On the tests for muscular asthenopia and on insufficiency of the external recti muscles / Henry D. Noyes.

  • Noyes, Henry D. (Henry Drury), 1832?-1900.
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: On the tests for muscular asthenopia and on insufficiency of the external recti muscles / Henry D. Noyes. 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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    Of the above cases, in no. 6 no treatment of the muscles was attempted, in one, no. 12, no relief was obtained because the treatment was unsuitable; in four, nr. 9, 10, 11 & 13, partial relief was secured, and of these the imperfect result was due, in two, nos. 11 and 13, to error in not using different proceedings, in the others, nos. 9 & 10, the: general conditions were infavorable and the local measures were such as were best calculated to do service. Of the remaining cases, nos. 1 & 2 were properly cases of spasm of A., while in no. 3 the ultimate effect was not yet known. There remain 5 cases in this category, in which adductive prisms had a most happy and decisive influence, viz nos. 4, 5, 6, 7, 8 & 9. I will not undertake to ap- portion the benefit, which some of them may have obtained by treatment employed before such prisms were used. But my convictions are very strong that for those who did not at an early period employ adductive prisms the success would have been more speedy if they had been then employed At the same time the error of the externi was no ex- hibited in all of them until a late period and for such cases our means of diagnosis do not suffice until the suggestive symptoms appear. One of the above cases presented itself to me as a lesson, viz. Case XXIII. Mr. C, aged 27, a highly nervous man and a hard student, himself neurotic and coming from neurotic parents. Had severe headache and various nervous symptoms and was commended to me in Sept. 1882, by Dr. Weir Mitchell of Philadelphia. He had had much trouble with his eyes, but he complained chiefly of his head. His refraction without atropine was O. U. E. 20/20, no spasm of A. at 20' add. = io°) c 0 abd.= 8°(IS v. d. = 4 0 div, I gave him abductive prisms, i. e. 2° for constant wear. After using them for 11 days, he reported his condition as no better, and one of his chief troubles was palpebral conjunctivitis: at20/add. = 140) 0 at 14 v. d. = 8° div. abd.= 8°(22 The abductive prisms were increased adding 2°. To the left eye, but this only made him more uncomfortable and in a week he reverted to the original prisms. For 3 weeks longer he wore them and the condition became at 20' add. = I2°l q abd.= 5°i 7 which in 5 days became at 20'add. = 21 °| ,, 0 at 14 v. d. = 2 0 conv. abd. = 61/2°i27 12 Then atropine was employed, which revealed a trifling astigmatism, which however was thought to be of importance to him, after the atropine effect had passed, he was found to have at 20' add. = 30 o» at 14 v. d. = 2 0 conv. abd. = 5 °f 35 (O. D. + 96c 900 He was given for constant use: |q g _j_ ^oc gQ0