Granular ophthalmia / by Assistant-Surgeon Welch.

  • Welch, Francis Henry, 1839-1910.
Date:
[1870?]
Catalogue details

Licence: Public Domain Mark

Credit: Granular ophthalmia / by Assistant-Surgeon Welch. 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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    GRANULAR OPHTHALMIA.* By Assistant-Surgeon Welch, 22nd Regiment. The important position which this disease maintains in the Medical Statistics of the British Army, both in reference to temporary inefficiency and permanent loss ; its existence among the poorer communities of these islandst, and common to all countries where squalor and impure air—the concomitants of poverty abound ; the gravity and chronicity of the local lesion compared in extent to other structural diseases, consequent on contiguity with the visual organs, with the frequent defects or total loss of sight as sequelae by which youth is marred or able-bodied adults rendered helpless and a burden on the community at large, with all the attendant wretchedness and misery ; demand the assistance of all for the elucidation of its phenomena and deductions for its eradication. The following observations on the disease, dispersed over a number of years, are mainly derived from the 1st Battalion 22nd Regiment, supplemented by data from the military and civil elements indiscriminately. It is in the former that the opportunities of watching the early phase of the malady and its development are most frequent, while among the applicants at civil ophthalmic hospitals, the profound organic changes from long continued morbid action predominate ; the constant supervision, the great controlling influence, the variations in climate, the massing of large numbers under known conditions, existent in the military element, allow of accuracy of data and general deductions not obtainable in civil life ; while the identification of the disease—the elementary structures and phases discernible alike in one or other community under similar conditions being acknowledged—renders the observa- tions gleaned from one segment generally applicable, unmodified but by the forced circumstances pertaining to military life as contrasted with the civil section. Ophthalmia in the Army generally.—The most cursory examination of the records emanating from time to time from the Army Medical Department will demonstrate that this disease did, and still does, play a most promient rule in the production of sickness and invaliding in the British Army—a rule which demands a much greater shave of attention than has hitherto been accorded to it. “ During a period of 27 years, ending 31st March. 1854, 2,648, or 5*8 per “cent, of 45,411 invalids were discharged from the service for impairment of “ vision. During the last six years of this period the percentage had risen to “ 7*5.” “ Of 16,654 soldiers found unfit during the six years ending “ December 1860, 1,393, or 8*4 per cent., had been rendered ineffective by “ diesases of the eye ; and during the year 1860, 9 per cent., or nearly 1 in every 11 invalids, were discharged on account of defective ey e-sight. In this category is included all diseases of the eye followed by defective * I limit the term “ granular ophthalmia ” to that variety of conjunctival inflammation preceded by chronic follicular hypertrophy; the latter phrase syno- nymous with “ sago grain bodies,” “ vesicles,” “ grey granulations,” and expressive of an abnormal state of certain physiological elements of the conjunctiva normally invisible to the naked eye—the closed solitary follicles. + The numerous instances of blindness among the occupants of asylums, the beggars, and lower class in the south of Ireland, from disorganization of the eye- ball, and the partial defects of sight from corneal opacities so common among servant girls, the sequelae of this ophthalmia, substantiate its existence equally with the applicants at he various ophthalmic hospitals studding the larger towns of the British Islands. X Frank, “ Ophthalmia Chronica,” Army Medical Report, I860, p. 400.