Ophthalmic hospitals in Egypt / by A.F. MacCallan.

  • MacCallan, A. F. (Arthur Ferguson)
Date:
1910
Catalogue details

Licence: In copyright

Credit: Ophthalmic hospitals in Egypt / by A.F. MacCallan. 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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    ally supposed to be pathognomonic of Trachoma, this statement, however, is not strictly true. Trachoma IV is a condition in whiqh there is a smooth con- junctiva seamed by white lines of connective tissue. This is the stage of practically complete cicatrization of the conjunctiva or of cured Trachoma. I am aware that there are many cases which cannot be defi- nitely stated to belong to one or other category, for instance a case may be between Trachoma II and Trachoma III or between Tra- choma III and Trachoma IV. But it is my experience that for teaching purposes this division of Trachoma is a valuable means of differentiating between its various phases. By means of this classification of four stages, it is possible to differentiate between the severity of cases of Trachoma, and to gauge the progress during treatment of an individual or group of indi- viduals. Without any classification, it is impossible to obtain more than a general idea of such progress, an idea which is frequently erroneous.® Amongst well-known surgeons to whom I have exhibited pa- tients in the various stages, I may mention Dr. Casey Wood of Chicago, Dr. Landolt of Paris and Professor Greef of Berlin. The lines of treatment adopted in Egypt are as follows: Trachoma I. Application of silver nitrate solution, 2 per cent, or of perchloride of mercury solution, 1 or 2 per cent, with or with- out previous scarification. Trachoma Ila. Scraping the granular conjunctiva, with or without expression of the granulations with forceps; subsequent ap- plication of perchloride of mercury solution, 1 or 2 per cent. Kuhnt’s combined excision operation is done in a certain number of cases where cicatrization of the fornix has already occurred. Trachoma III is best treated by means of Kuhnf s combined excision operation, provided the fornix is cicatrized. Otherwise the treatment is the same as for Trachoma Ila. Trachoma III. The application of copper sulphate stick or of perchloride of mercury solution, 2 per cent, with or wiftout pre- vious scraping of the remaining granules of the cicatrizing con- junctiva.