Eye symptoms in tabes dorsalis / by J. H. Tomlinson.

  • Tomlinson, J. H.
Date:
[1902?]
Catalogue details

Licence: In copyright

Credit: Eye symptoms in tabes dorsalis / by J. H. Tomlinson. 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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    was the surgeon in charge, noticed his pupils, tested his knee-jerks, and found they were absent. It transpired he had had some weak- ness and fugitive pains, but, with these exceptions, the difficulty in driving at night-time was his only subjective symptom. I have notes of a case of a country clergyman who came to London about his sight, his trouble being that when he came out of church after the evening service he could not see sufficiently well to reach his home without assistance. It was found that he was suffering from tabes. Of course, ataxic patients have increased difficulty in walking in the dark, because their deficient muscle- sense is not helped out by the added information accorded by the eye. But even in their case part of the difficulty ia due to the defective illumination of the retina. To test for myself the disability under which a tabetic suffers, I upon one occasion instilled eserine into my right eye, and went for a country walk in the evening. The experiment was very in- structive. I was very glad the control eye was there to help me. The difficulty is not so great in well-lighted streets. It was a country clergyman who felt the night-blindness. There is a second result that must optically follow a contracted pupil, viz., improvement of vision in an ametropic eye. Objects are focussed now that could not be focussed previously. I am on the look-out, gentlemen, for the tabetic high myope who will volunteer the remark that he has noticed a decided improvement in his distant vision lately. I think I shall meet him. The muscle of accommodation, the ciliary muscle, is supplied by fibres coming from the front portion of the nucleus of the third. I am not aware that interference with these fibres. i& often seen, but I think the following case is worthy of mention. A young woman of thirty or thereabouts applied some years ago at the West- minster Ophthalmic Hospital for failing sight for near objects. Six or seven years later she returned with well-marked tabetic symptoms. It may have been a coincidence^many are the causes for the loss of accommodation in a young woman—but it is not at all improbable that it was an early effect of the disease that pre- ceded by some years the onset of more characteristic symptoms. After the pupillary symptoms come, in chronological order, various oculo-motor paralyses, generally one-sided, and at this state often fugitive. The third and sixth nerves are affected with about equal frequency. A man will wake one morning to find himself with double vision, or with ptosis of one or both eyes, or with both diplopia and ptosis. On inquiry there is often the history of a specially hard day's work the day before, or perhaps a