advantages for photography are many and sufficiently well known to obviate de­tailed description in the present report.

SUMMARY

A relatively light, hand-held, fixed-focus, and easily operated speedlight unit for eye photography is described.

1025 Walnut Street.

ACKNOWLEDGMENT We wish to thank Mr. Chauncey H. Elliott who

constructed the mounting plate and its accessories and who gave valuable aid in designing the ap­paratus.

REPAIR O F A CUT McLEAN SUTURE*

SAMUEL I. KAUFMAN, M.D. Chicago, Illinois

The McLean sclerocorneal suture* may be accidentally cut when, with the loops drawn aside, the limbal section is being enlarged

* From the Department of Ophthalmology of the Cook County Hospital and of Mount Sinai Hos­pital.

t McLean, J. M. A new corneoscleral suture. Arch. Ophth. 23 :SS4 (Mar.) 1940.