Faculty Bibliography

Although toxoplasmosis is the most common infectious cause of posterior intraocular inflammation, it is rarely described in association with scleritis. The authors present five cases of toxoplasmosis with scleritis. Two of the five cases were diagnosed clinically and serologically as having toxoplasmosis. Their retinochoroiditis and scleritis responded well to medical therapy. Retinochroiditis and scleritis that was refractory to treatment developed in the other three patients, two of whom had been receiving immunosuppressive therapy for systemic diseases. Their therapeutic regimens did not include treatment for toxoplasmosis. All three eyes became blind and were enucleated. Results of pathologic examination of all three enucleated eyes showed Toxoplasma gondii in the retina. There was severe inflammation of the retina, choroid, and sclera. Toxoplasmosis should be considered in the clinical differential diagnosis of scleritis associated with retinochoroiditis, particularly in immunosuppressed patients.

Senior-Loken syndrome is a rare hereditary disease that combines a disorder resembling familial juvenile nephronophthisis with retinitis pigmentosa. Retinitis pigmentosa is even less frequently associated with exudative retinopathy. The patient, a 15-year-old boy, had hereditary renal-retinal dystrophy combined with an exudative vasculopathy of the Coats' type. The patient is on thrice-weekly hemodialysis after two kidney transplants failed. One eye became painful and blind and was eventually enucleated.

The purpose of this study was to describe the family physician's patient population in epidemiologic terms and to elucidate why a person would choose to see a family physician rather than other specialists in an urban area. The patient populations of family practices in New York City are described in terms of their demographic and practice attendance characteristics. Comparing their family physicians with other specialists, the patients rated their family physicians on the 12 aspects of care shown in the literature to be most important to patients in terms of physician consulting behavior (continuity, comprehensiveness, family care, rapport, low cost, convenience, interest, time with patient, support, personalized care, convenience of appointment and follow-up, and waiting time). Family physicians scored significantly better than other specialists on each aspect of care (P less than .0001). This study indicates that patients choose to consult family physicians rather than other specialists in New York City because patients view the family physician as performing better than other specialists those aspects of care most important to the patient. There is a need for further study to determine the attitudes of patients seeing other specialists.

The ocular manifestations of 34 patients with the Acquired Immune Deficiency Syndrome (AIDS), are reviewed. Cytomegalovirus retinitis was seen in 18 patients, cotton wool spots were observed in 11 patients with Pneumocystis carinii pneumonia; Fungal retinitis and Toxoplasmosis retinochoroiditis were each seen in 2 patients. A review of literature regarding AIDS is included.