The question of excision of the eye in cases of injury / by R. Affleck Greeves.

  • Greeves, R. Affleck.
Date:
[1913]
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Licence: In copyright

Credit: The question of excision of the eye in cases of injury / by R. Affleck Greeves. 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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    Reprinted from the British Medical Journal, November 1st, 191S. THE QUESTION OF EXCISION OF THE EYE IN CASES OF INJURY. Contribution to a Discussion in the Section of Ophthalmology at the Annual Meeting of the British Medical Association, Brighton, July, 1913. By E. Affleck Greevbs, F.R.C.S., London. When an injured eye is seen immediately after injury the question of its removal will depend on whether the damage to the eye is so severe as to preclude any possibility of preserving useful vision. The development of panophthalmitis, or suppuration in the eyeball, which is the result of the introduction of septic matter through a perforating wound and necessarily an early sequela of injury, is in the same way an indication for the removal of the eye or its contents; an eye in which panophthalmitis has developed will never serve any useful purpose, phthisis bulbi being the inevitable result. The question of the advisability of removing an eye some time after it has been injured is usually a more difficult matter. All will admit as an axiom, I think, that a blind, unsightly, and painful eye must be removed in all cases, but it is a different matter when the injured eye retains a measure of useful vision, or even when, though blind, the eye is not so disfigured as not to be preferable to an artificial one. By far the most impor- tant consideration in most cases of this kind is the possibility of damage to the sound eye through the development of sympathetic ophthalmitis if the injured eye be preserved. And although there are certain important danger signals, of which the appearance of keratitis punctata in the injured eye is probably the most serious, sympathetic ophthalmitis is unfortunately not diagnosable clinically until the uninjured eye has become affected by the disease, the causative agent and method of spread of which are still matters of conjecture. bnSt°L°f-+aUy' h°WGVer'tbe inflammatory changes found scomcallv tflmf ST^thzi»S ^ examined micro- scopically, have been shown to conform to a definite type. other foSeafanCe-+- ^ ,di£ferent from those found in by^Zt^:^' Td ^ tbey are ^P^al is shown [395/13] ' 7 mere examinatiou of the