An ophthalmic retrospect / by Freeland Fergus.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932.
Date:
[1909?]
Catalogue details

Licence: In copyright

Credit: An ophthalmic retrospect / by Freeland Fergus. Source: Wellcome Collection.

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    become so red and inflanjed that no surgeon would have thought of attempting any operation, and, what seemed most surprising, Dr. Buchanan’s examination showed that the micro¬ organisms continued to flourish. Looking back on it, I think that probably all we had effected was the destruction of the protecting epithelium, in consequence of which the parasite had obtained an even greater hold. My old patient by this time began to suspect that she was the subject of some ominous experiment, and was getting very uneasy in her own mind, while I myself felt almost at my wits’ end, and wondered if the eye was ever to be in a condition which would admit of operation. As a last resource, I visited the home in which she was placed twice or thrice daily, and everted the eyelids, and thoroughly scoured the conjunctival sacs with plain sterilised water, then applied gauze moistened with sterilised water so as to swab them out thoroughly. What the so-called remedies did not effect, this simple treatment at once attained. Within ten days the conjunctival sacs were pronounced to be free from pathogenic micro-organisms, and ultimately good sight was obtained. That is only one of several cases which I carefully investi¬ gated at that time, but as it is typical, and as the others are simply a repetition of much the same sort of thing, I will not detain you further with their enumeration. I learned from this case that so-called antiseptics had only a limited applica¬ tion ; that if they were to be applied strong enough to kill micro-organic life in such a tissue as the human conjunctiva, then we must be prepared for the destruction of the con¬ junctiva, and probably also of the cornea. No one denies for a moment that germs can be killed by these remedies, but the strengths in which they must be used to effect this end are such as to render their application to ophthalmic surgery absolutely impossible. From that time to this I have never willingly opened an eyeball for operation without first carefully investigating the condition of the conjunctival sac, or, at anyrate, having it carefully investigated for me, and I have come to the conclusion that no one is justified in operating on an eye when the conjunctival sac contains such micro-organisms as the pneumococcus, the streptococcus, the staphylococcus aureus, and several others. So far as I remember, there is only one exception to this rule, and that is in cases of acute glaucoma, where even the delay of an hour or two must make a difference in the prognosis as regards Vision; here we must run the risk. But apart from this, no one is entitled to operate on an eye unless the