Tuberculosis of the eye / by Sydney Stephenson.

  • Stephenson, Sydney, 1862-1923.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Tuberculosis of the eye / by Sydney Stephenson. 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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    (opened by E. Kollet) on tuberculosis of the lacrymal passages took place at the French Oph- thalmological Society. Interstitial keratitis was described by the famous William Mackenzie in 1830 as “scrofulous corneitis,” but in 1863 Sir Jonathan Hutchinson showed that the affection was almost always a direct result of inherited syphilis. The influence of acquired syphilis in that direction was not then recognised by Hutchinson. To some extent professional opinion has now veered round to Mackenzie’s view. It is known that some of the cases, particularly the unilateral and less typical ones, are due to tubercle. For example, in my own series of 101 cases of inter- stitial keratitis 1 tuberculosis was identified as the cause in 9'90 per cent. In short, the modern bio- logical tests for tuberculosis have supported the view, originally based on clinical observation, that tubercle is a cause of primary keratitis. Conditions that we should now regard as tuber- culosis of the iris were described by Lawrence in 1833 and by Mackenzie in 1854. Such cases were examined with the microscope by Richetti in 1869 and by Berthold a couple of years later. In 1890 Julius von Michel 2 stoutly maintained that inflam- mation of the iris due to tubercle was nearly as common as that due to syphilis. Iritis might result from tuberculous infection, and yet might not be accompanied by tubercles. Michel held that a tuberculous inflammation of the iris might be the first visible expression of tubercle in some other part of the body. The foregoing views received support from the experimental work of W. Stock,2 who by the injec- tion of pure cultures of tubercle bacilli into the auricular vein of rabbits was able to produce in- flammation of the iris and ciliary body (anterior uvea), to say nothing of other structures of the eye, such as the cornea, the sclera, the choroid, the •conjunctiva, and the tarsus. The naked-eye cha- racters of these experimental inflammations in many instances did not conform with those gene- rally regarded as characteristic of tubercle, neither did their histological structure, despite the all- important fact that tubercle bacilli could be found in them.