The principles and practice of ophthalmic medicine and surgery / By T. Wharton Jones.
- Thomas Wharton Jones
- Date:
- 1863
Licence: Public Domain Mark
Credit: The principles and practice of ophthalmic medicine and surgery / By T. Wharton Jones. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
143/508 (page 129)
![from th.it state of constitution in connection with which the ophthal- mia so frequently manifests itself in early life. It is to be observed, that at such age, and in such constitutions, it may in one case be the eye, in another the ear, in a third some other organ which is affected; but in all, the digestive organs are found more or less at fault. Pre- vious attacks, and also exanthematous diseases, predispose to it. (See Exanthematous ophthaImise.) Exciting causes.—This inflammation may be excited by any of the ordinary exciting causes of ophthalmic inflammation, the age, constitu- tion, and state of health determining its particular character. Any common inflammation of the eye is in such circumstances apt to merge into this. The ophthalmia often appears to be excited and kept up by the irritation of teething. [The characteristic phenomena of scrofulous ophthalmia are caused, or, at least, arc directly influenced. by a special condition of the nervous apparatus of vision. The lesion in question is a state of hyperesthesia, or exalted sensibility of the retina and optic nerve, and the ciliary and conjunctival branches of the ophthalmic branch of the fifth pair. The phenomena attendant upon photophobia, namely, contraction of the pupil, spasm of the or- bicularis, sneezing, and lachrymation, are the results of reflex action, displayed in a morbid form under the influence of this lesion.—Ed.] Diagnosis.—The s}rmptoms of this ophthalmia are so very striking, that it can scarcely be confounded with any other, especially if the age of the patient be taken into account. In so far as regards the slight degree of redness of the white of the eyes and the great intolerance of light, scrofulous corneitis resembles it; but the changes which take place in the cornea in the two oph- thalmia are quite different. In scrofulous corneitis there is no forma- tion of phlyctenule, nor ulceration, and rarely onyx or abscess, but opaque adhesive exudation into the substance of the cornea, and development of a general deep-seated vascularity, with increased prominence of the cornea. Scrofulo-catarrhal ophthalmia is distinguished from phlyctenular ophthalmia by the greater redness of the white of the eye, and the less degree or absence of intolerance of light. The age of the patient alone, independent of other points of difference, distinguishes between this ophthalmia and catarrho-rheu- matic. Course and prognosis.—Phlyctenule on the cornea may either recede without being much matured, or pass into ulceration. If a phlyctenula on the cornea recede, it will leave a speck called albugo—round, smooth, slightly elevated, and densely opaque in its centre, but shaded off at its circumference. Sometimes a vessel or two may be seen running into an albugo, or a nebulous streak indicates where vessels had run. If ulceration has taken place, the ulcer will probably be the point of termination of a fasciculus of vessels as above mentioned (p. 128): but when the healing process commences, one vessel after another shrinks and disappears. If the ulcer has penetrated to any depth, an opaque cicatrice or hucoma will be left (p. 91). There is a circumscribed and rather deep ulcer of the cornea met 9](https://iiif.wellcomecollection.org/image/b21018327_0143.jp2/full/800%2C/0/default.jpg)
