On albuminuric retinitis / by D. Argyll Robertson.

  • Robertson, Douglas Moray Cooper Lamb Argyll, 1837-1909.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: On albuminuric retinitis / by D. Argyll Robertson. 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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    recently become stonter. The family history was exceptionally good. Inquiry regarding the origin and progress of her eye- symptoms disclosed that she had always been short-sighted, but had otherwise good vision, till about three weeks ago, when she noticed that her sight was dim and misty, and that on attempting to read a journal a black cloud appeared between her and the print. Both eyes were equally affected. For a long time previous to this occur- rence her eyes got readily fatigued Avhile reading. Her sight has since then become gradually more impaired. Her father was very short-sighted, but her mother’s sight is good. The patient was a moderately stout, dark-complexioned, healthy- looking girl; to all outward appearance free from disease. On examining the eyes, the media were found clear and the pupils active, but the sight much impaired. With each eye she was only able to read No. CC. of Snellen’s types at 15 feet distance (V = 2V0). Neither convex nor eoneave glasses materially improved her sight. On ophthalmoscopic examination, both eyes Avere found to be affected with retinitis, Avhich presented all the characters of the albuminuric variety. The disease appeared to be a little further advaneed in the right than in tlie left eye. In both tlie morbid process Avas almost entirely limited to the neighbourhood of the optic disc and macula lutea and the inteiwening retina. The optic papilla Avas of a grayish colour, and could scarcely be distinguished from the infiltrated retina AAdiich immediately surrounded it. At the macula lutea, and for some distance around it, the retina Avas of a gray colour from diffuse exudation into its substance; Avhile, eor- responding to the punetum centrale, there Avas a small round pearly Avhite spot, and arranged in lines radiating outAvards from it like tlie spokes of a wheel there Avere numerous other small wliite glis- tening spots. This AA^as most marked in tlie right eye. Some similar but larger white patehes Avere found betAA’een the macula lutea and optic disc. At several points, small extravasations of blood were observed. The retinal vessels were here and there obseured, but at other points lay superficial to the exudation. The results obtained by the ophthalmoscope at once direeted attention to the kidneys. The urine was found to be pale, of low speeific gravity (1012), and very highly albuminous. It deposited no tube- casts or other sediment. She Avas ordered bromide of potassium (gr. xii. thrice daily), and to continue a mixture containing iron and arsenic which had been previously preseribed by Dr Matthews Duncan. I again examined the patient carefully on the 23d March. The sight in the right eye had become still more dim, so that she could only count fingers with it at the distance of four feet. The sight in the left eye AA^as the same as at first examination. There was now slight eonvergent strabismus of the right eye. Fatty degeneration of the retina is in both eyes much more marked, and in the right AAdiite patches are noAv visible in some peripheral portions of the