Uveitis : symposium of papers read before the Ophthalmological section of the American Medical Association, at the annual meeting, Saratoga, N.Y., June, 1902.

JAMA Ophthalmology

Date:: [1902]

Credit: Uveitis : symposium of papers read before the Ophthalmological section of the American Medical Association, at the annual meeting, Saratoga, N.Y., June, 1902. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

65/108

$[Reprinted from Maryland Medical Journal, November, 1902.] PERMANENT LEFT HEMIANOPSIA, SEQUEL OF PUERPERAL ECLAMPSIA. By Hiram Woods, M.B., Professor of Diseases of the Eye and Ear, University of Maryland, Baltimore. READ BEFORE THE AMERICAN OPHTHALMOLOGICAL) SOCIETY AT ITS THIRTY-EIGHTH ANNUAL MEETING, NEW LONDON, CONN., JULY, 1902. The following case came under my care in September, 1901, through the kindness of my friend, Dr. J. Whitridge Williams of Baltimore, professor of obstetrics in the Johns Hopkins University: Mrs. X., thirty-three years of age, in good health save for the condition of her eyes, had 20/15 central vision in each eye, refrac- tion error being only 0.5 D. H. Accommodation showed a near point of six diopters. Perimetric examination revealed the fields illustrated in Figs. 1 and 2. In each eye there is left hemianopsia, complete save for a small area above near the median line. The line of separation between the seeing and blind halves in the inferior fields cuts the median line in the right eye, while in the left it encroaches upon the nasal half to about 15°. The greatest interest n the case lies in the history. Mrs. X. was confined with her first jhild on March 17, 1900. Her previous health had been excellent, and the period of gestation showed nothing abnormal until traces of albuminuria were found in the sixth month, and persisted through the rest of the pregnancy. On the morning of the 17th Mrs. X. ate her breakfast with relish, and felt well. Between 9 and 10 o'clock, while returning from the toilet to the bedroom she became confused and lost her way.'' She was giddy, and did not know where she was. Her husband, a physician, helped her to her room. He tells me that there was high arterial tension, flushed face, and, what he specially noted, very rapid dilatation and con- traction of the pupils. Bromide and chloral were administered, but about 11 o'clock, after convulsive twitchings of the limbs for some time, there occurred an eclamptic convulsion, lasting, Dr. X. thinks, not over five minutes. His wife recovered from this in a condition of stupor, from which she could not be aroused. Dr. Williams was summoned as promptly as possible, and effected instrumental delivery, under chloroform anesthesia, about 2 P. M. There was but one convulsion. The description of the visual dis- turbances was given me by Mrs. X. herself. While recovering from anesthesia she seemed to be seeing through steam, yet there was no trouble in seeing all about her. The next day she was troubled with persistence of retinal impressions. She saw the flowers which were on the wallpaper when she looked out the win- dow ; a picture opposite her bed followed wherever she turned her$