Staphyloma
Opacity of the Cornea and Staphyloma.
Georginia Larkins, aged 10, at No. 25, Grafton Street, Newport Market, and at the Blind School, Queen Square. Her aunt states that this patient has been blind since she was sixdays old, in consequence of an attack of inflammation, which gave rise to a great discharge from the eyes. In her infancy fluids of various kinds were injected underneath the eye-lids, and when four months old she was taken for three years regularly to an Ophthalmic Hospital, where she was told that the right eye was destroyed. The left eye had caustic applied to it for a length of time thrice a week. Ointment was then applied underneath the eye-lids until the eye became so very large that she was at last told that it was a hopeless case, and that no more could be done for her. Her next visit was to an eminent oculist, who said he would not undertake the treatment of such a case. She then went to another Ophthalmic Institution, where she remained for about two years without deriving any improvement in her sight; but she was relieved from much pain.
I saw her first on the 6th of April, 1840, when the appearance of the left eye seemed to be at least twice the size of a natural eye. Itwas of a dark-blue colour, standing out beyond the lids; and where the pupil ought to have been, there was a blue circular ring of lighter hue than the rest of the eye, and in the centre of this ring was a white body about the size of a pea.
The right eye was quite a contrast, for it appeared perfectly white, without the slightest appearance of iris or pupil. The eyes were continually rolling about in their sockets. Looking at the little creature, I said, "What do you expect me to do in such a fearful case?" Without waiting for a reply, I said, "I will endeavour to diminish the size of the eye, but unquestionably no hope can be held out that I can restore the use of sight."
I at first put, daily, a drop of castor oil into each eye, occasionally substituting for the castor oil the oil of almonds. This treatment in about two months diminished much the size of both eyes, and the opacity of the right eye greatly decreased; so much so that a little edge of thepupil became visible, and the child began to see, and in four months she could walk alone. Shortly afterwards the pupil could be distinctly seen, and there appeared a white speck upon the anterior capsule of the lens. She ceased to be a patient of mine in December, 1840, but returned in January, 1842, when the prussic acid was daily applied to both eyes. The left eye is diminished about one-half in size, and light is becoming perceptible. The right has assumed a healthy appearance; the cornea is transparent, and there is still a spot upon the capsule, about the size of the eighth part of the pupil. This does not appear to impede the vision. She can now read, with the eye, the raised letters with great quickness. She was formerly taught to read the letters with her fingers; she is also learning to read common print.
When the child came to me I had not had sufficient experience of the effects of the prussic acid vapour, and I hesitated in using a remedy of such acknowledged potency until I had, withgreat care, thoroughly investigated its properties. This I have been engaged in doing for several years, and I am now able to state, that in no case in which I have used it has it been attended with any injurious effects either to the eye or general health.
Staphyloma of both Eyes.
Mary Ann Goodman, aged 22, of St. Giles's Workhouse, and a scholar at the Blind School, Queen Square, fourteen years ago was attacked with violent inflammation of both eyes. To remove this she was subjected to very active antiphlogistic treatment. The inflammatory symptoms subsided, after which she was regularly led for five years to an Ophthalmic Institution, at which place the right eye was operated upon five times; in addition to which she was cupped three times and bled from the arm twice;caustic was applied frequently to the inside of the eye-lids; she was also blistered behind the ear and nape of the neck. The patient was unable to walk about without assistance; if she attempted to do so, she was knocked and jostled about.
On the 4th of March her friends brought her to me, to ascertain whether I could do anything for her. I could not hold out to her any great hope of recovery; for both eyes were affected with staphyloma, and perfectly opaque and studded with blue spots, and standing prominently out beyond the lids, and having no appearance of iris or pupil in either eye.
In the space of a fortnight the eye assumed a very different appearance; each eye became greatly diminished in size. As the opacity cleared off, a large triangular pupil made its appearance at the bottom of the iris in the right eye, enabling her to see with the eye with which, for fourteen years, she had not been able to discern light from darkness.
The progress of cure in the left eye is fully equal to that of the right; so that now she is able to walk about in the crowded streets with safety, and is intrusted to lead about two or three other persons in the Blind School. She can distinguish colours, and is able to perceive large letters.
In such a state of disorganization as this poor girl's eyes were in, it is unreasonable to anticipate that she can make much greater progress.