Ulceration of the cornea also takes place in order to afford an exit
to matter formed between its layers deeply or superficially. Deep
abscess of the cornea is by no means a rare consequence of violent
inflammatory action in the part. A minute opaque spot is at first
seen; this extends, assumes a yellow colour, and does not change its
situation on the head being moved. The internal lamellæ may ulcerate
in consequence of the pressure; but this seldom happens; the matter
is discharged externally. Suppuration in this situation is often
attended with much pain. Abscess of the surface of the cornea is of
more frequent occurrence than one more deeply seated: from its external
covering yielding readily to the pressure of the accumulating matter,
it generally assumes a pustular form. The fluid in such cases is
sometimes absorbed, and no vestige of disease remains in the part; but
more frequently the apex of the pustule gives way, and an ulcer is the
consequence. A similar result takes place if an artificial opening is
made for evacuation of the matter; and it may be considered as a good
rule in practice not to interfere with collections in the cornea, as
there is a probable chance of the matter being absorbed, and the cornea
regaining its transparency; while it is certain that breach of its
surface, in such cases, though made by the most delicate instrument,
will give rise to ulceration.
_Pustular Opthalmia_ is at some seasons frequently met with: small
pustules, sometimes numerous, form on the conjunctiva, whilst that
membrane is turgid and its vessels dilated; the sclerotic conjunctiva
around the cornea is their most common situation, but sometimes almost
the whole conjunctival surface appears studded with them. When the
cornea is affected, the pustules frequently give way, and produce
ulceration; and when the pustules are numerous, and surrounded by much
vascularity, the part becomes opaque as well as ulcerated.
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