Treatise on the diseases of the eye, including the anatomy of the organ / by Carl Stellwag von Carion ; translated from the fourth German edition and edited by D.B. St John Roosa, Charles S. Bull, and Charles E. Hackney.
- Date:
- 1873
Licence: Public Domain Mark
Credit: Treatise on the diseases of the eye, including the anatomy of the organ / by Carl Stellwag von Carion ; translated from the fourth German edition and edited by D.B. St John Roosa, Charles S. Bull, and Charles E. Hackney. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![2 . Herpes of the Cornea [Phlyctenular Keratitis]. Symptoms.—The chief characteristics of corneal herpes are the development of cir- cumscribed, rounded points of inflammation about the size of a poppy-seed, in the super- ficial layers of the cornea, and vascular injection of the ciliary region of the eyeball. 1. The herpetic eruption appears first as a rounded cloudy nodule, which is im- bedded more or less in the substance of the cornea, and generally protrudes some- what above the surface. Sometimes a vesicle containing a watery fluid comes on the summit of this nodule. Occasionally this vesicle bursts before being perceived, and then in its place is found an excoriation or a loss of substance, which appears as an ulcer, with sharp edges and a fatty or purulent covering. Sometimes no vesicles are formed. The nodule quickly becomes cloudy-white, or it throws oft the epithelial covering and is replaced by an ulcer, covered with fat or pus, of the size and shape of the original nodule. Sometimes the inflammation proceeds, and the nodule or ulcer is surrounded by a cloudy border. The cloudy mass forming this border is often destroyed and the ulcer extends, changing its original form. Not unfrequently the cloudiness departs, and the efflorescence appears as a round loss of substance of variable depth, with perfectly smooth transparent walls, which give no other evidence of inflammatory alteration than a so-called “ resorption ulcer.” The vesicles may develop on any part of the cornea. Often only one is found, in other cases numbers. Occasionally they form groups. At the limbus conjuncti- valis they often collect, and so cover a greater or less arc of the corneal periphery. They often occur with herpes conjunctive, and form connected groups with its eruptions. As the vesicles do not all develop at once, but one after the other, they may be found on the cornea and conjunctiva at various stages of development. 2. Congestion of the conjunctiva and episclera precedes and accompanies the eruption; this is generally universal when the number of vesicles is large, or if they are scattered. A coarse net-work of vessels runs through the conjunctiva, while under it, around the margin of the cornea, may be seen the fine rosy net-wTork of the episclera. Where the eruption is slight or limited, the hyperemia is confined to the immediate neighborhood supplied by the ciliary nerves that are irritated; so that a greater or less section of the ocular conjunctiva and episclera is injected. Then we find in the ocular conjunctiva a more or less broad bundle of intensely injected, variously-branched vessels, which, proceeding from the reflection, of conjunctiva, advance towards the edge of the cornea, forming an irregular triangle, one of whose sides is in a meridional direction, and whose base is toward the reflection of the conjunctiva. If the efflorescence is on the margin of the cornea, it forms the apex of the triangle ; if it is removed from it, the apex appears to be cut off at the limbus conjunctivalis ; if the sides of the triangle are imagined as prolonged they meet in, the efflorescence. This vascular injection is the objective expression for the state of irritation](https://iiif.wellcomecollection.org/image/b21987634_0090.jp2/full/800%2C/0/default.jpg)
