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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    baseball, and watching the course of the ball in the air, it will D02] disappear for a second or more and then again become visible. In order to see anything plainly he has to rub his eyes. In near vision it is more impossible to hold the image. The peculiai and persistent blepharospasm for twelve years, with the rapid fading of the image, seemed to point to difficult holding of the retinal function due to faulty blood-supply. Competent general physicians had examined him and pronounced him free from all recognizable systemic or organic disease. Having in mind the case above described, I was quick to recognize the existence in this man’s eyes of the anomalies of the network of the retinal veins and arteries. From the point of emergence or entrance at the disc they curled about each other, crossed and recrossed each other, in a manner to strike immediate attention. Description would be almost impossible. The upper temporal artery of the right eye crosses over the vein on the disc, and crosses under the vein twice after leaving the disc. The lower temporal artery crosses over the vein on the disc and does not recover full size and color for 30° below the disc. The upper temporal artery of the left eye passes over the vein on the disc, again passes under the vein on the disc, and once more passes under the vein about 40° from the disc. The lower temporal [1031 artery passes beneath the vein on the disc, passes over the vein 20° from the disc; and again over the vein 40° from the disc. The arteries are smaller and thinner and lighter in color on the disc than toward the periphery, whereas the veins are turgid and swollen as they approach the disc. There was noteworthy general venous stasis, and venous pulsation was present. Both eyes were affected in the same way, but the right possibly in a more decided manner. I felt justified in ordering correct lenses, in explaining what I thought the cause of his symptoms, their incur- ability, and in urging a life-time renunciation of nearly all reading, writing, or near-work occupations. This advice was accepted, and after a year the reports are that the symptoms though somewhat improved still remain essentially as before, increased of course by “ near-work ” with the eyes. Case III is that of the physician’s wife reported in American Medicine, February 24, 1906, and included in Vol. V, Biographic Clinics, page 115. Up to the present time the woman has been as healthy and as happy as could be wished. There is not a trace of “ neurasthenia,” “ hysteria,” “ retroversion,” “ exhaustion,” back- ache, headache, etc. But one bothersome symptom was discovered after the complete re-establishment of the general health. It was not noticed earlier because near-work with the eyes was not undertaken. During the last year it has been found that reading, writing, or sewing at once produces waves of inability to hold the