Trachoma : its character and effects / by T. Clark and J.W. Schereschewsky ; prepared by direction of the Surgeon-General.
- Clark, Taliaferro, 1867-1948
- Date:
- 1907
Licence: In copyright
Credit: Trachoma : its character and effects / by T. Clark and J.W. Schereschewsky ; prepared by direction of the Surgeon-General. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![frequent sequel even in the mildest cases, and it has already been shown to what an extent an even apparently unimportant degree of obscuration of corneal lucidity will reduce useful vision. The change in corneal curvature which takes place under the softening and macerating effect of the disease and the increased pressure of the lids has also been adverted to, and also the difficulty or impossibility of the correction by glasses of the irregular astigmatism thereby induced. Api^ropriate treatment is in most cases able to modify the course of trachoma. In mild attacks early and careful therap}'^ may effect a l^ractical restitutio ad integrum. In severer forms of the disease, provided the degree of infiltration be not too great and confined to the cul-de-sacs, the same result may be achieved after a longer strug- gle. It is the cases of long standing, with pannus and brawny indura- tion of the lids, which resist our therapeutic measures. In such cases a long course of treatment, extending over months, seems to effect but trivial results in modifying the course of the affection. In gen- eral, it may be said that the longer the duration of the disease the harder it is to cure and the less likelihood there is of such cure being effected without leaving some permanent visual defect behind. TREATMENT. To describe in full all the various remedial measures Avhich have been advocated for the cure of trachoma, and the special conditions in which they ma}’’ be essayed, would be beyond the province of this memorandum. The basic principle of treatment is to facilitate nature’s attempts at a cure, and above all to i^revent or restrict as far as possible corneal complications. To this end our methods should not be too harsh in the initial stage of the disease. At this time the paramount indication is to reduce the inflammatory symptoms as soon as ])ossible in order to restrict the production of inflammatory infiltrate. All more active measures must be postponed until the eye is in practically a quiescent condition. The patient should, therefore, be placed in a darkened i-oom; cold applications are to be made to the eyes for two hours at a time, with an interval of one hour. Three times a day a 20 per cent solution of arg}^rol should be instilled into the eyes and any secretion present be removed by washing the eye with a 4 per cent solution of boric acid or deci-nonnal salt solution. After the subsidence of the initial inflammation a critical inspection of the interior of the eyelid will decide the remedial measures to follow. If the degree of infiltration be not very great and the trachoma granules are soft and prominent, expression will probabl}'^ give the best results. This is accomplished by thoroughly cocainizing the parts; the eyelids are everted, and by means of Knapp’s roller](https://iiif.wellcomecollection.org/image/b2240997x_0038.jp2/full/800%2C/0/default.jpg)
