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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    serve as a measure of the subnormality of general ocular [102] function. There is one symptom of subnormal retinal function which has been impressed upon my attention for many years. I have probably noted it in my case-records hundreds of times, but from apparent negligence I failed to recognize its true nature and amazing significance. From the first I have named it, Fading Image. Up to the last year I was so dull as not even to measure the length of time during which the image could be held, i. e., the time from opening and fixation until the fading of the image or the failure of sensation began. One further preliminary: Amblyopia per se may beget the symptom of “fading image”; but when visual acuteness has been retained; when perfect correction of ametropia has been secured; and when the plainest, most severe, and most direct symptoms of ocular malfunction persist; and especially when as sometimes they persist after other more severe local and systemic diseases have at once ceased with the wearing of scientific spectacles,—then, other diseases having been ex- cluded, there must arise the suspicion of some more occult pathogenetic factor in the eyes themselves. Such, more or less, were the conditions existing in the ten cases I shall briefly describe. The manifest existence of eye-strain symptoms after perfect correction of ametropia, with “ fading image,” plus the equally manifest ophthalmoscopic demonstration of “ ^ ascular Choke,” brought to view a new disease, which I cannot help feeling is of too great frequency and significance. Case I.1—For most of her life a highly intellectual and non- hysterical woman, 46 years of age, had suffered abominably from evident eye-strain. A number of the best oculists of the United States had failed to cure her with the best glasses and treatments they could suggest. The worst diagnoses and treatments (general paresis, said one brutally and erroneously), tenotomies and despair, the woman had wisely refused to illustrate or assent to. I was to be the last oculist consulted. But my glasses, etc., did no more good than those of my predecessors. At the first visit in using the opnthalmoscope I spoke of a curious loop in the 1 The first two of the following cases are epitomized from reports of my first article upon the subject in the Medical Record