Contributions to practical surgery / by William Stokes.

  • Stokes, Sir William, 1839-1900.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to practical surgery / by William Stokes. 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.

    6/32 (page 2)
    might be described in different ways of classification, but I propose to consider it under two heads—the stationary and the progressive staphylomata. From whichever kind the patient suffers he probably comes to you complaining of myopia. In the latter form he probably complains of in- creasing myopia, and other and more serious complications may exist, or will be likely to arise. In the stationary kind of posterior staphyloma the great characteristic of an oph- thalmoscopic examination is a white crescentic mark touch- ing the optic nerve entrance, and embracing it more or less, that is to say, its concavity corresponds with and is joined to some part of the circumference of the optic nerve entrance. Not unfrequently, however, it is not thus partial in its extent in relation to the optic nerve. The horns of the crescent may encircle the nerve altogether. If this white mark completely surrounds the nerve it is not equally broad, but, as in the case of the simple crescent, its greatest breadth is towards the posterior pole of the eye, that is to say, to the outer side of the nerve. Sometimes it is below the optic nerve entrance, and but very rarely in other posi- tions. Liebreich says “ I have never seen it above ” the optic nerve entrance, but in our last course of ophthal- moscopic demonstrations we have seen a case in 'fthich there was a small crescent in that position. Some of you will, no doubt, recollect the case. The outer margin of the crescentic mark generally forms a tolerably regular curve, and when it extends nearly or quite around the optic nerve entrance it might be described as a part of the circumference of a circle, somewhat larger than the optic nerve entrance, and of which the centre is to one side (generally external) to that of the nerve. The con- vexity of the crescentic mark is generally more or less bounded by streaks or by a continuous line of brown pig- ment. Beyond the dark margin is the normally bright red choroid, with its epithelium, etc., all apparently un- changed, and the contrast between this and the white of that portion of the fundus to which the disease appears to