Handbook of Ophthalmology

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HANDBOOK

OF

OPHTHALMOLOGY.


BY

PROF. C. SCHWEIGGER,
OF THE UNIVERSITY OF BERLIN.


TRANSLATED FROM THE THIRD GERMAN EDITION

BY

PORTER FARLEY, M.D.,
ROCHESTER, NEW YORK.



WITH DIAGRAMS AND OTHER ILLUSTRATIONS.



PHILADELPHIA:
J. B. LIPPINCOTT & CO.
1878.


Copyright, 1878, by J. B. Lippincott & Co.


TRANSLATOR'S PREFACE.


In presenting his work to the profession, the translator wishes to acknowledge the assistance received during its preparation from his friend Dr. Charles E. Rider, of Rochester, N.Y.

During the work of translation his advice on all doubtful points was freely sought and as freely given. While the book has been passing through the press, he has, at the expense of great labor and care, assisted in the reading and revision of the entire proof.

Rochester, N.Y., Feb. 15, 1878.

CONTENTS.

 

 

PART FIRST.

Anomalies of Refraction and Accommodation. Condition of refraction. Emmetropia. Far point. Near point. Limits of range of accommodation. Relative range of accommodation. Mechanism of accommodation. Optical determination of range of accommodation. Senile changes in eye. Presbyopia. Correction by convex lenses. Acuteness of vision
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
11—30
Myopia. Its degree,—anatomical and ophthalmoscopical changes, causes, and course. Functional anomalies and complications. Position of absolute and relative range of accommodation. Insufficiency of internal recti. Relative divergence. Amblyopia complicating extreme myopia. Myodesopia. Cloudiness of vitreous. Posterior polar cataract. Choroiditis near equator and macula lutea. Enlargement of Mariotte's spot. Scleral staphyloma near posterior pole. Metamorphopsia. Detachment of retina. Use of eyes in myopia. Correction by concave lenses. Symptoms of irritation
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
31—51
Hypermetropia, absolute, relative, facultative. Range of accommodation and its relative extent. Latent tension of accommodation. Accommodative asthenopia. Causes and diagnosis. Correction by convex lenses
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
52—62
Astigmatism, irregular and regular. Physiological meridional asymmetry. Principal meridian. Focal lines. Focal range. Abnormal meridional asymmetry. Impairment of vision. Accommodative asthenopia in hypermetropic astigmatism. Diagnosis. Degree of astigmatism. Lens participates in the asymmetry. Directions of principal meridians. Correction by cylindrical and sphero-cylindrical lenses. Stokes' lenses
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
63—73
Difference of Refraction. Anisometropia
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
74—76
Paralysis of Accommodation. Differs from presbyopia. Micropia. Paresis of accommodation a symptom of oculo-motorius paralysis. Paralysis of pupillary branches alone. Connection with facial paralysis. Paresis of accommodation after diphtheritis faucium. Traumatic mydriasis and paresis of accommodation
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
76—82
Spasm of Accommodation. Apparent myopia. Calabar myosis. Asthenopia from spasm of ciliary muscle. Nervous sthenopia. Myosis
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
83—86
Monocular Polyopia and Diplopia
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
86
Spectacles. Spherical lenses. Concave, convex, and cylindrical lenses. Prismatic spectacles. Stenopaic apparatus. Protective spectacles
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
87—94
Ophthalmoscope. Upright image in emmetropia, in myopia, in hypermetropia. Inverted image. Size of ophthalmoscopic image. Binocular ophthalmoscope. Hering's experiment. Examination by daylight
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
95—115
Ophthalmoscopic Diagnosis of Anomalies of Refraction, of astigmatism
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
116—119
Ophthalmometer. Corneal curvature in emmetropia, myopia, and hypermetropia. Angle α. Apparent strabismus divergens and convergens
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
119—125
Diseases of the Ocular Muscles. Movements of the eyes, and laws of diplopia. Centre of revolution. Extent of ocular movements. Laws of innervation. Overcoming prisms. Physiological diplopia. Double images united by prisms
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
126—134
Paralysis of Abducens. Diminished motion. Imperfect associated movement. Secondary deviation of healthy eye. Paralytic squint. Behavior of double images. Limit between region of single vision and diplopia. Masked diplopia. Treatment. Use of prismatic spectacles. Exercise of paralyzed muscle. Result in strabismus convergens
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
134—141
Paralysis of Oculo-Motorius, complete and partial. Dizziness from false projection of visual field. Etiology. Treatment. Indications for tenotomy of rectus superior and inferior
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
141—145
Paralysis of Trochlearis. Action of rectus inferior. Behavior of double images. Differential diagnosis from paralysis of rectus inferior
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
145—147
Spasm of Ocular Muscles
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
148
Strabismus. Distinction between paralytic and typical or concomitant squint
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
149
Strabismus Convergens. Its connection with hypermetropia, amblyopia, and loss of accommodation. Elasticity of muscles. Reflex impulses. Stationary monolateral squint. Invariability of squinting angle upon change of fixation, and exceptions to the rule. Alternating strabismus convergens. Periodic squint. Linear measure of squint. Simultaneous upward or downward squint. Binocular vision with strabismus. Suppression of retinal images in squinting eye. Proof that squinting eye participates in vision. Provocation of double images. Use of stereoscope. Vision in squinting eye. Amblyopia congenita. Separate exercise. Spontaneous disappearance of squint. Therapeutic use of convex lenses
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
149—165
Strabismus Divergens. Preponderance of externi. Unilateral blindness. Unilateral myopia. Relative divergence in myopia
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
165—168
Muscular Asthenopia and Dynamic Squint. Insufficiency of recti interni. Condition of refraction in reference to diagnosis. Use of prismatic spectacles. Indications for tenotomy of recti externi
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
168—173
Squinting Upward and Downward
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
173, 174
Operation for Strabismus. Simple tenotomy. Mechanical effect of operation. Operation divided between both eyes. Influence upon acuteness of vision and binocular vision. Correction of the hypermetropia by lenses. Dissimilarity of squinting angle after unilateral operation. Twitching fixation movement. Bringing forward ocular muscle
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
174—187
Nystagmus
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
187, 188

PART SECOND.

Diseases of the Orbit. Inflammation of fat and connective tissue. Abscess. Purulent periostitis. Danger of blindness from ulceration of cornea, from neuritis, from detachment of retina, or from purulent choroiditis. Course and treatment. Caries and necrosis of orbital walls. Exophthalmus from morbus Basedowii, from obstruction of circulation. Pulsating exophthalmus. Tumors of orbit. Hemorrhage. Fractures of orbital walls. Emphysema of orbit. Foreign bodies. Exophthalmometer
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
191—202
Diseases of Lachrymal Organs. Inflammation of lachrymal gland (dacryoadenitis). Fistula of gland. Dacryops. Tumors and extirpation of gland. Congenital anomalies of puneta lacrymalia. Foreign bodies and cryptogams in canaliculi. Ectropion and occlusion of canaliculi. Dacryocystitis. Strictures of canaliculi. Bowman's probes. Cutting stricture. Cauterization of lachrymal sac. Lachrymal fistula. Polypi of canaliculi
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
203—217
Diseases of Eyelids. Blepharitis. Phtheiriasis of cilia and eyebrows. Hordeolum. Abnormities of tarsal glands. Chalazion. Herpes zoster frontalis. Eczema, erysipelas, and abscess of lids. Syphilitic ulceration of lids and conjunctiva. Lupus. Epithelioma. Telangiectasia. Cystic tumors of lids. Ephidrosis. Seborrhœa. Chromhidrosis. Xanthelasma. Blepharospasm. Ptosis. Paralysis of orbicular muscle. Lagophthalmus. Ectropion. Entropion. Blepharophimosis. Distichiasis congenita. Epicanthus. Coloboma of upper lid. Symblepharon. Blepharoplastic operations
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
218—251
Diseases of Conjunctiva. Hyperæmia. Conjunctivitis, simple or catarrhal. Chronic conjunctivitis. Atropine conjunctivitis. Blennorrhœa of conjunctiva. Blennorrhœal corneal affections. Rules for cauterization. Chronic blennorrhœal processes. Diphtheritic conjunctivitis. Swelling of conjunctival follicles. Trachoma. Ophthalmia militaris, granulosa, etc. Hemorrhage beneath the conjunctiva. Serous swelling. Lupus. Pemphigus. Foreign bodies. Burns. Pterygium. Pinguecula. Phlyctenular conjunctivitis
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
252—290
Diseases of the Cornea. Examination by focal illumination. Keratitis phlyctænulosa, parenchymatosa, punctata. Hypopion. Keratitis. Corneal abscess. Ulcus corneæ serpens. Neuro-paralytic keratitis. Corneal ulceration with interstitial encephalitis. Corneal ulcers. Corneal opacities. Irregular astigmatism. Staphyloma. Corneal fistula. Cysts on cornea. Keratoconus. Wounds of cornea. Tumors of cornea. Arcus senilis
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
291—325
Diseases of the Sclera. Scleritis and episcleritis, simple and complicated. Scleral staphyloma
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
326—331
Diseases of the Iris. Iritis idiopathica. Relapsing iritis. Total adhesion of pupillary margin. Irido-choroiditis. Corelysis. Iritis syphilitica, gummosa. Hydro-meningitis. Secondary iritis. Irido-cyclitis. Sympathetic disease. Enucleatio bulbi. Membrana pupillaris perseverans. Irideremia. Disappearance of iris by sinking. Coloboma iridis. Tumors of iris
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
332—355
Diseases of the Lens. Senile changes. Soft cortical cataract. Cataracta senilis, congenita, diabetica. Complicated cataract. Examination of vision. Partial opacity of lens. Cataracta incipiens, punctata, striata. Lamellar cataract. Cataracta centralis anterior, pyramidalis, centralis, posterior. Calcification of lens. Cataract operation. Linear extraction. Iridectomy in flap operation. Peripheral linear incision. Discision. Cataracta traumatica. Capsular and secondary cataract. Luxation of lens. Aphakia
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
356—392
Diseases of the Vitreous Body. Liquefaction and detachment. Myodesopia. Opacities. Hyalitis. Cholesterin in vitreous. Recurring hemorrhages into vitreous. Development of vessels in vitreous. Arteria hyaloidea persistens. Cysticercus
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
393—400

PART THIRD.

Normal Fundus of Eye. Optic disc. Lamina cribrosa. Differences in level about disc. Physiological excavation. Ophthalmoscopic diagnosis of differences of level. Central vessels of retina. Adventitial layer visible. Venous pulsation. Arterial pulsation. Retina visible. Its physiological opacity and reflex. Macula lutea. Fovea centralis. Choroid, differences in its pigmentation. Albinismus. Intervascular spaces of choroid
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
403—417
Diseases of Choroid. Hyperæmia. Cyclitis, idiopathic and as sequel of recurring fever. Purulent choroiditis. Puerperal choroiditis. Embolism. Irido-choroiditis in cerebro-spinal meningitis. Acute irido-choroiditis. Calcification and ossification. Acute choroiditis, disseminated, syphilitic. Detachment. Rupture. Miliary tubercle. Choroidal sarcoma. Coloboma of choroid
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
418—438
Diseases of Retina and Optic Nerve. Medullary nerve-sheaths. Hyperæmia of retina. Detachment of retina. Pigmentation of retina. Hemorrhage in retina. Retinitis. Ophthalmoscopic indications. Disturbances of vision. Different forms of retinitis. Anatomical changes. Neuro-retinitis. Choked disc. Connection with intracranial diseases. Retrobulbar neuritis. Ischæmia retinæ. Anatomical changes in neuritis and neuro-retinitis. Embolism of central artery of retina. Atrophic degeneration of optic nerve. Glioma of retina
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
439—500
Glaucoma. Glaucoma simplex. Pressure excavation. Differential diagnosis of optic-nerve excavations. Determining increased tension by touch. Tonometer. Atrophy of nerve fibres in consequence of excavation. Contraction of visual field and diminution of vision. Inflammatory glaucoma. Symptoms of intraocular pressure. Clouding of refracting media. Arterial pulsation. Seeing colors of spectrum. Prodromal stage. Glaucoma ehronicum, acutum, and fulminans. Glaucomatous degeneration and atrophy of eyeball with detachment of retina. Etiology. Secondary glaucoma. Iridectomy in glaucoma. Cystoid cicatrization. Cure by iridectomy
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
501—523
Essential Phthisis Bulbi
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
524—525
Amblyopia and Amaurosis. Examination of visual field. Amblyopia congenita. Color-blindness. Hemeralopia. Anæsthesia and hyperæsthesia of retina. Amblyopia with no cause to be seen ophthalmoscopically. Amblyopia potatoria and saturnina. Scotoma centrale. Progressive atrophy of optic nerve. Hemiopic defect in visual field. Amaurosis from intracranial and cerebral causes. Uræmic amaurosis. Amaurosis following hæmatemesis. Amaurosis simulata
.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .
526—546