Ophthalmic semiology and diagnosis / by Charles H. Beard.

  • Beard, Charles H., 1855-1916.
Date:
1913]
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Licence: In copyright

Credit: Ophthalmic semiology and diagnosis / by Charles H. Beard. Source: Wellcome Collection.

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    the advancing borders of the detachment, and are supposed to be derived from linear accumulations of fibrin beneath the retina that marked former limits of the separation (Fig. 81). Similar lines in the applied retina are of the same origin, but the retina in which they are situated has become reapplied. The striae are always behind the retinal vessels, and are sometimes pigmented (see Striated Retinitis). In addition to the striae there are other tokens that mark the areas of former detachments, or where the retina has managed to stick itself to the choroid again. Traces are left behind, even when the separation was of very short duration. The part that was involved is distinguished from the normally applied retina by the paler tint, espe- cially as it approaches the line of demarcation. Instead of the white lines there are sometimes series of pigment spots (Fig. 84). In most instances there are numerous pigment mottlings over the entire territory of the old sepa- ration, imparting a marbleized appearance. The grillage of the choroidal vessels is conspicuous in places. The aspect of the restuck retina may resemble so closely the final stages of an old chorio-retinitis that it is only its strict limitation to a certain sector of the fundus, at least, in the absence of an appropriate history, that assures the differentiation. Spontaneous Detachment and that Secondary to a Tumor.— Examinations of enucleated eyes have often demonstrated that total detachment has been produced by a very small tumor; and, on the other hand, limited or partial detach- ments have been found associated with choroidal tumors of considerable volume. In most cases the separation is due less to the neoplasm than to an exudate, probably choroidal. The maximum of massing of the exudate is not necessarily at the site of the tumor, probably because the retina is often adherent to the growth. It is not infrequently diametric- ally opposite to the latter. Nor has it any special tendency to accumulate at the lowest part of the fundus, even when