A manual and atlas of medical ophthalmoscopy.

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1890
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Licence: Public Domain Mark

Credit: A manual and atlas of medical ophthalmoscopy. 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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    by ULricb,^ the changes were noted a few minutes after an attack of hiematemesis. The optic discs were pale, and the vessels on its surface presented a normal appearance. At its edge, however, the veins suddenly lost their dark red colour, and became bright red, like arteries. There were numerous htemorrhages and white spots along the course of the vessels. This condition of the veins gradually disappeared, and in two months the fundi and vision were normal. The same observer has more recently recorded three additional cases with similar ophthalmoscopic appearances.^ Forster has recorded a case, in which, twelve days after a hsemorrhage, there was a pecuhar white opacity of the Tetina, with small haemorrhages around the disc; vessels small, but not as in emboHsm. There was no affection of sight. The opacity slowly disappeared without neuritis. So in a case seen by Horstmann, three days after a haemate- mesis, disturbance of sight occurred with shght opacity of the optic nerves and adjacent retina. The changes gradually lessened, and sight became normal. On the other hand, ten days after loss of sight, which occurred seven days after an abortion, Herter^ found neuro-retinitis with haemor- rhages, quickly subsiding to atrophy; loss of sight per- manent in both eyes. Colsmann, however, four days after •onset, found only pallor of disc, small arteries, large veins, and no neuritis. Many theories have been framed to account for the phenomena, but the variety in the changes renders the appearances very difficult to explain. The theory which has obtained most acceptance is that of v. Grraefe, that there is a retro-ocular haemorrhage situated sometimes near, some- times far from the eye. The evidence in favour of this theory is that small retinal haemorrhages have been seen, that there are sometimes haemorrhages into other organs in cases of loss of blood, and that in one case there were simultaneous symptoms of a cerebral lesion. But this affords a veiy 1 2 2 “Klin. Monatsbl. f. Augenh.,” 1883, p. 183. “Graefe’sArch. f. Ophth.,” 1887, p. 1. See“Ophth. Rev., “Charite Annalen,” 1887, p. 52.5. vol. vii. p.l6.