A peculiar case of herpes zoster ophthalmicus, serous iritis, or 'ophthalmo-neuritis' / by George M. Gould.
- Gould, George Milbrey, 1848-1922.
- Date:
- 1888
Licence: Public Domain Mark
Credit: A peculiar case of herpes zoster ophthalmicus, serous iritis, or 'ophthalmo-neuritis' / by George M. Gould. 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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![A PECULIAR CASE OF HERPES ZOSTER OPHTHALMICUS, SEROUS IRITIS, OR “OPHTHALMO-NEURITIS.” By GEORGE M. GOULD, M.D. [Reprinted from The Polyclinic, October, 1888.] • On July 6th, I was called to see F. P. M. , who, it was said, was suffering with “severe inflammation’’ of the left eye. His complaint was of a persistent boring pain behind and above the eye, and extend- ing thence to the vertex of the head. Ques- tioned as to the history and cause of the trouble, he said that on June 24th he became very much heated carrying water in the sun- shine, and that immediately thereafter he rode in a railway car several miles to the city, sitting beside an open window, the wind blowing strong and cool upon the side of the face affected. The next day his eye became intensely congested and red, and there was pain, lachrymation and photo- phobia. From this time till July 6th, various home remedies were uselessly tried, the eye and head growing steadily more painful, and the conjunctiva continuing very much inflamed. I found the eye in the following condition: The lids and adjacent parts, were not swollen; the whole conjunctiva was intensely congested and of a bright scarlet hue; there was no pannus, and the cornea and anterior chamber were clear. The iris to all appearance was normal or but slightly hyperaemic. The pupil was somewhat contracted, but responded to light and darkness fairly well. There was cer- tainly no pronounced iritis, the delicate striation and reflex of the fibres being clear and perfect. There was such great photo- phobia and lachrymation that a perfect oph- thalmoscopic examination was not possible. but under cocaine I was convinced that the details of the fundus were not visible; they seemed obscured by a cloudiness and haze, greatest at the papilla and growing less toward the periphery where the retinal reflex and small vessels seemed normal. Vision was of course impaired, letters the size of J. 18 being legible with difficulty. I failed to elicit any history of a blow or injury, and syphilis was I think truthfully denied.* The patient had been a healthy man all his life, without vicious habijs or constitutional disease of any kind. What was to be the diagnosis ? The ab- sence of any symptoms of iritis, either due to the exposure to cold or to any injury, led me to believe there must have been some history of traumatism concealed or unknown. I endeavored to ascertain if some sliver of metal (he was a worker upon brass tubing) may not have penetrated the globe or orbit without leaving any trace. The second week I asked my friend, Dr. Oliver, to examine the eye, and he judged there must have been some traumatic injury. Astringent and antiseptic collyria kept the conjunctiva clean and without secretion, but did not in the least lessen its injection. I found several dacryoliths in the upper palpebral conjunctiva and removed them, but neither this nor the most energetic anti- phlogistic measures, with paralysis of the * The second week of the disease I tried antisyphilitic treat- ment for three days, but with such aggravation of all the symp-](https://iiif.wellcomecollection.org/image/b22459303_0005.jp2/full/800%2C/0/default.jpg)
