Tobacco amblyopia in a woman, with anomalous scotomas / by G. E. de Schweinitz.

  • De Schweinitz, G. E. (George Edmund), 1858-1938.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: Tobacco amblyopia in a woman, with anomalous scotomas / by G. E. de Schweinitz. 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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    center of the field of vision which had so annoyed her had practically disappeared. Ophthalmoscopic appearances seem to be nnchanged. In the left eye the vision was as previously reported and the scotoma somewhat different in shape but still demon- strable. It begins outward and above at 5 degrees to the temporal side of the fixing point, passing then to 20 degrees. There is no scotomatous area below the horizontal meridian. RemarKvS. —Tobacco amblyopia is much more frequent in males than in females, not because the former are more predisposed, but because they are more exposed to the influence of tobacco. Indeed, Hill-Griffith is no doubt correct when he says that more cases would be found among women if the investigations of central visual defects were more frequent]}^ made, especially if search for color scotomata were more common. He records fourteen cases of toxic amblyopia in women. Berry has noted a number of instances and numerous others have been reported. This is the second case in my own experience in which I feel sure that tobacco was the prime etiological factor. The typical scotoma in intoxication-amblyopia, according to my own measurements w^hich closely agree with those of Sachs, is an oval with its pointed end towards the blind spot and its blunt end towards the fixing spot, to the nasal side of which it passes only slightly. The average measurements are outward 18 degrees, inward 3 degrees, upward 7 degrees and downward 6 degrees. This scotoma represents a red-green-blind area and commonly the extent of green blindness is greater than that of red, w^hich in its turn may be surrounded hy an area of imperfect color-sense. The culmination spot, or nuclear spot, in the language of Sachs, of the scotoma, lies horizontal!}' from I degree to 8 degrees in a lateral direction from the fixing point, its breadth, vertically, being mostly below the horizontal line. vSome- times a small, easily over-looked scotoma exactly over the fixing spot is the beginning of the trouble. According to Groenouw's observa- tions the typical egg-shaped scotoma results from the union of the scotoma from the fixing spot with a supplemental scotoma around the blind spot. The process may cease at this point or there may be progression characterized by an increase in the size of the color defect, usually above, until it meets the limit of the red field, that is the scotoma breaks through, and if this goes on, the patient may event- ually resemble a congenitally color blind person. In severe cases scotomas for blue and ^^ellow form in similar manner to the red-green scotomas, and occasionally, especially in neglected cases, absolute defects are found wdthin the relative area, and sometimes the entire