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

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 / by Max Knies ; edited by Henry D. Noyes. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    tended with hemorrhages are more unfavorable, as regards progno- sis, than those which consist solely of degenerative foci and exuda- tions. Similar hemorrhagic lesions are found even more frequently within the cranial cavity, where they not alone threaten the organ of vision but also life. Hence every diabetic disease of the retina has an ominous prognostic significance. A hemorrhage behind the retina occasionally leads to its detach- ment. In long-continued, severe diabetes vascular changes (particularly sclerosis) are found not only in the retina, but in almost all the tissues of the eye and in many other tissues of the body, especially the central nervous system. These also give rise to spontaneous hemorrhages into the conjunctiva. Various central and peripheral disorders of vision may develop during the course of diabetes, such as amblyopia and amaurosis with- out findings (almost always bilateral, according to Cohn, and almost always unilateral, according to Galezowski), homonymous defects in the field of vision (Leber, l.c., p. 288), homonymous hemianopsia (Schiess, Jahres., 1886, p. 50). On the whole, diabetic hemianopsias are rare, but they are usually obstinate (Leber, l.c., p. 295). Hemi- plegia, aphasia, ataxia, etc., also occur occasionally. Central or paracentral scotomata in an almost normal visual field, as in toxic amblyopia and probably from a similar cause (auto-intoxication), have been reported by Bresgen (Centr. f. Aug., 1881, Feb.), Samuel (ib., 1882, July), Lawford (,Jcilir. f. Aug., 1882, p. 293), Stanford Morton (ibicl), Edmunds and Nettleship (ibid.). As the last-men- tioned cases occurred in smokers, it is not improbable that the tobacco was especially injurious on account of the influence of the diabetic auto-infection. [A central scotoma for red has been noted by many observers in cases of diabetes. See Leber in Graefe and Saemisch’s “Handbuch,” etc. I have noted it several times.—Ed.] According to Hirschberg such cases present a bad prognosis. Many of the last-mentioned affections are due to hemorrhages or circumscribed spots of softening; others are co-ordinate symptoms of a lesion situated at the floor of the fourth ventricle. Of paralyses of the ocular muscles, which are usually incomplete