Faculty Bibliography

Infection with diplobacilli of the Moraxella group was the most common cause of bacterial corneal ulcer in a population of derelict alcoholics living in the Bowery district in New York City from 1965 through 1968. No distinction could be made between Moraxella subspecies on the basis of severity of ulcer or antibiotic sensitivities. Of 100 Bowery inhabitants examined, 35 harbored Moraxella in their noses. After 1968 and coinciding with an improvement in nutrition and sanitation, but with no apparent change in the incidence of alcoholism in this population, we noted a marked decline in the incidence of corneal ulcers caused by Moraxella species.

Tear flow and volume were measured in 15 normal volunteers, divided into young and old age groups, using subjective fluorophotometric analysis and Schirmer testing with and without topical anesthesia. Proparacaine 0.5% was found to anesthetize cornea and conjunctiva better than cocaine 4% and produced fewer complications. Older subjects responded to stimulation with less reflex tearing than younger subjects, but had an identical rate of physiologic tear flow, and equivalent corneal and conjunctival sensitivity. Tear flow and volume decreased significantly below physiologic values in both age groups following topical anesthetic instillation. Lid margin and cilia stimulation increased the tear turnover rate more than 300% despite adequate topical anesthesia. Flow rates determined by Schirmer testing with topical anesthesia were higher than both physiologic tear flow and tear flow following topical anesthesia when these values were determined by fluorophotometry. As sensory input was decreased, tear secretion fell correspondingly, implying that all significant tear flow results frp, reflex secretion.