Gouty retinitis, chorio-retinitis, and neuro-retinitis / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1893]
Catalogue details

Licence: Public Domain Mark

Credit: Gouty retinitis, chorio-retinitis, and neuro-retinitis / by Charles Stedman Bull. 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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    ible with liability to rupture of the capillaries. A condition of loss of balance is easily induced, as the vessels are not well un- der vasomotor control. The risks of rupture of the capillaries will be increased if there be hypertrophy of the heart or weak- ness of the walls of the blood vessels. (Transactions of the Ophthalmological Society of tJie United Kingdom, Vol. I, p. 26.) Gowers speaks more positively in regard to retinal lesions in gout. He believes that spontaneous inflammation of nerve trunks and plexuses on one side only, and recurring after the age of thirty or forty, is seldom due to any other cause than gout. This always means primary perineuritis. Still, inflam- mation of the sheath of the optic nerve behind the eye is less common in ordinary gout than inflammation of the retina. Gowers thinks the characteristics of these cases are the greater degree of disturbance of the vision than corresponds to the visible changes in the optic disc, the tendency to irregular de- fects in the field of vision, and the strong tendency to lesion of the other optic nerve by an independent, symmetrical morbid process. (Medical Ophthalmoscopy, 3d edition, 1890.) Galezowski says that in this disease the changes may begin in the retina and extend to the choroid and give rise to a retino- choroiditis, characterized by an alteration in their vessels and deposits in and outside their walls. When the retina alone is involved there exist only vascular alterations. Atheroma (?) is frequent in the retinal vessels of gouty people, and usually at- tacks persons of advanced years—from seventy to seventy-five. The papilla is ordinarily not involved, but all around the macula and along the vessels are brilliant patches of exudation, gen- erally along the arteries. The rest of the retina may remain intact. The lesion is generally unilateral. The subjective symptoms are the same as those of ordinary retinitis. Gouty retino-choroiditis occupies the central zone of the fundus, is circumscribed posteriorly, the exudation is usually extensive, with hemorrhages and sometimes pigmentary deposits. The disease develops slowly, usually involves both eyes, and never ends in total blindness, as the periphery of the retina is rarely affected. (Annali de Ottalmologia, XIX, p. 199.) We know that the retinal hemorrhages met with in gouty