A manual and atlas of medical ophthalmoscopy / by W.R. Gowers.

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A manual and atlas of medical ophthalmoscopy / by W.R. Gowers. Source: Wellcome Collection.

    344/392 (page 316)
    MEDICAL OPHTHALMOSCOPY. rotiiial vessel which passes among them. (They slowly lessened under observation. The swelling gradually subsided, the edges of the disc reappearing and its aspect becoming that of consecutive atrophy. Its appearance is shown in section in Figs. 49, 50.) Vision 0. He died from meningitis, probably tuberculai-. At the necropsy tubercles were foimd in the cerebellum and medulla oblongata. Figs. 4 & 5.—Subsiding neuritis, recent haemorrhages, and same disc after recovery. The patient had been in the London Hospital, under the care of Dr. Hnghlings-Jackson, suffering fi'om the symptoms of cerebral tumour, and presenting intense optic nem-itis. Under treatment the symp- toms subsided and the nem'itis gradually lessened, but dm-ing sub- sidence several fresh hsemorrhages appeared. He died some yeai's later, and the brain presented softening of one anterior lobe, Avith the remains of an absorbed sj^philitic gumma. Cicatrices were also found in the liver. Fia. 4.—Subsiding neuritis. The outline of the disc can be seen, but is not clear; its surface is reddish in tint, and the swelling of the papilla is still considerable, as evidenced by the curves formed by the veins in passing over its edge. Several large extravasations are seen. One of these, below, follows the course of an artery. Another above and to the left is round, not striated, and therefore probably situated in the deeper layers and not in the neive-fibre layer. Vision -]; fields normal. Fig. 5.— The same, two months later. The hgemorrhages have entirely disappeared. The disc is clear, and its swelling has almost subsided. But the tortuosity of the vessels has increased, probably on account of their permanent extension by the long-continued swelling. PLATE VIL Figs. 1 & 2.—Unilateral optic neuritis; jyrobably cerebral syphiloma. Man aged forty-four. 1.—Left optic disc concealed by a swelling—reddish, striated, depressed in the centre. The veins, a little larger than normal, curve over it, and some are concealed beyond the edge. In the central depression the veins pass behind the arteries and are unduly concealed by the swollen tissue. The artery which passes upwards is visible throughout; those which pass doAvnwards are distinct at their emergence in the depressed centre, but are concealed by the sweUing, to reappear at its edge. No hsemorrhages. Just beyond the edge of the papilla is a series of pale concentric lines pai-allel to the edge, due to the folds in the displaced retina; they are limited above and below by a small vein. Vision : counts lingers only.