A Synopsis of Ophthalmology by J. L. C. Martin-Doyle (Auth.)

By J. L. C. Martin-Doyle (Auth.)

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4. D E S C E M E T ' S M E M B R A N E . — T h i s also is structureless. 5. E N D O T H E L I U M . — T h i s is a single layer of cells which is prolonged backwards t o c o v e r the pectinate ligament and on t o the iris. I t is o w i n g t o this continuity t h a t pathological processes in the deeper layers of the cornea tend t o spread and lead t o such complications as iritis, iridocyclitis, and e v e n choroiditis. Since the healthy cornea is completely avascular, its nutrition is carried out b y diffusion from the vascular arcades at the limbus.

I n t e r s t i t i a l keratitis shows a marked tendency t o i m p r o v e m e n t , and this must always be borne in m i n d when treating w h a t m i g h t well appear t o the uninitiated t o be a hopeless case. I t is not uncommon in t h e acute stage for the vision t o be d o w n t o hand m o v e m e n t s only, but when complete r e c o v e r y occurs i t m a y be 6/18 or e v e n 6/12. N o t e v e r y case runs this favourable course. I n some, a marked permanent o p a c i t y remains w i t h great impairment o f vision.

T h e s e usually occur at the junction o f the cornea and sclera and b o t h these structures m a y be i n v o l v e d . A dermoid is an o v o i d , flesh- or yellow-coloured tumour with a c o n v e x surface. R e m o v a l should be undertaken, for, although innocent, it is v e r y unsightly. 2. P i g m e n t e d N a e v u s . — T h i s is usually situated near the limbus and is light t o dark b r o w n in colour. I t is freely m o v a b l e w i t h the conjunctiva. R e m o v a l is advised, for there is always the risk o f a p i g m e n t e d tumour developing malignant changes.

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