Cataract extraction / by H. Herbert.

  • Herbert, H.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Cataract extraction / by H. Herbert. 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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    The state of the fellow eye may need a small precautionary attention. If the anterior chamber be very shallow, it will be wise to instil eserin, lest an attack of glaucoma be brought on by the excitement and general conditions appertaining to the operation. We had experience of a few such cases. Very rarely a cataract may be ripe for extraction, and yet the operation may be impossible. I once had to depress the lens in each eye of a patient with extremely small corneas—a congenital defect associated with coloboma of the iris. When one eye has been lost from profuse intra-ocular haemorrhage complicating cataract extraction, it is a question whether reclination should not be preferred in the second eye (see Chapter III). The possession of good sight in one eye influences the question of operation on the other eye, only in so far that it permits of waiting for complete ripeness of the cataract without serious inconvenience. The cataract must not be allowed to become hypermature, because it is then in a less favourable state for operation. After the extraction, although both eyes do not work together, there is the advantage of the larger field of vision, and the patient has the satisfaction of being provided for during the anticipated slow onset and progress of opacity in the fellow eye. It has been argued that until our methods improve so that we can guarantee the fellow eye against loss by sympathetic ophthalmia, we have no right to operate while the fellow eye has useful vision. The improved results obtained nowadays by a number of operators show that it should be quite possible to guard against sympathetic ophthalmia, especi- ally where patients can be kept under observation and treat- ment for a sufficient length of time after operation. In India, if we did not operate upon all cataracts ready for extraction, we should drive many patients into the hands of the travelling quacks. It is almost universally held to be unjustifiable to extract cataracts from both eyes of a patient at the same time. The possible loss of both eyes is too appalling a risk to run, and the danger from mental derangement, coughing, sneezing, etc., is more serious. Operation upon one eye may show the need of special precautions in dealing with the second eye. Finally, ^ See, for example, Devereux Marshall in The Ophthahnoscope^ iv (1906).