On the anomalies on accommodation and refraction of the eye : with a preliminary essay on physiological dioptrics / by F. C. Donders ; translated from the author's manuscript by William Daniel Moore.

  • Donders, F. C. (Franciscus Cornelis), 1818-1889.
Date:
1864
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Licence: Public Domain Mark

Credit: On the anomalies on accommodation and refraction of the eye : with a preliminary essay on physiological dioptrics / by F. C. Donders ; translated from the author's manuscript by William Daniel Moore. 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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    Probably there is in this case, in consequence of tension of the chorioi- deal ring and of the lamina cribrosa, some mechanical irritation, per- haps even pressure on the smal fasciculi of the optic nerve. Subse- quently, as the extent becomes greater, and the disproportionate ten- sion is augmented, the phenomena of irritation increase, and at the boundaries of the circumscribed atrophy hyperemia exists, showing that the chorioidea before atrophying, here also passes through a period of irritation. . . . Even the abundant deposition of pigment on the boundaries of the crescent, again absorbed in the progress of the atrophy, in order to be anew deposited more externally, is in favour of a state of irritation. At a later period the subjective phenomena, also, become more characteristic, and in different parts of the fundus oculi atrophic spots are formed, preceded by inflammatory action : chorioiditis disseminata, I repeat it, is in the highest degrees of M at a more advanced age, connected with its normal development. Our conclusion is, therefore, briefly as follows: that almost without excep- tion the predisposition to the development of staphyloma posticum exists at birth; that it is developed with symptoms of irritation, which in moderate degrees of staphyloma do not attain any great clinical importance; but that in the higher degrees an inflammatory state almost always occurs, at least at a somewhat more advanced time of life, as a result and as a co-operative cause of the further development of the distention of the atrophy. This conclusion is certainly not inconsistent with the fact, that after death so few products of inflammation are to be met with. For these products pass, as well as the normal tissue, into a state of atrophy. In this way false membranes, as we see in the synechia of the iris, in adhesions between the pleurae, and in other places, become atrophied and absorbed when extended. Even on the capsule of the lens sometimes nothing else remains of the inflammatory products of iritis than some spots of pigment. In staphyloma posticum the inflammation exists almost as the transition period to atrophy. Another important question is, in what the predisposition to sta- phyloma posticum may consist. It appears to be as yet not satisfac- torily solved; at least I have no decided opinion on the subject. Now, this predispostion has been brought into connexion with the history of the development of the eye. If we look at the drawing given in the Archivfilr Ophthalmologic by Von Ammon, to the protuberantia scleralis, described by him thirty-five vears previously, as existing at a certain period of the fcetal eye, which is here reproduced as fig 41, the form of staphyloma posticum is at once suggested to the mind. Von Ammon states, that in an early period of fcetal existence the sclera is still open at the Fig. 41