Ophthalmovascular choke / by George M. Gould.

  • Gould, George Milbrey, 1848-1922.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Ophthalmovascular choke / 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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    lios] is no “typical case,” individualism being peculiarly empha- sized in this disease; in conjunction with the fading image, the existence of objectively observable vascular choking, and more surely if with venous pulsation, there can be little doubt of the existence of this sad disease. Two profoundly sug- gestive symptoms may have been overlooked in some of the foregoing cases in which I have failed in the recording, but that swoonings or fainting attacks were strangely marked in five, and a notably peculiar photophobia in two, arrests the attention. They are natural results of the deficiency of blood- supply to the macular regions. The effect of this disease upon the cerebral and mental processes, upon the disposition, the occupation, upon a host of evervarying conditions called “ nervous,” upon “ hysteria,” “ neurasthenia,” and the like, is startling in illumination. The transcendent importance of clear and healthy vision to the success and happiness of life should be unquestioned. A cause that cuts it off or impairs it every few seconds is of vast import. The function of vision, never to be renounced, ailing and fluctuating every minute, never to be cured or even understood, add elements of pitiless mystery and despair aptly fitted to induce psychic disease or neurologic morbidity. The inane and fatuous ex- planations so fashionable with neurologists, “ neuropathic tendency,” “ heredity,” “ autotoxemia,” etc., will not be ended perhaps for a generation, but the study of such cases as these should with genuine clinical knowledge sign their death- certificates in 24 hours—at least so far as pertains to patients with eyestrain or ophthalmovasc-ular choke. May not this disease explain some or many cases of the development of acute myopia ? It supplies the precise condi- tion which would seem required. And of otherwise mysterious and sudden changes in the amounts of myopia, or in the axes of astigmatism? Just in proportion as the various single symptoms and signs mentioned are united with others, just in proportion to the number conjoined in a single case, will the disease approach “ typicality.” In order of their importance these may be enumerated as: