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.

    97/142 page 75
    AFTER-COMPLICA TIONS wound infections or as intra-ocular invasions, they cul- minate in panophthalmitis. The signs and symptoms are generally pronounced within twenty-four hours. There is severe pain, much inflammatory swelling of conjunctiva and eyelids (that of the margin of the upper lid being well marked), with semi-purulent conjunctival discharge lying about the borders of the lids. The edges of the wound may or may not be infiltrated. The corneal surface is often steamy, and the iris and pupil are covered with dirty lymph. In spite of all treatment the inflammatory conditions rapidly intensify. Fibrinous and purulent exudation accumulates in the anterior and posterior chambers, and in the vitreous, distending the eyeball and opening the wound ; and, where the wound itself is directly invaded, suppurative destruction of the cornea spreads from it. These most intense cases are quite hopeless from the start; but there are others which begin rather less acutely, and hang for some days apparently in the balance. And there are destructive inflammations, rarely seen, which begin later, possibly several days after operation, in which the infection gains access to the eye in some way after the operation. In one of our suppurations everything went well, with easily dilated pupil and but little injection of the eye, until the case was transferred, five days after operation, to another ward, where some patients were being treated for conjunctivitis, pre- paratory to cataract extraction. The next day the eye became inflamed, and in a few days had advanced to panophthalmitis. The treatment of acute infection is as follows: I. If the edges of the wound are infiltrated, the actual cautery freely applied may, it is said, possibly arrest the mischief. Cases in which the infective material is confined to the wound must be very few in number; so localized an invasion can
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