Licence: In copyright
Credit: Ocular affections due to nasal disease / by Henry Eales. Source: Wellcome Collection.
Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)
10/16 (page 8)
![proptosis occurs without signs of orbital inflammation, and evidently caused by bulging of the orbital wall in the cases of proptosis, just described, shows how easily these thin walls yield when there is retention in the underlying cells; but in cases where there is much inflammatory change in the muco- pet'iosteum of these cavities with such thin walls, and where retention is maintained inirelieved for any length of time, it is probal^lc that the inflammatory condition extends to the perios- teum on the other side of these tliin bonj^ walls, which at the optic foramen is closely associated with the sheath of the optic- nerve, which would therefore almost certainly become involved in the inflammatory process. The first case of whicli I have notes, in wliich there appeared to be nasal trouble as tlie probable cause of the visual failure, is tliat.of L.C., wliich was reported fully in the Lancet for 8e])tember, 1905, by the Eesident Surgical Officer to the- Eye Hospital, Mr. Percival Hay, and Dr. Glegg. She attended first on January 20, 1905, complaining of being unable to continue her work at the telephone office, owing to inability to see the keys, especially on her right-hand side, and having to turn her head to see this side—she also- complained of dull headache and of diplojiia—which had come on after an attack of influenza, about Christmas before. On examination I found E.V.=y%, and L.V.=x'V;iDd charts taken showed the E.F.V. to have lost almost the entire temporal half, while there was a sinn'lar Init less deficiency in the tem- poral half of the F.V. in the left eye also. I also found she had apparent complete paralysis of the right external rectus (6th nerve), moreover the left eye did not deviate much beyond the middle line in attempts to look at the right side ; while on look- ing to extreme left, movements of both eyes were jerky in this- position. The fundus was normal in each e)'e. I diagnosed retro-ocular neuritis, from probable sphe- noidal or post-ethmoidal sinusitis, following influenza, and sent her to the Ear and Throat Hospital on January 31st. Dr. Glegg found slight muco-pus at the roof of the nose on the right side, in the spheno-ethmoid recess, which was again observed](https://iiif.wellcomecollection.org/image/b2164682x_0012.jp2/full/800%2C/0/default.jpg)
