Remarks on ocular symptoms in cerebrospinal meningitis : notes based on the examination of 73 cases / by Arthur J. Ballantyne.

  • Ballantyne, Arthur J.
Date:
[1907]
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Credit: Remarks on ocular symptoms in cerebrospinal meningitis : notes based on the examination of 73 cases / by Arthur J. Ballantyne. 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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    th(se tw) o.irputnstances. This diffinulty has ah-'af1y been noticed in connexion with the reflex contraction of the papil in near vision. Nystagmun was found 7 times. In 2 of these it was veHijat and occasional; in I it was vertical and constant. In I case rotary nystagmus was found lu 1 of the cases exhibiting occasional vertical nystagmus and in 3 others a symptom was present which coj'- aisted of rapid winking movements of the lids, each wiok being accompanied by a jerky movement of both eyes to one or other side or even in a vertical direction. Nystagmus seems to occur only in severe cases. Of the 7 in whom it was observed 2 had relapsed into the chronic stage, and the other 5 died a few days after the symptom was noted. Pieudo-ny^tagmus, or jerky movement of the eyes at the limits of tne deld of fixation, was seea in 5 cases. It appeared to have no significance. Vision. It was often very diffi-'ult to get any reliable informa- tion as to the state of vision, but when the patient could not be tested with types, he was considered to have good vision if he recognized small objects, followed the finger, etc. In this sense vision was good in 34, in 12 it was defective, in 9 absent, and in 7 it varied between very deficient and absent in the course of the examina- tion. One case of defective vision was a high myopia wif.h choroidal ai-jrophy. The visual defect was seldom to be entirely explained by any condition discovered by the ophthalmoscope, but in 2 cases in which vision was abolished there was optic neuritis. In a third the discs were congested, their margins blurred, and the veins full. The cause ol the visual defect in most of the cases must probably be looked for in the higher centres, although amblyopia or amaurosis was never found associated with perfect pupil reactions. None of the convalescent cases in this series had any notable defect of vision. Ophthalmoscopio Changes. Ophthalmoscopic examination was made in 61 cases. Double optic neuritig, well marked, was found in 5 cases. One of these, who was seen on the fourteenth day of his Illness, died o.i the seventeenth day. and was foundJJ0S< mortem to have been suffering from a combination of tuberculous and diplococcal menineltis. ,„„„„j Another, a boy of 11, after apparent recovery, had relapsed into a chronic illness, with repeated attacks of sickness, head retraction, and olher symptoms The 0P'»° '^^^''V^J.^.^ff,?? at two examinations on the twenty-second and forty-third ''fheti^irdca7e, a man of 21 years, when first seen (on the thirtieth day of hl8 illness) was apparently conva-