A study of the effects of orally administered female hormones on the volume and composition of lacrimal fluid related to the toleration of corneal contact lenses

This study was designed to evaluate the effects of certain orally active contraceptive steroids on the eye, related to the tolerance of a corneal contact lens. An oestrogen, ethinyloestradiol BP. 0.05 mg, a progestogen, norethisterone acetate BP. 2.50 mg and a control tablet (vitamin C, 50 mg) were utilised. The effect of these preparations on corneal curvature, lacrimal fluid volume and protein composition and directly on corneal lens tolerance was monitored in a group of 23 volunteer patients. The progestogen was found to produce a significant (P≥ 0.05) decrease in tear volume as measured by a 3 minute Schirmer test. A smaller volume reduction was observed with ethinyloestradiol. A normal cornea appears unaffected, within the measurement limits available, by the use of either hormone. However, in the presence of a corneal lens, oestrogen was found to induce substantial corneal steepening, indicative of tissue oedema, during the initial 2-3 weeks of medication. Progestogen occasionally produced a similar effect, which could recur with either hormone shortly after the end of the treatment period. A new method of acrylamide gel electrophoresis was developed for examination of the protein concentration and composition of lacrimal fluid. This allowed much greater resolution of microquantities of unconcentrated fluid than anything previously reported. Quantitation by densitometry has permitted the recording of medication and lens-induced changes in the protein pattern. Tear albumin has been shown to differ from serum albumin and to consist of up to 3 subfractions, 7 further protein fractions may also be resolved. The concentration and probable origin of these proteins have been established and the overall effects of hormone administration described. Individual idiosyncratic responses are also discussed. The study has established tbenature of some effects of contraceptive steroids on the anterior eye, and the probable reasons for resultant corneal lens intolerance.

The core executive's approach to regulation:from 'better regulation' to 'risk-tolerant deregulation'

This article examines changes in the New Labour core executive’s approach to regulation and its relationship with risk, through analysing documentary, legislative and press sources concerning approaches to regulatory decision-making. It claims that an initial commitment to ‘better regulation’ has gradually been replaced by explicit support for deregulation. A reduction in the scope of regulation was also promoted by the Thatcher and Major governments. The New Labour core executive shares previous (Conservative) administrations’ concern to include business in deregulatory decision-making. However, the article claims that there is one significant difference in the New Labour deregulatory approach: a new toleration of risk. Deregulation is, now, described as a corrective to regulators’ over-reactions to perceived risks, which, it is claimed, are holding back economic and technological progress. However, this new approach excludes competing views concerning how risk should be regulated. In particular, it does not engage with widespread popular views that governments should continue to protect against risk.