Congenital cataract, with imperfect development of the lenses / by William Walker.

  • Walker, William (Surgeon)
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Congenital cataract, with imperfect development of the lenses / by William Walker. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    On examining the eyes, the first thing which attracted my attention, was the tremulous state of the iris in both ; this gave them exactly the appearance which the eyes of those have, who have been operated on for cataract, and made me think, at first sight, that the lenses might be wanting. On exposing them to the influence of light, the iris in both was found to be lively and active in its movements, and the pupillary margin sharp and clear. The colour of the iris was grey. The anterior chambers were of their natural size, and there did not seem to be any opacity, either in the lens or deeper seated, at least that could be detected when the pupils were in a quiescent state. The globes were of their usual shape and firmness. When the eyes were examined catoptrically with a lighted candle, only the corneal image could be seen; there was neither deep upright nor inverted image. On dilating the pupils fully with atropine, and then examining the eyes with the aid of a powerful condenser, a very slight greyish mist or opacity was seen to occupy the position of the lenses. In colour this opacity resembled a drop of very slightly turbid water on a black ground; it was evidently seated in the lenses themselves, and occupied their whole extent. The lenses, however, did not as usual fill up the whole space behind the pupils. They appeared to be fixed to the ciliary processes above and towards the outer sides ; while towards the inner and lower sides, they were free, and had this free edge turned a little backwards, so that it was at a greater distance from the posterior surface of the iris, than the centre or upper edge which lay close to it—in fact almost touch- ing it. Through the clear portion of the pupil below, and on the inner side of the opaque lenses, he could see a very little better. Both lenses had a very slightly tremulous motion when the eye was moved rapidly about. The ap- pearance of both eyes is represented in Fig. I., the pupils being under the in- fluence of atropine. No treatment was adojited. Case II.—J. K., set. 25, a stout, healthy young woman, came under my care in November 1849. Ever since her infancy she has had imperfect sight; and although able to work at both in and out-door occupations, she could never read when the book was held at a greater distance from the eyes than eight inches. She could always see best when looking directly forwards. Six months ago the vision with both eyes became so much worse, that she could neither work nor read, and was in consequence obliged to leave her situation. She could, however, manage to go about tolerably well when using the right eye, but very imperfectly when the left was employed. Glasses did no good. As in the former case, the first thing which arrested attention, was the very tremulous state of the iris in both eyes, which looked as if it had no support behind. The eyes themselves were of their usual size and shape, and of their natural firmness. The irides were of a waxy Iirown colour, and they acted well. The left pupil dilated rather more fully than the right, but even when a strong solution of atropine was used, neither dilated so fully as they generally do. On looking very carefully into the pupils, a very slight greyish opacity- could be seen, but indistinctly, unless a considerable body of light was thrown upon the eyes. The opacity resembled in colour a drop of turbid water, hav- ing a slightly greenish hue. On holding a lighted candle before the eyes, no inverted image could be seen, and the deep upright image was very faint and indistinct. When the pupils were dilated as much as possible with atropine, the lenses were brought fully into view, and instead of their being of their natural form and size, they presented the appearance represented in Fig. II., with a clear space at their inner and lower edges, and through which she saw consi- derably better. Both lenses looked as if they had been arrested in their deve- lopment, the left being rather larger, and also rather more opaque tlian the right, which accounted for her less perfect vision with that eye. The opacity of both was uniform throughout, and not very dense. They were apimrently adherent at their upper and outer edges to the ciliary processes ; their centres