Some ocular manifestations of hysteria / by Walter Baer Weidler.

  • Weidler, Walter Baer.
Date:
[1912]
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Licence: In copyright

Credit: Some ocular manifestations of hysteria / by Walter Baer Weidler. 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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    INTERNATIONAL CLINICS 2. Those affecting the movements of the iris, or pupillary changes. 3. Those affecting the movements of the ciliary body, or accom- modative changes. 4. Painful visual sensations, or asthenopia. 5. Partial loss of vision, or amblyopia. 6. Complete loss of vision, or amaurosis. Y. Other ocular changes not included in the above and at present impossible to classify, such as disturbances of sensation and secre- tion affecting the lachrymal gland and the skin of the eyelids. This classification vdll readily show the wide and varied disturbances that the eye alone can present in hysteria. Hysterical affections may be spoken of as those of permauent duration, which means that they may last for years, or those which are transitory, lasting for days, weeks, and months. Class 1.—There is a condition, frequently seen, affecting one or both eyelids, which we call blepharospasm. This may be of two forms, the clonic and tonic. In the clonic form we have continuous blinking of the eyelids, which may be seen as a constant vibration or trembling of the closed or half-closed lids. This condition may persist even during sleep. The tonic variety is convulsive. The skin of the lids is forcibly folded and the palpebral margins are tightly closed. It will be found difficult to open the lids with the fingers, and there is usually marked photophobia associated with the tonic form of blepharospasm. Prom the clinical standpoint there are also two forms of blepharospasm, the painful and nonpainful. These spastic affections of the lids may appear suddenly and disappear in the same manner, or they may last for years. Hysterical blepharo- spasm may be due to a spasm of the orbicularis palpebrarum muscle or to a hypersensitive condition of the retina. We may see at times pseudoparalytic ptosis caused by a cramp or spasm of the palpebral portion of the orbicularis. This condition must not be confounded with true ptosis or paralysis of the levator palpebral muscle. In pseudoparalytic ptosis the upper lid droops without much wrinkling of the skin, which condition is more or less constant in true ptosis. The lids, if raised by means of the fingers, when released fall more rapidly, and the patient may, if his thoughts be decentered for the moment, open the lids. These hysterical patients very often are able to open the eyes in the dusk or in a dull light. Landolt has
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