The principles and practice of ophthalmic medicine and surgery / by T. Wharton Jones.

  • Jones, Thomas Wharton, 1808-1891.
Date:
1847
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Licence: Public Domain Mark

Credit: The principles and practice of ophthalmic medicine and surgery / by T. Wharton Jones. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    1793. Subjective visual sensations.—Photopsy, chroopsy, and the undue retention of impressions, giving rise to ocular spectra and accidental colours, are frequent attendants on amau- rosis. The gauze or network seen in the light may still be visible in the dark; but instead of being gray or black, it is of a silvery or gold colour. 1794. Common subjective sensations.—Uneasy feelings or actual pain in the eye, may or may not have been, or be present. Dryness of the eyes and nostrils is sometimes felt. 1795. Double vision, confusion and distortion of objects sometimes occur early in the disease, from some degree of attending strabismus. A similar disturbance of vision may occur without evident strabismus or loss of correspondence of the axes of the eyeballs, but in consequence of loss of corre- spondence of the vertical and horizontal diameters of the eye- balls, from disturbance of the harmonic action of the oblique muscles. The nature of such disturbance of vision is ascer- tained by closing one eye, whereupon vision with the other is improved. 1796. Objective symptoms.—The defective and disturbed vision may be the only symptoms present. There may be no objective symptom, even the staring appearance of the eyes, and their want of power to converge on an object with precision, may be absent in incipient cases. In general, however, there are objective symptoms enough to indicate the nature of the affection, and to confirm the patient's statements.* 1797. The pupil is more or less dilated, and if not quite im- movable, its movements are limited and slow. This, although one of the most characteristic appearances presented by the amaurotic eye, is not constant. In cases in which one eye only is affected, the pupil often moves quite naturally, consenta- neously with the pupil of the healthy eye ; but if this latter eye be covered, whilst the amaurotic eye is examined under the in- fluence of different degrees of light, then the pupil of the amau- rotic eye is found to remain dilated and fixed, uninfluenced by the degree of light. Sometimes again, in complete amaurosis of both eyes, the pupils are as obedient to changes in the degree of light, as in health, (s. 1617.) •1798. Besides the peculiarities of the pupil just considered, there may be deformity of it from greater dilatation towards some one or other side, or even a displacement of the pupil, and the iris may be inclined towards the cornea, or its pupillary margin reverted backwards from the cornea. * The genera] aspect of the amaurotic patient is above sketched, (s. 9.)