A new operation for the cure of amaurosis, impaired vision, and short-sightedness : in a letter, addressed to John Richard Farre / by James J. Adams.

Date:
[1841]
Catalogue details

Licence: Public Domain Mark

Credit: A new operation for the cure of amaurosis, impaired vision, and short-sightedness : in a letter, addressed to John Richard Farre / by James J. Adams. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Tlie optic nerve, from its escape at the optic foramen, takes a tortaous course to its point of junction with the clerotica, and is enveloped by a 'fibrous sheath which separates it from the contents of the orbit; its sheath, at the edge of the optic foramen, is almost inseparably united to a strong aponimosis formed by the conjoined tendons of external inferior, and internal recti muscles, which are firmly attached by it to the elevated ridge at the under part of the optic foramen; in all other parts of the orbit, the sheath of the optic nerve is surrounded by globules of oily fat, and cellular membrane, to which may be added a ganglions- several small nerves and blood-vessels, one of which, the arteria centralis retinas, pierces the nerve obliquely and is lodged among its fibrillae. The intimate connexion which exists between the muscles of the orbit and the optic nerve being as above stated, I, for the present, leave the reader to reflect on the possibility of the former influencing the latter by any unusual contraction, and proceed, lastly, to mention the causes most likely to disorder the functions of the remaining position of the optic nerve: they are, namely, diseases of the choroid and other tunics of the eye, characterised by a temporary congestion, or by a permanent organic change. Having emimerated the above causes, as liable to interfere with the due performance of the functions of the optic nerve, from their seat being closely approximated to it, I venture to believe that no cause will be fovmd so likely in its consequences to produce the peculiar disease of which we have been considering, as the arrangement of the recti muscles with respect to the nerve, for whatever the cause may be, it must possess the power of anting' suddenly., of varying its degree by becoming complete or incomplete by turns, and of changing from eye to eye ; moreover, of existing without danger to the life of the patient, and,, frequently, witlmut in the least degree altering the healthy and natural appearances of the eye, from childhood to old age. I am therefore of opinion that the peculiar form of amaurosis, here designated by me as Muscular Amaurosis, depends on the bending or partial folding, and compression of the optic nerve, caused by the shorten- ing and thickening of the recti muscles during a state of morbid con- traction, which further may be attributed to an affection of the third and sixth nerve, probably at or near to their origins. The form of impaired vision, just described as muscular amurosis, may be complicated by a slightly prominent, or extremely conical state