NOTES, CASES, INSTRUMENTS 1265

mother and two daughters, there was a his­
tory of consanguinity (first cousins) in the
grandparents of the probandus. The mi­
crophthalmos was unique in that the right
eye in all three patients was smaller than the
left eye, representing monocular hereditary
transmission of the size of the eye. All these
patients had pendular nystagmus.
Many authors classify microphthalmos
into three groups: (1) pure microphthalmos
(2)colobomatous microphthalmos and (3)
complicated microphthalmos. Our family
manifests the complicated type, since all
the affected patients had cataracts. Many
other general malformations have been de­
scribed with microphthalmos, among them
the irregular implantation of the teeth seen
Generation IV, Case 2.
All modes of inheritance have been de­
scribed in complicated microphthalmos, in­
cluding the sex-linked recessive (Sj^gren
and Larsson). From our pedigree we were
unable to establish the mode of inheritance
definitely, since only three females were
affected in two generations. However, the
history of consanguinity of the maternal
grandparents suggests an autosomal reces­
sive mode of inheritance, as does the fact
that the probandus had a sister affected
with microphthalmos.
Department of Ophthalmology
University Hospital.

REFERENCES
Ash, W. M.: Hereditary microphthalmia. Brit. M. J., 1:558, 1922.
Bruns, H. : Microphthalmus with cataracts. Am. J. Ophth., 16:68, 1899.
Cuendet, J. F.: La microphtalmie compliquée. Ophthalmologica, 141:380-385, 1961
Franceschetti, A., and Klein, D.: Les affections génétiques en'ophthalmologie. Encyclopédie Medico-
Chirurgical, Paris, 1955.
François, J. : L'Heredite en Ophthalmologie. Paris, Masson et Cie, 1958.
Sj^gren, T., and Larsson, T.: Microphthalmus with oligophrenia. Acta. Psych. & Neurol. Suppl. 56,
1949.
Woolff, T.: A microphthalmic family. Proc. Roy. Soc. Med., 23:623, 1929-1930.

CENTRAL SEROUS On June 25, 1960, his identical twin, a drug

R E T I N O P A T H Y IN T W I N S
GEORGE J. W Y M A N , M.D.
Peoria, Illinois
Central angiospastic retinopathy has been
described by von Graefe in 1866 and by
many other observers under a variety of
names. The etiology remains obscure. Toxic
factors as well as vasospasms are among the
most popular causes. Recently, I had an ex­
perience which I believe is unique and worth
reporting.
CASE REPORT
On May 21, 1960, a physician, aged 40 years,
consulted me because he was seeing, as he described
it, a "circle around lights" with the left eye. Visual
acuity was 20/20 in each eye but fundus examina­
tion revealed an edematous macula on the left. He
was placed on steroids by mouth and nicotinic acid.
His symptoms gradually disappeared over a three-
week period.
salesman came in with a history of distortion and
blurry vision in the right eye for approximately
one month. When seen, the vision in the right eye
was 20/70 ; left eye 20/20. The right macula showed
a definite edema with some flecks of exudate. He
received the same therapy as his twin, but the
edema persisted for several months because he
stopped treatment on his own. On November 5,
1960, visual acuity was 20/20 in the right eye, the
fundus looked normal and symptoms had disap­
peared.
The mechanism that produces a central
serous retinopathy remains unknown. Here
are reported two identical twins who at the
age of 40 years developed similar conditions
one in the right eye, the other the left eye,
and both within a week or two of the other.
Interestingly enough the second brother did
not know his twin had a similar difficulty
until the father remarked about it.
1200 Hamilton Boulevard.