A practical treatise on the diseases of the eye / by Haynes Walton.

  • Walton, H. Haynes (Henry Haynes), 1816-1889.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of the eye / by Haynes Walton. Source: Wellcome Collection.

    1196/1250 page 1148
    DISEASES OF THE CHOROIDEA. pressure. ^ It is probable that the nerve-fibres escape destruction by hiteral displacement. The excrescences are surrounded by black pigment, some of which is enclosed in the retina. Of course I see the almost inappropriateness of placing this under an exudative heading. The ophthalmoscopic image corresponds to the pathological changes, but unfortunately a variety is met with in the areolar form just described, in which there is more interspace of healthy retina, and we cannot always distinguish it from this form. Later pathological changes take place in both forms. Neoplastic masses occur between the remains of the choroidea and sclerotica, and the] retina and the vitreous body, followed by atrophy of the. optic nerve, the retina, and the entire choroidea. I have said that cases come under notice which are difficult to classify, according to the headings, retinitis pigmentosa, and choroid- itis disseminata. In the phase of the latter, when the exudations are absorbed and the sclerotica is seen, who can tell the difference between it and a ease of the former, where the choroidal atrophy alone, unpreceded by exudation, exposes the sclerotica ? A third form, described by Liebreich, consists of white exudative points in the neighbourhood of the optic disc, and in other parts, some with black borders, all deeply seated in the choroidea, and of large irregular white patches of exudations upon the inner sui-face of the choroidea, some of which have no pigmentary border. Another form he describes, and particularly distinguishes by the groups of epithelial cells which are enlarged and filled with abnor- mally black pigment, forming black spots of most varied shapes, which are almost always surrounded by a narrow light-colom^ed border, in which the epithelium is either absent or deprived of its pigment. In the illustration which accompanies the description, there are atrophic portions of choroidea with pigmentary margins. Choroidal hcemorrhage. This- is an occui-rence incidental to the blood-vessel degeneration of choroiditis. Apart from wounds or blows which rent the choroidea singly, or along with other ocular tissues, it may safely be assumed that hfEmorrhage is due to an abnormal condition of the chorio-capillaries, arising out of inflammation, so called inflammatory relaxation, whereby they become distended, or even sacculated, or. undergo atheromatous change. Under such conditions of disease, any strani, as that arising from the check given to the blood retui-ning to the heart, from coughing, sneezing, vomiting, stooping, or great exertion, is apt to cause haemorrhage. So, again, pressui-e on the eyeball, or a slight blow, either of. which would be nothing to a healthy eye, is
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