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There are two editorials in the current issue. In the first of these I report the very positive development that Acta is undergoing. We have changed to an internet-based submission and review system. As a result the number of submitted manuscripts has increased even more rapidly than during the past few years and exceeded 600 during 2004. The number of editors and reviewers that are involved in the review process is now quite large. Our impact factor has doubled during the past two years. The International Perimetric Society is the 6th society after the five Nordic Ophthalmological Societies to team up with Acta as their membership journal, and the end of my term as Chief Editor of the journal is approaching. Professor Einar Stefánsson takes over as the new Chief Editor of the journal and the Editorial Office moves to Reykjavik

The new Chief Editor has written the second editorial, Nordic Academy of Ophthalmology, a speech that he delivered at the recent XXXVIth Nordic Congress of Ophthalmolgy in Malmö. Stefánsson argues in favour of creating such a Nordic Academy, describing the background and the advantages. With the five Nordic Societies supporting our biannual Nordic Congresses, as well as NOK, and with Acta as our membership journal, we should take the next stage and form a Nordic Academy of Ophthalmology. This idea certainly has the support of many members of the national ophthalmic societies, and we can hope that this Academy might be founded at the upcoming XXXVIIth Congress in Copenhagen in 2006. Certainly, this would give Nordic ophthalmology a stronger voice and clearer role in Europe and around the world.

The Swedish National Cataract Register is unique because of its impressive size, long duration and almost complete coverage. Many important papers have been published on results obtained from the data in the register, in Acta and in other journals. In this issue prospectively collected data from 1999 to 2001 – 188 151 cataract operations – show a very low incidence of endophthalmitis, 0.0595%. Most infections were caused by Gram-positive bacteria. The administration of intracameral antibiotics may have contributed to these good figures.

Sundelin et al. report results from a randomized study of two different silicone IOLs with different design (CeeOn Edge and SI40NB). There were considerably and significantly less posterior capsule opacification in the group of patients who received the sharp edge optic lens. A second lens study in the current issue comes from Siena, where Casprini and coworkers randomized patients to five different IOLs. New generation IOLs offered lower incidence of glare and of spherical aberrations, while the lenses did not differ significantly when patients reported their ability to perform ordinary activities under light and dark conditions.

Most of us have probably not seen a typical TNT-induced cataract. Kruse and coworkers from Aalborg have studied the prevalence of cataract in exposed workers and a control group, and demonstrate a clear difference between the groups. And you may recognize the typical features, if you read their paper!

There are two cornea papers. Funding et al. from Århus compared the proteomic composition of aqueous humour in patients with acute corneal rejection, with that of controls. There were many differences and the authors' conclusion is that the different composition of the of aqueous humour in corneal rejection are due breakdown of the blood–aqueous barrier, enzymatic degradation and liberation of locally synthesized proteins. The second cornea paper comes from Taiwan, where Lin and Tsai have studied 386 operated with LASIK of 200 consecutive patients. The results are good, but better if the myopia is less than −10D.

In two papers Jansonius and coworkers from Groningen test new techniques for glaucoma diagnosis. The studies are very interesting as they have been conducted under very ‘clinically realistic’ conditions, involving large numbers of patients with manifest and suspect glaucoma from a regular outpatient department plus normal control subjects. The number of excluded patients is small and the results therefore mirror what one could expect in many clinical settings. The techniques studied are laser polarimetry as performed with the GDx instrument and FDT visual field testing performed with the original FDT instrument in its full threshold mode. One of the papers, on baseline sensitivity and specificity of the two techniques is the first report from Jansonius' ambitious, prospective long-term cohort study. The sensitivities of the two techniques were similar. With sensitivities fixed at 90%, specifities were close to 80%, nota bene using the best parameters that the authors could find in this material. The majority of positive findings in glaucoma suspects did not occur in the same patients with the two techniques, and presumably represent false-positive cases particularly with GDx. This instrument, as opposed to FDT, failed to detect a rather large number (5%) of patients with moderate or severe glaucoma. In the second paper the authors show that FDT specificity could be increased from 80 to 90% by re-testing, but that sensitivity then decreased from 88 to 82%.

Acta has had the privilege to publish a great number of papers on diabetic retinopathy during the past few years. This issue is no exception, with three such papers. Loukovaara et al. evaluated the relationship between vasoactive hormones and development of diabetic retinopathy during pregnancy and post partum. While the levels of vasoactive hormones were lower in diabetic than in nondiabetic patients, they could not demonstrate a clear association between hormonal levels and progression of retinopathy.

With OCT Ozdemir and coworkers found that serous macular detachment was much more common (31%) in their group of 78 patients with diabetic cystoid macular edema than previously reported.

Thirteen of the 34 eyes with macular oedema treated with intravitreal triamcinolone by Sørensen and coworkers had diabetes. Marked improvement of the edemas was seen in diabetes, as in other diagnoses. Another triamcinolone paper comes from Vienna. Krepler and coworkers report improvements lasting up to 9 months of macular edema caused by central retinal venous thrombosis.

Visual acuity testing in young children is always a challenge. Kvarnström and Jakobsson from Linköping tested the Swedish HVOT and the Finnish Lea symbol chart in 3-year-old children. The great majority of these young children could be successfully tested with both charts; testability was the same with these two quite diffirent charts.

In a paper from Japan Iwasaki and coworkers describe that accommodation relaxation with far point shift stimuli can reduce asthenopia.

Digital photography was discussed above in conjunction with photographic screening for diabetic retinopathy, but modern cameras are taking over from film cameras for many different purposes. Möller Pedersen and coworkers from Copenhagen compared the quality of micrographs captured on film or with a high resolution digital CCD camera. Detail was judged better in the CCD images, colour was better on film. The authors conclude that digital histopathology micrographs can now replace documentation on 35 mm film.

Two other papers from the Eye Pathology Institute in Copenhagen have used the institutes large archives. One paper describes the nature of 643 biopsy specimens from the lacrimal drainage system obtained between 1910 and 1999. The other paper deals with lacrimal gland tissue outside the lacrimal fossa. Prolapsed palpebral lobe tissue was very common, usually in the temporal conjunctiva, and often misunderstood.

In a purely experimental paper Ehrich et al. studied the effects of interleukin-1β and dexamethasone on trabecular cells in culture, under normal and elevated hydrostatic pressure. Observed changes in MMP-3 mRNA are interpreted as indicating that trabecular cells preferentially degrade and turn over proteoglycan products in response to short-term elevation of pressure.

The Diagnosis/Therapy article in the current issue describes a misdiagnosed patient with malignant melanoma.

We have three case reports. One patient suffered total iris expulsion when vomiting two weeks after sutureless cataract surgery. One report is a most unusual description of ultrastructural changes in Chandler's syndrome, including the formation of a basement membrane-like tissue. The third is a report of recurrent secondary frosted branch angiitis after Toxoplasma vasculitis.

And as always – do not forget the letters.