The ophthalmoscope in medical practice / by James Hinshelwood, M.A., M.D., F.F.P.S.G., Surgeon to the Glasgow Eye Infirmary.

  • Hinshelwood, James.
Date:
[1897?]
Catalogue details

Licence: Public Domain Mark

Credit: The ophthalmoscope in medical practice / by James Hinshelwood, M.A., M.D., F.F.P.S.G., Surgeon to the Glasgow Eye Infirmary. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    18/24 (page 16)
    The first case was that of a woman, aet. forty-five, suffering from bronchitis, who, while in the waiting-room of the Western Infirmary, after a fit of coughing, suddenly lost the sight of the right eye. She was seen on the following day in the wards, and on ophthalmoscopic examination it was evident that the loss of vision was due to embolism of one of the main lateral branches of the central artery of the retina. The embolus could be seen as a dark-red swelling plugging the main lateral branch supplying the macular region, and beyond it the vessel was reduced to a mere thread. The retina showed a diffuse greyish opacity round the macular region, with the macula clearly showing as a bright cherry-red spot. These appearances were especially characteristic. On examining her heart, a systolic murmur was heard at the apex, but the patient herself was not aware that she had heart disease. On examining this patient a year afterwards, it was found that with the right eye she could only see large objects somewhat indistinctly in the peripheral parts of the field. On ophthalmoscopic examination the disc presented all the appearances of optic atrophy. It was silvery white, with clean cut edges, and the branches of the retinal artery supplying the macular region were reduced to mere threads. The other case was that of a man, aet. fifty-eight, who presented himself at the Eye Infirmary with the history that on the preceding day he had suddenly lost the sight of his right eye. There was no complaint whatever about his general health. On ophthalmoscopic examination it was evident that the sudden failure of vision was due to embolism of the central artery of the retina, as evidenced by the pallor of the disc, the retinal arteries reduced to mere threads, and the bright cherry- red spot in the macular region, surrounded by the opaque greyish oedematous retina. On examining his heart there was a loud systolic murmur, best heard at the apex, which was displaced downwards and to the left. In these two cases the ophthalmoscopic examination led -directly to the discovery of cardiac disease. Embolism of the retinal artery is not a common affection, and unless it is seen within a few days of its occurrence, the typical appearances will have disappeared, and the nature of the case can only be