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

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

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A t t e n t i o n should be paid t o the general health and some surgeons h a v e found salicylates helpful ; also full doses of v i t a m i n C (500 m g . t . d . s . ) . d. Dendritic ulcer is a positive indication for cauterization, which m a y be done w i t h carbolic, iodine, or e v e n the electric cautery if the other t w o fail. T h e importance of cauterization cannot be t o o strongly stressed, for the majority o f cases respond v e r y quickly, but i f not undertaken the ulcer m a y g o on branching and lead eventually t o an opaque cornea.

Nodules sometimes appear at the pupillary or ciliary margins. T h e y are usually multiple and about ^—1 m m . in diameter. Much l y m p h is present and synechiae occur in these gummatous cases. A r e a s o f atrophy appear in the iris. Care must be taken n o t t o confuse g u m m a t a w i t h nodules due t o tuberculosis or sarcoma. I t must be remembered t h a t sarcoma is nearly always a single tumour and t h a t signs o f iritis are absent in this ACUTE IRITIS 49 condition. Furthermore, sarcoma o f the iris is a v e r y rare disease.

I n the most severe cases the whole pupil m a y become bound d o w n t o the lens capsule. 4 4 It This is k n o w n as ring synechiae ' or seclusio pupillae is a serious condition, for i t prevents the intra-ocular fluid from circulating from the posterior chamber through the pupil t o the filtration angle. T h e iris in these cases is ballooned forwards b y the accumulation of fluid (iris b o m b é ) , and a serious secondary glaucoma results. I n this condition the peripheral margin of the iris is in contact w i t h the cornea, thus obliterating the filtration angle, and the inflamed iris m a y adhere t o the cornea at its periphery (peripheral anterior synechiae).

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