_Inflammation of the Cornea_ supervenes on simple conjunctival
inflammation, and frequently on the purulent. The vessels of the part,
both veins and arteries, previously carrying single and therefore
invisible blood corpuscules, become much dilated, are filled with
numerous globules, and hence are rendered red and conspicuous to the
unassisted eye. Writers on ophthalmic surgery, in their rage for
refinement, speak of three kinds of this inflammation—inflammation
of the external or conjunctival covering, of the middle tunics or
cornea propria, and, lastly, of the third coat, the capsule of the
aqueous humour: such distinctions, however, are found to effect no good
practical end, and it is unnecessary to follow them. One particular
layer of the cornea may be first attacked, but the whole structure
soon becomes involved. The inflammation generally commences in the
conjunctival covering. Vision is necessarily much obscured from even
slight inflammatory affection of the cornea. Part only of the organ may
be affected, but frequently the whole is involved. Sometimes only one
or two vessels remain dilated; but still they, passing over the centre
of the cornea, render vision indistinct. Opacity of the cornea, to a
greater or less degree, always attends dilatation of its vessels.
In inflammation of the internal and middle tunics of the cornea,
most of the enlarged vessels which traverse it are seen to be
continuations of those that ramify in the conjunctival covering; while
the anastomotic vessels derived from the sclerotic coat are smaller
and less apparent than those of the conjunctiva. The cornea, and the
sclerotic immediately surrounding it, frequently appear to be almost
entirely covered with meshes of their dilated capillaries. At first
the whole cornea has a clouded appearance, but as the disease advances
portions become distinctly opaque, and at these points either lymph
or pus is effused. Sometimes matter collects between the laminæ,
distends them, and, causing ulceration, discharges itself either into
the anterior chamber or externally. Inflammation of the cornea arises
frequently from lodgement of a foreign body in it: and ulcers of it
are often produced by a similar cause. If the extraneous matter is not
removed soon after its insertion, nature commences her endeavours to
detach it, and the process employed is ulceration. Sometimes, however,
a sac is formed around the foreign body as in other parts, and no ulcer
is produced.
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