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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    membranes. The choroid presented, in each case, brownish flecks of exudation without disturbance of pigment or atrophy. The microscopical examination (by Nettleship) showed the chorio-capillaris beneath these flecks to be infil- trated with pus-like cells, and in several instances there was* a layer of flattened cells on the sm’face next to the retina. In the other case Barlow traced the progress of similar flecks to a stage of atrophy, such as is seen in disseminated choroiditis—the condition occasionally met with later on in life. Several cases of this character have been recorded by Hutchinson.^ A peculiar form of atrophy of the disc has several times come under my notice in children the subjects of tliis disease. The disc has a uniform reddish tint, the edges are not well defined, and the vessels are small. There has not commonly been any atrophy of the choroid or pigmentary accumulation. It is probably secondary to retinitis or widespread capillary choroiditis. Several times since first observing the connection between the two conditions, this form of atrophy has drawn my attention to the existence of inherited syphilis, which had otherwise escaped notice. Sight is usually impau’ed, some- times considerably. Retinitis sometimes occurs in the inherited just as in the acquired disease. Retinitis pigmentosa is, by some, believed to be connected with inherited syphilis, and an instance of the association of the two diseases has been described by Swanzy. Deposits of pigment in the retina occasionally accompany the atrophic changes in disseminated choroiditis, but the connection of true retinitis pigmentosa with syphilis is generally considered to be very doubtful. ^ One is figured in the “ Oplith. Hosp. Rep.,” vii. PI. 4, Fig. 3. Mr. Hutchinson has suggested that the condition of choroidal atrophy and choroidal and retinal pigmentation may occur without an exudative stage.