Four cases of bi-temporal hemianopsia / by A. Hill Griffith.

  • Griffiths, A. Hill.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Four cases of bi-temporal hemianopsia / by A. Hill Griffith. 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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    ciyschromatopsia in right eye, loss of sense of smell in left nostril, taste not aifected. The symptoms appeared nine months ago, when engaged in nursing a head case, she could not lift her eyelids, and she suffered from diplopia and also a good deal of pain in head ; she has not been able to read for eight months, and is afraid of crossing the streets. Menstruation ceased five years ago, and has not returned ; she has been getting stout for the last few years ; the gait is not affected. The pupils were dilated, and a thorough examination made, but nothing abnormal was found except a circle of white opaque striae at the periphery of each lens, a condition which, I believe, is physiological, and have seen other examples of the same condition. No improvement of vision was obtained by correcting the slight hypermetropia present. February 23rd, a tracing of the fields was taken, and showed well-marked bitemporal hemianopsia (Fig. III). There is slight left ovarian tenderness, and the patient tells me Left. Fig. III. Right. that about the time menstruation ceased, she had a slight yellowish vaginal discharge, and she was examined by a medical man, who said she had ulceration of the womb. With the right eye she calls white light green, light blue is called grey, but pinks are named correctly; the colour perception with the left eye is normal. This exami- nation was performed on three different visits with a similar result. She was ordered bromide of potassium, and shortly afterwards the iodide was substituted. At the end of seven months she said she felt much better and had returned to her work. The vision in the left eye had improved to 2 and ^fj. There is still loss of smell in the left nostril; she complained for the first time to me of a noise like a wave in her head, but I could detect no sound with the stethoscope. The urine was examined twice and found to be normal. On the first examination of this patient I was incHned to regard the nature of the case as hysterical, for the first tracing of the visual fields was not unlike general peripheral contraction, and the mode of onset, temporary ptosis, left anosmia, and dulness of cutaneous sensibility were all consistent with the diagnosis. On the other hand the impair- ment of colour perception was on the right side, and on taking the fields the second time there could be no doubt the contraction was due to pressure on the chiasma, for I am not aware that any well marked per- sistent case has been shown to be functional In its nature. A case of rapid amblyopia, with partial loss of the temporal sides of the fields, has