A Synopsis of Ophthalmology by J. L. C. Martin–Doyle (Auth.)

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By J. L. C. Martin–Doyle (Auth.)

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I. U L C E R A T I O N S 1. S i m p l e C o r n e a l U l c e r s a r e b y far t h e m o s t c o m m o n of all corneal diseases a n d a r e a l m o s t a l w a y s of exogenous origin. ULCERATIONS 29 I n view of t h e high b a c t e r i a l c o n t e n t of t h e n o r m a l conjunctival sac, it is r a t h e r r e m a r k a b l e t h a t corneal ulceration does n o t occur m o r e often. T h i s is explained b y t w o facts : (1) t h e corneal e p i t h e l i u m is v e r y r e s i s t a n t t o infecting organisms ; a n d (2) t h e a n t i b a c t e r i a l c o n t e n t of t h e lysozyme in t h e t e a r s is m o d e r a t e l y high.

I n discussing t h e signs a n d s y m p t o m s of corneal ulcers it w a s m e n t i o n e d t h a t in t h e w o r s t cases t o x i n s from t h e ulcer e n t e r t h e a n t e r i o r c h a m b e r a n d cause hyperaemia of t h e iris a n d a large-scale m i g r a t i o n of leucocytes from t h e iris a n d ciliary b o d y i n t o t h e a n t e r i o r c h a m b e r . T h e s e g r a v i t a t e t o t h e b o t t o m forming a fluid level w h i c h varies a c c o r d i n g t o t h e position of t h e h e a d .

A t t e n t i o n should b e p a i d t o t h e general h e a l t h a n d some surgeons h a v e found salicylates helpful ; also full doses of v i t a m i n C 1 g. daily. d. D e n d r i t i c ulcer is a positive indication for c a u t e r i z a t i o n , which m a y be d o n e w i t h carbolic, iodine, or e v e n t h e electric c a u t e r y if t h e o t h e r t w o fail. T h e i m p o r t a n c e of c a u t e r i z a t i o n c a n n o t b e t o o s t r o n g l y stressed, for t h e m a j o r i t y of cases r e s p o n d v e r y quickly, b u t if n o t u n d e r t a k e n t h e ulcer m a y go o n b r a n c h i n g a n d lead e v e n t u a l l y t o a n o p a q u e c o r n e a .

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