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

By J. L. C. Martin–Doyle (Auth.)

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T h e r e is a s u d d e n fall t o zero of t h e i n t r a - o c u l a r pressure a n d a c o n s e q u e n t r u s h of i n t r a ocular fluid t o escape. As t h i s r u s h occurs t h e iris a n d t h e lens are p u s h e d forwards in c o n t a c t w i t h t h e b a c k of t h e cornea. P a r t of t h e iris m a y even prolapse, a n d t h e lens m a y b e dislocated if t h e pressure w a s v e r y high. R E S U L T . — T h e i m m e d i a t e effect of perforation on t h e ulcer is good a n d t h e lessening of t h e i n t r a - o c u l a r pressure p e r m i t s a freer flow of l y m p h t h r o u g h t h e corneal tissues, w i t h c o n s e q u e n t i m p r o v e m e n t in its n u t r i t i o n a n d powers of resistance.

I t often h a s a ' t a r g e t ' a p p e a r a n c e w i t h a v e r y dense ' bull's-eye '. Somet i m e s it is associated w i t h a small h y p o p y o n . I t r u n s a chronic course w i t h o u t v e r y m u c h i r r i t a t i o n , b u t i t a l w a y s leaves a p e r m a n e n t o p a c i t y w i t h c o r r e s p o n d i n g visual i m p a i r m e n t . I t is n o t a m e n a b l e t o t r e a t m e n t . P A T H O L O G Y . — U n c e r t a i n , b u t t h e r e a r e t w o theories :— a.

A t r o p i n . 1 p e r c e n t t h r e e t i m e s a d a y should be instilled. iv. After anaesthetizing t h e eye w i t h Novesine t h e ulcer should be carbolized a n d a single a p p l i c a t i o n of a few crystals of p u r e penicillin should be m a d e t o t h e ulcer. T h i s a l w a y s causes a n i m m e d i a t e high penicillin conc e n t r a t i o n in t h e a n t e r i o r c h a m b e r , a n d often p r o d u c e s a d r a m a t i c i m p r o v e m e n t . A l t e r n a t i v e l y , a subconj u n c t i v a l injection of soframycin m a y b e given.

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