Pseudoglioma / by John B. Story.

  • Story, John B.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Pseudoglioma / by John B. Story. Source: Wellcome Collection.

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

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    the diagnosis to be made with approximative certainty. In spite of all that has been written since, we are still mainly dependent upon the principles laid down by the late von Grsefe to differentiate retinal glioma from inflammatory choroidal exudations. Whether the latter be due to cerebro-spinal meningitis or other less well- established causes of such inflammations, the anterior chamber is usually shallow, the iris discoloured and disorganised, the pupil of variable size (not widely dilated as is common in glioma), and adherent to the anterior lens capsule; and the reflection from the fundus is of a more dull whitish yellow than in glioma. The tension, too, is mostly subnormal, and data are usually present in the history of the case and its clinical features pointing to the existence of some inflammatory affection. My patient was a boy aged eight months, who was brought to me in March, 1883. [Mrs. C.'s baby, p. 236. Case Book C] He had been vaccinated at the age of two months without unusual sequelas, and had had neither measles, whooping-cough, nor any of the usual or unusual diseases of children, having been, in fact, in perfect health until shortly before he came under my observation. The first thing noticed to be wrong with him was that he kept his eyes constantly closed, after which he became peevish and fretful, and lost appetite. A slight discharge, too, was observed to come from the eyes; and Dr. Gibson, of Clontarf, who was called in to attend the child, finding that this discharge did not yield to treatment, sent the patient on to me. I should mention that he had also some cutaneous spots on his arm, hip, and knee, which his mother said did not resemble boils, but were more like small- pox. They were black, and after the black scab came away a small hole was left, which soon healed. I found three depressed bluish cicatrices at the places mentioned. On first seeing the case I considered it to be one of simple catarrhal ophthalmia of very considerable severity, but somewhat abnormal in character, the subjective symptoms being out of proportion to the physical signs. The lids, though tightly closed, were but very slightly reddened or swollen, and the discharge from the mucous membrane was not abundant, and was purely