Subjective symptoms in eye diseases : being chapters on the disorders of vision symptomatic of diseases in the eye and central nervous system / by George A. Berry.

  • Berry, George A. (George Andreas), 1853-
Date:
1886
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Licence: Public Domain Mark

Credit: Subjective symptoms in eye diseases : being chapters on the disorders of vision symptomatic of diseases in the eye and central nervous system / by George A. Berry. 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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    central scotoma, it would seem extremely improbable, owing to tbe complete curability of the large majority of cases in which tobacco is the prime cause of the symptoms, that such an inflammation is at all frequent. From the preceding short sketch of the state of peripheral vision in different diseases it is evident that there are many points of diagnostic importance to be gathered from an examination of the field. This, in the case of the diagnosis between intra ocular and extra-ocular cause, which, so far as our present knowledge goes, is the direction in which the observed differences are most pro- nounced, is not so necessary, as there are, as a rule, objective signs which lead us to the same conclusions. But there can be little doubt that in the thorough examination of the relative as well as absolute functional activity of all parts of the retina we possess a means of immense value in the localization of intra-cranial disease. But it is not merely as a method of diagnosis that this examina- tion deserves attention ; in many cases it affords the most delicate means of ascertaining the course taken by any disease, especially when of intra-cranial origin. Here, however, it is necessary to bear in mind the circumstances which have been already men- tioned as influencing the result of the examination, viz., intensity of light, practice, etc., so as not to ascribe, without good cause, slight or sometimes even considerable alterations in these results to progress of the disease either in the direction of recovery or blindness. The prognostic importance attaching to the state of the field has been alluded to under the different affections, but it may be well to recall a few points here. The prognosis is good if there be diminution of central vision without any limitation of the field, or if the limitation takes the form of homonymous hemianopia in which the portions affected are sharply separated from those in which the function is retained. If, on the other hand, there be limitation of the field, even without any apparent cause, the probability of subsequent atrophy and blindness is very great, and this is all but certain if there be a previous atrophy of one eye. A good deal of prognostic significance, however, attaches to the