REFLECTIONS ON OPHTHALMIC WORK IN THE ARMY
Authors: J. Grimshaw
Journal: BMJ (1902)

1MTEm liRrALs; 133 central vein, disc lhyperwamie, veins tortuous, stream in them broken up.Scattered haemorrhages of dark colour throughout fundus.Right eve always weak, disc slightly pale.R.V. 6g, not improved by glasses.L.V. Hand movements.Urilie, specific glavity 1020, no albumen, blood, or sugar; no cardiac hypertrophy, very slight tllickening of radial arterial wall.Dark glasses were ordered, and a mixture ot potassium iodide and iron prescribed.The patient made periodical visits to the hospital, but very little change occurr-ed in the fundus.On October 8th, however (thlat is about six weeks after onset), it was noted that the left eye was in a condition of acute glaucoma, with tension + 2. cornea very hazy, very marked conjunctival and ciliary injection, -small hasmorrhages on surface and in the substance of the iris, fundus not visible, vision1=perception of light only.Admitted as in-patient same day, and kept under eserine, but no improvement taking place, and the eye being painful, excisioni was advised, but this the patient refused to have done.He was discharged November hth, being then fairly free from pain.On March 25th, Igoi, the eye was nearly quiet, pupil semi- dilated, absolute glaucoma, no perception of light, lens becoming opaque.Tension markedly raised.CASE II.-Mrs.M. A. P., aged 66, came as out-patient August 3Xst, I90o.Complaint: Sudden loss of sight of left eye the day before.On examina- tion marked thrombosis of central vein was found, with some swelling of disc and cedema of retina, but no albuminuric retinitis; urine, specific gravity Ioi8, no albumen, blood, or sugar; verv slight thickening of arterial walls.Right eye, fundus normal.R. V. f, L. V. hand move- ments only.She was treated as above.and on October i6th she also developed acute glaucoma in left eye.Tension + I, much dilatation of episcleral veins and a few haemorrhages on the iris.V = perception of light only.The patient was admitte and treated in hospital for about a month, but no improvement took place; the eye gradually quieted down but no vision remained.CASE iJI.-T.D., aged 59, came as out-patient August 14th, I900.Complaint: Sudden failure of sight of left eye ten days ago.Ophthal- snoscopic examination revealed marked lhrombosis of central vein, swollen disc, hiemorrhages, especially abundant near disc, around which were a few white areas (?) resulting from bmmorrhages.There was no trace of macular degeneration or any other appearani e of albuminuric Tetinitis.Right eye: Retinal veins dilated, and in places cTossed and partly obstructed by rigid arteries: disc healthv.full vision; urine, specific gravity IOI-, albumen a trace.no sugar: arterial walls thickened and some hypertrophy of left heart.The usual remedies were administered until Oetober 24th, I9CO when he was admitted into bospital with left acute glaucoma (with a history of onset three days previously), the pupil being semidilated and cornea very hazy.Tension + I, hmemorrhages on surface of iris very marked.L.V. perception of siglht.Practically no improve- ment took place under eserine.and he was diseharged from hospital on December zoth.On March I9th, x90o, he complained of increasing dim- ness in right eye, and on examination the disc was found to be cupped, the field being very contracted on the Dasal side, R V. = r.He was at once admitted and iridectomy was performed.When discharged a fortnight later R.V. was = T6 C.-2 cyl.ax.go'.L.V. = Perception of light.CASE iv.-Mrs.C. P., aged 59. came to hospital on January I9111, 1895, complaining of dimness of right-eye, which had lasted a week.Exanii- nation of fundus disclosed fairly marked thrombosis of retinal vein, with some thickening of retinal arteries.Urine: Specific gravity IO3O, no albumen, blood, or sugar.R. V. = 1,v P. + 2.June zsth, I9o0.-R.V. -h + 2, haemorrhages nearly all cleared up.She did not come to hospitai again utntU October Aoth of same year, when it was noticed that the right disc was cupved.R.V. = Perception of light only; no hoemorrha.sesin fundus.On November i6th riglht iridectomy was performed.The left eye up to this time had remained good, and L. V. was 6 C. + 2.5.She came again to the hospital in March, i89Q.com-