Two cases of glaucoma, following cataract extraction / by S. Mitchell.
- Mitchell, Samuel, 1855-
- Date:
- [1897]
Licence: Public Domain Mark
Credit: Two cases of glaucoma, following cataract extraction / by S. Mitchell. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![to retire from business with a comfortable bank account,that permitted him to live at his leisure in a near by citv. Although in his dotage and nearly blind from cataracts,the blindness seemed to be his only impediment to a thorough enjoyment of the many follies and pleasures that are supposed to be the prerogative of the giddy youth, rather than the octogenarian. His vision was as follows: 0. D. Fingerstat ten feet; O. S. Fingers at two feet; Projection of light good in the left eye, and vision was normal. The cataract was removed from the left eye by the simple operation, under cocaine anaesthesia. The operation waspefertly smooth and recovery uneventful. Sixteen days after the operation, the dense semi-opaque capsule was divided with a Knapp’s knife needle. The eye at this time was nearly free from redness and there was no increased tension. The reaction following the discission was insignificant. Thirteen days later vision was ?{} W. -j- 4 D. sp. O + 8 D. cyl. axis 165°,and J. 4. W. 11 D. sp-^H-j- S D. cyl. axis 165°. Measured by the Javal ophthalmometer that was 13 D. of astigmatism, but the use of any stronger cylinder than 8 D. was not attended with any further improvement in vision. The eye was now free from redness and tension was not increased. The glasses were prescribed and a few days later he returned to his home. Just previous to his departure, his vision had improved to !!]. So this eye was numbered among the successes; only for the brief period of two months however, as succeeding events proved. One morning two months later, my heart was saddened by the sudden ap- pearance of this patient at my office. He informed me that he had experienced a very sudden and severe attack of pain in the eye operated upon, a few days previous, accompanied with headache and bilious vomiting. The sight of the eye, he said, declined rapidly. The pain and general wretchedness continued un- abated, and indeed his whole appearance told more eloquently than his words, the story of his sufferings. There was some enlargement of the blood vessels in the sclera, and T. -)- 2. The cornea was clear and the pupil dilated ad maximum. Vision was reduced to 1. p. A geneal haziness of the vitreous prevented an examination of the fundus. The anterior chamber was deeper than normal. This, together with the fact that the free border of ill • iris seemed to be curled backward, led me to believe that this pa-t of the iris had become adhered to the edges of the button-hole in the capsule; thus impeding the flow of the intraocular fluid and high tension was the result. No amelioration could be expected by the use of myotics, so long as the con- dition detailed above existed. So I decided to preform an iridectomy at once. Under chloroform anaesthesia, assisted by Dr. W. E. Hathaway of this city, the usual opening for iridectomy in glaucoma,was made into the anterior chamber; but the iris having shrunken to such a narrow bin 1, with the pupilliary border curved backward, it was impossible to grasp it with forceps. A firm hold on the membrane was secured, however, by the means of an iris hook, and the first effort at traction resulted in breaking, to quite an extent the adhesion that bound the iris. A copious gush of vitreous accompanied the breaking of the adhesions, and each effort to draw the iris out of the wound, only resulted in allowing more](https://iiif.wellcomecollection.org/image/b22399276_0006.jp2/full/800%2C/0/default.jpg)
