Treatise on the diseases of the eye : including the anatomy of the organ / by Carl Stellwag von Carion ; tr. from the 3rd German ed. and ed. by Charles E. Hackley and D.B. St. John Roosa ; with an appendix by the editors.

Karl Stellwag von Carion

Date:: 1870

Credit: Treatise on the diseases of the eye : including the anatomy of the organ / by Carl Stellwag von Carion ; tr. from the 3rd German ed. and ed. by Charles E. Hackley and D.B. St. John Roosa ; with an appendix by the editors. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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$border, while the copper pole is applied to the forehead. (Benedikt.) [It is claimed that, besides the universally conceded value of electricity in paralysis of the ocular muscles, partial elec- trization with the Faradaic current, the hands of the patient being placed on the negative pole, and the positive applied over the eye with the hand of the operator, the current passing through his body, has a positive beneficial effect in conjunctivitis and inflammations of the lachrymal pas- sages. (Beard and Rockwell.)] Proper exercise of the paralytic muscle at the same time is of importance. For this purpose it is well to bandage the healthy eye for some time, often during the day, and cause the patient to use the affected one only. At the same time the patient should be instructed to fix or look at objects which lie in the course of the affec- ted muscle and outside of the meridian position. In order to increase the innerva- tion of the muscle as much as possible, it is very important to choose near objects for corrections in motions of adduction, and far objects for abduction, and where it is necessary to lessen or increase the refraction by the proper convex or concave For the same purpose, some advise the use of two lines, one of which is fixed by the healthy eye, while the other, which is movable, is approached so near the visual line of the affected eye, that the double images unite. Then the second line is gradually pushed away in the course of the paralytic muscle, and the latter thus excited to corrective contractions. (Javal.) Others, having the head immovable, bring the object of fixation into a position in which bi- nocular single vision is still possible, and then gradually remove it in the course of the paralyzed muscle so far, that the images begin to separate, and the effort for single vision causes a correct- ive innervation. (Szokalski.) If we wish to correct slight paralytic deviations, the trial of prismatic plane glasses is ^commended, since, if chosen and used properly, they allow binocular vision, and perhaps accustom the eyes to work together. If they are to accom- plish what, we desire cf them, their angle of refraction should be, of course, that one which requires a slight tension of the paralytic muscle, and one which can be kept up, in order to unite the double images. If the power of the muscle gradually increases, weaker prisms should be chosen, until finally they can be dispensed with. (Graefe.) 3. If contraction of the antagonist has already commenced, and it is desired to restore the functional activity of the affected muscle, or if a slight degree of paresis in one or other rectus muscle withstands all attempts to remove it, in slight limita- tion of the mobility, we may attempt the stitching forward of the end of the mu-cle, but in greater limitations the bringing forward by the thread operation. In this way, wi.h the aid of proper afrer-treatment, the attainment of correct adjustment of both optic axes, with binocular vision, has often been accomplished, or at least a less annoying position of.the muscularly affected eye, with suppression of the double images secured. (Graefe.) In general, the hopes of the patient shouM be very slightly raised, even as to any improvement in the appearance. The regulation of the amount of effect from an operation is very difficult, and even in theory it is not easy, unless we disregard important factors, such as the changed resistance in various states of the accommo- dation, &c. We should not overlook the fact that these mechanical influences of the action of the muscles vary exceedingly after, as well as before, the operation, and tlat any correction attained can only be sufficient for certain conditions.$