Palpebral gangrene and other ocular complications of varicella / by J. D. Rolleston.

  • Rolleston, John Davy, 1873-1946.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Palpebral gangrene and other ocular complications of varicella / by J. D. Rolleston. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    PALPEBRAL GANGRENE AND OTHER OCULAR COMPLICATIONS OF VARICELLA. By J. D. RoLLESTON, M.A., M.D. (Oxon), Assistant Medical Officer at the Grove Fever Hospital, London. A HEALTHY boy, aged i6 months, was admitted to hospital on October 9, 1908, certified to be suffering from scarlet fever. In addition to a bright punctate erythema and an injected throat he presented a discrete eruption of desiccating varicella vesicles, one of which was situated just above the external canthus of the right eye, and had been irritated by scratching. The lids were so oedematous that the eye could not be opened. The following day the oedema was less, but a patch of gangrene had begun to appear, starting from the irritated pock and extending inwards just below the margin of the lower lid. The conjunctiva was quite intact, and did not subsequently show any signs of inflammation. On the 12th the gangrenous process involved the whole cutaneous surface of the lower lid. No foetor was noticed. The necrotic area had now separated, and the fibres of the lower portion of the orbicularis oculi were clearly exposed. From the outer extremity of the wound a probe could be passed in a horizontal direction backwards for about an inch into the orbit. The lymph glands draining the lower lid, viz., the anterior auricular and submaxillary, became inflamed, but, whereas complete resolution took place in the former, the sub- maxillary adenitis ended in suppuration. Treatment consisted at first in dusting the gangrenous area with iodoform and later in the appHcation of compresses of sodium citrate (-5%) and sodium chloride (5%) and in syringing the wound with the same lotion, with five grains of sodium citrate internally every four hours as advocated by Sir Almroth Wright. For the first few