A handbook of ophthalmic science and practice / by Henry E. Juler.

  • Juler, Henry E. (Henry Edward), 1866-1921.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of ophthalmic science and practice / by Henry E. Juler. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    72/514 (page 48)
    tract of the mother into the conjunctival sac of the infant shortly after parturition. The great frequency of purulent discharges from the os uteri in pregnant women is universally admitted ; and it is easy to understand how this could come into contact with the eyelids during the passage of the head per vaginam, shortly after which the child opens its eyes. Hence the necessity of scrupulous care in washing the eyes of the newly born. Symptoms.—Purulent conjunctivitis usually commences in one to four days after infection ; in some cases its progress is so rapid that it attains its maximum intensity in forty-eight hours. At first there is a gritty sensation in the eye ; this is soon followed by pain, which sometimes becomes excruciating in character. The eyelids become red, infiltrated, and swollen to such a degree that they can only with difficulty be everted; the palpebral conjunctiva is greatly congested and swollen ; the ocular conjunctiva is also infiltrated, and forms an elevated ridge of chemosis all round the cornea, which in some cases is sufficiently prominent to overlap and conceal its peripheral portion. The discharge at first consists only of a serous fluid containing a few flocculi of pus, but it soon becomes thicker, and of a yellow or even greenish-yellow colour. This purulent secretion fills the palpebral sac, and generally flows over on to the cheek ; at times it is retained by the swollen lids, and causes great danger to the globe by the pressure thus exerted. The establishment of free suppuration is marked by immediate relief of pain and some diminution of swelling; this may lead the patient to consider his condition to be improving, but in reality the risk of serious and irreparable mischief commencing in the cornea is greater now than at any other period of the disease. The great danger of purulent conjunctivitis is lest the cornea should slough or become ulcerated. Ulcers vary in their position and depth; a very common situation is beneath the limbus conjunctivae; in whatever part of the cornea they occur, they are very likely indeed to lead to its perforation. When we come to treat of affections of the cornea we shall see that a perforating ulcer from any cause may be followed by dangerous sequelae ; but when the perforation takes place in the course of an attack of purulent conjunctivitis, we have the