Tuberculosis of the choroid : perforation of the sclera ; extension posteriorly with involvement of the optic nerve ; histological and bacteriological examination of the specimen / by G. E. de Schweinitz and E. A. Shumway.
- George Edmund de Schweinitz
- Date:
- [1906]
Licence: In copyright
Credit: Tuberculosis of the choroid : perforation of the sclera ; extension posteriorly with involvement of the optic nerve ; histological and bacteriological examination of the specimen / by G. E. de Schweinitz and E. A. Shumway. 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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![The lens is cataractous, shows deposits of lime salts, and is pressed forward so that the iris is adherent to the cornea at the position of a healed perforating ulcer of the latter. There is a mod- erately severe plastic irido-cyclitis, and the iris is covered with a connective-tissue membrane which occludes the pupil. A number of sections were stained and examined for tubercle bacilli, and a few typical organisms were found. Pour weeks after the inoculation the rabbit's eye showed distinct iinjection, and a number of grayish-white nodules appeared in the iiris. The cornea became cloudy and staphylomatous, and the eye \was enucleated one week later. Sections in celloidin show marked iinfiltration of the staphylomatous cornea and an intense irido- ccyclitis. The round cells axe massed in the form of nodules in tthe iris stroma and as an exudate on its surface. Stains with car- bbol fuchsin reveal the presence of myriads of tubercle bacilli tthroughout the iris, and thick masses of them in the nodules and iin the exudate on the surface. The diagnosis, therefore, of con- glomerate tubercle of the choroid is proved by the histological eexamination of the eyeball, and by the results of animal inocula- Ittibn. Eemarks.—The number of cases of tuberculosis of the choroid, whether of the diffuse or conglomerate type, is still comparatively ;3mall, and there are questions of differential diagnosis, tlierefore, wvhich still remain to be settled. The literature of the subject has )Deen analyzed recently by Zur ISTedden^ and La Grange^, so that it will be unnecessary to review it here. The conditions with which choroidal tuberculosis is most frequently confoimded are glioma 1 ncuro-epithelioma) of the retina in the young and sarcoma of he choroid in adults. As most of the cases occur in children, the lifferential diagnosis usually rests between it and glioma. Certain )oints of value in making this diagnosis have been determined and ;i,ve been recorded by Dupuy-Dutemps'' in a recent investigation of his subject, as follows: 1. Although conglomerate tubercle has been found almost con- tantly in young subjects, sometimes it appears in adults. In a 1. Klin. Monatsbl. f. Augenhellk., vol. xll, No. 2, 1903, p. 351 2. Tralte des Tnmeurs de I'Oell, Tome I, I'arls, 100] 3. Arcblv. a'Opbthalmologle, vol. xxlv, lOOf, p. 317.](https://iiif.wellcomecollection.org/image/b21647070_0009.jp2/full/800%2C/0/default.jpg)
