Cases illustrating various types of scotoma in the visual field : portion of a lecture on "The visual field as a factor in diagnosis" delivered before the J. M. Da Costa Medical Society of the Jefferson Medical College / by G. E. De Schweinitz.

  • De Schweinitz, G. E. (George Edmund), 1858-1938.
Date:
[1894?]
Catalogue details

Licence: Public Domain Mark

Credit: Cases illustrating various types of scotoma in the visual field : portion of a lecture on "The visual field as a factor in diagnosis" delivered before the J. M. Da Costa Medical Society of the Jefferson Medical College / by G. E. De Schweinitz. 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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    culty. Hence it is not without interest to remark that the later fields in this case—namely, Figs. 10 to 15—were verified by independent observers, particularly by my former assistant, Dr. William Bruner who studied the case with me at the time of the disappearance, or apparent disappearance, of the hemianopsia and the formation of the ring scotoma. While this does not eliminate error, it establishes the accuracy of the fields more firmly than if they were the results of one observer alone. It may be assumed that the original disease or lesion was situated in the right cuneus ; that a later lesion upon the opposite side caused right lateral hemianopsia, and that the resulting ring scotoma is not explainable in the light of our present knowledge. If these hemianopic phenomena were correctly observed, the lesions that caused them must have been temporary in character, or at least of such nature that they cleared up sufficiently to permit a restoration of function in the pre- viously affected portions of the visual centres, because we find, first, a reappearance of the right upper quadrants, and, finally, a restoration of the entire field, except where the ring scotomas appeared. In the final figures (14 and 15) the areas of preserved vision within the ring scotomas give somewhat the impression of hemianopic fields, particularly upon the right side, the dividing line so passing as to leave central vision intact. In one of Burnett's cases (loc. cit.) a some- what similar condition was observed, and he refers to the possibility of a tract lesion being responsible for the visual field changes which he noted. If this were the case in the present instance, the hemiopic pupillary inaction ought to be demonstrable. Now, while I have no note that it was carefully sought for in the earlier observations, in all of the later examinations the pupillary phenomena were normal. At some future time, when further study of this case shall have been made, I trust that I may bring the matter before you again with more definite information than I have been able to express this evening, because I could do no more than speculate upon the probable localiza- tion of the lesions, especially in so far as the ring scotomata are con- cerned. UNILATERAL CENTRAL SCOTOMA; NORMAL FUNDUS OCULI; TRANSIENT ALBUMINURIA; POSSIBLE INFLUENCE OF HYS- TERIA. Case IV.—Lizzie M., aged twenty-one, born in Ireland, presented herself for treatment, at the request of Dr. Edward Martin, October 21, 1893, with the statement that three days previously her vision had suddenly become misty before the left eye, the difficulty of sight,