The clinical value of repeated careful correction of manifest refractive error in plastic iritis / by Charles A. Oliver.

  • Charles Augustus Oliver
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Licence: Public Domain Mark

Credit: The clinical value of repeated careful correction of manifest refractive error in plastic iritis / by Charles A. Oliver. 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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    Three days after this, the sixteenth day of the disease, vision still remained at two-thirds by the use of a — S. o. 50 D. 3 — o. 50D. ax. 180°, the eye being much quieter. In two days' time the minus cylinder was alone necessary to bring the vision of the inflamed organ from two-thirds to nearly full acuity. The instillation of the cocaine and atropine was ordered to be used but once a day, and although the eye was much better, the papules subsided and the secondary node on the os frontalis had disappeared, the ointment was continued. On the following day a plus meridian of one-quarter diopter strength, at right angles to that corrected by the negative cylinder, appeared, causing the manifest refraction to assume that of mixed astig- matism. fiight days later, under the same treatment, the minus cylinder was lost, and vision was brought from not quite full acuity to normal by a + C. o. 50 D. ax. 90° alone. The local treatment was now re- duced to atropine every other night, the use of the mercury being faithfully persisted in. Eight days after the above visit, during which she failed to report, a violent plastic iritis burst out in the right eye, causing severe ciliary neuralgia. The patient having been previously warned, imme- diately instilled quite a large amount of atropine into the right con- junctival sac, with the result of almost thoroughly dilating the pupil. Vision in this eye, which was now reduced to one-half, was brought to nearly normal by — S. i. D. 3 — C. o. 75 D. ax. 180°. In three days' time, in spite of the liberal use of cocaine ana atropine, continuance of mercurial inunction and free leeching, a Des- cemetitis appeared, lowering vision to an incorrectible one-fourth. Hot stupes were now added to the treatment, resulting in a quick subsidence of the severity of the symptoms and a restoration of vision from two- thirds of normal to nearly full acuity by the use of — C. o. 50 D. ax. 180°, the uncorrected artificial focussing point being but little inside of twenty-five centimetres. Seven days later a fresh exacerbation of iritis in the left eye again ■ lowered its vision to one-tenth of normal, which could be brought to full acuity by a — i. D. 3 — C. o. 50 D. ax. 180°; the atropine having been instilled four times daily for two days. Three days after this visit, while both eyes were quiet and no ocular or circum-orbital pain of any kind existed, vision in the right eye, which was now two-thirds of normal, was brought to almost full acuity by the use of a + C. o. 50 D. ax. 90° (the lens originally used when O. S. was primarily inflamed), while that of the left eye, which equaled one-half, took a mixed astigmatism correction of— C. o. 50 D. ax. 180° 3 + C. o. 25 D. ax. 90° to bring it to normal.
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