Coloboma of the choroid and optic nerve sheath / by Arthur H. Benson.

  • Benson, Arthur H.
Date:
1882
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Licence: Public Domain Mark

Credit: Coloboma of the choroid and optic nerve sheath / by Arthur H. Benson. 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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    Anophthalmos and extreme microphthalmos are, probably, in many cases, the result of early and extensive coloboma of the optic nerve sheath. Coloboma of the optic nerve sheath, as seen in B. M., is an extremely rare affection, and when combined, as it is in her right eye, with a distinct and separate coloboma of the bulb, and in her left eye with a raphe-like disturbance of pigment in the line usually occupied by bulbar colobomata, it must be regarded as entirely unique. A. Nieden, of Bochum, in his article on Coloboma of the Optic Nerve Sheatli in Knapps Archives of Ophthalmology, December, 1879, describes four cases of the affection, in the largest of which the colobomatous disc was only three times the normal size, whereas in B. M.'s right eye the colobomatous disc is, at least, six times as large as any normal disc. Time would fail me to dwell upon the many interesting questions which such cases as these suggest—how far the refraction of the eye is influenced by the coloboma, and how far the coloboma is affected by the primary inclination of the globe to hypermetropia or myopia. A majority of, perhaps all, colobomatous eyes are primarily hypermetropic, but many develop axial myopia from subsequent stretching of the globe backwards ; or what part (an important one, I feel sure) is played by heredity; and how far such maldevelopments are associated with maldevelopments else- where. But before closing I may be permitted to allude to the interesting monograph lately published by Dr. Van Duyse, of Gand, on Coloboma of the Eye, and its connexion with Congenital Serous Cysts of the Orbit, in which he shows that these congenital serous cysts of the orbit, which occur either in anophthalmic or microphthalmic patients, and for which the surgeon is at times called on to operate, frequently have their origin in a coloboma, the weakened floor of which yields before the increasing intra- ocular pressure. Considering the rarity of coloboma of the eye, it is remarkable that amongst about 500 deaf-mutes in the Dublin asylums there should be found two double cases ; but, of course, the number is too small to draw any firm conclusions from regarding the con- nexion of coloboma and deaf-mutism. This subject, amongst others, is being worked up by Dr. Fox, for whose statistics I helped to examine the mutes in Dublin. In the cases at present before us we have, then, a very remarkable
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