Text-book of ophthalmology (1919) (14778280531)

Identifier: textbookofophtha1919fuch (find matches)

Title: Text-book of ophthalmology

Year: 1919 (1910s)

Authors: Fuchs, Hofrat Ernst, 1851- Duane, A. (Alexander), b. 1858, tr

Subjects: Ophthalmology Eye Ophthalmology Eye Diseases

Publisher: Philadelphia & London : Lippincott

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

Text Appearing Before Image:

more extensiveperforation of the cornea occurs thanwe should expect from the intensityof the inflammation. The changes which simultaneouslytake place at the posterior surface of thecornea contribute to the production ofperforation. Here an accumulation ofpus corpuscles takes place early, andthese migrate toward the inflammatorydeposit, making their way mainly alongthe posterior surface of Descemetsmembrane. They are derived fromthe vessels of the uvea, and chieflyfrom the vessels surrounding the sinusof the anterior chamber; and as proofof the origin, many of them containsmall granules of pigment derived fromthe uvea. The pus corpuscles congre-gate to form a mass of pus upon theposterior wall of the cornea; they thenpenetrate into Descemets membraneand ultimately into the cornea itself.In this latter, therefore, there is formeda sort of posterior abscess (Fig. 98 C, e)at a point corresponding to the site ofthe ulcus serpens. Directly in front ofthis abscess lie those corneal lamellae

Text Appearing After Image:

Fig. 98.—Ulcus Serpens. A, front view; B, vertical cross section. Magnified 2.5 X 1.— C, longitudinal cross section. Magnified 20X1-In this, as in most of the cases of ulcus serpensthat have been examined anatomically, the eyewas affected with absolute glaucoma. Theulcer occupied about the center of the cornea;its upper, advancing border, a, was clearly rec-ognizable as a yellow crescent, while the lowerborder, b, being but slightly opaque, did notspecially stand out against the subjacent massesof pus which lay in the anterior chamber andextended as low down as c. Farther below,between the cornea and the iris, is seen thehypopyon, the upper border of which is convex(A,d). Owing to the glaucoma, the iris has,rather peculiarly, become adherent by itsperiphery to the cornea, e, posterior abscessin the cornea. which, as already mentioned, are destitute of corneal corpuscles and are undergoingdissolution; and their necrosis in conjunction with the abscess gives rise to the per-foration

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1919

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