The treatment of serpiginous ulcer of the cornea / Charles J. Kipp.

  • Kipp, Charles John.
Date:
[1902]
Catalogue details

Licence: In copyright

Credit: The treatment of serpiginous ulcer of the cornea / Charles J. Kipp. 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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    hig treatment is, of course: required in nearly all cases. An e.\amiiiation of the urine should be made in all cases as soon as they come under observation, as I have found that in almost all of the cases in -which the progress of the idcer could not be arrested the pa- tient either suffered from diabetes or nephritis. Treat- ment of these affections, if present, is of coarse required. In many of my bad cases I have noticed that the irido- cyclitis persisted in spite of all treatment, even while the ulcer was healing, and in some ended with closure of the pupil and secondary glaucoma, and in others cataract was developed. In nearly all of these cases the ulcer did not perforate, and no artificial opening was made, and I am under the impression that the artificial per- foration, either by galvano-cautery or the knife, has a good effect not only on the ulcer but also on the irido- cyclitis, and I would recommend its performance in all eases in which the irido-cyclitis is at all severe. With regard to the treatment of the blennorrhea of the sac which is so often present in these eases, I have noth- ing new to offer. I usually split the canaliculus, and if the secretion is very profuse syringe the sac with a solution of bichlorid of mercury, 1 ;1000, once or twice daily. Otherwise I simply have the patient press the contents out of the sac every few hours. In a few cases in which a phlegmon of the sac was present I in- cised the sac and packed it with iodoform. I have never found it necessary to extirpate the sac in such, cases while under treatment of the ulcer, although others have highly recommended this procedure. Attention to the nose, if disease is present should, of course, not be neglected. The presence or absence of the pneumococci in cases of ulcerus serpens is, according to ISTellhagen,'^ of great importance so far as treatment is concerned. According to this writer the cauterization and other ac- tive treatment is required only if they are present. In three cases of large ulcers with iritis and h3^popion and
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