A compend of the diseases of the eye and refraction : including treatment and surgery / by George M. Gould and Walter L. Pyle.

  • Gould, George M. (George Milbry), 1848-1922.
Date:
[1914]
Catalogue details

Licence: In copyright

Credit: A compend of the diseases of the eye and refraction : including treatment and surgery / by George M. Gould and Walter L. Pyle. 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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    TRAUMATIC CATARACT results from a rupture of the capsule by a contusion of the eyeball, by penetration from a foreign body, or from injury to the lens itself. The lens fibers coming in contact with the aqueous become cloudy and swollen, and if the wound is of any extent, as is usually the case, the entire lens participates in the morbid process. The contents of the capsule gradually protrude into the anterior chamber and are absorbed. Iritis is a frequent accompani- ment, and if there is much swelling of the lens, glaucoma may be produced. The younger the patient, the quicker the absorption and the less inclination to increased tension. The slightest touch in an operation may give rise to a traumatic cataract, and in elderly per- sons a small aseptic foreign body may cause cataract so slowly that the patient forgets about the injury long before there is marked visual disturbance. The treatment in young subjects is to wait for absorp- tion, while in elderly persons extraction is indicated after the subsid- ence of inflammatory signs. Marked increase of intraocular tension calls for early iridectomy and extraction. The general procedures for associate traumatic and inflammatory conditions—such as cold, leech- ing, antiseptic douching, and atropin—are necessary. TREATMENT OF CATARACT. General Remarks.—The treatment of unripe cataract must be the use of proper reading glasses, protecting the eyes from irritation of any kind, and the maintenance of the general health of the patient. In considering what cataracts may be operated on, we must first determine whether any retinal, choroidal, or nerve-disease coexists, which may be discovered by examining the light-sensation or field of vision. Stationary cataract, in which the visual acuity is sufficient for the patient's occupation, or in which an artificial pupil will suffice, should not be operated on. If one eye is unaffected and healthy, it is not advisable to operate, for, even under the most successful conditions, we can not expect perfect binocular vision, on account of the great optic disparity between the eyes. Ripe and overripe cataracts are best treated by operation. Unripe cataracts should be waited for, or, if absolutely necessary, should be artificially ripened by intracapsular irrigation (McKeown), or by Forster's method, which consists in performing an iridectomy or a 16