Trachoma and its complications in Egypt / by A. F. MacCallan.

  • MacCallan, A. F. (Arthur Ferguson)
Date:
1913
Catalogue details

Licence: In copyright

Credit: Trachoma and its complications in Egypt / by A. F. MacCallan. 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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    or the eye may increase as a whole, the condition called buphthal- mos. In any case, blindness results unless the tension is relieved by trephining or by iridectomy as soon as it becomes manifest. In all such cases of recently formed anterior synechia or adherent leucoma, it is wiser to do a prophylactic operation, before any rise of tension becomes manifest. The operation of iridectomy may be satisfactorily performed with a keratome if there is sufficient depth of anterior chamber for the safe passage of this instrument; the portion of iris removed should be torn from its ciliary attachment, two snips with the scissors being required for its separation from the rest of the iris. If the anterior chamber is shallow the corneo-sclera should be trephined and an iridectomy done through the trephine hole. The corneal opacity may lead to nystagmus, strabismus, or amblyopia. Panophthalmitis rarely results from ophthalmia neo- natorum. In many severe cases the preauricular lymphatic gland which is in direct communication with the orbit becomes inflamed, and rarely suppuration may occur .Gonorrhoeal arthritis and septicaemia are not common in Egypt. The corneal haze above described is the precursor of pannus in most cases (in non-trachomatous ophthalmia neonatorum, however, the corneal haze may clear up rapidly under treatment). When the acute stage subsides the presence of follicles can be detected. Scarring of the conjunctiva is characteristic. The conjunctiva of the upper fornix exhibits a thin bluish-white scar which, however, does not extend to the tarsal conjunctiva. The retro- tarsal fold is frequently prominent as a ruck in the conjunctiva. Crescentic lines of scarring may be seen which follow the contour of the lower lid. Rarely the scarring is much denser, involving the tarsal conjunctiva of the upper lid as well as the fornix and the conjunctiva of the lower lid; or it may be very localized and show irregular branchings. Such scarring is the result of the gonococcal inflammation; trachomatous scarring is very different and takes longer to develop. Scarring of the conjunctiva may be also caused by the use of caustics such as silver nitrate stick, in the treatment of the acute ophthalmia.