An ophthalmic retrospect / F. Fergus.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932.
Date:
[1909]
Catalogue details

Licence: In copyright

Credit: An ophthalmic retrospect / F. Fergus. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    become so red and inflamed that no surgeon would have thought of attempting an}’ operation, and, what seemed most surprising, ])r. Buchanan’s examination showed that the micro- organisms continued to flourish. Looking back on it, I think that probably all we had effected was tlie destruction of the protectii»g epithelium, in conse((uence of which the para.site had obtained an even greater hold. My old patient by this time began to suspect that she was the subject of some ominous experiment, and wsis getting very unea.sy in her own mind, while 1 my.self felt almost at my wits’ end, and wondered if the eye was ever to be in a condition which would admit of operation. As a last resource, I visited the home in which she was placed twice or thrice daily, and everted the eyelitls, and thoroughly scoured the conjunctival sacs with plain sterilised water, then applied gau/.e moistened with sterilised water so as to swab them out thoroughly. What the .so-called remedies did not effect, this simple treatment at once attained. Within ten days the conjunctival sacs were pronounced to be free from pathogenic micro-organisms, and ultimately good sight was obtained. That is only one of several ca.ses which I carefully investi- gated at that time, but as it is typical, and as the others are simply a repetition of much the same sort of thing, I will not detain you. further with their enumeration. I learned from this ca.se that so-called anti.septics had only a limited applica- tion ; that if they were to be applied strong enough to kill micro-organic life in such a ti.ssue as the human conjunctiva, then we must be prepared for the destruction of the con- junctiva, and probai)ly also of the cornea. ^Jo one denies for a moment that germs can be killed by these remedie.s, but the strengths in which they must be u.sed to effect this end ai'e such as to render their application to ophthalmic surgery absolutely impos.sible. From that time to this I have never willingly opened an eyeball for operation witliout first carefully investigating the condition of the conjunctival .sac, or, at anyrate, liaving it carefully investigated for me, and I have come to the conclu.sion that no one is justified in operating on an eye when the conjunctival sac contains such miero-oiganisms as the pneumococcus, the streptococcus, tlie staphylococcus aureus, and .several others. So far as T remember, there is only one exception to this rule, and that is in cjuses of acute glaucoma, where even the delay of an hour or two must make a difference in the prognosis as regards vision; here we must run the risk. Hut apart from this, no one is entitled to operate on an eye unless the