Ophthalmic surgery / by Robert Brudenell Carter and William Adams Frost.

  • Robert Brudenell Carter
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Ophthalmic surgery / by Robert Brudenell Carter and William Adams Frost. Source: Wellcome Collection.

    543/582 (page 531)
    The nature of the tumour varies much, some bein soft, and so vascular that pulsation can be felt in them ; others of cartilaginous firmness. They occur, too in patients of all ages, although childhood and advanced middle life are most liable to be attacked. Pulsating malignant tumours of the orbit are gene- rally associated with similar growths elsewhere, es- pecially in the flat bones, as the sternum, parietal bone, and scapula; this is, however, not always the case. Sometimes the pulsation is distinctly visible, in other cases it can only be made out by firm pressure; it is not of the distensile character peculiar to an aneurism, and the diagnosis between these affections never pre- sents any difficulty. Glioma always commences in the retina, involving the orbit by extension ; it has already been considered with affections of the retina. Many instances of so-called melanotic sarcoma have been recorded. In most of these the pigmentation which has given rise to the name, and which sometimes renders the tumour almost jet-black, would seem to be an accident depending on the situation of the growth. As regards those which have commenced in the choroid, and thence spread to the orbit, this is certainly the case, and it is probably also true of other tumours which have commenced external to the eye. At any rate, these tumours do not appear to possess that ex- treme malignancy which is characteristic of melanotic sarcoma when it occurs in other parts of the system. It is of the utmost importance to diagnose a malig- nant tumour of the orbit at the earliest possible moment. ^ Rapidly growing non-inflammatory swell- ings within the orbit should at once arouse a strong suspicion of malignancy, and no time should be lost in operating. It must, however, be as far as possible ascertained that there is a reasonable probability of the whole growth being accessible, as partial operations