On granular disease of the conjunctiva and contagious ophthalmia / by Edward Nettleship.

  • Edward Nettleship
Date:
[1874]
Catalogue details

Licence: Public Domain Mark

Credit: On granular disease of the conjunctiva and contagious ophthalmia / by Edward Nettleship. Source: Wellcome Collection.

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

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    nation of granular disease, when at all severe, if not interfered with From the constancy with which it occurs in cases of the sfme decree of severity, from the invariable occurrence of the chief cicatrix in exactly the same part of the lid and this the least vascSr part L S rom the fact that treatment of precisely the same kind as has been there anTthT. ?^i sfmilar scarring in mild ones there can, I think, be no doubt whatever that most of the cica- ices commonly met with now, especially the worst ones/are due to ment nTto'the^^ been allowed to g/on without suffi'ciTnt t'^- ment, not to the use of too powerful caustic applications! The scars following the spontaneous cure of granular ophthalmia may be fi ly compared to those following the disappearance of non-ulcSirS deposits of lupus, or the spontaneous cure of navi. ^ bymptoms^ accompanying Granular OpJdAalmia.--T\iere is the lltt 't^'^'' ^y^P*°«^« of this disease a variation which bears no relation at aU, in cUffereni cases, to he objective changes, although m the same patient this relation remains almost always constant. The great majority of children with abundant sago-grams on their lower lids and often a good deal of congestion and papillary hypertrophy, will tell you they have nothing the matter with their eyes. Generally there is no photophobiS whatever. There is often more or less drooping of the upper M rom elonga ion of the tarsal ligament and this gives the pl^ent a sleepy aspect This total absence of discomfort is quite common even m much more advanced cases where the conjunctiva of the upper and lower ids is crimson, thickened and converted into a mass of mmgled follicular granulations and enlarged papillae. There is no redness of the exposed part of the ocular conjunctiva, but often, perhaps generaUy, the parts ordinarily covered by the lids are more or less congested. This condition is most intense at the oculo- palpebral fold where it merges into the redness of the palpebral conjunctiva; gradually diminishing, its last traces are seen in a few ot the larger conjunctival vessels as they straggle towards the cornea. The state of congestion of the palpebral conjunctiva is 1 Scars do sometimes result from ulceration of the conjunctiva produced bv ?omTot;^]:,Vt'':f f] f^^'t^' '^PPeince, and cWte^ i om those due to the natural cure of the disease. They are generi.lly fouud on the lower hd near its centre in the form of short wide hands johnng toLtW two principal folds of the conjunctiva which is in this position very laxTn oftm niuch phcated. They are always preceded by superficial ulcei^ition/ a d hU generally takes p ace on the two opposed surfaces ot'a sulcus in Jhe Jdded con- junctiva and IS the result of a too free application of nitrate of silv.^ or Ss JolYow ?v.° ^ '''''' any distortion of the edge of the Hd follow them. It very occasionally happens that similar ulceration and scaiTl S occur on a sma 1 patch of the upper lid from the same cause; these scS arf mXi;; o7£ ^ circumscribed, quite suporfici.l, devoid oF the ,;eculiar te.idin s thoiid. spontaneous scars, and especially have no uniform position oa.