On puerperal amaurosis / by Sydney Stephenson ; with a note by W.P. Herringham.

  • Stephenson, Sydney, 1862-1923.
Date:
1910
Catalogue details

Licence: In copyright

Credit: On puerperal amaurosis / by Sydney Stephenson ; with a note by W.P. Herringham. 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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    patient could tell light from dark, and on the next day sight was fully restored. Even after several weeks the urine contained much albumin. Two subsequent labours were free from either eclampsia or amaurosis. 3. An obese woman of 40 years, who had had six children without accident, developed headache and sparks and flashes before her eyes after the birth of her seventh child. Six hours later, amblyopia, and four hours after that, amaurosis of so complete a description that she possessed the faintest perception only of a bright light. The blindness had improved in a fortnight, and had disappeared at the end of a month. Albumin was never found in the urine of this patient. A second confinement, which occurred eighteen months later, was followed by no unusual symptoms. 4. The last patient was a 3-para, aged 30 years. Seven hours after labour complete blindness was ushered in by pain in the forehead and temples. The urine was both scanty and albuminous. A few hours after the amaurosis the woman had a severe eclamptic fit, which was followed by two others. Morphia and chloroform were given, and when full consciousness was regained, objects could be clearly seen by the patient. It would seem that the case reported by George Reuling28 belongs to this class. A woman, aged 30 years and weighing over two hundred pounds, was seized about a week after parturition with violent pain in the eyes, followed two weeks later by a failure of vision culminating (after twelve days) in inability to see even the motion of the hand. In six days there was recovery of fair sight, followed by complete cure. The ophthalmoscopic appearances were almost negative. There was apparently no albumin in the urine. The condition was ascribed by the author to “ retro-bulbar neuritis.” Walliser29 reported the case of a primipara, aged 18 years, who was affected with post-partum amaurosis. Labour began at 7 a.m., the waters escaped at 10 a.m., and the baby was born at 11 a.m. At the moment when the occiput disengaged itself, the woman was seized with convulsions, and the pains, strong until then, ceased. The eclampsia came to an end shortly after the placenta had been removed towards mid-day. At this moment the patient requested that the lamp might be lighted, as she could not see her baby, and it was with difficulty that she could be persuaded that it was full noon. When examined by Walliser twenty hours after accouchment, the pupils were dilated and insensi- tive to light. The urine contained a little albumin. On the following day the pupils reacted slightly to the light of a candle, and the patient could tell light from dark. Next day fingers could be counted. Improvement continued, and a fortnight after labour, the patient was able to read a newspaper with ease. Under the name of “Amaurosis uraemica ” Paul Markuse30 reported a case of post-partum amaurosis, observed in a woman of 42 years, who had given birth to nine children without accident during her eighteen years of married life, and who had always enjoyed good health. But about five weeks before delivery her urine had become dark and scanty and her ankles swollen. Whilst in labour, headache made its appearance, and soon increased to an almost unbearable degree. Soon after the baby was born, vomiting came on, and this had lasted for scarcely a quarter of an hour when the patient suddenly went blind in both eyes. Markuse, who examined the patient some eighteen hours after labour, found the woman exhausted but conscious, free from convulsions, and continually calling out “ My head ! ”, “ My head ! ” The pulse was about 100 per minute, hard, and strikingly tense. The urine, of which not quite half a litre had been passed in the last twenty-four hours,