A treatise on the diseases of the eye / By J. Soelberg Wells... Together with selections from the test-types of Prof. E. Jaeger and Prof. H. Snellen.

  • Wells, J. Soelberg (John Soelberg), -1879
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the eye / By J. Soelberg Wells... Together with selections from the test-types of Prof. E. Jaeger and Prof. H. Snellen. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    iris, Ave find the latter discolored, and the pupil contracted, irregular, and perhaps blocked up with lymph, or there may be pus in the anterior cham- ber. The inflammation may extend from the iris to the other tissues of the eye, and general inflammation of the eyeball (panophthalmitis) set in, accompanied by excruciating pain. Pannus occurs but seldom in acute purulent ophthalmia, and only in cases where the papillse have been much swollen from the very commencement of the disease, and from their rubbing against the cornea have induced a superficial vascular keratitis. It is more frequently met with in chronic ophthalmia. It is an interesting circum- stance, that if the cornea has been suffering from pannus before the attack of purulent ophthalmia, there is far less danger of its ulcerating or suppu- rating than if it is quite transparent. This important fact has been utilized in the treatment by inoculation of pannus dependent upon granular lids. Purulent ophthalmia generally runs its course in three or four weeks. It may, however, become chronic, and last for many months or even years, and prove very obstinate. This is especially the case if the papillae remain swollen and prominent, for by their constant friction against the cornea, pannus is but too often produced. The relaxed condition of the conjunctiva may also give rise to ectropion, or this may be produced by the lids having become everted during the progress of the disease, and not having been properly replaced. Causes.—[Purulent ophthalmia is generally due to contagion from the same disease, or from an acute or chronic discharge from the urethra or vagina, whether gonorrhoeal or not. (Nettleship.)—B.] It may become developed from an acute catarrhal ophthalmia, by the symptoms of the latter increasing in severity, either through a continuation of the original cause, through neglect, or through a mistaken course of treatment. The same causes which may give rise to catarrhal ophthalmia, viz., exposure to cold or draught, great glare, etc., may also produce the purulent form. We sometimes find that it occurs epidemically, and that mild irritants, which would at other times only have caused a simple catarrhal conjunctivitis, now produce purulent ophthalmia. An unhealthy locality, a vitiated atmosphere, ■crowded and badly ventilated rooms, exposure to great heat or cold, dust, and glare, intensify the character of the epidemic. Some of these causes are frequently met with in places where many persons are collected together, as in work-houses, foundling hospitals, and large barracks. If purulent or even catarrhal ophthalmia once breaks out in such establishments, it is often very diflScult to arrest it before it has spread widely amongst the inmates and committed gi*eat ravages. If soldiers on their march or in camp are exposed to great heat and glare, and to hot Avinds carrying before them clouds of sand and dust, as occurs in India or Egypt, ophthalmia will soon show itself amongst them. Hence the terms military and Egyptian ophthalmia. These names should, however, be abandoned, for this affection shows no special characteristics warranting its being classed as a disease sui generis. The epidemic is in such cases generally one of purulent ophthalmia, but some- times it may assume the character of severe catarrhal or granular conjunc- tivitis. Or these affections may pass one into the other, or exist side by side in the same army. This being so, we can easily understand how such various, and often conflicting and confused accounts have been given of the character, the severity, and the contagiousness of the so-called military ophthalmia. Contagion is the most frequent cause, as the contagious power of the dis- charge is often very great. This varies, however, according to the severity 10
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