Cases illustrating the use of the ophthalmoscope / by Robert Taylor and Edward Charles Hulme.

  • Taylor, Robert, 1815?-1883.
Date:
1860
Catalogue details

Licence: Public Domain Mark

Credit: Cases illustrating the use of the ophthalmoscope / by Robert Taylor and Edward Charles Hulme. 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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    From Dr. Beale’s Archives of Medicine, No. V, 1860. CASES ILLUSTRATING THE USE OP THE OPHTHALMOSCOPE.^-; %GL ! Nf /' By Robert Taylor, P.R.C.S. Surgeon to the Central London Ophthalmic Hospital, and to the Cripples’ Home, AND Edward Charles Hxjlhe, P.R.C.S. ^-Surgeon to the Central London Ophthalmic Hospital, and Surgeon to the Blenheh^. . Free Dispensary. W' Case 5.—Martha Hollis, aged 20, a girl, of a brown, sallow complexion, vacant expression, and dull intellect, applied October 20, 1858. With the excep- tion of frequent fits, to which she had been subject for some years, her general health was tolerably good. Catamenia regular, urine healthy and normal; she occasionally passes lumbrici. She complains that the sight of the right eye began to fail her about two years ago, and has been gradually getting worse up to the present time. She is now perfectly blind of the right eye, and cannot dis- tinguish light from darkness; the sight of the left one is also impaired, but she can read large type with it (great primer). On examination, the conjunctiva and sclerotic appear healthy. Palpation normal. Some lachrymation with a trifling mucous discharge. Both pupils fully dilated. There is external strabismus of the right eye. No pain or other subjective symptoms accompanied the gradual loss of sight. OphtHxVlmoscopic Examination.—Plate 1, Pig. 1.—Right Eye.—Cornea, lens, and humours clear. The optic disc is of a pure, glistening white, circular, of normal size, and well-defined edge. No shadow of bulging or cupping is reflected from its uniform flat white surface. Four small retinal vessels enter and leave its centre, taking their ordinary course. The choroid around the optic disc reflects a bluish grey shade, which gradu- ally fades into a somewhat pale red, the vessels being dimly seen; two or three spots of pigment are deposited below the optic disc. Over the situation of the macula lutea, fig. 2, is a patch of effused blood, apparently proceeding from a rupture of the choroidal vessels; around this are three other distinct, well- defined, blue deposits, with yellowish centres, elevated, and capped with spots of black pigment. N.B.—The blue deposits are rather too well defined at their edges by the chromo-lithographer. Ophthalmoscopic examination of the left eye, shows the same appearance of the optic disc, hut over the macula lutea is an increased state of vascularity of the choroidal, but not of the retinal vessels. The treatment consisted of a combined tonic and purgative plan. Iron, with an occasional mercurial purge. [mo]