Relations of diseases of the eye to general diseases : forming a supplementary volume to every manual and text-book of practical medicine and ophthalmology / Ed. by Henry D. Noyes.

  • Knies, Max.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Relations of diseases of the eye to general diseases : forming a supplementary volume to every manual and text-book of practical medicine and ophthalmology / Ed. by Henry D. Noyes. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    nervous supply from the branch of the motor oculi which passes to the inferior oblique (vide p. 27). Otherwise the conclusion depends mainly on the complications, such as exophthalmos, unilateral or bilateral character, number and kind of the muscles. Primary affec- tions of the muscles are rare and usually diagnosed with difficulty unless cedema of the insertion of the muscle into the eye, pain on at- tempting movement, etc., point to such a condition. In orbital in- flammation the eye is more or less immovable, either as a whole or chiefly toward one side. Exophthalmus is present or the eye is pushed forward toward the side opposite to that in which movement is abolished. A similar condition is observed in orbital tumors. There is often coincident disorder of sight and even complete blind- ness. After a certain lapse of time atrophic conditions may be found at the entrance of the optic nerves. Pressure on the eye is almost always painful. The internal ocular muscles may escape when the cause of paralysis is situated within the orbit. In congenital paralyses the muscle in question is very often absent (usually the levator palpebrse superioris [congenital ptosis], more rarely the superior rectus or some other muscle). Intracranial or basilar paral}Tses are not easily diagnosed if only a single nerve is involved. In many cases several adjacent nerves at the base of the brain are implicated, particularly those on the same side, or disorders are found in the distribution of the olfactory, optic tract, chiasm, etc. (meningitis, tumors, aneurism). Paralysis of the motor oculi with exemption of the internal ocular muscles can hardly be basilar. On the other hand post-mortems have shown that the majority of so-called periodical paralyses of the ocular muscles are basilar in character (multiple neuritis of the nerve roots and origins). Fascicular location of a paral}'sis (root paralysis) is assumed, for example, when an ophthalmoplegia (vide above) is complicated with crossed hemiplegia, because in the cerebral peduncle the roots of the nerves of the ocular muscles intermingle with the still uncrossed motor portion of the former. The decussation of the motor fibres in the pes pedunculi only takes place in the medulla (decussation of the pyramids). Such paralyses are extremely rare without coincident lesion of the nucleus.
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