Observations on extraction and displacement of the cataract : with tables showing the relative success resulting from the performance of these operations / by J. Argyll Robertson.

  • Robertson, J. A. (John Argyll), 1799 or 1800-1855.
Date:
[1837]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on extraction and displacement of the cataract : with tables showing the relative success resulting from the performance of these operations / by J. 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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    The objection to the operation of Reclmation^ which is consi- dered by many to be of the greatest weight, is, that the lens re- i mains a constant source of irritation, and that by its pressure and friction on the retina it is apt to induce chronic internal in- Hamraation and amaurosis. As the lens is imbedded and fixed in the vitreous humour, ind as no motion exists between the vitreous humour and ^|rretina, it is clear that there can be no friction, and, besides, if ^grdicre were motion between these parts, the surface of the lens s so perfectly smooth, that no injury would result. Again, illowing that the lens is in contact with the retina, which in !.he majority of cases I believe is not the case, the whole tjoressure it can exert will be proportioned to the difference I :n the specific gravity of the lens, and of the vitreous humour, )ut this difference is very trifling. The lens, if left to itself, is :iot heavy enough to sink to the bottom of the vitreous humour, out, atthesame time, when once depressed, its difference in gra- rity is such as to prevent its being floated up to the surface ..gain, even if it did not contract adhesions, or if the passage in ^he vitreous humour through which it had been depressed did Hot become obliterated. (Specific gravity of aqueous humour, d.0003; do. of vitreous do. 1.0009; do. of lens do. 1.0790.) dut the best argument which can he adduced is the result of ^‘hhe operation. Scarpa in speaking of internal ophthalmia fol- owed by amaurosis, as taking place after the operation o?Recli- lation., says, “ This distressing accident has only happened to ||i.ae in a single instance during my long practice.” It cannot i herefore be considered as arising from the pressure of the de- ressed lens, otherwise it would be of more frequent occurrence, myself cannot say that I have witnessed any case of internal iphthalmia followed by amaurosis, which was distinctly traceable '3 the irritation arising from a reclined lens. There is a very interesting case related by Scarpa of Signor .^attuada, a young man 25 years of age, in whose right eye there no iris, and apparently no hyaloid membrane. The lens inclos- i d in its capsule is free from all attachment, and is perceived mov- ig in the cavities of the eye in various directions. When he in- ^ lines the head forward, it comes in contact with the cornea, when It backward, it falls to the back part of the eye, with the same faci- i ty as it would do in a watery fluid. If he remains long in the ho- zontal position, as during sleej), and consequently with the lens jsting on the bottom of the eye, he has never experienced the .ightest uneasiness, and he has never been aflected with pain or »Hammation of the eyes, ily means of a convex glass he can stinguish well minute objects. In the left eye, the derange- i 'I aft*' 1 ’i