The practical details of cataract extraction / by H. Herbert.

  • Herbert, H.
Date:
1903
Catalogue details

Licence: In copyright

Credit: The practical details of cataract extraction / by H. Herbert. Source: Wellcome Collection.

    18/142 page 2
    lens-substance, or general. Completeness, or a near approach to it, is considered necessary for the treatment by extraction of the lens, which is almost the only recognised measure* nowadays for lenses with hard nuclei, absorption being practicable in young persons with lenses still ‘ soft.’ Progressive Cataracts, those which become general or complete, are classified thus: I. Primary, independent of other recognisable affec- tion of the eye. This includes by far the largest group, the purely idiopathic cases, mostly senile, yet occurring at any age, even before birth. Senility in this connection is in India a very relative term, since the cases begin to be numerous after forty years of age.f There are also the cataracts developing in diabetes, nephritis, extreme anaemia (see p. 14), tetany, and in ergotism ; and glass- blowers’ cataract. II. Complicated, or secondary to obvious disease of the eye—e.g., disease of the vitreous in high myopia with choroidal changes, and in late stages of retinitis pigmentosa; or due to advanced glaucoma, or to the effects of irido-cyclitis—atrophy of ciliary body and posterior synechiae ; or a result of dislocation of the lens. III. Traumatic, due to penetrating wound, or merely to rupture of the capsule, J With these may be grouped * Depression and reclination of cataracts, still very frequently performed hyvaids and hakims in India, may, in very rare instances, be the only treatment available. f It is not true, however, of Bombay that ‘ the majority of cataract patients come to operation at forty years or thereabouts.’ (Hirschberg, speaking of the East Indies generally, quoted in Norris and Oliver’s ‘ System,’Uv. 324.) In Bombay there are, roughly speaking, twice as many patients over fifty as under fifty years of age. Probably in the intense heat and glare of the northern plains of India cataract comes earlier. X A few traumatic cataracts have been recorded without rupture of capsule, but they have been partial, and in some cases even transient.
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