The natural and morbid changes of the human eye, and their treatment / by Charles Bader.
- Date:
- 1868
Licence: Public Domain Mark
Credit: The natural and morbid changes of the human eye, and their treatment / by Charles Bader. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![affected side at bedtime ; after which both eyes must be kept closed for two or three days, aud the patient must remain in bed. The improvement in some cases is very great after repeated leeching. Patients with bare per- ception of shadows have been able, after the second leeching,, to read large letters. In some, however, effusion of blood has occurred between the choroid and retina after the leeching; in others no improvement has fol- lowed. No treatment restores even perception of light if the entire retina is displaced. The local application of atropia, though it may not effect improvement of vision, seems to retard further displacement. Atropia should be used sufficiently frequently to keep the ciliary muscle of the affected eye at rest. No treatment seems of use— (1.) If the entire retina is displaced, or if the displaced retina has lost its transparency, or if there exists atrophy of the rest of the retina and of the optic disc. (2.) If the displacement has occurred in the course of ophthalmitis,, or of suppuration of the retina, or if suppuration of the vitreous substance within the area of the retina has set in. (3.) If the displacement is a complication of intra-ocular tumours. In the two latter cases excision of the eyeball may have to be per- formed. Myopic jjersons are the only subjects in whom the displacement has hitherto been observed in both eyes. It is in myopics that photo]^)sia and haemorrhage into the vitreous chamber most frequently precede the dis- placement. A diffused red colour appearing suddenly in the interior of a myopic eye (viewed with the ophthalmoscope), so that no distinct view can be obtained of the optic disc and of the tunics, has been observed as a symp- tom of commencing displacement ( of loosening ) of the retina. The displaced retina occasionally becomes ruptured spontaneously, and the fluid between it and the choroid escapes into the vitreous chamber, while the retina resimaes its position upon the choroid. This has led to the operation of perforating the displaced retina. No serious accidents have followed in the cases hitherto operated upon. The earlier the operation is performed the greater is the improvement of vision that may be obtained. This, sometimes, is almost immediate, or appears a few days later. Signs of the success of the operation are :—disappearing or diminution of the displacement; turbidity of the previously transparent vitreous sub- stance ; improved sensibility of the peripheral parts of the retina. Imme- diately before performing the operation we should ascertain the degree of impairment of vision, and the extent and position of the displacement. 31](https://iiif.wellcomecollection.org/image/b2194099x_0493.jp2/full/800%2C/0/default.jpg)
