A Synopsis of Ophthalmology by J. L. C. Martin-Doyle and Martin H. Kemp (Auth.)

By J. L. C. Martin-Doyle and Martin H. Kemp (Auth.)

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Attention should be paid to the patient's general health, and particularly to any disorder tending to lower the resistance of the cornea. COMPLICATIONS OF CORNEAL ULCERS. a. HYPOPYON: In discussing the signs and symptoms of corneal ulcers it was mentioned that in the worst cases toxins from the ulcer enter the anterior chamber and cause hyperaemia of the iris and a large-scale migration of leucocytes from the iris and ciliary body into the anterior chamber. These gravitate to the bottom forming a fluid level which varies according to the position of the head.

Iii. Anterior Synechiae may be formed by the iris becoming adherent to the posterior corneal surface. This often seals off the perforation and allows the anterior chamber to re-form. v. Anterior Capsular Cataract: If the perforation is central and the lens comes into contact with the ulcer for any length of time a localized central cataract results. This is not a lenticular opacity but a proliferation of the subcapsular epithelium due to its contact with the inflamed cornea. v. Corneal Fistula is a rare result.

The skin over the affected areas is swollen and erysipeloid. Vesicles appear, which often suppurate leaving depressed scars. Some anaesthesia of the skin area is often present. When these symptoms begin to subside the eye troubles appear. Tiny spots appear on the cornea, which soon develops a deep-seated infiltration, and a troublesome and persistent iridocyclitis commences. The cornea is anaesthetic, and in rare cases a transient paralysis of one or more cranial nerves occurs, lasting for many weeks or even months.

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