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To the Editor.
—The contention that an eye with normal corneal epithelium is resistant to the miotic effects of topically applied dilute methacholine is not invariably correct. As pointed out in two articles in the Archives, one in 1937 by Myerson and Thau (18:78-90 [July]) and one in 1959 by de Haas (61:866-884), in 1963 by Dodge in discussion of an article by Smith and Dancis (J Pediat63:839-840), and again by us in the December issue of the Archives, normal eyes will occasionally develop miosis from this agent when topically instilled.Conversely, the presence of corneal epithelial damage does not insure the development of methacholine-induced miosis, even, as reported in 1965 by Keith in an article in the British Journal of Ophthalmology (49:667-672 [Dec] ), in a patient with dysautonomia. This concept was studied in systemically normal individuals by Smith et al in an article in
Goldberg MF, Payne JW. COMMENTS ON GOLDBERG ET AL'S ARTICLE IN DECEMBER 1968 ISSUE-Reply. Arch Ophthalmol. 1969;81(4):601-602. doi:10.1001/archopht.1969.00990010603031