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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    Other constitutional anomalies are also observed, such as diabetes mellitus and insipidus, Addison’s disease (in the face the eyelids are chiefly pigmented; Drummond, Brit. Med. Journ., May 14th, 1887 six cases; Mackenzie, Lancet, 1890, II, five cases; even the conjunc- tiva may be pigmented, Oppenlieim, Muench. med. Woch. 1887 No. 52). Peripheral visual disorders with ophthalmoscopic findings are rare (Story, Ophth. Revieiv, 1883, p. 161, double optic neuritis; Emmert, Arch. f. Ophtli., XXVII, 1, p. 203, atrophy of the optic nerve). These disorders without ophthalmoscopic findings are quite frequent, especially concentric narrowing of the field of vision, with or without impairment of central vision or the color sense. Such symptoms are commonly bilateral, as in neurasthenia. As a matter of course, conditions of exhaustion of the eye (weak- ness of accommodation and convergence, asthenopia retinge) are no- ticeable. Headache, vertigo, insomnia, impairment of memory and the like are probably due to the same cause. Extreme angemia may lead to oedema of the lids and finally to a sort of hemorrhagic diathe- sis in which the eye also takes part. The frequent menstrual disor- ders (the majority of the patients are females) are to be regarded as results, not as causes of the disease. [Diarrhoea is not infrequent. —Ed.] According to Ballet {Rev. de Med., 1888, May and July), the disease points toward the nuclear region of the facial and ocular mus- cles; he thinks it is located in the medulla oblongata, perhaps as far down as the cilio-spinal centre. According to this writer the dis- ease is a functional bulbar neurosis; the scanty anatomical changes which are found there appear to be secondary. Moebius’ theory is much more plausible. He believes that we have to deal with the toxic effects of products of disassimilation, which are furnished b}’ the diseased thyroid gland. These appear to act chiefly on the vaso- motor cells and the cortical motor cells. As in all other diseases of the kind, we find the signs of increasing weakness and diminishing nutritive energy, sometimes passing into spontaneous necrosis of peripheral parts. It is only in late stages that we find local and dif- fuse necrobioses, vessel changes, interstitial inflammations, hemor-