On traumatic keratitis : with a report of nineteen cases treated at the London Ophthalmic Hospital, between December, 1862, and May, 1865 / by Spencer Watson.
- Watson, Sir William Spencer, 1836-1906.
- Date:
- 1865
Licence: Public Domain Mark
Credit: On traumatic keratitis : with a report of nineteen cases treated at the London Ophthalmic Hospital, between December, 1862, and May, 1865 / by Spencer Watson. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
9/20 page 5
![tesis may avail iu the acute stage of the disease, but that iridec- tomy will be necessary at a later period, when the existence of synechia) has been ascertained, and when the keratitis having subsided, a better opportunity is atl'orded for choosing the most favourable situation for an artificial pupiL; / The residts, however, must not be j udged of by the amount of vision remaining, the question of operation being one of relief of present pain, with the possibility of leaving a clear pupil and the restoration of some amount of vision; the alternative being an inevitable slough of the cornea, prolapse of the iris, staphyloma, or collapse and shrinking of the globe. Thus, ;Ca:Se 12 terminated in this way, and many similar cases are constantly occurring, in. >vhich the result would probably have been different had a timely iridectomy been resorted to. So much has been said and written on the advantage of this operation! ioiyer! tbat ; !Of ^pie^rat centesis, that it is superfluous to repeat the arguments in.9. paper of this kind ; but it would not be out of place to observ,? that in cases of ulceration of the cornea; in which there is reason to believe that extension of the ulcerative process is kept up.by the tension of the eyeball, and consequent compression of the vessels supplying the cornea, it is necessary to afford a means of relief which will be lasting, iu order to allow of a,' healthy action taking place in the xdcer ; and .as it is well known that a mere l)uncture of the cornea very rapidly heals .over (often in the course of twenty-four hours),/.iti!is(!obyiousi that andridectouiy which permanently relieves the tension has considerable advan- t iges over the mere temporary relief of paracentesis. The lymph found in the anterior chamber in these cases, is moife-often .serair solid or gelatinous than in a fluid condition,, it. mu.st not there- fore be expected that the effusion can be removed ;! but weimust be satisfied with having; allowed the aqueous humoiu'.to^escape and so relieved the intraocular pressure. Further illustrations of the advantage of this plan of treatment in cases of catarrho- rheuraatic ophthalmia will, 1 believe, shortly ajjpear in the Ophthalmic Hospital Repoi'ts ; and I;may herelremark,that,the latter class of cases (viz., the catarrho-rheumatie) bears a vej-y .strong resemblance in many respects to. the reported cases, of traumatic keratitis, in which there .is effusioiii between ;t]i0 layers of the cornea, and go much so, that it haS! been su|»pose^l by soiiie sui^eons that the two are identical, and that the train of symptoms usually described as cataiTho-rheumatic are iu reality always duo to irritation from.somie foreign, body on the f. trnea, the patient's system being at the time vei-y much dcbir- litated and unable to carry on the reparative process and to prevent destnictive 'proce^se?'continuingj iln t«uppovt,l()f this theory, there nrp some vers' curious facts adduced, hiitaf pretsent not. t^uHifjout to sMtisfv all the requiroment.?, and therclbre, |](https://iiif.wellcomecollection.org/image/b22273840_0009.jp2/full/800%2C/0/default.jpg)
