The use of crystalline penicillin in corneal and intraocular infection.

IN a recent review of the literatume concerning the use of penicillin in ophthalmology, Rycroft (1945) makes no mention of the direct application of the undissolved salt to the surface of the eyeball. Sorsby (1945) in a similar review does just mention the method, itn referring to a paper byJuler and Young (1945) on infective corneal ulcer, but in a recent annotation in the Brit. Med. J1. (1946) entitled ' Penicillin in Ophthalmology" no mention is made of this procedure. From practical clinical experience we feel that this method is worth emphasis, as affording tlhe maximunm concentration of the drug in relation to the infection itself. The method was suggested to one of us (F. A. J.) by Professor Ida Mann (personal commun ication, February, 1944) who wrote as follows -" In a small child with a large corneal abscess an incision was made and some crystals of penicillin were put into the cavity. This was repeated twice a day for three days.and, although the cornea perforated it healed completely without synechiae and with a scar which was only slightly opaque." In the report by Juler and Young (1945) the method was described after an extensive trial, chiefly in senile patients with severe corneal lesions.. -In' that series it was found that the instillation of drops on the cornea did not suffice in the more heavily infected cases, especially in persons of marked senility, and especially, where hypopyon was