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George W. Jean, M.D.
JAMA. 1933;100(22):1793-1794. doi:10.1001/jama.1933.02740220059032.
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To the Editor:  —The newspaper notoriety given to the Vasco case—the child whose parents refused operation for a tumor of the retina—brings up several questions. If surgery fails, the irregulars and the general public perhaps will say that here scientific medicine stepped in at the behest of the law and yet the life of the child was not saved.Glioma of the retina is a terrible disease and demands primarily brain and not eye surgery. When it kills, it does so practically always by direct extension of the tumor backward through the optic nerve to the brain. The surgical problem, then, is always to remove all the nerve possible.The optic nerve is 5 cm. long, of which 3 cm. is in the orbit, 1 cm. in the bony optic canal and 1 cm. intracranial (Norris and Oliver, vol. 1, p. 386). The usual procedure among eye surgeons (of whom


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