Conjunctival melanoma.

and similar software but a long sequence of consecutive tests is required.12 It might therefore be more effective if a less sensitive test was used in the first place. With the appearance of FASTPAC and other simple test programs it seems that computerised field analysis is approaching the performance of machines such as the venerable Friedmann visual field analyser. Is the emperor's new suit being replaced by something more appropriate for everyday use? Having been to the limits of complex physiological measurement of visual field, it is timely to establish the minimum test strategy to enable us to make practical management decisions. We should develop a pragmatic view of testing the visual field. primary treatment trial: changes in the visual field analysis by computer-assisted perimetry. rim area in suspected glaucoma and early chronic open angle glaucoma: correlation with parameters of visual function. measurement with computerised analysis of stereo video images. nerve damage in human glaucoma, III: quantitive correlation of nerve fibres and visual field defect in glaucoma, ischaemic neuropathy, papilloedema and toxic neuropathy. comparison of experienced clinical observers and statistical tests in detection of progressive visual field loss in glaucoma using automated perimetry. Conjunctival melanoma (CM) is a rare unilateral disease of the middle aged and elderly. It is those centres where these cases are collected which have developed and reported current management strategies.' For example, in this issue of the journal Paridaens et al report on 95 cases from 1948 to 1991 where orbital exenteration was undertaken for CM, and conclude that this drastic operation often fails to cure. As a professional community however, we have yet to pool the resources at our disposal to understand the nature of the condition. Until we do it will be difficult to assess whether there has been any change in the behaviour of CM. While some ophthalmologists will never see a new case in their careers, most of us are confronted from time to time by lesions which might be CM. At this early point we should seek to avoid the pitfalls of generating needless anxiety while ensuring appropriate intervention and referral when necessary. This has become easier since the concept of primary acquired melanosis (PAM) has become widely accepted and has done much to clarify diagnostic and management strategy .378 Accordingly we have derived diagnostic algorithms for 'in-house' use which are published on page 592, which some readers may find useful. …