Pemphigus of the conjunctiva / von Prof. Dr. Wicherkiewicz.

  • Dickinson, William.
Date:
[1886]
Catalogue details

Licence: Public Domain Mark

Credit: Pemphigus of the conjunctiva / von Prof. Dr. Wicherkiewicz. 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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    me I should get well. At this time, also, the lower lids began to turn inwards and the lashes to touch and irritate the eye. At the instance of a mutual friend she consulted me first, as stated, June 25. The upper lids then drooped, and she was suffer- ing from photophobia, entropion and trichiasis, not only from the normal cilia, but from abnormal ones which to a great number had developed along the inner border of the lower lids. Both upper lids were thickened and indurated, rendering eversion difficult and painful. However, there was but little general conjunctivitis of the upper lids, but the vessels of the entire sub-conjunctival tissue of the eye ball were deeply engorged with blood, from which by pressure through the lid, it could be expressed, but it speedily re- turned. A striking and very observable feature was a broad, fibrous band, striated, of whitish color, evidently cicatricial in character, resem - bling a pterygium, lacking the red color, occupying the inner as- pect of the left globe, extending from the inner canthus nearly to the cornea. It presented the same appearance as is seen after the contact of some powerful escharotic. On inquiry she stated that nothing of the kind had ever happened to her. This was unques- tionably the sequel of the large blister (bleb) from which she had for so long a time suffered some months before, and which was pathog- nomonic of pemphigus. The lower conjunctival sac was much dimin- ished in depth and extent. Immediately after this visit the patient went to the country, and her next visit was on August 18. The eyes and lids were in much the same condition as when last seen but more aggravated, espe- cially the entropion and consequently the photophobia. The punc- tual of left lower lid being contracted, and as was probable, also the lachrymal duct, I passed a Bowman's probe with benefit. In the early weeks of treatment I pulled out the abnormal cilia, and also those of the normal series which were most offending. In conse- quence of the progressive contraction of the conjunctiva, both pal- pebral and ocular, the inversion of the lower lid continued to in- crease. To resist this tendency I removed from the integument of the lid an oval piece, which for a short time restored completely the lid, and at the same time the normal cilia, to their normal posi- tion. About November 1, for the first time since she came under my observation, blebs appeared on the integument of the upper lids,