Atlas fundus oculi / by William Holland Wilmer.

  • Wilmer, William Holland, 1863-1936
Date:
1934
Catalogue details

Licence: In copyright

Credit: Atlas fundus oculi / by William Holland Wilmer. Source: Wellcome Collection.

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    Carcinoma of Choroid, Metastatic, Bilateral (after use of radium), right eye of a woman 40 years old. W. 0. I. No. 3,249. (Plate 99 illustrates the same eye six months earlier). Interval History.— Since first examination, Oct. 11, 1928, patient has had intensive radiation. Ophthalmoscopic Exami¬ nation. — April 6, 1929. Media, clear. Disk, clear-cut; margins, fairly distinct; optic cup, visible; no elevation. Area around disk, stippled with pigment. Retinal vessels, clearly-defined above the disk and over the tumour. The tumour mass is a chalky, yellowish red colour, and it is elevated less than 3 dioptres. There are deposits of disintegrated and accumulated pigment granules in the retina over the tumour. These pigment spots occupy various positions relative to the retinal vessels. During the past six months, there has been a great change in the cellular architecture of the tumour. It is smaller, flatter, and of a lighter colour. The changes in the left eye are even more marked. Sept. 1929. Dr. Burnam stated that the right eye has been radiated for 5.6 grm. hrs., and the left eye for 7.7 grm. hrs. The same arrangement and portals as formerly described were employed. Oct. 17, 1929. Patient’s general condition, good; eyes comfortable. April 3, 1930 (17 months after Plate 99 was made). Patient states that apart from accumulation of fluid in abdomen, general health has been good ; eyes have given no trouble. R. E. V. with correction = 6/5 ; L. E. V. = 6/60. Visual Fields: right eye, practically normal; left eye, improved; but there is still contraction above, and a central scotoma. Extracts from Dr. Burnam’s notes: “July 1930, right eye received 2 grm. hrs. of radiation, left eye 3 grm. hrs. Oct. 16, 1930. Patient confined to house for some time. Radium given over abdomen in an effort to prevent recurrent accumulation of fluid. In spite of radium, abdomen fills about once a week and abdominal masses, which formerly responded so satisfactorily to radiation, now cease to respond at all.” Patient died two days later, on Oct. 18. Up to the end, the right eye remained normal in function, and the left eye retained its slight improvement.