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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    In the fourth place, What was the state of the lens itself ? On attempting to break up the lens at my second operation, the sensa- tion communicated, when the needle passed into its substance, was, that it was of the consistence of firm curd; and here another pecu- liarity manifested itself,—not the smallest portion could be separated from the body of the lens ; and the lacerations which were made in it by the point of the needle closed up again completely as soon as the instrument was withdrawn from the eye ; and the day following the operation no trace of a wound in the lens could be discovered; the eye was exactly in the same state that it had been in previous to the operation. This shows a state of the lens quite different from what we meet with in cases of ordinary cataract. In the fifth place, the tremulous state of the iris may, I think, easily be accounted for by the lenses not occupying their usual situa- tion, and so giving support to the iris behind. We generally find that the iris becomes tremulous when the lenses have been removed either by accident or by opei-ation ; here neither of these occurrences had taken place, but the lens was small and drawn away to one side, —consequently the iris, particularly at its lower and inner side, had a much larger space to move in than it ought to have had ; and it was at this part that the tremor was principally observed. Lastly, these cases show the importance of maldng a very careful and minute diagnosis in affections of the lens, as they may easily be passed over or mistaken for other diseases. In the first case, from the imperfection of vision, the tremulous state of the iris, the want of the deep upright and the inverted images, and there being no ap- pearance of any opacity behind the pupil, I had almost come to the conclusion that the lenses were wanting; it was only on dilating the pupil as fully as was possible with atropine, and then throw- ing in a strong body of light with a powerful condenser, and examining the eyes in various lights that the opacity became visible. In the second patient the diagnosis was not so difficult, as, fi-om the history of the case, the greater opacity of the lenses, and from hav- ing seen the former case, I was in a manner prepared for it, at least for an opacity, but certainly not for the peculiar state of the lenses which was brought into view when the pupils were dilated. 47, Northumberland Street, February 1850. MURRAY AND QIBB, PRINTEUS, EDINBURGH.