Case of primary lupus of the ocular conjunctiva / by A. Hill Griffith.

  • Griffiths, A. Hill.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Case of primary lupus of the ocular conjunctiva / by A. Hill Griffith. 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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    generally injected, cliemosis, no purulence, the fold of conjunctiva at inner canthus is very much swollen and hypertrophied, and dotted over it are numerous small yellowish-white specks. No induration in the fold or around it. There is a little secretion on the surface, but no ulcera- tion. The eye is otherwise normal. There is great swelling of cervical and pre-auricular glands on the same side. No skin eruption; fauces a little red, but no ulceration. The eye had been affected one week, the glands three weeks. The glands suppurated, and the eye got well. I saw him two years after; there was not a trace of anything to be seen. I never understood the above case, and Dr. Little, w^ho had charge of it, and Mr. Bilton Pollard, who saw it afterwards at the Royal Infirmary, were unable to throw any light on its probable nature. To return to the first-mentioned case, I did not see the child again till five months, when I showed him at the Medical Society. By this time the conjunctiva was almost entirely well, the glands were still somewhat enlarged and hard, several abscesses had formed and burst on the neck, leaving fistulous openings with dry indurated sides. On the skin, a little beyond the external commissure of the right eye, a superficial ulcer had formed, with sinuous spreading edge and grey nodules on its surface. As this ulceration of the integument was cer- tainly lupus, and my opinion was confirmed by several gentlemen pre- sent, it appeared to me quite reasonable to assign a similar origin to the affection of the conjunctiva. At a meeting of the Ophthalmological Society last year, Brailey showed a child with the ocular conjunctiva of one eye affected in a precisely similar manner to the above patient, and the glands were also enlarged. I was much struck with the exceedingly close resemblance in every detail to my own case, and on this ground ventured to express an opinion that it might also turn out to be lupus. I shall mention now, with Dr. Little's permission, a case of his which I saw at the Eye Hospital, as it appeared to me very like. my case, and I drew his attention to this. Sam. M., aged 35, married, glands of left side enlarged, acute che- mosis of bulbar conjunctiva of left eye, and covered with follicular swellings. Lids red and swollen. Patient had his inferior tear duct slit up about eight months ago, but the present affection of the con- junctiva and glands had only come on three days ago, and appeared to be quite unconnected with the lacrymal obstruction. Three days after I found the eye worse; the conjunctiva forms a dense waxy or doughy swelling, and when the lower lid is everted, a distinct swollen roll of '■ Bi'iiiley kindly writes me that, microscopically, it was distinctly tubercular, showing giant colls and areas of degeneration, but no bacilli were found. The growth gradually flattened, and at the upper and outer side, where it had softened and ulcerated, resulted in the formation of some band-like adhesions between lid and globe.