The ophthalmoscopic appearances of the optic nerve in cases of cerebral tumour / by C.E. Fitzgerald.

  • Fitzgerald, Charles Edward.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: The ophthalmoscopic appearances of the optic nerve in cases of cerebral tumour / by C.E. Fitzgerald. 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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    On testing his vision I found he could read XX. (Snellen) at 15'. With the ophthalmoscope both eyes presented almost similar appear- ances ; the disks were enormously congested, and very prominent; the margins ill-defined and hazy; the veins were greatly engorged and tortuous, and presented well-marked curves at the edges of the swollen disks. Owing to the zone of effusion surrounding the margin of the disks, the veins were veiled, or were completely hidden for some distance; the arteries were greatly reduced in size and number, the few that were visible being quite small and thread-like. The treatment consisted in the administration of five grain doses of the iodide of potassium three times daily. After continuing this treat- ment for some time, the patient expressed himself as greatly better, and indeed there was a marked improvement in his appearance. His coun- tenance had lost the peculiarly pained expression to a great extent, and, on the whole, he looked much brighter; he slept much better now. The bromide of potassium was now combined with the iodide. The following month feeling had returned to the left side of the head and face, with the exception of one small portion of the lower lip. He continued to improve rapidly, and with the o})hthalmoscope the veins could be traced much more distinctly at the margins of the disks. He was now able to resume his work, and stated that he felt almost as well as ever. Towards the end of last August he again presented himself. His countenance exhibited the same peculiarly pained expression that it did at first, and he stated that for the last few weeks he had suffered greatly from the frontal pain. He was obliged to give up working, and he would ‘‘fain” be constantly lying in bed. The left pupil was dilated, but responded to light. No change could be detected in the condition of the disks, and vision remained the same. His memory was very defective; he forgot my name a few minutes after he was told it. I now lost sight of the patient for about two months, and when I next saw him he was an inmate of one of the general hospitals in this city, where he had been admitted with well-marked exophthalmos of the left eye, and ptosis of the left eye-lid. I then examined him with the ophthalmoscope, but could detect little or no change in the disks— perhaps they were not quite so prominent. I saw nothing more of the patient until December, when he again cante to me. He had been suffering intense pain across the forehead, the left side of the head and face, and in the left eye. The exophthalmos and ptosis had greatly diminished. He was admitted into the South Union Workhouse, where I attended him. A subcutaneous injection of morphia relieved the pain somewhat. He was ordered the iodide of potassium; in a few days the pain lessened, and in about a week he left the Workhouse. The exophthalmos and