Detachment of corneal epithelium / by J. Acworth Menzies.

  • Menzies, James Acworth, 1869-1921.
Date:
[1902]
Catalogue details

Licence: In copyright

Credit: Detachment of corneal epithelium / by J. Acworth Menzies. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    experience goes, the pain seems to be less severe in the latter case. Causation.—In the majority of cases there is the history of a blow or other injury. In four of Szili's cases there was no history of injury. In my own cases the history of injury was definite in all but one, and in that the patient was somewhat vague as to whether the trouble began with his getting some coal dust in his eye or not. The other patients ascribed their condition to injuries with a cricket ball, a tennis ball, a broom handle, finger-nail (two cases), and a chip of iron respectively. Pathology.—In the traumatic cases there has been a superficial injury to the cornea, following which the epithelium has not become firmly attached to the subjacent tissue. Then, as in dry catarrh, the in- equalities of the corneal epithelium become interlocked with corresponding inequalities on the tarsal surface when the eyes have been closed for a time. When the eye is suddenly opened the lid pulls upon the corneal epithelium, raising it in the form of a blister and dragging upon the nerve filaments so as to cause pain. In cases of the first type the detached epithelium soon settles down again and the lid moves smoothly over it. In the second type of case the movements of the lid continue to drag on the epithelium, which becomes stretched so as to form a blister. This blister may burst, when the ragged epithelial margins are easily detected, or an ulcer may result. This occurs at or near the site of the original injury. The pain is very severe. Szili has examined pieces of the detached epithelium microscopically, and finds that the cells show shrinking of the nuclei with perinuclear vacuole formation, and also that intercellular spaces appear, some of them filled with granular masses, v. Reuss suggests that the movements of the lids draw out the epithelial cells at the edge of the original abrasion in