Ophthalmia nodosa / by J.B. Lawford.

  • Lawford, J. B. (John Bowring)
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Ophthalmia nodosa / by J.B. Lawford. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    mydriatics, local depletion, and counter-irritation and application of heat. In my patient one of tlie peculiari- ties was the defective reaction of tlie iris to atropine or other mydriatic, the drug having to be applied very fre- quently in order to keep the pupil even moderately dilated. This has also been noted by Wagenmann in his case. Mercury has been administered in several cases, but without striking results. Operative treatment has been limited to iridectomy to combat the results of the iritic inflammation, e. g. blocking of pupil or secondary glau- coma, and for the removal of nodules and portions of hairs, and the excision of nodules in the conjunctiva or episcleral tissue. The prognosis in ophthalmia nodosa, judging from a study of the cases hitherto recorded, must be guarded; and the opinion given will necessarily depend upon the severity of the case, the extent of structural change present, and the date at which the patient comes under observation. It would seem from the history of my case, which I might here remark was in some respects less severe than any previously recorded, that the deep pene- tration of the hairs does not appear to have much influ- ence on the duration of the disease. In no case has sight in the affected eye been destroyed, although in several (Kruger, Becker, Hillemanns) it has been seriously damaged. As to diagnosis, the chief and perhaps the only ocular lesion with which ophthalmia nodosa is liable to be mis- taken is a tubercular iritis ; and the difficulty is not likely to be insurmountable. Excision and examination of the nodules will in a doubtful case determine the nature of the disease, should the clinical features not be sufficiently distinctive. Turning our attention now to some more general facts in connection with this disease, I may point out that, as it is natural to expect, all the reported cases have occurred among the rural population. No case lias occurred in a town dweller. The penetration by the caterpillar hairs