Cases in ophthalmic practice : with notes and observations / by Edward Nettleship.

  • Nettleship, Edward, 1845-1913.
Date:
[1890?]
Catalogue details

Licence: Public Domain Mark

Credit: Cases in ophthalmic practice : with notes and observations / by Edward Nettleship. 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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    GASESIN OPHTHALMIC PRACTICE, WITH NOTES AND OBSERVATIONS. Bt -edwaed nettleship OPniHAlMIC SURGEOIf TO THE HOSPITAL. I.—Cases of Syphilitic Choroido-Retinitis. The cases of choroido-retinitis given below are recorded in illustration of the following among other important points in the natural history and prognosis of this grave but rather rare mani- festation of secondary syphilis:— 1. Syphilitic retinitis is so often associated with demonstrable choroiditis, that, in those cases where no choroiditis can be proved, it is highly probable that this condition is present, either in a degree too slight to cause positive changes, or in parts of the fundus which cannot be reached in ophthalmoscopic exa- mination. 2. The choroiditis here referred to generally affects only the inner (capillary) layer of the choroid, and the pigment epithelium. The ophthalmoscopic changes produced by it are comparatively slight, and sometimes escape notice unless carefully looked for. It may occur at any part of the fundus. Sometimes it appears to be localized in a zone around the oj)tic disc, whilst occurring separately in other parts; in other cases the disc is situated in a large unbroken area of choroidal disease. 3. These facts, together with the close dependence of the outer layers of the retina on the blood-supply of the chorio-capillaris, make it probable that the retinitis of syphilis is in a very large number of cases, if not always, secondary to superficial choroi- ditis. The occurrence of neuritis with the retinitis is readily accounted for in the same way, for the disc is to a large extent