'School ophthalmia' : a paper read before the Association on February 25th, 1897 / by Sydney Stephenson.

  • Stephenson, Sydney, 1862-1923
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: 'School ophthalmia' : a paper read before the Association on February 25th, 1897 / by Sydney Stephenson. 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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    of mucous memlirane. Its signs and syinjdoms are.of such a nature that they cannot he overlooked. The disease makes its appearance, as a rule, within three da^s after the eye has been infected. Stiffness of the lids and pain, i)hotophohia and lacrymation, are constantly present, and hear a direct relationship to the intensity of the virus. The lids are glossy, red, and shining, and in marked cases so much swollen that the patient is alto- gether unahle to open his eye. The discharge, at first thin and whey-like, when fully established may run from the eye in great quantity ; it has an alkaline reaction, and exactly resembles pus, such as that of an ordinary abscess. The palpebral conjunctiva, when it can be exposed for examination, is found to he swollen, rough, of crimson- lake hue, and arranged in folds that spring forward as soon as the lids are everted. The inner surface of the upper lid is not infrequently shaggy enough to recall the pile of red velvet, while the retro-tarsal folds are laden with pus. Slight Inemorrhages from the conjunctiva readily occur, even when the parts are handled with the utmost gentleness. The ocular conjunctiva is often greatly swollen, so that it may overlap the cornea on every side or even protrude from between the tumified lids, and a[)pear upon the cheek as a reddish, semi-transparent mass. The cornea suffers in certainly one-third of the cases, the commonest condition being one of marginal ulceration, which comes on early, spreads rapidly, and perhaps leads to perforation of the membrane and loss of the eye. These corneal lesions are thought to be due to direct invasion by the specific organisms, which gain admission to the .stroma through a spot from which the protecting epithelial investment has been detached. How- ever this may he, 1 have more than once succeeded in cultiviiting ordinary pyococci from scrapings taken from the ulcers. Then, the swollen lids and conjunctiva have something to do with the result, i>OBsihly by mechanically interfering with the nutrition of the cornea. My own experience teaches me that corneal complications arc likely to occur in ])roportion to the amount of chemosis,