Lectures on diseases of the eye / by Charles Bell Taylor.

  • Bell Taylor
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on diseases of the eye / by Charles Bell Taylor. Source: Wellcome Collection.

    94/106 page 90
    is tlie matter,—Phlyctenular conjunctivitis, or conjunctivitis scrofulosa, as it used to be called. There are two forms of this affection, the miliary and the solitary. The miliary phlyctens are scattered like grains of sand on the vascular limbus of the cornea ; usually come on after measles or scarlet fever ; and ai*e masked by considerable general conjunctivitis. The solitary phlycten is about the size of a hemp seed, is surrounded by a vascular zone, and marked by a small bundle of vessels which radiate outwards towards the equator of the globe. Both forms yield readily to the yellow oxide of mercury ointment, with general treatment, and it is only when the phlyctenular conjunctivitis becomes phlyctenular keratitis, that you are likely to have any trouble with the case. Vesica- tion and ulceration of the cornea, however, is a very painful process. Nerve terminals are exposed, photophobia is intense, iritis is sometimes set up, the constitution sympathizes, the patient loses his rest, and the ulcers, even when healed, leave scars which may subsequently seriously interfere with vision. In these cases it is necessary to apply leeches, give mercury, put a seton behind the ear, and use hot belladonna fomenta- tions. You will also find that an excellent plan of treatment is to open the anterior chamber with a broad keratome, so as to divide the vessels and nerves at the base of the ulcer. In this way tension is reduced, pain relieved, healing promoted, and the effect may be kept up by daily tapping of the aqueous with a blunt probe, and the ulcer, if obstinate, may be touched with the galvanic or thermo cautery, after the method so successfully practised by Dr. Nieden, of Bochum, Prussia. The worst forms of ulceration of the cornea, however, with •which we have to deal, are those occasioned by foreign bodies, often aggravated by attempts at removal. In order to avoid
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