The bacteriology of the eye / by Theodor Axenfeld ; translated by Angus Macnab.

  • Theodor Axenfeld
Date:
1908
Catalogue details

Licence: Public Domain Mark

Credit: The bacteriology of the eye / by Theodor Axenfeld ; translated by Angus Macnab. Source: Wellcome Collection.

    99/438 page 81
    cleansing; there is often a very variable individual disposition to such a condition. . Many patients develop it after every operative interference, even when physio¬ logical saline alone is used; the loosening of the epithelium by cocaine has perhaps something to do with it. Post-operative catarrh usually commences after several days. The bacterial contents of the secretion vary. In three almost consecutive cataract cases Ahelsdorff and Neumann (A. f. A., 1900, xlii., S. 68) found Gram¬ negative Pdiplococci. De Lieto-Vollaro (Archivio di Ottalmol., 1905, xii., 7, 8), working in my clinic, obtained xerose bacilli and occasional yellow Staphiylococci of low virulence ; and since then I have often obtained cultures of B. xerosis and white Staphylococci,l the latter of low or moderate virulence. Bardelli and Bossalino, on the contrary, report that the virulence of these Bacteria is raised by the same causes which promote their growth. The varying findings show that the Bacteria here are of quite of secondary im¬ portance. This view is confirmed by Knapp’s researches. He found the common conjunctival organisms in the secretions in post-operative conjunctivitis. We cannot, however, exclude the possibility that they influence the catarrh, or that they can cause a wound infection later, although that only rarely occurs. This post-operative conjunctivitis certainly is less common with the open treatment and thorough asepsis. Entropion spasticum and similar conditions can act in the same way and produce a catarrh. I have seen a peculiar case with profuse secretion and numbers of Pneumococci, where, as a result of the wound giving way, secondary infection resulted, and the eye was lost from pneumococcal panophthalmitis. As there was no previous catarrh, perhaps scattered Pneumococci on a normal conjunctiva multi¬ plied and increased in virulence in this case. Let alone that patients find it objectionable, from a bacteriological point of view suspicion has been aroused as to the formerly universal bandage after cataract operation. This has led many ophthalmic surgeons to dispense with it altogether. The bandage certainly pre¬ vents lid-blinking, and thus removes a considerable factor in the physiological self-cleansing. By its action, and also from the increase in temperature, a renewal of bacterial growth in the conjunctiva must occur in spite of previous cleansing. Bepeated experimental and bacteriological researches prove that a bandag’e applied for twenty-four hours considerably increases the number of organ¬ isms in the conjunctiva [Bernheim (loc. cit.), Marthen (loc. cit.), Morax,2 Bach,3 Dalen,4 Knapp5]. 1 The drawing, Plate II., Fig. 6&, showing Gram-positive Diplococci, was made from such a conjunctivitis. 2 ; Recherches Bacteriologiques sur l’Etiologie des Conjonctivites Aigues et sur l’Asepsie Oculaire’ (These de Paris, 1894). 3 ‘ Über den Keimgelialt des Bindehautsackes, dessen natürliche und künstliche Beein¬ flussung, sowie über den antiseptischen Wert der Augensalben’ (A. f. 0., 1894, xl. 3). Again, ‘Antisepsis und Asepsis in ihrer Bedeutung für das Auge’ [‘Samml. zwangloser Abhandl.’ (Vossius), 1897 (Marhold, Halle)]. 4 £ Mitteilungen aus der Univ.-Augenkl. in Stockholm,’ 1899 (Fischer, Jena). 5 Berlin. O'phth. Ges.. June, 1907 ; K. M. f. A., July, 1907, Bd. ii. 6
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